Heart disease refers to conditions that affect the heart's functioning and blood flow to it. The most common type of heart disease is coronary artery disease (coronary heart disease).
Coronary artery disease occurs when the arteries that supply blood to the heart harden and narrow, a process called atherosclerosis. This results in less blood flow to the heart, and is the usual cause of heart attacks.
The good news is that much of this process can be prevented, and you can help.
Heart disease is the leading cause of death in Wisconsin. Together we can change that.
What You Can Do
Use these simple steps for heart health and wellness:
- Know your blood pressure numbers. To learn more about healthy and unhealthy blood pressure ranges, visit the American Heart Association's Understanding Blood Pressure Readings.
- Know your cholesterol levels. For more information about what cholesterol is and what your levels mean, visit Control Your Cholesterol.
- Understand your blood glucose (sugar) levels. Uncontrolled blood sugar levels can lead to type 2 diabetes and heart disease.
- Get active and eat better to maintain a healthy weight. Check out our index of public resources for tools, logs, and other materials that can help.
- Don't smoke, or get the help you need to quit. Visit the Wisconsin Tobacco Quit Line or call 800-QUIT-NOW (800-784-8669) to get free access to coaching and medication to help you quit.
When making lifestyle change, talk to your health care provider for support and guidance.
Self-management and self-measurement of blood pressure
Self-management programs can help you better manage chronic conditions like heart disease, improve quality of life, and even lower health care costs. The Wisconsin Institute for Healthy Aging offers Living Well with Chronic Conditions, a self-management program for individuals with high blood pressure, heart disease, as well as asthma, depression, and obesity. To find a program near you, visit the Wisconsin Institute for Healthy Aging website.
Self-measurement of blood pressure is the regular measurement of blood pressure by oneself outside of appointments with a clinical support from your provider, such as care navigator, community health worker, pharmacist, or other care team member. Self-measurement of blood pressure can be done at home or in the community. Monitoring your blood pressure is key to understanding your risks and maintaining a healthy lifestyle. Check with your health care provider, pharmacist, or local health department for locations to check your blood pressure at no cost. You can also purchase your own blood pressure monitor for home use, record measurements using a log, app, or tracker, and then share results with your health care provider. For more resources on self-measured blood pressure monitoring, visit the Million Hearts website.
The American Heart Association offers blood pressure logs and online trackers for personal use:
Health care and electronic health records
Be an active part in your own care. Before your medical visits, make a list of your medications, health history, and think about what problems are most important for you to discuss. And, if you don't understand something, ask questions. If possible, bring a family member or trusted friend along to your appointments for support and to take notes.
Some health systems provide their patients with online health portals that connect to electronic health records, and allow you to communicate with providers. If available, use it to track your goals, progress, and communicate with your care team.
If you take medication to treat high cholesterol, high blood pressure, or diabetes, follow your doctor's instructions carefully. Always ask questions if you don't understand something. Never stop taking your medication without talking to your doctor, nurse, or pharmacist.
What We Are Doing
The Chronic Disease Prevention Program partners with communities, health systems, health care providers, insurers, and professional organizations to improve heart disease prevention and management. Select a topic below to explore our current projects and partnerships.
Electronic health records, health information technology, and quality measures
Many health systems use electronic health records and health information technology to measure and track clinical quality measures. Our program promotes the adoption of standardized clinical quality measures to prevent and manage heart disease and related conditions, like high blood pressure and cholesterol. Additionally, we promote the adoption of these measures to improve monitoring of health and health care disparities among populations, and inform activities to eliminate them. Below are our current partnerships specific to these efforts:
- The Chronic Disease Quality Improvement Project is a partnership between health plans, health care providers, Wisconsin's Chronic Disease Prevention and Medicaid Programs, and the University of Wisconsin Population Health Institute. The project was established in 1998, with an initial focus on diabetes. Over the years, its scope expanded to include other chronic diseases and their risk factors. Members evaluate and report chronic disease prevention and health care quality measures. They also share information, population-based strategies, and evidence-based approaches to improve care. Check out our annual reports for this project:
- We partner with the Wisconsin Primary Healthcare Association to increase the number of Wisconsin's community health centers using Azara DRVS, a centralized data reporting system that leverages electronic health record data for population health management and quality improvement. We encourage provider-level quality improvement projects that use blood pressure and cholesterol control measures found in Azara DRVS. Currently, 12 of 18 community health centers are live on this system.
- The Wisconsin Collaborative for Health Care Quality publicly reports electronic health record-derived performance measures to drive health care quality improvement. Many measures focus on heart health, like blood pressure control, and appropriate use of statins to treat high cholesterol.
