CDC National Heart Disease and Stroke Prevention Program

Tennessee
Capacity Building

The Tennessee Department of Health began receiving funds from CDC in 2001 to support a state heart disease and stroke prevention program.

Burden of Heart Disease and Stroke

More than 1 out of 4 deaths in Tennessee are due to heart disease. (National Vital Statistics Report, 2009.)
14,642 Tennesseans died from heart disease in 2006 (25.8% of total deaths in Tennessee). (National Vital Statistics Report, 2009.)
3,407 Tennesseans died from stroke in 2006 (6.0% of total deaths in Tennessee). (National Vital Statistics Report, 2009.)

See the Tennessee Department of Health’s The Burden of Heart Disease and Stroke in Tennessee 2006 Report, [PDF–5.5M] and Special 2007 Update Report, [PDF–3.9M] for more burden statistics.

According to 2007 Behavioral Risk Factor Surveillance System (BRFSS) survey results, adults in Tennessee reported having the following risk factors for heart disease and stroke:
- 33.8% had high blood pressure
- 34.2% of those screened reported having high blood cholesterol
- 11.9% had diabetes
- 24.3% were current smokers
- 67.4% were overweight or obese (Body Mass Index greater than or equal to 25.0)
- 61.2% reported no exercise in the prior 30 days
- 73.6% ate fruit and vegetables less than 5 times a day

Heart disease and stroke risk factors among adults—Tennessee compared with the United States.

Risk Factor	Tennessee	Nationwide (States and D.C.)
Eat fruits and vegetables less than 5 times/day	73.6	75.6
Overweight or obese	67.4	62.9
No moderate or vigorous physical activity	61.2	50.5
High total blood cholesterol	34.2	37.6
High blood pressure	33.8	27.8
Cigarette smoking	24.3	19.8
Diabetes	11.9	8.0

Key Responsibilities

Facilitate collaboration among public and private sector partners, such as managed care organizations, health insurers, federally funded health centers, businesses, priority population organizations, and emergency response agencies.
Define the burden of heart disease and stroke and assess existing population-based strategies for primary and secondary prevention of heart disease and stroke within the state.
Develop and update a comprehensive state plan for heart disease and stroke prevention with emphasis on heart-healthy policies development, physical and social environments change, and disparities elimination (e.g., based on geography, gender, race or ethnicity, or socioeconomic status).
Identify culturally appropriate approaches to promote heart disease and stroke prevention among racial, ethnic, and other priority populations.
Use population-based public health strategies to increase public awareness of the heart disease and stroke urgency, the signs and symptoms of heart disease and stroke, and the need to call 9–1–1.

State Highlights

In 2010, the Tennessee Heart Disease and Stroke Prevention (HDSP) program, in partnership with the Tennessee Hospital Association, implemented an intervention that focused on blood pressure control and sodium intake reduction among diabetes patients in six federally qualified health centers and one hospital. The aim of the project was to
- Improve site capacity to collect and interpret quality data on high blood pressure, using the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure.
- Improve patient compliance with high blood pressure treatment.
- Improve patient high blood pressure and diabetes self-management capacity
The HDSP program provided training to the clinical staff that included JNC7 and American Diabetes Association Clinical Practice Guidelines, blood pressure measurement, sodium reduction education, and strategies to educate patients on self management of their high blood pressure and diabetes.
In collaboration with the Tennessee Hospital Association and the American Heart and Stroke Associations, the HDSP program implemented a standards of care–improvement project to increase the number of Joint Commission–certified, primary stroke care centers in Tennessee from one to at least one in each of the three regions of the state. Tennessee currently has 11 Joint Commission–certified primary stroke care centers.
The HDSP program is partnering with Vanderbilt University Hospital and the Stroke Task Force to implement Tennessee’s first stroke telemedicine project. Stroke telemedicine services will improve quality care for acute stroke patients by allowing improved access to primary stroke centers. The telestroke program currently has a total of three spoke hospitals and is sustained by Vanderbilt University Hospital.
The HDSP Program successfully implemented the American Heart Association’s hospital-based quality improvement initiative, Get With the Guidelines®, addressing stroke and heart failure in 35 hospitals.
The HDSP program developed the Burden of Heart Disease and Stroke in Tennessee Summary Report Update 2007. The report contains various data sets and findings that will help the partners to understand the burden of heart disease and stroke in Tennessee. The updated version of the burden report is available on the HDSP website: http://health.state.tn.us/Downloads/SpecialReport.pdf [PDF-3.9M].