Sustaining the CVD Victories of the Past by Rededicating Commitment to Community

Updated:May 24,2014

Sustaining the CVD Victories of the Past by Rededicating Commitment to Community Intervention

Disclosure: Dr. Howard has nothing to disclose.
Pub Date: Thursday, March 21, 2013
Author: George Howard, DrPH, FAHA
Affiliation: University of Alabama, Birmingham, School of Public Health, Birmingham, Ala.

Citation

Pearson TA, Palaniappan LP, Artinian NT, Carnethon MR, Criqui MH, Daniels SR, Fonarow GC, Fortmann SP, Franklin BA, Galloway JM, Goff DC Jr, Heath GW, Holland Frank AT, Kris-Etherton PM, Labarthe DR, Murabito JM, Sacco RL, Sasson C, Turner MB; on behalf of the American Heart Association Council on Epidemiology and Prevention. American Heart Association guide for improving cardiovascular health at the community level, 2013 update: a scientific statement for public health practitioners, healthcare providers, and health policy makers. Circulation. 2013: published online before print March 21, 2013, 10.1161/CIR.0b013e31828f8a94. 
http://circ.ahajournals.org/lookup/doi/10.1161/CIR.0b013e31828f8a94


Article Text

In the conclusions to the Cardiovascular Health at the Community Level, 2013 Update1 the authors appropriately note that heart disease and stroke have been the major causes of death in the US for the past 100 years, and in the future these causes are expected to substantially expand with the “graying of America.”2   While these concerns are valid, we need to simultaneously celebrate the remarkable declines in stroke (with relatively consistent declines since the early 1900s) and heart disease mortality (with relatively consistent declines since the mid-1960s). These remarkable declines that have been recognized as among the top 10 public health achievements of the previous century,3 with continuing declines also recognized as among the top 10 public health achievements of the most recent decade.4  It should be noted, however, that declines of numbers of cardiovascular events and deaths are substantially less dramatic than these declines in rates.

There are many potential contributors to these remarkable declines including better identification of disease onset, improved acute clinical care of incident diseases, and better post-event care and secondary prevention of subsequent events. However, it would seem most likely a major contributor has been population changes in cardiovascular risk factors, including reduction in smoking prevalence since the 1960s,5 and potential long-term declines in hypertension prevalence6 and lipid levels.7  However, these positive trends may be challenged by current population changes, including the remarkable obesity epidemic and the potential plateauing smoking rates.

Given these challenges to the continuation of the reduction in cardiovascular mortality, the importance of this contribution by Pearson and colleagues is hard to overstate. The authors offer a broad palette of potential contributors and pathways to continue the success, and equally important they offer approaches to coordinate these efforts. Continued success of interventions at the community level is critical to sustaining the victories of the past. This update is a powerful force to rededicate our commitment to community-level interventions, and their contribution to a bright cardiovascular future.

References

  1. Pearson TA, Palaniappan LP, Artinian NT, Carnethon MR, Criqui MH, Daniels SR, Fonarow GC, Fortmann SP, Franklin BA, Galloway JM, Goff DC Jr, Heath GW, Holland Frank AT, Kris-Etherton PM, Labarthe DR, Murabito JM, Sacco RL, Sasson C, Turner MB; on behalf of the American Heart Association Council on Epidemiology and Prevention. American Heart Association guide for improving cardiovascular health at the community level, 2013 update: a scientific statement for public health practitioners, healthcare providers, and health policy makers. Circulation. 2013: published online before print March 21, 2013, 10.1161/CIR.0b013e31828f8a94.
  2. Heidenreich PA, Trogdon JG, Khavjou OA, Butler J, Dracup K, Ezekowitz MD, et al. Forecasting the future of cardiovascular disease in the United States: A policy statement from the American Heart Association. Circulation. 2011;123:933-944.
  3. Centers for Disease Control and Prevention. Ten great public health achievements--United States, 1900-1999. MMWR. Morbidity and Mortality Weekly Report. 1999;48:241-243.
  4. Centers for Disease C, Prevention. Ten great public health achievements--United States, 2001-2010. MMWR. Morbidity and Mortality Weekly Report. 2011;60:619-623.
  5. Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Borden WB, Bravata DM, Dai S, Ford ES, Fox CS, Franco S, Fullerton HJ, Gillespie C, Hailpern SM, Heit JA, Howard VJ, Huffman MD, Kissela BM, Kittner SJ, Lackland DT, Lichtman JH, Lisabeth LD, Magid D, Marcus GM, Marelli A, Matchar DB, McGuire DK, Mohler ER, Moy CS, Mussolino ME, Nichol G, Paynter NP, Schreiner PJ, Sorlie PD, Stein J, Turan TN, Virani SS, Wong ND, Woo D, Turner MB; on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics—2013 update: a report from the American Heart Association. Circulation. 2013;127:e6-e245.
  6. Goff DC, Howard G, Russell GB, Labarthe DR. Birth cohort evidence of population influences on blood pressure in the United States, 1887-1994. Annals of Epidemiology. 2001;11:271-279.
  7. Goff DC Jr, Labarthe DR, Howard G, Russell GB. Primary prevention of high blood cholesterol concentrations in the United States. Archives of Internal Medicine. 2002;162:913-919.


-- The opinions expressed in this commentary are not necessarily those of the editors or of the American Heart Association --
 

AHA Scientific Journals

AHA Scientific Journals


Connect with AHA Science News

Follow AHAScience on Twitter (opens in new window)
Like AHA Science News on Facebook (opens in new window)

Commentaries View All