Team-based care is a strategy to enhance patient care by having two or more health care providers working collaboratively. It involves a multidisciplinary team collaboratively educating patients, identifying risk factors, prescribing and modifying treatments, and maintaining an ongoing dialogue with patients. Teams may include doctors, nurses, pharmacists, community health workers, and others. Evidence shows that team-based care can lead to significantly improved hypertension control, lowered blood pressure, and improvement medication adherence.
In 2016, we partnered with the Wisconsin Nurses Association to develop a Wisconsin model of patient-centered team-based care to drive health care transformation that moves toward value-based care, better patient health and safety, and improved population health. We are currently disseminating and assessing implementation of this model with the Wisconsin Heart Health Community of Practice. If you would like to connect with the Wisconsin Heart Health Community of Practice, contact Rebecca Cohen 608-261-7826.
Medication therapy management (MTM)
Medication therapy management (MTM) is a distinct service to ensure the best therapeutic outcomes for patients. It includes five core elements:
- Medication therapy review
- Personal medication record
- Medication-related action plan
- Intervention or referral
- Documentation and follow-up
MTM has been shown to lower blood pressure, cholesterol, and improve medication adherence. In Wisconsin, MTM is a covered benefit for Medicaid-eligible members. Eligible members receive a comprehensive medical review/assessment (CMR/A). We work closely with the Pharmacy Society of Wisconsin (PSW) and their Wisconsin Pharmacy Quality Collaborative (WPQC) program to engage pharmacists in the promotion of MTM and lifestyle modification. The Pharmacy Society of Wisconsin provides professional training, toolkits, and technical assistance to 250+ accredited pharmacies and nearly 500 certified pharmacists across Wisconsin.
Community health worker (CHW) infrastructure and sustainability
Community health workers (CHWs) are frontline, culturally competent, public health workers who serve as a bridge between underserved communities and healthcare systems. They are from, or have a close understanding of, the communities served. We support the advancement of a statewide community health worker network, training and apprenticeships, and engage with the Wisconsin Public Health Association's Community Health Worker Section. We also promote sustainability of care models for hypertension and cholesterol that engage CHWs. Collaborative partners include organizations utilizing the Pathways Community HUB model, like UniteMKE in Milwaukee and Great Rivers HUB in La Crosse.
Self-measured blood pressure monitoring
Self-measured blood pressure monitoring involves an individual's regular use of personal blood pressure monitoring devices to assess and record blood pressure across different points in time outside of a clinical setting. There is strong evidence that self-measured blood pressure monitoring with clinical support helps people with hypertension lower their blood pressure. Clinical support should occur before, during, and after a health care appointment, and may include instructing clients on how to measure their blood pressure with a home device, helping individuals with medication access and management, leading their own care, and emotional management. Services should consider individuals' perspectives and be tailored to their needs.
Along with the American Heart Association, we promote the use of Check. Change. Control., an evidence-based hypertension management program that utilizes self-measured blood pressure monitoring to empower patients in ownership of their cardiovascular health.
Cardiac rehabilitation is a program to improve health following a cardiac-related event or procedure. Optimal programs have 36 one-hour sessions that include team-based, supervised exercise training; education and skills development for healthy living; and counseling on stress and other psychosocial factors. Despite numerous benefits of cardiac rehabilitation, only 56% of Wisconsin adults who survived a heart attack report receiving cardiac rehabilitation. Our program reduces barriers to cardiac rehabilitation enrollment in order to meet the national Million Hearts 2022 goal of 70% participation for eligible patients.
Currently, we partner with community health workers through the Great Rivers HUB and Scenic Bluffs Community Health Centers in La Crosse, and Gerald L. Ignace Indian Health Center in Milwaukee to enhance referral, participation, and adherence to cardiac rehabilitation programs.
We also encourage using the Centers for Disease Control and Prevention's Cardiac Rehabilitation: Change Package for anyone interested in improving cardiac rehabilitation utilization and optimization.
- Cardiac Rehabilitation: Change Package: A quality improvement tool for hospitals and cardiac rehabilitation programs.
- CDC Million Hearts® Evidence-based Hypertension Treatment Protocols: Simple, evidence-based protocols can have a powerful impact on hypertension control.
- Hypertension Control: Change Package for Clinicians: A quality improvement tool for ambulatory clinics.
- Measure Up Pressure Down™: Provider Toolkit to Improve Hypertension Control: Useful tools, tips, and resources to jump-start hypertension quality improvement initiatives.
- Improving Hypertension Care and Outcomes: Wisconsin Collaborative for Healthcare Quality (registration required to download)
- MyHEART: Information & Resources for Young Adults with Hypertension: Resource developed by Dr. Heather Johnson from the University of Wisconsin-Madison to address the unmet need of educating young adults on hypertension.