A Public Health Action Plan To Prevent Heart Disease And Stroke

Purpose of the plan: To chart a course for the Centers for Disease Control and Prevention (CDC) and collaborating public health agencies, with all interested partners and the public at large, to help in promoting achievement of national goals for preventing heart disease and stroke over the next two decades-through 2020 and beyond. Heart disease and stroke are among the nation's leading causes of death and major causes of disability, projected to cost more than $351 billion in 2003. In the next two decades, these conditions can be expected to increase sharply as this country's "baby boom" generation ages. The current disease burden, recent trends, and growing disparities among certain populations reinforce this projection. Yet these conditions are largely preventable. As expressed in the Steps to a HealthierUS initiative from Secretary of Health and Human Services Tommy G. Thompson, the long-term solution for our nation's health care crisis requires embracing prevention as the first step. To reverse the epidemic of heart disease and stroke through increasingly effective prevention, action is needed now. A Public Health Action Plan to Prevent Heart Disease and Stroke addresses this urgent need for action. Key partners, public health experts, and heart disease and stroke prevention specialists came together to develop targeted recommendations and specific action steps toward achievement of this goal, through a process convened by CDC and its parent agency, the U.S. Department of Health and Human Services (HHS). CDC and public health partners will provide national leadership to assure meaningful progress in implementing the plan. This includes bringing the public health community together with new and existing partners representing every interested segment of society. An important aspect of this process is continuing coordination between CDC and the National Institutes of Health (NIH), HHS, which is the co-lead agency with CDC for the heart disease and stroke focus area of Healthy People 2010. Today, support for public health programs to prevent heart disease and stroke remains low, constituting less than 3% of the aggregate budget of our state public health agencies. Despite substantial public health gains in recent years, the failure to halt and reverse the epidemic has been extremely costly. Numbers of victims and health care expenses will only escalate unless the epidemic is reversed. Fortunately, a new promise of success exists today. We have knowledge from decades of research and experience, especially because of the contributions of NIH and the American Heart Association. We also have a growing commitment to prevention, exemplified by the Secretary's Steps to a HealthierUS initiative. And we have the potential collaboration of many major national partners. The Action Plan represents a comprehensive public health strategy to assist in addressing the Healthy People 2010 goal of improving cardiovascular health through the prevention, detection, and treatment of risk factors; early identification and treatment of heart attacks and strokes; and prevention of recurrent cardiovascular events. This strategy depends on a balanced investment in all available intervention approaches, from policy and environmental changes designed to prevent risk factors to assurance of quality care for the victims of heart disease and stroke, and it includes education to support individual efforts to prevent or control risk factors. To successfully implement the plan, two fundamental requirements must be met. First, we must communicate to the public at large and to policy makers the urgent need and unprecedented opportunity to prevent heart disease and stroke. Second, we must transform the nation's public health infrastructure to provide leadership and to develop and maintain effective partnerships and collaborations to support the needed actions.

Hypertension is one of the leading causes of death in the United States, affecting nearly one in three Americans. It is prevalent in adults and endemic in the older adult population. Hypertension is a major contributor to cardiovascular morbidity and disability. Although there is a simple test to diagnose hypertension and relatively inexpensive drugs to treat it, the disease is often undiagnosed and uncontrolled. A Population-Based Policy and Systems Change Approach to the Prevention and Control Hypertension identifies a small set of high-priority areas in which public health officials can focus their efforts to accelerate progress in hypertension reduction and control. It offers several recommendations that embody a population-based approach grounded in the principles of measurement, system change, and accountability. The recommendations are designed to shift current hypertension reduction strategies from an individual-based approach to a population-based approach. They are also designed to improve the quality of care provided to individuals with hypertension and to strengthen the Center for Disease Control and Prevention's leadership in seeking a reduction in the sodium intake in the American diet to meet dietary guidelines. The book is an important resource for federal public health officials and organizations, especially the Center for Disease Control and Prevention, as well as medical professionals and community health workers.

Cardiovascular disease (CVD), once thought to be confined primarily to industrialized nations, has emerged as a major health threat in developing countries. Cardiovascular disease now accounts for nearly 30 percent of deaths in low and middle income countries each year, and is accompanied by significant economic repercussions. Yet most governments, global health institutions, and development agencies have largely overlooked CVD as they have invested in health in developing countries. Recognizing the gap between the compelling evidence of the global CVD burden and the investment needed to prevent and control CVD, the National Heart, Lung, and Blood Institute (NHLBI) turned to the IOM for advice on how to catalyze change. In this report, the IOM recommends that the NHLBI, development agencies, nongovernmental organizations, and governments work toward two essential goals: creating environments that promote heart healthy lifestyle choices and help reduce the risk of chronic diseases, and building public health infrastructure and health systems with the capacity to implement programs that will effectively detect and reduce risk and manage CVD. To meet these goals, the IOM recommends several steps, including improving cooperation and collaboration; implementing effective and feasible strategies; and informing efforts through research and health surveillance. Without better efforts to promote cardiovascular health, global health as a whole will be undermined.

A revolutionary, personalized guide to preventing heart disease—America’s #1 killer Heart disease is the #1 cause of death in America. It affects 81 million Americans and is the culprit in one of every two deaths in the United States. Most people think that they are not at risk of a heart attack if they control their cholesterol and blood pressure, but they aren’t aware of other major risk factors. The good news is that with the right information and strategies, heart attacks are preventable—even if heart disease runs in the family. In Beat the Heart Attack Gene, world-renowned cardiovascular specialists Bradley Bale, MD and Amy Doneen, ARNP, present a new model for understanding and preventing heart disease. They explain the three different genetic types of cholesterol profiles and tailor treatments for each type, using their cutting-edge Bale/Doneen Method, a comprehensive, evidence-based medical treatment plan that detects cardiovascular disease (CVD) at early stages and stabilizes it with individualized medical and lifestyle therapy. Beat the Heart Attack Gene includes easy quizzes and self-tests that show how to determine cholesterol genotype as well as advice for how to apply that knowledge through and individualized lifestyle advice. For heart attack and stroke survivors, the Bale/Doneen Method also helps prevent recurrences by identifying and treating what's triggering the patient's disease—a crucial step that many cardiologists neglect. With their proven method utilized by healthcare professionals worldwide, Bale and Doneen empower readers by alerting them to potential health threats, and then offer personalized strategies so they can live healthy, active lives without fear of heart attack or stroke. Specifically, Beat the Heart Attack Gene addresses: *The hidden cause of most heart attacks *Early prevention methods *The dangerous cholesterol most doctors don’t check *Major red flags for heart attack and stroke risk, including gum disease *The genes that increase cardiovascular risk as much as smoking *The best and worst supplements and foods for your heart *10 surprising ways to prevent heart attacks