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This resource highlights state-based program initiatives tailored to improving hypertensive disorders of pregnancy outcomes.

Learn about how five jurisdictions approached self-measured blood pressure monitoring programs to reduce hypertension and uncover systemic barriers to care.

Heart Disease and Stroke Prevention in the Pacific Territories heart disease, stroke prevention, american heart month, cardiovascular health, chronic disease, pacific territories, environmental infrastructure, disease epidemic, tobacco use, mental health, united states, physical activity, health problems, leading cause of death, health conditions, american heart, cardiovascular disease, chest pain, type of heart disease, coronary heart disease, heart health, flow to the heart, risk of heart disease, heart disease and stroke, prevent heart disease, astho, association of state and territorial health officials Marcus Plescia Heart disease and stroke prevention in the pacific territories. Each February, American Heart Month raises awareness for heart disease and cardiovascular health—a matter that warrants attention year-round. In ASTHO’s 2023 Environmental Scan, territorial health officials highlighted chronic disease prevention and treatment as top current public health program and service priorities, emphasizing heart disease and stroke as key focus areas. As such, I want to highlight heart disease as a public health issue in the U.S. territories, which have played an important role in ASTHO’s chronic disease prevention efforts. Several years ago, ASTHO CEO Mike Fraser pointed out Mark Durand’s work in the Pacific territories. Durand developed a list of prioritized chronic disease-related health policies and a matrix to map progress across six jurisdictions. This ultimately provided the basis for ASTHO’s Essential Policies for Chronic Disease Prevention and Control—which served as a foundation for ASTHO’s Heart Disease and Stroke Prevention (HDSP) Learning Collaborative—and led to the launch of ASTHO’s technical packages in all program areas. Heart Disease and Stroke Prevalence in the Pacific In the United States, heart disease is the first leading cause of death and stroke is the fifth. Disparities exist across several demographic lines, including race, ethnicity, and nationality. U.S.-Affiliated Pacific Islands (USAPIs) adults have the second-highest death rate from cardiovascular disease in the country. Additionally, in all USAPIs involved in ASTHO’s HDSP Learning Collaborative—Commonwealth of Northern Mariana Islands (CNMI), Federated States of Micronesia (FSM), Republic of the Marshall Islands (RMI), Guam, and Republic of Palau—heart disease and stroke are in the top three leading causes of death, with cases soaring in recent years. The U.S. territories are home to small and diverse populations with rich history, cultural practices, and languages. Unfortunately, the long-lasting impacts of colonialism have weakened the social, cultural, and environmental infrastructure that has historically protected the health of USAPIs communities. In recent decades, health threats have shifted from infectious diseases to preventable chronic diseases; the Pacific Island Health Officers Association even declared a Regional State of Emergency in 2010 because of their non-communicable disease epidemic. Since this declaration, there has been increased interest in and efforts toward policy and health system interventions in USAPIs, which ASTHO has been proud to support through our learning collaborative. Heart Disease and Stroke Prevention Learning Collaborative: Key Accomplishments Since 2013, ASTHO has partnered with CDC to develop and sustain the HDSP Learning Collaborative, focused on improving rates of hypertension. In all, 36 participating states, territories, and freely associated states have implemented innovative strategies through systems, policy, and quality improvement processes. Historically, this learning collaborative—open to both states and islands—has focused on the design and implementation of hypertension control programs. In USAPIs, program efforts evolved to address and improve cardiovascular health more broadly. Although USAPIs workplans differ from each other, they all have advanced health equity by understanding community needs and adapting to health system capacity. Table-CMO Heart Disease Stroke Prevention in the Pacific Tools for Change/Spotlight-CMO Heart Disease Stroke Prevention in the Pacific website yes

This white paper shares how states have identified a number of successes, challenges, and lessons learned about how to effectively use health information systems (HIS) to improve hypertension identification, management, and control.

Partnerships between state health agencies and public and private payers are critical to effective statewide efforts to improve hypertension identification and control. This white paper describes opportunities, strategies, and example partnerships identified through the ASTHO Million Hearts Learning Collaborative.

ASTHO convened a Million Hearts Advisory Roundtable to find innovative strategies for public health and primary care integration to support the Million Hearts initiative. Key recommendations from this action-oriented meeting outline possible roles for how state health agencies can support the goals of Million Hearts.

Data summary of the Las Animas-Huerfano Counties Million Hearts learning collaborative, aiming to improve the use and sharing of clinical data to better identify individuals with undiagnosed or uncontrolled hypertension and support patients diagnosed with hypertension.

The Oklahoma Foundation for Medical Quality published this one-page document with guidance on accurate blood pressure measurement and a protocol for clinicians to use with patients who have elevated blood pressure and are not currently diagnosed with hypertension.

This document features opportunities and resources for state health departments to support health systems change and the goals of several federal and national initiatives of the Division for Heart Disease and Stroke Prevention (DHDSP), the Million Hearts® Initiative, and the CDC 6|18 Initiative.

This resource is a snapshot of the work North Dakota performed as a part of the Year 4 Cohort of the ASTHO Million Hearts Learning Collaborative. It includes details on their priority population, partners, aim statement, evidence-based practices used, project success, and potential for spread and scalability.

This resource is a snapshot of the work Texas performed as a part of the Year 4 Cohort of the ASTHO Million Hearts Learning Collaborative. It includes details on their priority population, partners, aim statement, evidence-based practices used, project success, and potential for spread and scalability.

This resource is a snapshot of the work Wisconsin performed as a part of the Year 4 Cohort of the ASTHO Million Hearts Learning Collaborative. It includes details on their priority population, partners, aim statement, evidence-based practices used, project success, and potential for spread and scalability.

This resource is a snapshot of the work Arkansas performed as a part of the Year 4 Cohort of the ASTHO Million Hearts Learning Collaborative. It includes details on their priority population, partners, aim statement, evidence-based practices used, project success, and potential for spread and scalability.

This resource is a snapshot of the work Connecticut performed as a part of the Year 4 Cohort of the ASTHO Million Hearts Learning Collaborative. It includes details on their priority population, partners, aim statement, evidence-based practices used, project success, and potential for spread and scalability.

A summary of Colorado Department of Public Health and Environement's (CDPHE) development of a model to engage local public health agencies (LHPAs) and primary care clinics to improve hypertension diagnosis and control in two frontier counties, Las Animas and Huerfano.

2016 presentation describing partnership project between United Health Care and Texas State Department of Health, whose aim was to reduce hypertension across the State with a focus on disparate populations.

This brief explores how state and territorial health agencies can engage people who provide social support for individuals and families with hypertension.