Indicator Definitions: Priority Indicators
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Million Hearts®
Prevalence of acute myocardial infarction (heart attack) among US adults (18+); BRFSS
Measure: Self-report: “Has a doctor, nurse, or other health professional ever told you that you had a heart attack, also called myocardial infarction?” Numerator: Adults (18+) who answered “yes” to the question: “Has a doctor, nurse, or other health professional ever told you that you had a heart attack, also called myocardial infarction?” Denominator: Adults (18+) who answered “yes” or “no” to the question: “Has a doctor, nurse, or other health professional ever told you that you had a heart attack, also called myocardial infarction?”
Data Source: Behavioral Risk Factor Surveillance System; Centers for Disease Control and Prevention (BRFSS)
Prevalence of stroke among US adults (18+); BRFSS
Measure: Self-report: “Has a doctor, nurse, or other health professional ever told you that you had a stroke?” Numerator: Adults (18+) who answered “yes” to the question “Has a doctor, nurse, or other health professional ever told you that you had a stroke?” Denominator: Adults (18+) who answered “yes” or “no” to the question “Has a doctor, nurse, or other health professional ever told you that you had a stroke?”
Data Source: Behavioral Risk Factor Surveillance System; Centers for Disease Control and Prevention (BRFSS)
Million Hearts Cardiovascular event rates among US adults (18+); HCUP/NVSS
Measure: Million Hearts cardiovascular events (ICD-10: I21, I63, I60-I61, I6789, I200, I24, I201, I208, I209, G450-G452, G458-G462, I67841, I67848, I50, I110, I130, I7102, I713, I75, I70, I739, I10, I119, I129, I1310, I46). Numerator: Number of adults (18+) with Million Hearts® events hospitalizations or deaths. Denominator: U.S. Adults (18+) / 100,000
Data Source: Healthcare Cost and Utilization Project; Nationwide Inpatient Sample (HCUP)
Acute Myocardial Infarction (heart attack) hospitalization rate among US adults (18+); HCUP-NIS
Measure: In-patient hospitalizations with a primary diagnosis of myocardial infarction (heart attack; ICD-10: I21-I22). Numerator: Number of adult (18+) hospitalizations with myocardial infarction (heart attack) as the primary diagnosis. Denominator: U.S. Adults (18+) / 100,000
Data Source: Healthcare Cost and Utilization Project; Nationwide Inpatient Sample (HCUP)
Cerebrovascular disease hospitalization rate among US adults (18+); HCUP-NIS
Measure: In-patient hospitalizations with a primary diagnosis of cerebrovascular disease (stroke; ICD-10: I60-I69). Numerator: Number of adult (18+) hospitalizations with cerebrovascular disease (stroke) as the primary diagnosis. Denominator: U.S. Adults (18+) / 100,000
Data Source: Healthcare Cost and Utilization Project; Nationwide Inpatient Sample (HCUP)
Prevalence of acute myocardial infarction (heart attack) among US adults (20+); NHANES
Measure: Self-report: “Has a doctor or other health professional ever told you that you had a heart attack (also called myocardial infarction)?” Numerator: Adults (20+) who answered “yes” to the question “Has a doctor or other health professional ever told you that you had a heart attack (also called myocardial infarction)?” Denominator: Adults (20+) who answered “yes” or “no” to the question “Has a doctor or other health professional ever told you that you had a heart attack (also called myocardial infarction)?”
Prevalence of stroke among US adults (20+); NHANES
Measure: Self-report: “Has a doctor or other health professional ever told you that you had a stroke?” Numerator: Adults (20+) who answered “yes” to the question “Has a doctor or other health professional ever told you that you had a stroke?” Denominator: Adults (20+) who answered “yes” or “no” to the question “Has a doctor or other health professional ever told you that you had a stroke?”
Prevalence of blood pressure control among US adults (18+) with hypertension (BP ≥130/90); NHANES
Measure: Measured blood pressure: based on the average of up to 3 measurements taken during the MEC examination. Numerator: Non-pregnant adults (18+) with an average systolic BP<130 mmHg and an average diastolic BP <80 mmHg. Denominator: Non-pregnant adults (18+) with hypertension, defined as an average systolic BP>=130 mmHg, an average diastolic BP >=80 mmHg, or self-reported current use of BP-lowering medication.
