MMWR Morb Mortal Wkly Rep. 2014 May 30;63(21):462-7.
Each year, approximately 1.5 million U.S. adults have a heart attack or stroke, resulting in approximately 30 deaths every hour and, for nonfatal events, often leading to long-term disability. Overall, an estimated 14 million survivors of heart attacks and strokes are living in the United States. In 2011, the U.S. Department of Health and Human Services, in collaboration with nonprofit and private organizations, launched Million Hearts (http://www.millionhearts.hhs.gov), an initiative focused on implementing clinical and community-level evidence-based strategies to reduce cardiovascular disease (CVD) risk factors and prevent a total of 1 million heart attacks and strokes during the 5-year period 2012-2016. From 2005-2006 to the period with the most current data, analysis of the Million Hearts four "ABCS" clinical measures (for aspirin, blood pressure, cholesterol, and smoking) showed 1) no statistically significant change in the prevalence of aspirin use for secondary prevention (53.8% in 2009-2010), 2) an increase to 51.9% in the prevalence of blood pressure control (in 2011-2012), 3) an increase to 42.8% in the prevalence of cholesterol management (in 2011-2012), and 4) no statistically significant change in the prevalence of smoking assessment and treatment (22.2% in 2009-2010). In addition, analysis of two community-level indicators found 1) a decrease in current tobacco product smoking (including cigarette, cigar, or pipe use) prevalence to 25.1% in 2011-2012 and 2) minimal change in mean daily sodium intake (3,594 mg/day in 2009-2010). Although trends in some measures are encouraging, further reductions of CVD risk factors will be needed to meet Million Hearts goals by 2017.
每年,约有 150 万美国成年人心脏病发作或中风,每小时约有 30 人死亡,而非致命性事件通常会导致长期残疾。总体而言,美国约有 1400 万心脏病发作和中风幸存者。2011 年,美国卫生与公众服务部与非营利组织和私营机构合作,发起了“百万心脏”(http://www.millionhearts.hhs.gov)行动,该行动专注于实施临床和社区层面的循证策略,以降低心血管疾病(CVD)风险因素,并在 2012 年至 2016 年的 5 年期间预防总计 100 万例心脏病发作和中风。从 2005 年至 2006 年到目前数据的时间段,对“百万心脏”的四项“ABCS”临床措施(阿司匹林、血压、胆固醇和吸烟)进行的分析表明,1)二级预防中阿司匹林使用率的流行率没有统计学意义上的变化(2009-2010 年为 53.8%),2)血压控制的流行率增加到 51.9%(2011-2012 年),3)胆固醇管理的流行率增加到 42.8%(2011-2012 年),以及 4)吸烟评估和治疗的流行率没有统计学意义上的变化(2009-2010 年为 22.2%)。此外,对两个社区层面指标的分析发现,1)当前烟草制品(包括香烟、雪茄或烟斗)使用率的流行率下降到 2011-2012 年的 25.1%,以及 2)每日平均钠摄入量的变化极小(2009-2010 年为 3594 毫克/天)。尽管一些措施的趋势令人鼓舞,但要到 2017 年实现“百万心脏”的目标,还需要进一步降低 CVD 风险因素。