Fifty years ago, President Lyndon Johnson signed designated February as American Heart Month to acknowledge and combat the “staggering physical and economic loss to the nation” caused by cardiovascular disease.
Unfortunately, that proclamation is proving to be a timeless document.
Even with broad awareness of heart disease, expansive research and a number of clinical and public health efforts to prevent, diagnose and treat cardiovascular conditions, it remains the leading cause of death in the nation. About 600,000 people die from heart disease in the United States each year—making it responsible for one out of every four American deaths.
As a research institute dedicated to helping patients and those who care for them make better informed decisions that lead to better outcomes, the Patient-Centered Outcomes Research Institute (PCORI) is acutely interested in producing new information that supports more effective cardiovascular care. The directive in our establishing legislation to consider “disease incidence, prevalence, and burden” when prioritizing research funding is a clear call for studies of cardiovascular conditions.
I’m proud to say that PCORI has answered that call. Cardiovascular disease, including heart disease and stroke, is the most commonly studied topic in our research portfolio. It is addressed in several dozen of the 192 primary research studies that PCORI has funded to date, including projects that conduct a comparative assessment of heart disease interventions, as well as those that test the effectiveness of decision support tools. Communicating information and providing tools to patients in ways that motivate them to make healthy choices is often a major challenge for clinicians.
Our comprehensive approach funds research that addresses the gaps in both information and communication that are responsible for poor outcomes in cardiovascular care.
One study being conducted by Brigham and Women’s Hospital in Boston is testing a strategy for preventing cardiovascular disease in women who suffered from pre-eclampsia, a condition of high blood pressure during pregnancy that is recognized as an early warning sign for heart disease. There currently are no programs designed specifically to inform young women with recent pre-eclampsia of their risk and to help them make appropriate lifestyle changes. In a randomized controlled trial, researchers will test the effectiveness of a web-based program in promoting proper nutrition and physical activity, and in encouraging women to speak with their primary care provider about their risks.
In 2012, the American Heart Association (AHA), in its comments to PCORI regarding our research priorities, emphasized the need to develop decision aids for heart failure patients to enhance shared decision making. A PCORI study under way at the Baylor College of Medicine in Houston tests the success of a decision support aid to help patients understand the benefits and trade-offs of ventricular assist devices (VADs), which are becoming much more common. VADs following heart failure can prolong life by up to five years, but they may harm quality of life and carry risks of neurological complications, infections, and multi-organ failure. The decision aid seeks to present outcomes, risks, experiences, and uncertainties about VAD placement in a clear, comprehensive, scientifically valid, and unbiased manner.
Studies like these address the real world challenges that patients and front-line clinicians face in supporting cardiovascular health. We are confident that the resulting findings will be relevant and useful in everyday clinical practice.
PCORI is launching an additional funding program in 2014 that will accelerate the creation of valuable research findings. Beginning this year, the institute will fund large pragmatic studies that focus on direct comparisons of drugs, devices and other forms of prevention, diagnosis and treatment to determine what works best for patients given their individual preferences. The focus of our initial funding will include 15 high-priority topics, one of them being the reduction of cardiovascular disease risk in underserved populations, such as racial and ethnic minorities and those living in rural communities. With substantial research investment, we can help communities with a high prevalence of poorly managed heart conditions achieve better outcomes.
The proclamation signed by President Johnson 50 years ago still resonates in more ways than just our persistent struggle with heart disease. It said the expansion of programs to support cardiovascular health, such as research that studies “methods of prevention, diagnosis, and treatment of the cardiovascular diseases,” gives us hope that we “may eventually eliminate these diseases as important causes of death.” The promise of reliable research still rings true today.
We welcome your support as we seek to reduce the pain that heart disease inflicts on millions of Americans. Please visit us at pcori.org to find out more about our work and how you can play a meaningful role in research that helps patients receive the best care possible.