Improving Blood Pressure Control in the United States: At the Heart of Million Hearts 2027

• Type of Material: Article
• Authors: Hilary K. Wall, Centers for Disease Control and Prevention; Janet S. Wright, Centers for Disease Control and Prevention; Lee A. Fleisher, Centers for Medicare and Medicaid Services; Laurence S Sperling, Emory University
• Language: English
• Date: 2023-07-14
• Publisher: Oxford University Press
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2023, © Published by Oxford University Press on behalf of American Journal of Hypertension Ltd 2023.
• Final Published Version (URL): https://doi.org/10.1093/ajh/hpad029
• Title of Journal or Parent Work: American Journal of Hypertension
• Volume: 36
• Issue: 8
• Start Page: 462
• End Page: 465
• Keywords: Million Hearts; acute cardiovascular events; high-impact strategies
• Research Categories: Health Sciences, Health Care Management; Health Sciences, Public Health

Abstract

Million Hearts, a national initiative co-led by the Centers for Disease Control and Prevention (CDC) and the Centers for Medicare and Medicaid Services (CMS), was launched in 2012 to focus and drive improvement on a small set of high-impact strategies known to prevent heart attacks, strokes, and other acute cardiovascular events. Optimizing the “ABCS” of cardiovascular disease prevention (Aspirin when appropriate, Blood pressure control, Cholesterol management, and Smoking cessation) has been at the heart of the initiative. Internal analyses suggest that compared to improvements in aspirin use for secondary prevention, cholesterol management, and smoking cessation, achieving national BP control (>80%) will prevent the greatest number of cardiovascular events in a 5-year period. Almost half of adults in the United States have hypertension, and only 1 in 4 has their BP controlled (<130/80 mm Hg).1 When it comes to BP control, we know what to do. There are effective strategies; we have the knowledge, tools, and resources. What we know less about is how to widely implement what works. How do we effectively scale and spread evidence-based strategies? How do we overcome systemic inequities that drive disparities in health? How do we leverage policy to support widespread implementation?