Prevalence of statin use among US adults (20+) for whom statin therapy is recommended; NHANES
Measure: Statin use as identified in the prescription medication data files. Statin therapy recommendations as described in:Grundy SM, Stone NJ, Bailey AL, Beam C, Birtcher KK, Blumenthal RS, Braun LT, de Ferranti S, Faiella-Tommasino J, Forman DE, Goldberg R, Heidenreich PA, Hlatky MA, Jones DW, Lloyd-Jones D, Lopez-Pajares N, Ndumele CE, Orringer CE, Peralta CA, Saseen JJ, Smith SC Jr, Sperling L, Virani SS, Yeboah J. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019 Jun 18;139(25):e1082-e1143. doi: 10.1161/CIR.0000000000000625. Epub 2018 Nov 10. Erratum in: Circulation. 2019 Jun 18;139(25):e1182-e1186. PMID: 30586774; PMCID: PMC7403606. Numerator: Non-pregnant adults (20+) who are currently taking a statin. Denominator: Non-pregnant adults (20+) for whom statin therapy is recommended to manage their cholesterol.
Statin therapy is recommended for the following risk groups: 1) History of clinical ASCVD; 2) Severe hypercholesterolemia (LDL-c >=190 mg/dL); 3) Diabetes; 4) 10-year ASCVD risk >=20% or or ASCVD risk 7.5% -<20% with ASCVD Risk enhancers
Prevalence of acute myocardial infarction (heart attack) among US adults (18+); NHIS
Measure: Self-report: “Has a doctor or other health professional ever told you that you had a heart attack (also called myocardial infarction)?” Numerator: Adults (18+) who answered “yes” to the question “Has a doctor or other health professional ever told you that you had a heart attack (also called myocardial infarction)?” Denominator: Adults (18+) who answered “yes” or “no” to the question “Has a doctor or other health professional ever told you that you had a heart attack (also called myocardial infarction)?”
Prevalence of stroke among US adults (18+); NHIS
Measure: Self-report: “Has a doctor or other health professional ever told you that you had a stroke?” Numerator: Adults (18+) who answered “yes” to the question “Has a doctor or other health professional ever told you that you had a stroke?” Denominator: Adults (18+) who answered “yes” or “no” to the question “Has a doctor or other health professional ever told you that you had a stroke?”
Healthy People 2030
Prevalence of post-hospitalization rehabilitation among heart attack patients, US adults (18+); BRFSS
Measure: Self-report: “Following your heart attack, did you go to any kind of outpatient rehabilitation? This is sometimes called ‘rehab’.” Numerator: Adults (18+) who answered “yes” to the question “Following your heart attack, did you go to any kind of outpatient rehabilitation?” Denominator: Adults (18+) who had ever been told they had a heart attack/myocardial infarction and answered “yes” or “no” to the question “Following your heart attack, did you go to any kind of outpatient rehabilitation?”
Data Source: Behavioral Risk Factor Surveillance System; Centers for Disease Control and Prevention (BRFSS)
Prevalence of hypertension among US adults (18+); BRFSS
Measure: Self-report: “Have you ever been told by a doctor, nurse, or other health professional that you have high blood pressure? (If “Yes” and respondent is female, “Was this only when you were pregnant?”). Excludes gestational hypertension. Numerator: Adults (18+) who answered “yes” to the question “”Have you ever been told by a doctor, nurse, or other health professional that you have high blood pressure?” Excludes women who reported gestational hypertension only. Denominator: Adults (18+) who answered “yes” or “no” to the question “”Have you ever been told by a doctor, nurse, or other health professional that you have high blood pressure?”
Data Source: Behavioral Risk Factor Surveillance System; Centers for Disease Control and Prevention (BRFSS)
Prevalence of hypertension medication use among US adults (18+) with hypertension; BRFSS
Measure: Self-report: “Are you currently taking medicine for your high blood pressure?” Excludes gestational hypertension. Numerator: Adults (18+) who answered “yes” to the question “Are you currently taking medicine for your high blood pressure?” Denominator: Adults (18+) who answered “yes” to the question “”Have you ever been told by a doctor, nurse, or other health professional that you have high blood pressure?” Excludes women who reported gestational hypertension only.
