Million Hearts Initiative to Bring Half US Adults into Medical System

The Million Hearts Initiative will not improve cardiovascular health. But that's just fine. It assures that people will be stuck on the medical system treadmill for the rest of their foreshortened lives.

by Heidi Stevenson

13 September 2011

According to the United States Department of Health and Human Services, half of the adult population suffers from heart disease. Therefore, they've cooked up a niftily titled program, the Million Hearts Initiative and added a bunch of new acronyms for us to learn so that all those people can be brought into the medical system and start taking drugs.

The Administrator for the Centers for Medicare and Medicaid Services, Donald M. Berwick, MD, and the Director of the Centers for Disease Control and Prevention, Thomas R. Frieden, MD, jointly published an announcement of the Million Hearts Initiative in the New England Journal of Medicine⁽¹⁾ a couple of hours ago. They state an intention of preventing half of all heart attacks through a campaign focused on "improving management of the ABCS".

ABCS

There's the first new acronym. ABCS stands for:

A: Aspirin for high risk patients
B: Blood pressure control (primarily through drugs)
C: Cholesterol management (primarily through drugs)
S: Smoking cessation (primarily through drugs)

Pharmaceutical drugs are, of course, the primary tools being suggested for each of those alphabetical bits. And they are always to be managed under the guidance of a doctor. On top of that, the program includes an effort to push and expand the use of computerized medical records to assure that people are actually taking their drugs—and also to standardize treatment. After all, we need to forget that we're individuals. Each of us must meet the same standards.

Drugs Don't Work

Never mind that it's never been shown that forcing blood pressure lower through drugs reduces heart attacks. Never mind that lowering cholesterol reduces heart attacks. And never mind that smoking, though certainly not healthy, is far more prevalent in both Japan and France, where people enjoy far longer lifespans than the US—and that no one has ever bothered to consider the risks of the drugs used in smoking cessation programs.

Diet and Exercise?

That's not the whole story, of course. Lip service is given to issues of trans fats, obesity, and diet in general—but not a single mention is made of the importance of eating real foods. Instead, discussion is about packaged and prepared foods. That's hardly the way to a healthy diet!

In the New England Journal of Medicine announcement, there isn't a single mention of exercise as a heart disease preventive measure. Not one! How can a program that purports to be about reducing heart disease ignore exercise?

Half of Adult Americans Targeted

Forbes reports that 49.7%—about half—⁽²⁾of all US adults suffer from at least one of the four ABCSs. Therefore, the Million Hearts Initiative intends to assure that half of America's adults are monitored and drugged by doctors.

Obviously, both the New England Journal of Medicine and Forbes were involved in coordination of the Million Hearts Initiative announcment. Isn't it interesting that, of the two primary announcers for a health-related program, the focus of one is strictly on financial matters? That shouldn't be too surprising, because that's what this is all about. Money. Big money.

The thought of bringing half the adult population of the US into the medical system, where they will likely be stuck—since starting on drugs usually means adding more and more—is serious money. Doctors will benefit. Hospitals will benefit. Pharmacies will benefit. And Big Pharma will rake it in.

Supporters of Million Hearts

Walgreen's, a major pharmacy chain, has already come out in support of the Million Hearts Initiative. The American Pharmacy Association has partnered with Health and Human Services, the Centers for Disease Control, and the Centers for Medicare and Medicaid Services in the program. It should come as no surprise. Pharmacies and pharmacists stand to profit from the program hugely.

The False "Proof"

In the end, it's going to be important to demonstrate that the program has been successful. How's that going to happen? If there's any improvement in the number of people who suffer heart attacks, it will have little to do with the program. So how are they going to pull it off?

That, in fact, will be the easy part. Notice how the entire program is focused on ABCS? It isn't focused on measuring the number of heart attacks. Instead, it's aimed at getting people to take drugs for the purpose of changing physiological measurements. So, all they'll need to do is keep track of those measurements and the number of people who take the drugs.

Therefore, they'll demonstrate that more people are taking the prescribed drugs and that their measurements for blood pressure and cholesterol are lower. Then, they'll claim success. And if there are fewer heart attacks, there will be no consideration of whether deaths from other causes go up. (The fact is that deaths from all causes tend to increase with use of the recommended drugs.)

Will they track reduction in heart attacks? That point is already being avoided. Just take a look at the fact that the Forbes-reported 49.7% figure of people with ABCS factors was taken from 2007-2008. In 1999-2000, the figure of people with ABCS factors was 57.8%—indicating a decrease of 8.1% in ABCS factors in 8 years.

So, if these factors are already in decline, why is a massive program required?

Program to Increase Big Pharma Profits

It's hard to imagine that this is about anything other than assuring that more and more people are brought into the medical system. It isn't about health. If it were, then the focus would be on things that genuinely reduce heart attacks and improve health. There would be an effort to get away from factory farms. Genetically modified organisms would be banned. The source of foods would be labeled. People would not be losing access to health-producing products like raw milk, herbs, and vitamins. Pesticides and other poisons would be reasonably controlled.

The Million Hearts Initiative will not improve cardiovascular health. It will likely make it worse with the increased use of drugs. That, though, is just fine. It assures that people will be stuck on the medical system treadmill for the rest of their foreshortened lives.

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