Law and Legislation

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Law and Legislation

Million Hearts® 2022 is a national initiative that is led jointly by the Centers for Disease Control and Prevention (CDC) and the Centers for Medicare and Medicaid Services (CMS). Million Heart® was initially launched in 2012 with a goal to prevent 1 million heart attacks and strokes by the year 2017.  The initiative emphasizes the implementation of evidence-based priorities and goals that can improve cardiovascular health across the U.S. The Million Hearts® initiative works with public and private partnerships at the federal, state, and local levels to promote the goals of the initiative (Cooke, 2017). This initiative enables Americans to make healthy choices while also improving the quality of cardiovascular care Americans receive.

Heart disease continues to be the leading cause of death in the U.S.; however, 80% of heart disease is preventable (Dickins & Braun, 2017). Approximately 100 million adults in the U.S. have hypertension which is the leading cause of cardiovascular disease-related deaths. There are approximately 79,000 deaths annually which are attributed to hypertension. Decreasing systolic blood pressure (BP) by 10mmhg can decrease the risk of cardiovascular disease events by 20%, coronary heart disease by 17%, stroke by 27%, heart failure by 28%, cardiovascular disease deaths by 25%, and deaths from all causes by 13%. According to Million Hearts®, every 10% increase in hypertension treatment can prevent 14,000 deaths (Shaikh et al, 2020).

It is imperative for APNs to understand the significance of cardiovascular health in the U.S. Through the implementation of evidence-based clinical practice guidelines, research, and support of health policy initiatives, like Million Hearts®, APNs can be instrumental in preventing heart disease and improving the health of the U.S. (Melnyk et al, 2016). APNs can initiate community-based prevention strategies to encourage people to make heart healthy choices, promote smoke-free environments, and promote efforts to eliminate artificial trans-fats and decrease sodium in the food supply. At the state and federal legislative level, APN’s can become active in promoting legislation to mandate healthy lifestyle intervention programs such as daily physical activity for children and adolescents in school, tobacco intervention programs for adults and children, improvement in access to cardiovascular rehabilitation for those who have suffered a cardiovascular event, etc. APNs can establish community health centers that focus on teaching, monitoring, and prevention of cardiovascular disease utilizing the Million Hearts® toolkits and resources (Sullivan, 2016).

 

References:

 

Cooke, C. (2017). Partnerships bring NP expertise to health care initiatives. The Journal for Nurse Practitioners, 13(5) doi:http://dx.doi.org/10.1016/j.nurpra.2017.04.010

 

Dickins, K. A., & Braun, L. T. (2017). Promotion of physical activity and cardiac rehabilitation for the management of cardiovascular disease. The Journal for Nurse Practitioners, 13(1), 47-53. doi:http://dx.doi.org/10.1016/j.nurpra.2016.10.026

Melnyk, B. M., Orsolini, L., Gawlik, K., Braun, L. T., Chyun, D., Conn, V., Dunbar-Jacob, J., Lewis, L, Melkus, Gail, Millan, A., Rice, V., Wilbur, J., Nowlin, S., Olin, A. R. (2016). The Million Hearts initiative, The Nurse Practitioner, 41(2), 46-53. doi:10.1097/01.NPR.0000476372.04620.7a

Shaikh, U., Petray, J., & Wisner, D. H. (2020). Improving blood pressure screening and control at an academic health system. BMJ Open Quality, 9(1) doi:http://dx.doi.org/10.1136/bmjoq-2018-000614

Sullivan, C. G. 2016, Call to action: Nursing action necessary to prevent one million heart attacks and strokes by 2017.American Academy of Nursing on Policy, 64(2), pp. 197-199. https://doi.org/10.1016/j.outlook.2016.02.003