Dr Janet Wright Outlines Goals and Roadblocks of Million Hearts Initiative

The Million Hearts initiative launched in 2012 set a lofty goal of preventing 1 million cardiovascular deaths in 5 years, but did not quite achieve that target. According to the program’s executive director, Janet Wright, MD, FACC, Million Hearts will continue to make progress in part due to the solid foundations it has formed in the initial stage.

Transcript (slightly modified)

What are the goals of the Million Hearts initiative?

The aim of Million Hearts 2022 is exactly the aim of Million Hearts 1.0, and that is to prevent a million cardiovascular events over a 5-year time frame. We made progress in our first 5 years, but I don’t think we’re going to get to a million. The projected numbers indicate we’ll probably fall short of that.

But we’ve amassed extraordinary partnerships and instituted policies. We’ve seen programs and pilots be launched during the first 5 years that will extend well beyond and will continue to make improvements in cardiovascular health and cardiovascular care.

What did your team learn from the obstacles the initiative has encountered in the first stage?

What we learned in 5 years of working is that change is hard, and it takes time. We’re frustrated by the slow pace of that change, but we did see progress. Over the 5 years of 2012 to 2016, we saw blood pressure control improve by about 1% per year. In order to deliver a million events, our model showed that we needed improvement at 5% per year.

The good news is that we saw, we met, and we learned from high performers in blood pressure control around the country over that 5 years’ time, so we know that high performance is possible, and many of those lessons turned into success stories that are available on our website.

With cholesterol, we saw an improvement a little bit greater, and we’re going to get close to the population level target that we set, but we’re not going to get all the way there. We did see a target reached in terms of smoking cessation, and it’s due to collective efforts around the country. In fact, 7 million people had stopped smoking over the period of Million Hearts.

We’ve seen a little bit of an improvement in aspirin, but we didn’t make any headway at all in sodium reduction. All of those factors needed to occur together in order to prevent a million.