Preventing One Million Heart Attacks and Strokes

Blood pressure and cholesterol management improving but further prevention efforts are necessary

What would it take to prevent one million heart attacks and strokes before 2017?

That's the question that a recent report answered for Million Hearts, a collaborative initiative between the US Department of Health and Human Services and several nonprofit and private organizations.

Using data from national surveys, researchers determined how well Americans were adhering to strategies to reduce heart attack and stroke risk. The report found that certain prevention strategies, like blood pressure and cholesterol management, have improved over recent years.

However, the authors of the report concluded that additional efforts are necessary to address cardiovascular risk factors.

"Talk to your doctor about heart attack and stroke prevention strategies."

Matthew D. Ritchey, DPT, of the Division for Heart Disease and Stroke Prevention, led the study.

According to the report, about 1.5 million Americans have a heart attack or stroke each year, often leading to death or long-term disability.

Million Hearts set population-wide goals of achieving a 20 percent reduction in sodium intake, a 10 percent reduction in smoking, and more than 65 percent prevalence in four clinical measures.

The four measures are aspirin use for patients with ischemic vascular disease, a risk factor for stroke and heart attack characterized by narrowing blood vessels; management of blood pressure for individuals with high blood pressure; management of cholesterol for individuals with high cholesterol; and smoking treatment for smokers.

Using data from several national surveys, the researchers calculated how much progress is being made to achieve the Million Hearts goals.

They found that between 2009 and 2010, 58.5 percent of men and 48 percent of women were prescribed aspirin use in response to ischemic vascular disease.

During the same time, 25.3 percent of adult smokers aged 45 to 64, 20 percent of those aged 18 to 44 and 18.9 percent of smokers over 65 years old received smoking assessment and treatment.

From 2011 to 2012, 54.6 percent of women and 48.9 percent of men with ischemic vascular disease received recommendations to take aspirin. The prevalence of aspirin recommendations were highest among adults between 45 and 64 years old.

Between the 2009-2010 and 2011-2012 survey periods, cholesterol management rose from 33 percent to 42.8 percent among patients with high cholesterol.

Additionally, in 2011-2012, 25.1 percent of individuals surveyed smoked, compared with 28.2 percent in 2005-2006.

The researchers also found that the average daily sodium intake decreased from 3,619 milligrams to 3,594 milligrams between 2005 and 2010.

They concluded that some trends, like the improvement in blood pressure control, cholesterol management, and smoking rates, were encouraging.

However, the authors of this study suggested that further measures to reduce the risk of heart attack and stroke are necessary.

According to Jeffrey Schussler, MD, an interventional cardiologist at Baylor University Medical Center's Heart and Vascular Hospital in Dallas, TX, "These four measures (aspirin for patients with cardiovascular risk, blood pressure control, cholesterol control, and smoking cessation) have been at the forefront of cardiovascular care. It is laudable to focus more attention on those measures which have shown historically to reduce cardiovascular risk and improve long-term mortality."

This report had several limitations. For example, response rates for the three surveys used ranged from 58.3 percent to 77.4 percent.

The report was published in the Center for Disease Control and Prevention Morbidity and Mortality Weekly Report on May 30.

The authors disclosed no conflicts of interest.

Review Date: 
May 30, 2014