Lead author Hilary K. Wall, from the CDC's Division for Heart Disease and Stroke Prevention, and colleagues explored the impact of Million Hearts 2022, the 5-year health initiative launched in 2017 to address cardiovascular disease (CVD) mortality, by examining the baseline prevalence and changes over time. Million Hearts 2022 priorities are focused on community-based strategies that decrease salt intake and tobacco use and increase physical activity and blood pressure (BP) and cholesterol control in prioritized populations at risk, including adults aged 35 to 64 years (heart-disease mortality rates are increasing), adults who have had a previous heart attack or stroke, African Americans with hypertension, and persons with mental-health or substance-use disorders who smoke.

Researchers assessed these risk factors using the National Health and Nutrition Examination Survey, National Survey on Drug Use and Health, and National Health Interview Survey. The most notable change was the prevalence of appropriate aspirin use for primary and secondary CVD prevention reported in 2013-2014 as 27.4% and 74.9%, respectively, with the largest decrease of appropriate use seen for primary prevention, which was recorded as 43.4% in 2011-2012.  

When rates of appropriate use for both primary and secondary prevention were combined, the overall prevalence of aspirin was 60.8%; however, this still represented an overall (and significant) decline from 69.2% reported in 2011-2012. “This equates to an estimated 9 million persons not taking aspirin as recommended,” the authors write. Health-system pharmacists can play a significant role in ensuring the appropriate use of aspirin, especially for secondary prevention when patients are discharged from the hospital.

There were no significant changes reported during the 2015-2016 period in terms of BP control and salt intake, and cholesterol management through statin use among eligible adults was 48.5% when compared with 2011-2012. There were small but notable decreases reported in the rate of physical inactivity and the use of combustible tobacco products. The authors reported that among the Million Hearts priority population of adults aged 35 to 64 years, the prevalence of tobacco-product use and average daily salt intake was higher than in adults aged 65 years and older; however, the prevalence of physical inactivity was lower in the younger age group.

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