Seeking to save a million hearts by 2022
Attention, all Americans: Too many of you are at risk of succumbing before your time to the nation’s leading killer, cardiovascular disease. Translation: heart attacks and strokes.
After a decadeslong drop, the cardiovascular death rate has all but stalled and, frighteningly, has even reversed in a young group of people — adults ages 35 to 64, among whom deaths from heart disease are now rising.
Accordingly, the Centers for Disease Control and Prevention has started an ambitious national effort — Million Hearts 2022 — to revive what had long been a steady downturn in the cardiovascular death rate fostered largely by a decline in smoking, and better detection and treatment of elevated blood pressure and cholesterol.
With your cooperation and the support of the medical profession, insurance companies, government agencies and communities throughout the country, the agency hopes to prevent 1 million heart attacks and strokes by the year 2022.
Achieving this goal does not require any new drugs, surgeries or discoveries. It is not rocket science. There is already a wellestablished path to countering cardiovascular disease. All it really requires is the will of individuals and society to follow it.
While this may involve additional dollars to bring cardiovascular risk factors under control in more people, in the end the savings could be astronomical.
As the centers’ experts estimated last year, if 2016 trends remain constant through 2021, an estimated 16.3 million potentially preventable life-threatening or fatal events, or 3.3 million a year, are projected to occur, including 2.2 million emergency department visits, 2.2 million deaths and 11.8 million hospitalizations, at a projected cost of $170 billion. A third of these preventable events are likely to afflict people ages 35 to 64, these experts, Dr. Janet S. Wright, Hilary K. Wall and Matthew D. Ritchey, calculated.
“A lot of the plateau stems from the epidemics of obesity and diabetes that have come home to roost,” said Ritchey, a senior scientist in the centers’ division of heart disease and stroke prevention. “This is especially so among adults aged 35 to 64, for whom heart disease and stroke mortality is rising. It’s very concerning. Many are people with young children and aging parents to care for.”
The experts are not calling for a revolution. “Small, sustained changes over time can have a big impact on individuals and on the country,” Ritchey said.
He and his colleagues cited 213 million opportunities to improve cardiovascular risk among Americans by addressing behaviors standing in the way of progress:
• 71 million people are physically inactive, participating in no leisure-time exercise.
• 54 million people smoke combustible tobacco products.
• 40 million adults have uncontrolled high blood pressure.
• 39 million with high cholesterol are not using medication to lower it.
• 9 million people for whom a daily baby aspirin is appropriate are not taking it.
The epidemic of obesity is most likely the leading cause of preventable cardiovascular disease and deaths. Excess weight can result in high blood pressure, high cholesterol levels, Type 2 diabetes and a reluctance to be physically active, all of which contribute to cardiovascular risk.
So if you do nothing else, make an effort to shed excess pounds and keep them off. Losing just 10 percent of body weight can have a major impact on your health.
If your cholesterol level is too high and dietary changes like eating less red meat and more seafood, fruits and vegetables and choosing heart-healthy fats are not enough to bring it down, talk to your doctor about cholesterollowering medication such as a statin. If prescribed, take it. Currently, 2 patients in 5 discontinue the drug within three months, and within six months only slightly more than half still take it.
Despite decades of efforts to get high blood pressure properly diagnosed and treated, Ritchey said this common contributor to cardiovascular disease often escapes medical surveillance.
One of the simplest steps people could take on their own to prevent and treat high blood pressure is to lower their sodium intake. Salt is the leading dietary source of sodium, which can raise blood pressure to dangerous levels in millions of people.
In the most recent national survey of American diets, the average daily sodium intake for young adults was 3,809 milligrams a day. Yet only 2,500 milligrams is considered suitable for a healthy person, and a maximum of 1,500 milligrams is recommended for those who already have high blood pressure.
Avoid foods that are high in salt, like smoked fish, processed meats, cured olives and salted snacks. Read labels on packaged foods — they must list sodium levels — and ask to have salt withheld when ordering food.
Encouraging physical activity can provide myriad health benefits by helping people control their weight, blood pressure and cholesterol and even smoking. The urban exodus of the last half-century has fostered dependence on motorized vehicles and a decline in daily exercise.
Americans are not likely to start walking miles to go grocery shopping, but many more could build activity into their daily lives. Just 10-minute bouts of activity three times a day can improve cardiovascular health. Communities can create safe areas in which to walk and cycle and host events to encourage such activities.
Finally, if you are a candidate for a daily baby aspirin (healthy people over 75 are not considered candidates), take it. This cheap over-the-counter medication, which can also reduce the risk of cancer of the colon and rectum, is recommended for adults 50 to 59 who have a 10 percent or greater 10-year risk of cardiovascular disease, a life expectancy of at least 10 years and no increased risk of bleeding, and those who have had a heart attack or stroke.