Data Source: Behavioral Risk Factor Surveillance System; Centers for Disease Control and Prevention (BRFSS)
Prevalence of cholesterol screening in the past 5 years among US adults (20+); BRFSS
Measure: Self-report: “Blood cholesterol is a fatty substance found in the blood. Have you EVER had your blood cholesterol checked?” and “About how long has it been since you last had your blood cholesterol checked?”. Numerator: Adults (20+) who reported having had their cholesterol checked within the past year, within the past 2 years, or within the past 5 years. Denominator: Adults (20+) who had and had not had their cholesterol checked within the past 5 years. Excludes unknowns and refusals.
Data Source: Behavioral Risk Factor Surveillance System; Centers for Disease Control and Prevention (BRFSS)
Prevalence of high total cholesterol among US adults (20+); BRFSS
Measure: Self-report: “Blood cholesterol is a fatty substance found in the blood. Have you EVER had your blood cholesterol checked?” and “Have you ever been told by a doctor, nurse or other health professional that your blood cholesterol is high?” Numerator: Adults (20+) who answered “yes” to the question “Have you ever been told by a doctor, nurse or other health professional that your blood cholesterol is high?” Denominator: Adults (20+) who answered “yes” to the question “Blood cholesterol is a fatty substance found in the blood. Have you EVER had your blood cholesterol checked?” and answered “yes” or “no” to the question “Have you ever been told by a doctor, nurse or other health professional that your blood cholesterol is high?”
Data Source: Behavioral Risk Factor Surveillance System; Centers for Disease Control and Prevention (BRFSS)
Prevalence of physical inactivity among US adults (18+); BRFSS
Measure: Self-report: “During the past month, other than your regular job, did you participate in any physical activities or exercises such as running, calisthenics, golf, gardening, or walking for exercise?” Numerator: Adults (18+) who answered “no” to the question “During the past month, other than your regular job, did you participate in any physical activities or exercises such as running, calisthenics, golf, gardening, or walking for exercise?” Denominator: Adults (18+) who answered “yes” or “no” to the question “During the past month, other than your
regular job, did you participate in any physical activities or exercises such as running, calisthenics, golf, gardening, or walking for exercise?”
Data Source: Behavioral Risk Factor Surveillance System; Centers for Disease Control and Prevention (BRFSS)
Prevalence of obesity among US adults (20+); BRFSS
Measure: Self-reported weight and height: “About how much do you weigh without shoes?” and “About how tall are you without shoes?” Body mass index (BMI) = [weight (kg) / height (m)^2] Numerator: Non-pregnant adults (20+) with a calculated body mass index (BMI) >=30.0. Denominator: Non-pregnant adults (20+) with complete weight and height data and self-reported weight <500 lbs. Excludes unknowns and refusals.
Data Source: Behavioral Risk Factor Surveillance System; Centers for Disease Control and Prevention (BRFSS)
Heart failure hospitalization rate among US adults (18+); HCUP-NIS
Measure: In-patient hospitalizations with a primary diagnosis of heart failure (ICD-10: I50). Numerator: Number of adult (18+) hospitalizations with heart failure as the primary diagnosis. Denominator: U.S. Adults (18+) / 100,000
Data Source: Healthcare Cost and Utilization Project; Nationwide Inpatient Sample (HCUP)
Prevalence of hypertension (BP ≥140/90) among US adults (18+); NHANES
Measure: Measured blood pressure: based on the average of up to 3 measurements taken during the MEC examination. Self-report: “Because of your (high blood pressure/hypertension), have you ever been told to take prescribed medicine?” and “Are you now taking prescribed medicine?” Numerator: Non-pregnant adults (18+) with an average systolic BP>=140 mmHg, an average diastolic BP >=90 mmHg, or self-reported current use of BP-lowering medication. Denominator: Non-pregnant adults (18+) with at least 1 complete BP measurement and self-reported BP-lowering medication use information.
