Million Hearts: A Population Health Approach to Reducing the Burden of Cardiovascular Disease

February 2, 2015

Cardiovascular disease (CVD) remains the single leading clinical cause of death in Georgia, accounting for more than 20,000 deaths a year, or about 1 in 5 deaths overall. A significant proportion of these deaths are premature and preventable. CVD is responsible for more than 88,000 hospitalizations, $7 billion dollars in direct and indirect costs, and 136,000 years of potential life lost in Georgia alone each year.

According to data from the 2013 Behavioral Risk Factor Surveillance Survey, nearly 1 in 3 adults in Georgia have ever been told they have hypertension, and an estimated additional nearly 1 million may have undiagnosed hypertension, bringing the total number of adults in Georgia with hypertension to well over 3 million.

The risk factors are similarly prevalent. Approximately half of all adults (47 percent) have at least one of the risk factors for CVD. Nearly 2 in 5 Georgia adults have high cholesterol, and an increasing proportion of cardiovascular-related mortality in Georgia, like in other states, is attributable to hypertension. While rates of smoking in our state are declining rapidly, down to under 18 percent in 2013, smoking is still a major contributor to rates of CVD in Georgia.

With high rates of overweight and obesity as well as a diabetes prevalence of 10.4 percent in the general population, more Georgia women are developing hypertension at younger ages. Sometimes, underlying chronic, primary hypertension that goes undiagnosed until it presents in pregnancy further increases the risk of complications in pregnancy and lifelong poor health.

For all of these reasons, the Georgia Department of Public Health (DPH) is proud join Million Hearts for National Heart Month this February.

Million Hearts is a national initiative sponsored by the U.S. Department of Health and Human Services to prevent 1 million heart attacks and strokes by 2017. Through this initiative, partners across the public and private sectors pledge to prevent heart disease through environmental interventions and, in clinical settings, to improve adherence to evidence-based protocols that promote the ABC’S:

  • Aspirin, when appropriate
  • Blood pressure control
  • Cholesterol management
  • Smoking cessation

Joining forces with DPH are an array of statewide and federal organizations prepared to unite their resources in an effort to improve Georgian’s heart health. Among the supports of this inspiring initiative include: five Georgia Public Health Districts (Augusta, Coastal, Gwinnett, Rome, and Valdosta); the Georgia OB/GYN Society; the Georgia Academy of Family Physicians; the Georgia Chapter of the American College of Physicians; the Georgia Hospital Association (GHA); Cahaba Government Business Associates, the Medicare claims payor for Georgia; the Georgia Health Policy Center which is Georgia’s nationally designated Public Health Institute and Alliant GMCF; and the Centers for Medicare and Medicaid Services (CMS) designated Quality Improvement Organization for Georgia.

To address smoking cessation, Georgia has already successfully expanded access to smoking cessation support by partnering with the Georgia Medicaid program to make the Georgia Tobacco Quitline available to Medicaid participants, including the more than 9,000 women in Georgia who smoke for the entire duration of their pregnancies. Together with other cessation support offered to the highest risk populations and the creation of tobacco-free environments, Georgia’s rates of tobacco use and tobacco-related cardiovascular disease should continue to decline.  

In this next phase of Million Hearts work, the Georgia partnership has been awarded funds from the CDC and the Association of State and Territorial Health officials to participate in a national learning collaborative to address the “B” (blood pressure) of the ABCS. DPH will also work to improve the hypertension control achieved in outpatient settings through use of evidence-based strategies, such as self-monitoring and team-based care.

According to data from HRSA health care sites reported through the HRSA Uniform Data System, Georgia falls below the regional and national target for percent of patients with hypertension controlled, with just 61 percent controlled.  The regional goal, and goal for Georgia, is 70 percent of patients with hypertension under control.   

While the initial cohort participating in the project will not have final results until late summer of 2015, there are promising signs that private and public health care partners in Georgia can successfully work together to identify ways to improve population health and improve the quality of care. 

In the Coastal Public Health District, for example, the Curtis V. Cooper Health Center is partnering with Alliant to train its nurses on hypertension control protocols, test home blood pressure monitoring, and use its electronic medical records and other tools from the American Heart Association to re-engineer care for patients with hypertension to improve control rates.

In the East Metro Public Health District (Gwinnett, Newton and Rockdale counties), DPH has partnered with five safety net clinics to improve control and identify undiagnosed hypertension. Statewide, the partners plan to convene in March to identify lessons learned, opportunities to expand the project, and future collaborations that will improve population health.  

During this month, we encourage everyone to join DPH and our dedicated partners in taking the Million Hearts pledge. By doing so, you will commit to improving your heart health and the health of those around you by implementing various health behaviors such as knowing your ABCS, consulting with health professionals, exercising for 30 minutes on most days of the week and eating a balanced diet.

Together, we can successfully support Million Heart in attaining its goal while increasing access to vital CVD, tobacco cessation and other resources that will help Georgians live a heart-healthy life for many generations to come.

For more information about the Million Hearts initiative, please visit www.millionhearts.hhs.gov

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Cardiovascular disease accounts for more than 20,000 deaths each year in Georgia. Although higher than the national average, Georgia is making progress in the fight against heart disease.

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The Georgia Department of Public Health (DPH) is paving the way for Georgians to live with healthier hearts. 

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