Million Hearts e-Update: July/August 2015 [Revised]

The U.S. Food and Drug Administration (FDA) is taking actionon partially hydrogenated oils (PHOs), the major source of artificially produced trans fat in processed foods, confirming that PHOs are not “generally recognized as safe” for use in human food. The FDA has granted companies 3 years to either reformulate their products or petition the FDA to permit certain specific uses of PHOs. Companies have already made strides toward reducing or eliminating PHOs, and the FDA expects manufacturers to be in compliance ahead of schedule. Removing PHOs from processed foods could prevent as many as 20,000 additional heart attacks and up to 7,000 cardiac deaths each year. Good-bye, PHOs. Hello, Heart Health. —Janet Wright, MD, FACC Executive Director, Million Hearts®

Tools You Can Use

• Explore and use the new Million Hearts^® Hypertension Control: Change Package for Clinicians—This quality improvement tool was created for health care professionals to improve patients’ hypertension control by focusing on three main areas: key foundations, population health management, and individual patient supports. The guide provides health care practices with an evidence-based listing of process improvements to more efficiently and effectively care for patients with hypertension.
• Browse the U.S. Environmental Protection Agency’s (EPA’s) easy-to-read fact sheets on environmental hazards—EPA offers a variety of free resources that provide information older Americans and their caregivers can use to reduce exposure to a range of environmental hazards, including fact sheets on staying safe during a heat wave and determining the air quality where you live. The fact sheets have been translated into several languages and are available in formats for people with limited sight or reading ability.
• Use these innovations and tools from the Agency for Healthcare Research and Quality to improve cardiovascular health—Primary care settings provide an important opportunity to deliver preventive services and care management for at-risk patients. Clinical practices are finding innovative ways to reduce the risk of cardiovascular disease and improve patient outcomes.
• Download a free Statin Intolerance App—Clinicians can answer questions, follow patient management steps, and compare statin characteristics and drug interactions with this free app from the American College of Cardiology (ACC) that is available on iTunes and Google Play app stores. With information and recommendations derived from the 2013 ACC/American Heart Association Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults, this app can help guide clinicians through the process of managing and treating patients who report muscle symptoms while on statin therapy.

Million Hearts^® in the Community

• TMF Health Institute provides quality improvement assistance to health care providers to support Million Hearts^® in Texas. TMF Health Institute, the quality improvement organization for Texas, has helped more than 60 physician practices evaluate the ABCS metrics and put into action electronic health records systems to reach target populations and achieve improvement goals to prevent heart disease and stroke. To learn more about this and other Million Hearts^® efforts from the Texas Medical Association and Texas Department of State Health Services, read this recent article in Texas Medicine.
• Video: How Peninsula Community Health Services became a Million Hearts^® Hypertension Control Champion. Through team-based care, Peninsula Community Health Services in Washington State was able to achieve blood pressure control rates of more than 70% for its adult patient population. This organization’s success is a great example of how effective coordination of a health care team can translate to high rates of blood pressure control. Be on the lookout for the 2015 Million Hearts^® Hypertension Control Challenge announcement coming soon!
• CDC Foundation-led initiative educates African American men in the southeastern U.S. African American men are 25% more likely to die from heart disease compared with non-Hispanic white men. To help address this health disparity, the CDC Foundation is partnering with Pfizer and Quest Diagnostics to launch the Million Hearts^® “Healthy Is Strong” initiative. The campaign aims to raise awareness about preventing heart attacks and strokes, particularly among African American men ages 40–65 living in the Southeast, where cardiovascular disease rates are high.
• Health care professionals: Participate in the Centers for Medicare & Medicaid Services’ Million Hearts^® Cardiovascular Disease Risk Reduction Model. This opportunity enables health care professionals to design sustainable models of care that help reduce 10-year atherosclerotic cardiovascular disease risk and prevent heart attacks and strokes for tens of thousands of eligible Medicare beneficiaries. Application deadline is September 10.

Let us know what you're doing to advance Million Hearts® in your community! Send us a short description with some key points, and we may feature you in a future e-Update!

The Science of Million Hearts^®

• Combined nutrition and sales data from 2009 show that fewer than half of selected food products met FDA sodium-per-serving conditions for labeling as “healthy.” Regional differences in hypertension were not reflected in differences in the sodium content of packaged foods from grocery stores. Findings suggest that current food environments, regardless of location, make it difficult to meet the standard sodium recommendations.
• CDC study reveals sodium reduction opportunities nationwide.A 2013 survey of more than 180,000 adults across 26 states, Washington, D.C., and Puerto Rico revealed that just over half of respondents reported taking action to watch or reduce sodium intake, while about 1 in 5 said they received professional medical advice related to sodium reduction. Among adults who self-reported hypertension, 20% (Puerto Rico) to 50% (Utah) did not report taking action to reduce sodium intake. This is the first report to provide state-level estimates of sodium intake behavior among the general population. It highlights the opportunity to increase the proportion of health care professionals who advise their patients to reduce sodium intake and the proportion of U.S. adults who take action to reduce sodium intake.
• Clinicians’ use of electronic health records as a quality improvement tool key to reducing cardiovascular disease. The pressure is on for clinicians to use their electronic health records systems to achieve measureable impact on addressing high-priority health problems like heart disease. As incentives are aligned and best practices become available, Million Hearts^® is emerging as a key contributor and convener to help drive adoption of evidence-based clinical-decision support to improve cardiovascular health outcomes.
• Public health interventions that engage community health workers (CHWs) in team-based care can help people manage risks for and prevent heart disease. According to a new systematic review of 31 studies by the Community Preventive Services Task Force, using a team-based care model through which CHWs work with patients, physicians, nurses, and other health care providers led to large improvements in blood pressure and cholesterol patient outcomes. CHW’s training to deliver culturally appropriate health education and information gives them the ability to make a real impact on patients’ lives. The Task Force provides heart disease and stroke prevention resources for CHWs on its website.