Prevalence of blood pressure control among US adults (18+) with hypertension (BP ≥140/90); NHANES
Measure: Measured blood pressure: based on the average of up to 3 measurements taken during the MEC examination. Numerator: Non-pregnant adults (18+) with an average systolic BP<140 mmHg and an average diastolic BP <90 mmHg. Denominator: Non-pregnant adults (18+) with hypertension, defined as an average systolic BP>=140 mmHg, an average diastolic BP >=90 mmHg, or self-reported current use of BP-lowering medication.
Mean serum total cholesterol among US adults (20+); NHANES
Measure: Serum total cholesterol (mg/dL) Numerator: Mean serum total cholesterol (mg/dL) Denominator: Non-pregnant adults (20+) with complete serum total cholesterol.
Prevalence of obesity among US adults (20+); NHANES
Measure: Measured weight and height: Body mass index (BMI) = [weight (kg) / height (m)^2] Numerator: Non-pregnant adults (20+) with body mass index (BMI) >=30.0. Denominator: Non-pregnant adults (20+) with complete weight and height data.
Prevalence of obesity among US children/adolescents (2-19); NHANES
Measure: Measured weight and height: Body mass index (BMI) = [weight (kg) / height (m)^2] Numerator: Children/adolescents (2-19) with body mass index (BMI) >= sex/height specific 95th percentile Denominator: children/adolescents (2-19) with complete weight and height data.
Mean dietary sodium intake (mg/day) among US adults (18+); NHANES
Measure: Total dietary sodium intake (mg/day), based on the day 1 24-hour deitary recall. Numerator: Mean total dietary sodium intake (mg/day) Denominator: Adults (18+) with a complete and reliable day 1 24-hour dietary recall.
Mean dietary sodium intake among US children/adolescents (2-17); NHANES
Measure: Total dietary sodium intake (mg/day), based on the day 1 24-hour deitary recall. Numerator: Mean total dietary sodium intake (mg/day) Denominator: Children/adolescents (2-17) with a complete and reliable day 1 24-hour dietary recall.
Prevalence of current smoking among adults (18+); NHIS
Measure: Self-report: “Do you NOW smoke cigarettes every day, some days or not at all?” Numerator: Adults (18+) who answered, “every day” or “some days” to the question: “Do you NOW smoke cigarettes every day, some days or not at all?” Denominator: Adults (18+) who answered, “every day,” “some days,” or “not at all” to the question: “Do you NOW smoke cigarettes every day, some days or not at all?”
Prevalence of physical inactivity among US adults (18+); NHIS
Measure: Self-report: “How often do you do MODERATE-INTENSITY LEISURE-TIME physical activities?”; “How often do you do VIGOROUS-INTENSITY LEISURE-TIME physical activities?”; “How often do you do LEISURETIME physical activities specifically designed to STRENGTHEN your muscles such as sit-ups, push-ups, or lifting weights?” Numerator: Adults (18+) who answered none or “unable to do activity” to the questions: “How often do you do MODERATE-INTENSITY LEISURE-TIME physical activities?”; “How often do you do VIGOROUS-INTENSITY LEISURE-TIME physical activities?”; “How often do you do LEISURETIME physical activities specifically designed to STRENGTHEN your muscles such as sit-ups, push-ups, or lifting weights?” Denominator: Adults (18+) who answered a range of values or “unable to do activity” to any of the questions: “How often do you do MODERATE-INTENSITY LEISURE-TIME physical activities?”; “How often do you do VIGOROUS-INTENSITY LEISURE-TIME physical activities?”; “How often do you do LEISURETIME physical activities specifically designed to STRENGTHEN your muscles such as sit-ups, push-ups, or lifting weights?”
Rate of coronary heart disease mortality among US adults (18+); NVSS
Measure: Mortality rate from coronary heart disease as the underlying cause of death (ICD-10: I20-I25) among US adults (18+) Numerator: Number of adults (18+) who died with coronary heart disease listed as the underlying cause of death. Denominator: Number of adults (18+) / 100,000.
Rate of cerebrovascular disease (stroke) mortality among US adults (18+); NVSS
Measure: Mortality rate from cerebrovascular disease (stroke) as the underlying cause of death (ICD-10: I60-I69) among US adults (18+) Numerator: Number of adults (18+) who died with cerebrovascular disease (stroke) listed as the underlying cause of death. Denominator: Number of adults (18+) / 100,000.
