Abstract 15862: Million Hearts—Estimating the Number of Events Prevented During 2012-2016
Introduction: Increased cardiovascular disease (CVD) prevalence and a slowing or reversal in previously declining CVD event rates have been forecast. The Million Hearts initiative was launched to coordinate prevention activities to counter this forecast and help prevent 1 million heart attacks, strokes, and other CVD events during 2012-2016. This study establishes the event burden prior to Million Hearts (2006-2011), and describes the estimated number of events prevented during its first 2 years.
Methods: We identify mutually exclusive events that occurred among US adults aged ≥18 using specified primary diagnosis ICD-9-CM codes for emergency department (ED) encounters and non-elective hospitalizations captured within the Nationwide ED Sample and National Inpatient Sample, respectively, and underlying cause-of-death ICD-10 codes captured within the National Vital Statistics System. We calculate age-sex-specific event rates from 2006-2011 and, based on log-linear models fitted to the rates, calculate their average annual percent change (AAPC). We describe 2 strategies that compare the actual versus expected event totals during 2012-2016: using the modeled 2011 rates to establish stable baselines, and using the AAPCs to establish baselines that incorporate previous trends. Events prevented estimates for 2012 and 2013 were calculated using available data.
Results: All but 1 group (males aged 45-64) experienced significant rate declines during the baseline period from 2006-2011 (P<.05). During 2012-2013, 115,211 (SD: 35,448) events were prevented using the stable baseline; an excess of 43,933 (38,123) events occurred using the trend baseline. Women aged ≥75 had the most events prevented [stable: 76,242 (22,836); trend: 39,050 (24,885)]. Men and women aged 45-64 had the greatest number of excess events; men [stable: 22,912 (13,695); trend: 38,810 (14,547)] and women [stable: 7,975 (6,207); trend: 24,080 (6,387)].
Conclusions: While events were prevented compared with what would have occurred had 2011 rates remained stable, the decline in rates did not keep pace with prior trends, especially among adults aged 45-64. These findings support intensifying national action on improving CVD risk factors to prevent heart attacks and strokes.
Author Disclosures: M.D. Ritchey: None. F. Loustalot: None. H. Wall: None. C. Steiner: None. C. Gillespie: None. M. George: None. J. Wright: None.
- © 2016 by American Heart Association, Inc.