Essential Features of a Surveillance System to Support the Prevention and Management of Heart Disease and Stroke

Essential Features of a Surveillance System to Support the Prevention and Management of Heart Disease and Stroke
A Scientific Statement From the American Heart Association Councils on Epidemiology and Prevention, Stroke, and Cardiovascular Nursing and the Interdisciplinary Working Groups on Quality of Care and Outcomes Research and Atherosclerotic Peripheral Vascular Disease
David C. Goff, Jr, MD, PhD; Lawrence Brass, MD†; Lynne T. Braun, PhD, RN, CNP; Janet B. Croft, PhD; Judd D. Flesch; Francis G.R. Fowkes, MD, PhD; Yuling Hong, MD, PhD; Virginia Howard, MSPH; Sara Huston, PhD; Stephen F. Jencks, MD, MPH; Russell Luepker, MD, MS; Teri Manolio, MD, PhD; Christopher O’Donnell, MD, MPH; Rose Marie Robertson, MD; Wayne Rosamond, PhD; John Rumsfeld, MD, PhD; Stephen Sidney, MD, MPH; Zhi Jie Zheng, MD, PhD
Executive Summary
A strategic goal of the American Heart Association (AHA) is to reduce heart disease, stroke, and risk for both by 25%,1 and Healthy People 2010 (HP2010) established 4 national goals for
heart disease and stroke prevention and management.2 However, the current health tracking systems (surveillance) in the United States cannot track progress toward these goals in a comprehensive and systematic manner. This article provides a brief overview of these goals, prevention and management strategies, and the role of surveillance in monitoring the impact of prevention and treatment efforts. It also provides a review of the existing surveillance system for monitoring progress toward preventing heart disease and stroke in the United States and recommendations for filling important gaps in that system. This information will serve as an important basis for advocacy to guide the development of a comprehensive surveillance system to support the current HP2010 and AHA goals and the likely future goal of eliminating the epidemic burden of heart disease and stroke.
Recommendations are categorized as overarching (fundamental recommendations that cut across goal areas) or as goal-specific.
They are further classified according to priority (P) (I for high priority and II for intermediate priority. No low-priority recommendations were made), staging (S) (I for early staging [1–2
years], II for intermediate staging [2–4 years], and III for later staging), and cost (C) ($ for items estimated to cost less than $10 million per year, $$ for estimates of $10 to $100 million, and $$$ for estimates exceeding $100 million). In addition, potential barriers to action are addressed.