Tracking ProgressThe Health Index Initiative tracks and monitors a variety of data sources to measure progress being made to decrease cardiovascular deaths. In 2016, MaineHealth leaders set bold, aggressive targets for two of these measures as a way to challenge MaineHealth organizations to continue achieving positive steps toward the MaineHealth vision:
Short-term cardiovascular measure and target:
- Among the 18- to 85-year old patients diagnosed with hypertension who receive care at a primary care practice in the MaineHealth Accountable Care Organization, greater than or equal to 72% will have blood pressure under control (<140/90mmHg) at their most recent office visit on or before September 30, 2018.
Long-term cardiovascular measure and target:
- In 2018-2020, the age-adjusted rate of deaths due to any cardiovascular condition will be less than or equal to155 per 100,000 people living in the 12-county MaineHealth service area.
Physician practices within the MaineHealth Accountable Care Organization (MaineHealth ACO) are focused on reducing cardiovascular disease and death by managing the high blood pressure of their patients.
Among the nearly 50,000 patients diagnosed with hypertension, the percentage whose blood pressure was under control (<140/90 mmHg) increased from 66% in January 2014 to 73% in October 2017, surpassing the target goal of 72%. This goal is continuously assessed and updated over time.
The rates of all cardiovascular deaths in Maine and within the MaineHealth service area have consistently been below the national rate. For decades, age-adjusted rates for deaths due to cardiovascular disease steadily decreased across the U.S. However, this long-running decline in mortality has recently plateaued, and the most recent data is suggesting an uptick in cardiovascular death rates both nationally and in Maine.
While the United States age-adjusted rate significantly decreased from 224 per 100,000 lives in 2011-2013 to 219 in 2014-2016, the three year rate in the MaineHealth service area increased slightly from 2011 to 2013 to 2014-2016, suggesting the upward trend may continue.
Death from all types of cardiovascular disease including heart disease, stroke, heart attack and heart failure have been steadily decreasing over the last several decades. In the case of heart attack, the age adjusted rate per 100,000 is almost half of what it was less than 20 years ago. The recent increase in cardiovascular deaths, while not yet a trend, is of concern.