How to Reduce Heart Disease and Stroke

Section 2. What Other Countries Have Done to Lower the Cardiovascular Diseases Rate

Nippon (Japan)

Nippon implemented nationwide preventive health examinations coordinated by the Ministry of Health, Labour and Welfare . Adults aged 40–74 receive metabolic syndrome screening that includes blood pressure, lipid testing and diabetes risk evaluation. (www.mhlw.go.jp)

Local governments fund public fitness facilities, senior exercise classes and community walking programs designed to maintain cardiovascular fitness among aging populations.

The Japanese Society of Hypertension established strict national treatment guidelines which significantly improved hypertension control rates. (www.jpnsh.jp)

Hanguk (South Korea)

The National Health Insurance Service administers mandatory health screening programs that include cardiovascular risk assessment for nearly all adults. (www.nhis.or.kr)

The Hanguk Disease Control and Prevention Agency monitors national nutrition and risk factor data through continuous health surveys. (kdca.go.kr)

Tobacco taxation and strict smoke‑free legislation introduced by the Ministry of Health and Welfare significantly reduced smoking prevalence. (www.mohw.go.kr)

Schweiz (Switzerland)

The Federal Office of Public Health coordinates national cardiovascular prevention strategies and dietary guidelines. (www.bag.admin.ch)

Mandatory health insurance ensures access to preventive cardiology consultations and lipid testing.

The Schweiz Heart Foundation funds large public awareness campaigns about hypertension and physical activity. (www.swissheart.ch)

République française (France)

The French Ministry of Health promotes nutrition policy integrated with cardiovascular disease prevention. (sante.gouv.fr)

The Nutri‑Score labeling system encourages healthier food choices by grading packaged foods based on nutritional quality.

The French Federation of Cardiology organizes national heart screening campaigns. (www.fedecardio.org)

España (Spain)

The Spanish Ministry of Health promotes Mediterranean diet adherence through national nutrition education. (www.sanidad.gob.es)

The España Heart Foundation conducts cardiovascular risk awareness campaigns. (fundaciondelcorazon.com)

Urban planning policies encourage walking and cycling transportation.

Italia (Italy)

The Italia Ministry of Health coordinates national cardiovascular risk monitoring programs. (www.salute.gov.it)

The Italia National Institute of Health conducts surveillance of hypertension and cholesterol prevalence. (www.iss.it)

Primary care physicians routinely provide preventive cardiology counseling.

Australia

The Australian Department of Health manages the National Preventive Health Strategy. (www.health.gov.au)

The National Heart Foundation of Australia funds public education campaigns. (www.heartfoundation.org.au)

Australia implemented strict tobacco plain packaging laws which reduced smoking.

Singapore

The Ministry of Health Singapore oversees national cardiovascular prevention programs. (www.moh.gov.sg)

The Health Promotion Board operates workplace wellness initiatives and healthy food subsidies. (www.hpb.gov.sg)

Urban planning ensures accessible parks, fitness facilities and walkable communities.

Section 3 What the U.S. Could Do to Reduce Cardiovascular Diseases

Create a nationwide cardiovascular screening program coordinated by the Department of Health and Human Services targeting early detection of hypertension and cholesterol disorders.

Require health insurers to fully cover preventive cardiology visits and nutrition counseling.

Provide federal grants for local governments to build walking and cycling infrastructure.

Implement national sodium reduction targets for food manufacturers.

Expand public education campaigns about heart disease risk factors through the Centers for Disease Control and Prevention.

Fund large scale hypertension detection programs in community clinics.

Subsidize fruits and vegetables through agricultural policy to encourage healthier diets.

Require front‑of‑package nutrition labeling for processed foods.

Expand Medicare coverage for cardiac rehabilitation services.

Create workplace wellness incentives encouraging employee health screenings.

Increase tobacco taxes to further reduce smoking prevalence.

Strengthen smoke‑free public space laws nationwide.

Provide grants for grocery stores in underserved communities.

Expand telehealth services for cardiovascular monitoring.

Fund national physical activity campaigns encouraging daily exercise.

Improve access to primary care physicians in rural areas.

Create federal research initiatives targeting cardiovascular disease prevention.

Require schools to provide heart‑healthy nutrition education.

Establish national cholesterol monitoring programs.

Provide tax incentives for companies producing healthier food products.

Fund community health worker programs addressing cardiovascular risk.

Develop digital monitoring tools for high‑risk patients.

Promote healthy school meal standards nationwide.

Increase funding for urban park and recreation infrastructure.

