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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EIn the late 1990s, the American Heart Association set a goal to reduce the rates of individual cardiovascular risk factors as well as death from CV causes by 25% by 2010. This article discusses the latest results on progress toward reaching those goals.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EPrevention \u0026amp; Screening\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EIn the late 1990s, the American Heart Association (AHA) set a goal to reduce the rates of individual cardiovascular (CV) risk factors as well as death from CV causes by 25% by 2010. Daniel W. Jones, MD, University of Mississippi, Jackson, MS, reported the latest results on progress toward reaching those goals.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EBy 2007, this goal had been achieved in three areas: the death rate from coronary heart disease had been reduced by 38%, the rate of strokes was down by 33%, and the percentage of individuals with uncontrolled high blood pressure was 28% lower. Progress was also being made toward meeting this goal for three additional risk factors; high cholesterol, smoking prevalence, and the number of individuals who were not engaged in moderate or vigorous physical activity were down 22%, 20%, and 9%, respectively.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EThe committee decided that the goal of a 25% reduction in diabetes and obesity was unattainable. Just stopping the growth of these two diseases would be significant progress, so they reset the target to 0% growth by 2010. The most recent data indicate a 1.9% annual growth rate for obesity and 1.8% for new diabetes. Good progress has been made toward the 2010 goal of reducing mortality and high blood pressure, fair progress has been made toward achieving the cholesterol goal, while poor progress has been made with changing the lifestyle issues, concluded Dr. Jones.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EAs reported by Donald M. Lloyd-Jones, MD, Northwestern University, Chicago, IL, the new goal commits AHA to the following: \u201cBy 2020, to improve the cardiovascular health of all Americans by 20% while reducing death from cardiovascular disease and stroke by 20%.\u201d\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EDr. Lloyd-Jones noted that studies indicate that a lower risk factor burden in middle age is associated with very low remaining lifetime risk for CV and other diseases (\u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E) [Lolyd-Jones D. \u003Cem\u003ECirculation\u003C\/em\u003E 2006], markedly longer survival, greater health-related quality of life, and substantially decreased Medicare expenditures in older ages. The fewer the lifestyle or other risk factors someone has, the greater their reduction in CVD risk. Thus, the focus for the CV health metric has shifted toward synthesizing and incorporating the entire spectrum of CV health, with \u003Cem\u003Eideal CV health\u003C\/em\u003E as the ultimate goal. The new mission offers opportunities for preventing risk factor development in the first place, while also controlling risk once it exists, treating disease, and improving quality of life in those with chronic illness. By providing opportunities for greater clinical prevention and public health approaches, new challenges and prospects will be made available for expansion in the area of primordial prevention (in particular, the prevention of risk factors in children and younger adults).\u003C\/p\u003E\u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/9\/5\/8\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Lifetime Risk: Age 50.\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-667430925\u0022 data-figure-caption=\u0022Lifetime Risk: Age 50.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/9\/5\/8\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/9\/5\/8\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/9\/5\/8\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/11500\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-7\u0022 class=\u0022first-child\u0022\u003ELifetime Risk: Age 50.\u003C\/p\u003E\n         \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-8\u0022\u003EAn improved diet is a critical component of the AHA\u0027s strategy for CVD risk reduction in the AHA Impact 2020 project. Lawrence Appel, MD, Johns Hopkins University, Baltimore, MD, reviewed the dietary components that have a potential to prevent disease and improve CV health. The AHA dietary guidelines and recommendations are consistent with the Dietary Approaches to Stop Hypertension (DASH), Okinawa, and Mediterranean diets. The five key components of the diet involve the consumption of more fruits, vegetables, oily fish, and fiber and less sodium and sugar. Data for US residents indicate that very few adults or children achieve optimal levels for at least 4 of these foods and nutrients\u2014just 0.6% for adults and 0.1% for children (\u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E).\u003C\/p\u003E\u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/11508\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/11508\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/11508\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-9\u0022 class=\u0022first-child\u0022\u003EPrevalence of Adherence to Healthy Diet Score (NHANES 2005\u20136).\u003C\/p\u003E\n         \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-10\u0022\u003EThe AHA 2006 Diet Guidelines recommend the consumption of a variety of foods within and among the basic food groups while staying within energy needs; the control of caloric intake to manage body weight; physical activity every day; increased daily intake of fruits and vegetables, whole grains, and fibrous foods; reduced-fat milk and milk products; limited intake of saturated and trans fats; the use of small amounts of salt and sugar; and reduced alcohol intake. Greater adherence to these and similar diet guidelines is associated with a significant reduction in mortality from all causes [Trichopoulou A et al. \u003Cem\u003EN Engl J Med\u003C\/em\u003E 2003; Fung TT et al. \u003Cem\u003EArch Intern Med\u003C\/em\u003E 2008].