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Commentary

How Do We Achieve Optimal Population Cardiovascular Health?


February 10, 2021

mungerCardiovascular health across the world is declining, especially in the older population.1-2 The rate of decline began in 2011 with downward trends in heart disease deaths and stroke in middle-aged Americans.  From 2011-2017 the rate of decline in cardiovascular mortality was 4%.3-5   Unfortunately, progress toward improving these outcomes has been slow.6 

We can reverse this poor outcome with artificial intelligence (AI) systems.   Application of AI can provide a learning healthcare system.  Population cardiovascular health metrics can be measured, evaluated, providing information for interventions. Thereafter, outcomes can be re-evaluated setting up a SMART evidenced base system for optimizing population cardiovascular health.4 

What can be done now with every patient in the healthcare system?  The 2020 American Heart Association goals are to stop smoking, have a body mass index < 25 kg/m2, incorporate daily physical activity to goal levels, eat a heart healthy diet, lower untreated total cholesterol < 200 mg/dL, evaluate blood pressure to a goal of < 120/80 mmHg, and have a fasting blood glucose < 100 mg/dL.5  The outcome of these goals is “to improve the cardiovascular health of all Americans by 20% while reducing deaths from cardiovascular disease and stroke by 20%”.5    

What can pharmacists do to assist in these goals to realize the AHA’s outcomes?  First, all pharmacists, pharmacy organizations, and employers need to evaluate the health of their clients and analyze workflow in the pharmacy to realize these outcomes.  Putting the patient first and always must become the true North Star Goal of all pharmacists.  Gathering and obtaining patient data is crucial to putting the patient first.  This will require that all pharmacists with one voice demand patient medical information be available at the time of patient interaction.  This is essential to the future of community pharmacy in the US. 

Mark A. Munger, PharmD, FCCP, FACC, is a professor of pharmacotherapy and adjunct professor of internal medicine, at the University of Utah, where he also serves as the associate dean of Academic Affairs for the College of Pharmacy.

Disclaimer: The views and opinions expressed are those of the authors and do not necessarily reflect the official policy or position of Population Health Learning Network. Any content provided by our bloggers or authors are of their opinion and are not intended to malign any religion, ethnic group, club, organization, company, individual or anyone or anything.   

References

  1. Hall EW, Vaughan AS, Ritchey MD, Schieb L, Casper M.  Stagnating national declines in stroke mortality mask widespread county-level increases.  201-2016. Stroke  2019;50:3355-9.
  2. Vaughn AS, Ritchey MD, Hannan J, Kramer MR, Casper M. Widespread recent increases in county-level heart disease mortality across age groups. Ann Epidemiol. 2017;27:796-800.
  3. Sidney S, Quesenberry CP Jr, Jaffe MG, et al. Recent trends in cardiovascular mortality in the United States and public health goals. JAMA Cardiol 2016;1:594-9.
  4. Sidney S, Go AS, Jaffe MG, Solomon MD, Ambrosy AP, Rana JS. Association between aging of the US population and heart disease mortality from 2011 to 2017. JAMA Cardiol 2019;4:1280-6
  5. Lloyd-Jones DM, Hong Y, Labarthe D, et al. on behalf of the American Heart Association Strategic Planning Task Force and Statistics Committee. Defining and setting national goals for cardiovascular health promotion and disease reduction. Circulation 2010;121:586-613.
  6. AHA Scientific Statement. Achieving optimal population cardiovascular health requires an interdisciplinary team and a learning healthcare system. Circulation 2021:143e9-e18.

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