Encourage city planning that prioritizes walkable neighborhoods.

Support early diabetes detection programs.

Improve cardiovascular data collection systems across states.

Promote employer supported fitness programs.

Support national obesity reduction initiatives.

Encourage collaboration between healthcare providers and community organizations.

Section 3A: What the U.S. Government, Corporations, Organizations and Individuals Could Do to Decrease Its Cardiovascular Disease

Cardiovascular disease (CVD) remains the leading cause of death in the United States, claiming more than 900,000 lives each year and costing the nation hundreds of billions of dollars in healthcare expenditures and lost productivity. Yet experts agree that up to 80 percent of premature heart attacks and strokes are preventable. Achieving meaningful reductions in CVD requires a coordinated, multi-sector strategy—spanning federal and state government agencies, elected officials, corporations, healthcare providers, and individual citizens. The following sections outline specific, evidence-based actions each stakeholder group could take.

3.1 General National Strategies

A comprehensive national strategy to reduce cardiovascular disease could address the full spectrum of risk factors—from unhealthy diet and physical inactivity to tobacco use, high blood pressure, elevated cholesterol, obesity, diabetes, stress, and inadequate access to preventive care.

Effective approaches integrate primary prevention (keeping healthy people healthy), secondary prevention (managing risk factors before disease develops), and tertiary prevention (treating existing disease to prevent recurrence). The following high-level priorities guide all subsequent sector-specific recommendations:

Establish and fund a National Cardiovascular Disease Prevention Initiative with clear, measurable 10-year targets.

Prioritize health equity by targeting interventions in communities disproportionately burdened by CVD, including Black, Hispanic, Native American, and low-income populations.

Embed cardiovascular health into all relevant public policies—food, transportation, housing, education, labor, and environment.

Expand research funding for prevention, early detection, and novel therapeutics.

Leverage technology—telehealth, wearables, and AI-assisted diagnostics—to extend the reach of preventive cardiovascular care.

3.2 Government Agencies

Federal and state agencies hold extraordinary regulatory, funding, and convening power. They could use each lever deliberately.

Centers for Disease Control and Prevention (CDC)

Expand the Million Hearts® initiative with dedicated funding to prevent one million additional heart attacks and strokes per decade.

Strengthen the WISEWOMAN program to provide CVD screening, lifestyle counseling, and referrals to low-income women nationwide.

Fund community health worker programs in high-burden ZIP codes to assist patients with medication adherence, diet coaching, and follow-up care.

Maintain and improve national CVD surveillance systems to track progress and identify emerging disparities in real time.

National Institutes of Health (NIH)

Double the National Heart, Lung, and Blood Institute (NHLBI) budget for population-level prevention research.

Fund large-scale clinical trials on dietary patterns, exercise prescriptions, and innovative pharmacological approaches.

Invest in health disparities research to understand and eliminate racial and socioeconomic gaps in cardiovascular outcomes.

Food and Drug Administration (FDA)

Finalize and enforce mandatory sodium reduction targets for commercially processed and restaurant foods.

Require front-of-package nutrition labeling with clear heart-health ratings to help consumers make informed choices.

Accelerate approval pathways for novel cardiovascular therapies while ensuring rigorous safety standards.

Strengthen regulation of tobacco and nicotine products, including e-cigarettes, which raise cardiovascular risk.

U.S. Department of Agriculture (USDA)

Align the Dietary Guidelines for Americans more closely with cardiovascular evidence, emphasizing plant-based foods, whole grains, and healthy fats.

Reform the National School Lunch and Breakfast Programs to prioritize heart-healthy meals and reduce saturated fat and sodium.

Expand SNAP incentives (such as Double Up Food Bucks) that enable low-income families to purchase fresh fruits and vegetables.

Centers for Medicare & Medicaid Services (CMS)

Mandate coverage of comprehensive cardiovascular risk screening and preventive counseling under Medicare and Medicaid without cost-sharing.

Reimburse cardiac rehabilitation and medically supervised lifestyle programs at rates that incentivize provider participation.

Implement value-based payment models that reward primary care providers for achieving population-level blood pressure, cholesterol, and blood sugar goals.

Environmental Protection Agency (EPA)

Enforce and tighten ambient air quality standards for particulate matter and ozone, both of which increase cardiovascular mortality.

Accelerate the transition to clean energy and electric vehicles to reduce cardiovascular harm from fossil fuel combustion.

Department of Transportation (DOT) and Housing and Urban Development (HUD)

Invest in pedestrian infrastructure, protected bike lanes, and transit-oriented development so that physical activity is built into daily routines.

