The Centers for Disease Control and Prevention’s (CDC) February Public Health Grand Rounds focused on Million Hearts, an initiative that aims to prevent one million heart attacks and strokes over the next five years. The presentation focused on effective strategies for helping Americans live longer, healthier and more productive lives and took a look at Million Hearts activities currently underway in New York City and San Diego.

Although cardiovascular care has come a long way, heart disease deaths dropped by 50 percent from 1980-2000, it is still the leading cause of death and disability in the U.S. CDC Director Thomas R. Frieden, MD, MPH, stressed that “we need to look not to what our rates have been in the past but to the potential of drastically reducing heart disease and stroke rates” in the future.

Balancing clinical and community intervention and implementing evidence-based prevention approaches, such as the ABCS of heart health, can significantly curb heart disease. During the session, the speakers offered solutions for addressing contributing factors, including sodium intake, trans fat consumption, and smoking. When it comes to the leading preventable cause of death—smoking—only 23 percent of people attempting smoking cessation reach out for help. Million Hearts Executive Director Janet Wright, MD, FACC, discussed the imperativeness of smoke free laws, cigarette price increases, access to treatments and mass media campaigns, to change behavior and reduce the incidence of cardiovascular disease (CVD).

The Commissioner of the New York City Department of Health and Mental Hygiene, Thomas Farley, MD, MPH, described the drastic and effective steps his city has taken over the last decade to reduce heart disease mortality. New York City began its prevention oriented approach in 2002 by enacting smoke-free air policies that have since been extended to all outdoor beaches and parks and will include 23 university campuses this year. Cigarette taxes have been hiked up to $6.86 per pack, bringing the total cost of a pack of cigarettes to nearly $11, the highest in the nation. Additionally, a powerful mass media campaign continues to build awareness of the effects of smoking and encourages behavior change. Over 10 years, ischemic heart disease mortality dropped 33 percent, cerebrovascular disease dropped 16 percent, and New York City greatly outpaces the nation in life expectancy at age 40.

New York isn’t stopping there. Trans fat regulations have already been put into place and over the next five years, the city is dedicated to reducing sodium intake by 20 percent as part of the National Salt Reduction Initiative. So far, 28 large food manufacturers and restaurant chains have jumped on board. As part of the Primary Care Information Project, New York City recognizes the importance of health IT in improving quality of care for CVD patients.

San Diego is a perfect example of a city that has successfully translated federal initiatives into local action. Anthony DeMaria, MD, FACC, discussed the “University of Best Practices”, a unique opportunity for competing medical groups to come together to share strategies and data, ultimately improving the health of San Diego residents.

Dr. DeMaria also showcased San Diego’s successful “Be There” campaign that has set the audacious goal of establishing a “Heart Attack and Stroke-Free Zone” and has caught  the public’s attention. A mass media campaign that employs an emotional tug, versus straight facts, communicates the gravity of heart disease and the importance of controlling risk factors. The hope is that this successful program can be adapted for other communities across the country and around the world.

As a partner of the Million Hearts initiative, ACC is addressing risk factors that contribute to heart events. CardioSmartTXT, which launched recently, leverages technology and uses a coaching approach to help patients quit smoking and prevent heart disease. A collection of patient fact sheets is also available to educate patients about heart disease risk factors.  For additional patient tools, visit CardioSmart.

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