CDC National Heart Disease and Stroke Prevention Program

Washington
Basic Implementation

The Washington Department of Health began receiving funds from CDC in 2003 to support a state heart disease and stroke prevention program. The program received increased funding for basic implementation beginning in 2005. They also received additional CDC funding to lead the Northwest Regional Stroke Network.

Burden of Heart Disease and Stroke

• Nearly 1 out of 4 deaths in Washington are due to heart disease. (National Vital Statistics Report, 2009.)
• 10,604 Washington residents died from heart disease in 2006 (23% of total deaths in Washington). (National Vital Statistics Report, 2009.)
• 2,725 Washington residents died from stroke in 2006 (5.9% of total deaths in Washington). (National Vital Statistics Report, 2009.)

See the Washington State Department of Health report, The Burden of Heart Disease and Stroke in Washington State 2004 [PDF-1.9M], fact sheets for coronary heart disease and stroke in Washington State 2008, and the Northwest Regional Stroke Network report, Burden of Stroke in the Pacific Northwest—August 2008, [PDF–692K] for more burden statistics.

• According to 2007 Behavioral Risk Factor Surveillance System (BRFSS) survey results, adults in Washington reported the following risk factors for heart disease and stroke:
  
  • 25.4% had high blood pressure
  • 36.7% of those screened reported having high blood cholesterol
  • 7.1% had diabetes
  • 16.8% were current smokers
  • 62.1% were overweight or obese (Body Mass Index greater than or equal to 25.0)
  • 46.3% reported no exercise in the prior 30 days.
  • 74.0% ate fruit and vegetables less than 5 times a day.

Key Responsibilities

• Facilitate collaboration among public and private sector partners, such as managed care organizations, health insurers, federally funded health centers, businesses, unions, school systems, priority population organizations, and emergency response agencies.
• Define the heart disease and stroke burden and assess existing population–based strategies for primary and secondary heart disease and stroke prevention within the state.
• Develop and update a comprehensive state plan for heart disease and stroke prevention with emphasis on developing heart–healthy policies, changing physical and social environments, and eliminating disparities (e.g., based on geography, gender, race or ethnicity, or income).
• Identify culturally appropriate approaches to promote cardiovascular health with racial, ethnic, and other priority populations.
• Use population-based public health strategies to increase public awareness of the signs and symptoms of heart diseases and stroke, the urgency of early treatment for heart disease and stroke, and the need to call 9–1–1.
• Support health care organizations system changes to assure quality of care and implementation of primary and secondary prevention for heart disease and stroke.
• Monitor, implement, and evaluate prevention strategies and programs in health care sites, work sites, and communities.
• Provide training and technical assistance to public health, health care professionals, and partners to support primary and secondary prevention of heart disease and stroke.
• Monitor quality of care for primary and secondary prevention.

State Highlights

• The Washington Patient-Centered Medical Home Collaborative is a partnership between the Department of Health (DOH) Heart Disease and Stroke Prevention (HDSP), Diabetes Prevention, Tobacco Prevention, and Cancer Prevention Programs, as well as the Washington Academy of Family Physicians. This two-year quality improvement project supports system improvements in comprehensive patient care.  Thirty-three clinical teams, representing primary care practices and community health centers from across the state, are participating in the collaborative. Participants receive training, assistance, and visits from coaches to ensure they have the necessary resources and skills to become a successful medical home. The project aims to improve the delivery and quality of care for patients with chronic disease, including cardiovascular disease, and is expected to reach 49,400 patients. After only two quarters, results show a 39% increase in high blood pressure control and a 27% increase in high cholesterol control among diabetic patients.
• The HDSP program developed and pilot tested materials to support awareness and self-management of high blood pressure in the work site. The package “How To Check Your Blood Pressure” has simple guidelines for site managers and coordinators on how to establish and maintain facilities and equipment for blood pressure self-monitoring. Materials developed include guidelines, a sample promotional flyer, and instructional tools, such as wall posters and an at-hand manual. This project has been expanded from the pilot site to five other state agencies, who are integrating the project with their overall wellness strategy to promote work site health. The project will reach an estimated 18,000 employees.
• In 2009 and 2010, the HDSP program partnered with Northwest Kidney Centers to create a curriculum and training materials on proper blood pressure measurement technique and health messaging, used to train all Kent Fire District Competency Based Training (CBT) trainers. If this strategy proves effective in offering blood pressure monitoring services to the community, it will be expanded throughout the entire Kent Fire District and possibly to all King County Emergency Medical Services CBT trainers.
• In 2011, the HDSP program is sponsoring training for primary care teams in high risk communities on management and accurate measurement of high blood pressure according to the Joint Committee guidelines. This is a partnership with the SeaMar Community Health Centers system and will build on work completed by the previous Washington State Collaborative on hypertension. SeaMar Community Health Centers primarily serves Latino, low-income, and other diverse populations and has a potential reach of approximately 100,000 patients.
• The HDSP program is part of an integrated effort with DOH chronic disease prevention and health promotion programs to improve health and quality of life in local communities. This effort aims to prevent chronic disease, including heart disease and stroke, by changing policies, environments, and systems. Twelve local health departments receive training, coaching, and technical assistance to build  capacity to
  
  • assess the needs of the community
  • pull together partners
  • develop local solutions
  • identify funding and resources to support local solutions

  Communities are addressing the primary risk factors of physical inactivity, poor nutrition, and tobacco use that contribute to most chronic conditions and diseases, including hypertension, high cholesterol and cardiovascular disease.

• On March 15, 2010, Governor Gregoire signed SSHB 2396 [PDF-46K], directing the DOH to support a comprehensive, statewide Emergency Cardiac and Stroke System similar to the Trauma System. The bill took effect on June 20, 2010 and acknowledged the HDSP program’s work on this system for the last three years. The law directs DOH to
  
  • Adopt standard procedures for EMS to assess and triage cardiac and stroke patients.
  • Identify hospitals that can treat cardiac and stroke patients and meet criteria to participate in the system.
  • Require quality improvement activities for participating hospitals.
  • Expand the scope of EMS and trauma regional quality assurance programs to include cardiac and stroke cases.

For more information on heart disease and stroke prevention in the state, visit the Washington State Department of Health Heart Disease and Stroke Prevention Program Web site.

To view county-level data, visit our interactive map site.