Top Things to Know: Achieving Optimal Population Cardiovascular Health Requires an Interdisciplinary Team and a Learning Healthcare System
Published: December 03, 2020
- Worldwide, the population burden of chronic diseases is increasing, amplified by the aging of populations. Additionally, the progress in improving population cardiovascular health (CVH) has been slow.
- From 2011 to 2017, the magnitude of the decline in annual CVD mortality diminished to less than 1% per year; 5-year CVD mortality declined by 4%.
- Recent mortality trends observed in the U.S. generate major concerns. Responses to these concerning trends must involve a redoubling of efforts on primordial and primary prevention of CVD.
- This statement summarizes the current evidence for population CVH, reviews contemporary sources for relevant performance and clinical metrics, and highlights the role of implementation science strategies.
- While many of the initiatives reviewed in this statement support the enhancement of secondary prevention (e.g., improving blood pressure control), this statement provides a roadmap to expand efforts to impact primordial and primary prevention to optimize CVH.
- Evidence-based interventions supporting enhanced CVD prevention and management are frequently underutilized due to the complexity of translating guidelines and recommendations into practice.
- Health systems that use guideline-oriented performance measures consistently are those best poised to achieve the vision of being a learning healthcare system and to report performance to health insurers and other key partners.
- De-implementation – the reducing or stopping use of ineffective, harmful, low-value, and/or unproven interventions, practices, and programs – is particularly important for population CVH interventions that may occur during already time-strapped clinical encounters.
- To advance population CVH management, the development and testing of frameworks, methods, measures, outcomes, and strategies that address issues specific to de-implementation is important.
- The clinical suggestions are practical and provide the literature that supports strategies for scaling evidence-based interventions across healthcare systems to maximize the population CVH impact.
Citation
Foraker RE, Benziger CP, DeBarmore BM, Cené CW, Loustalot F, Khan Y, Anderson CAM, Roger VL; on behalf of the American Heart Association Council on Epidemiology and Prevention; Council on Arteriosclerosis, Thrombosis and Vascular Biology; and Council on Lifestyle and Cardiometabolic Health. Achieving optimal population cardiovascular health requires an interdisciplinary team and a learning healthcare system: a scientific statement from the American Heart Association [published online ahead of print December 3, 2020]. Circulation. doi: 10.1161/CIR.0000000000000913.