\u003C\/p\u003E\u003Cp id=\u0022p-11\u0022\u003EBetween 1968 and 2003, mortality rates from coronary heart disease (CHD) declined by approximately 50% in many countries. Darwin R. Labarthe, MD, PhD, Centers for Disease Control, Atlanta, GA, discussed the causes for such a significant decrease (\u003Ca id=\u0022xref-fig-2-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F2\u0022\u003EFigure 2\u003C\/a\u003E). In the US, from 1980 to 2000, approximately 44% of the reduction\u2014equal to more than 150,000 deaths averted\u2014was attributable to changes in risk factors due to behavioral and lifestyle changes, including reductions in total cholesterol (24%), systolic blood pressure (20%), smoking prevalence (12%), and physical inactivity (5%), although these reductions were partially offset by increases in body mass index and the prevalence of diabetes, which accounted for increased numbers of deaths (8% and 10%, respectively). Most of the remainder of the reduction (47% of the total) can be attributed to improved therapies, including secondary preventive therapies after myocardial infarction (MI) or revascularization (11%), initial treatments for acute MI or unstable angina (10%), treatments for heart failure (9%), revascularization for chronic angina (5%), and other therapies (12%) [Ford ES et al. \u003Cem\u003EN Engl J Med\u003C\/em\u003E 2007]. About 9% of the decrease was unexplained.\u003C\/p\u003E\u003Cdiv id=\u0022F2\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/9\/5\/8\/F2.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022International Mortality Trends 1968\u0026#x2013;2003. Men, CHD.\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-667430925\u0022 data-figure-caption=\u0022International Mortality Trends 1968\u0026#x2013;2003. Men, CHD.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 2.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/9\/5\/8\/F2.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/9\/5\/8\/F2.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 2.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/9\/5\/8\/F2.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/11504\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 2.\u003C\/span\u003E \n            \u003Cp id=\u0022p-12\u0022 class=\u0022first-child\u0022\u003EInternational Mortality Trends 1968\u20132003. Men, CHD.\u003C\/p\u003E\n         \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-13\u0022\u003EData indicate that approximately 135,000 lives could have been saved in 2000 by increasing the proportion of eligible patients with CHD who received the appropriate treatment [Capewell S et al. \u003Cem\u003EAm J Cardiol\u003C\/em\u003E 2009]. Important progress has been made since 2000, but their burden, disparities and costs persist and require further risk factor reductions in the future. Strategies that enhance primordial prevention and maximize the delivery of appropriate therapies to all eligible patients with CHD and prioritize medical therapies for secondary prevention and heart failure should be encouraged, as these will be needed as well.\u003C\/p\u003E\u003Cp\u003EDarwin Labarthe, MD, Centers for Disease Control, Atlanta, GA, summarized the ideals that are driving the Impact 2020 program:\n\u003C\/p\u003E\u003Cul class=\u0022list-unord \u0022 id=\u0022list-1\u0022\u003E\u003Cli id=\u0022list-item-1\u0022\u003E\n               \u003Cp id=\u0022p-15\u0022\u003Eto attain high-quality, longer lives that are free of preventable disease, disability, injury, and premature death\u003C\/p\u003E\n            \u003C\/li\u003E\u003Cli id=\u0022list-item-2\u0022\u003E\n               \u003Cp id=\u0022p-16\u0022\u003Eto achieve health equity, eliminate disparities, and improve health for all\u003C\/p\u003E\n            \u003C\/li\u003E\u003Cli id=\u0022list-item-3\u0022\u003E\n               \u003Cp id=\u0022p-17\u0022\u003Eto create social and physical environments that promote good health for all\u003C\/p\u003E\n            \u003C\/li\u003E\u003Cli id=\u0022list-item-4\u0022\u003E\n               \u003Cp id=\u0022p-18\u0022\u003Eto promote quality of life, healthy development, and healthy behaviors across all life stages\u003C\/p\u003E\n            \u003C\/li\u003E\u003C\/ul\u003E\u003Cp\u003E\n      \u003C\/p\u003E\u003Cp\u003EThese ideals will be achieved through four primary goals:\n\u003C\/p\u003E\u003Col class=\u0022list-ord \u0022 id=\u0022list-2\u0022\u003E\u003Cli id=\u0022list-item-5\u0022\u003E\n               \u003Cp id=\u0022p-20\u0022\u003EPrevention of risk factors by reducing the proportion of persons in the population with hypertension and the mean total blood cholesterol levels among adults.\u003C\/p\u003E\n            \u003C\/li\u003E\u003Cli id=\u0022list-item-6\u0022\u003E\n               \u003Cp id=\u0022p-21\u0022\u003EDetection and treatment of risk factors by increasing the proportion of adults with high blood pressure whose blood pressure is under control and the proportion of persons with CHD who have their low-density lipoprotein cholesterol at or below recommended levels and by reducing the incidence rates for heart disease and stroke.\u003C\/p\u003E\n            \u003C\/li\u003E\u003Cli id=\u0022list-item-7\u0022\u003E\n               \u003Cp id=\u0022p-22\u0022\u003EEarly identification and treatment of cardiovascular events by increasing the 30-day survival rates following first occurrence of heart disease and stroke.\u003C\/p\u003E\n            \u003C\/li\u003E\u003Cli id=\u0022list-item-8\u0022\u003E\n               \u003Cp id=\u0022p-23\u0022\u003EPrevention of recurrent cardiovascular events by reducing the recurrent rates among survivors of heart disease and stroke.\u003C\/p\u003E\n            \u003C\/li\u003E\u003C\/ol\u003E\u003Cp\u003E\n      \u003C\/p\u003E\u003Cp id=\u0022p-24\u0022\u003E\u201cThe overarching objective of the four goals is to increase overall cardiovascular health in the US population,\u201d concluded Dr. Labarthe.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2009 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/9\/5\/8.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzmhn2\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzmhn2\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzmhn2\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}