The American Heart Association and the Million Hearts Initiative: a presidential advisory from the American Heart Association.

Building healthier lives, free of cardiovascular diseases and stroke” is the mission that unites the volunteers and staff of the American Heart Association (AHA). When the AHA established its 2020 Health Impact Goal, “to improve the cardiovascular health of all Americans by 20% while reducing deaths from cardiovascular diseases and stroke by 20%,”1 it recognized that to reach this goal the AHA would need to focus even more of its time, attention, and resources on improving cardiovascular health through a diverse range of prevention strategies. Passage of the 2010 Patient Protection and Affordable Care Act (ACA)2 has provided the health community with multiple opportunities to elevate the importance of clinicaland population-based prevention and thereby to reduce the morbidity and mortality of cardiovascular disease (CVD) and stroke while addressing in a more fundamental way these enormous drivers of healthcare costs. Although the resulting legislation remains politically divisive, a number of key provisions in the ACA have the potential to transform the current healthcare delivery system and its preponderance for “sick care” to one that better incorporates, coordinates, values, and financially rewards quality and prevention. Many of these provisions are found in Title IV: Prevention of Chronic Disease and Improving Public Health, leading Assistant Secretary for Health Howard Koh and Secretary of US Department of Health and Human Services (HHS) Kathleen Sebelius to observe that moving prevention toward the mainstream of health may well be one of the most lasting legacies of this landmark legislation.2 The question is whether we can seize this moment to fully leverage these provisions to affect CVD. One reason to be optimistic about the potential for a transformation to a focus on prevention is the HHS ’ recently announced Million Hearts Initiative (Million Hearts). This new initiative will focus, coordinate, and enhance CVD prevention in the programs, activities, and implementation of the ACA across all HHS agencies with the aggressive goal of preventing 1 million heart attacks and strokes over the next 5 years (by 2016). By pledging to partner with and work alongside healthcare providers, nonprofit organizations, and the private sector, Million Hearts represents an unprecedented commitment on the part of Secretary Sebelius and the HHS to make preventing heart attacks and stroke a top national health priority. The AHA not only applauds the launch of Million Hearts but also is grateful for the opportunities we have been provided to help inform, shape, and support the initiative. We look forward to joining and partnering with Secretary Sebelius and the HHS in implementing this initiative, which has the potential to advance the mission and work of the AHA dramatically and to help us achieve our ambitious 2020 Health Impact Goal.