American Heart Association, Duke Margolis Center issue call to action on cardiovascular disease prevention and treatment

January 24, 2019 – A new collaboration between the two institutions aims to address continued challenges in access and affordability of cardiovascular care.

A special report published this week in the journal Circulation calls for urgent action to counter the toll from heart disease, currently the leading cause of death in the United States and worldwide. The “Presidential Advisory,” which introduces a joint initiative on value in cardiovascular care between the American Heart Association (AHA) and the Duke Margolis Center for Health Policy, includes former FDA Commissioners Robert M. Califf, MD (DCRI founder and director of Duke Forge) and Mark McClellan, MD, PhD (director, Duke Margolis Center) as co-authors.

The advisory summarizes recent data showing that long-standing trends toward progress in the treatment and prevention of heart disease have stagnated and in some cases even reversed. The article’s authors, who also include AHA Past President John Warren, MD (University of Texas -Southwestern Medical Center) and AHA CEO Nancy Brown, note that these challenges are occurring as the pipeline of therapeutic innovation is slowing, costs of cardiovascular care are rising, and patients are increasingly concerned about the value of the care they receive relative to its expense.

In addition, long-standing disparities in risk factors and access to care according to race, ethnicity, and gender have remained stubbornly persistent. The authors also note multiple missed opportunities for preventing cardiovascular disease through early diagnosis, administering effective treatments, working to modify risk factors, and communicating directly about patients’ health goals and needs.

Against this background, the authors propose creating a series of collaborative learning teams, pilot studies, and patient surveys designed to improve understanding of pathways for effectively treating and preventing cardiovascular disease, and articulate possible solutions that take the perspectives of all stakeholders into account. These efforts will ultimately inform the creation of detailed “roadmaps” for providing greater value in cardiovascular care and ensuring a robust pipeline of therapeutic development and innovation.