Harvard Heart Letter

You could be one in a million

Are you doing everything possible to prevent a heart attack or stroke?

Dear Reader,

Information about health is often accompanied by numbers — how many people have this disease, what's the risk of developing that condition. Then there are more personal numbers, such as your targets for blood pressure and cholesterol. Understanding all those numbers can be confusing, and much of what the Harvard Heart Letter does is help you make sense of them.

Here's a big-picture number: Two million. That's how many Americans have a heart attack or stroke every year. Of course, if you or someone you love is in that group, "one" is the only number that matters.

Half of that big-picture number is one million. That's how many heart attacks and strokes the Million Hearts initiative seeks to prevent through 2016. This wide-ranging collaboration among communities, health systems, government agencies, and private-sector partners will rely on individuals like you and me to meet that goal.

Million Hearts encourages simple, effective, and inexpensive actions focused on the ABCS: taking daily low-dose aspirin if appropriate, managing your blood pressure and cholesterol levels, and quitting smoking. We'll give you the latest information on how you and your doctor can achieve your goals in those areas. Because heart health depends largely on diet, exercise, and weight control, we'll add some advice about those. We'll also tell you about the community components of Million Hearts.

Cardiovascular disease is everybody's business. Consider these numbers: fewer than half of the people in this country with confirmed heart disease take daily aspirin or a similar drug to lower their chances of developing a dangerous blood clot. Half of all American adults still smoke or have persistently high blood pressure or cholesterol levels that increase their risk for a heart attack or stroke. And a hefty portion of the approximately $450 billion annual price tag for these illnesses is paid with taxpayer dollars.

The federal agencies spearheading the Million Hearts charge — the Centers for Disease Control and Prevention (CDC) and the Centers for Medicare and Medicaid Services (CMS) — are led by real doctors who've treated real patients. CDC Director Dr. Thomas Frieden, the New York City Health Commissioner from 2002 until 2009, made tobacco control and eliminating trans fats a priority. Medicare Chief Dr. Donald Berwick, who left a professorship at Harvard Medical School to take the reins at CMS, began his career as a pediatrician and went on to found the Institute for Healthcare Improvement, a leading disseminator of best practices.

If you eat healthfully, get some exercise every day, and take your medications as prescribed, congratulations. But maybe there's a recommended target that you haven't hit yet, or something you can do to help others achieve the Million Hearts objective.

Also, we're devoting a section this month to "On the Horizon" articles about emerging techniques and technologies that may someday help you and your doctors better diagnose and treat heart disease.

Best wishes for a peaceful, prosperous, and healthy 2012.

— Thomas Lee, M.D.
Editor in Chief, Harvard Heart Letter