Million Hearts Cardiovascular Disease Risk Reduction Model

Cardiovascular disease (CVD) is the leading cause of death in the US 1,2 and is responsible for extensive costs to the health care system. 2 Although CVD mortality rates declined over the past several decades in the US, this decline has recently stagnated. 1,3dditionally, population-level increases in CVD risk factors and aging of the population threaten to further undermine progress. 1,2Key clinical guideline recommendation changes to chronic CVD treatment have been implemented over the past 10 years aiming to lower atherosclerotic CVD (ASCVD) risk in the US. 4,5In 2013, the American College of Cardiology/American Heart Association recommended statin use for primary prevention of CVD among adults with a 10-year predicted ASCVD risk greater than or equal to 7.5% calculated using the pooled cohort equations. 4,6In 2017, the American College of Cardiology/American Heart Association recommended reducing the blood pressure threshold for hypertension diagnoses and treatment from 140/90 mm Hg to 130/80 mm Hg. 5 However, guideline-recommended treatment goals at the population level have not been reached, and reductions in CVD rates are lagging.