Site affordable housing near parks, grocery stores, and healthcare facilities to create heart-healthy built environments.

State and Local Health Departments

Implement tobacco-free policies, clean indoor air ordinances, and tobacco tax increases proven to reduce smoking rates.

Create and fund local Heart Disease and Stroke Prevention coalitions that unite clinicians, community organizations, employers, and schools.

Deploy mobile health units to perform blood pressure and cholesterol screening in underserved communities.

3.3 Elected Government Officials

Legislators and executives at every level of government set budgetary, regulatory, and policy priorities. Their leadership is indispensable.

Congress

Pass legislation establishing a robust, fully funded National Cardiovascular Disease Prevention and Control Program with accountability metrics.

Enact meaningful prescription drug price reform to ensure statins, antihypertensives, diabetes medications, and blood thinners are affordable for all Americans.

Reauthorize and substantially increase funding for the Prevention and Public Health Fund to support evidence-based CVD interventions.

Convene bipartisan hearings on the social and commercial determinants of cardiovascular health—food marketing, tobacco lobbying, and urban planning—to inform comprehensive legislation.

The President and Executive Branch

Issue executive directives establishing heart health as a national priority and directing all relevant federal departments to integrate CVD prevention into their strategic plans.

Appoint a White House Cardiovascular Health Coordinator to align efforts across HHS, USDA, DOT, HUD, EPA, and the Department of Education.

Use the bully pulpit to champion healthy lifestyle choices, early screening, and adherence to evidence-based medical care.

State Governors and Legislators

Expand Medicaid in non-expansion states to extend coverage—and thus access to preventive cardiovascular care—to millions of uninsured adults.

Enact comprehensive tobacco control laws including flavored tobacco bans and increased cigarette taxes.

Fund physical education requirements in K-12 schools and safe, accessible parks and recreational facilities in all communities.

Local Mayors and City Councils

Adopt and enforce zoning regulations that limit fast food outlets and tobacco retailers near schools, while encouraging farmers' markets and green spaces.

Invest in complete streets policies to make walking and cycling safe for residents of all ages and abilities.

Eliminate food deserts by incentivizing full-service grocery stores to locate in underserved neighborhoods.

3.4 Corporations and the Private Sector

Businesses shape what Americans eat, how they move, and how they manage stress—making corporate action essential to any national CVD reduction effort.

Food and Beverage Industry

Voluntarily reduce sodium, trans fat, saturated fat, and added sugar in all packaged and restaurant food products, with independently verified annual benchmarks.

Adopt simple, transparent front-of-package nutrition labeling—such as traffic light or star rating systems—on all products.

Eliminate deceptive health claims on products high in saturated fat, sodium, or added sugar.

Invest in research and development of affordable, healthy food products that compete favorably in taste and price with less nutritious options.

Halt marketing of ultra-processed foods to children and adolescents across all media platforms.

Employers and Large Businesses

Offer comprehensive workplace wellness programs with incentives for employees to complete cardiovascular screenings, participate in exercise programs, and achieve measurable health goals.

Provide all employees—including part-time and gig workers—with health insurance that covers preventive cardiovascular services without cost-sharing.

Create smoke-free and tobacco-free campuses and offer free evidence-based smoking cessation programs.

Redesign workplace cafeterias and vending machines to make the healthy choice the easy and affordable choice.

Address occupational stress—a significant cardiovascular risk factor—through flexible scheduling, mental health support, and reasonable workload standards.

Healthcare Corporations and Insurance Companies

Hospital systems could implement evidence-based hypertension management protocols and measure, report, and publicly disclose blood pressure control rates.

Pharmacy chains could expand pharmacist-led blood pressure monitoring, medication therapy management, and health counseling in underserved communities.

Insurers could eliminate prior authorization barriers for guideline-recommended cardiovascular medications and procedures.

Health technology companies could develop and deploy FDA-cleared cardiovascular monitoring tools accessible to low-income populations, not just affluent early adopters.

Technology and Media Companies

Refrain from targeting unhealthy food and tobacco advertising to vulnerable populations through algorithmic ad placement.

Partner with health agencies to disseminate accurate, culturally competent cardiovascular health information across social and digital platforms.

Develop features in consumer health apps and wearables that actively promote blood pressure tracking, physical activity, stress management, and medication reminders.

3.5 Healthcare Providers and Professional Organizations

Primary care physicians could screen all adult patients for cardiovascular risk factors at every visit and follow evidence-based treatment guidelines for hypertension, dyslipidemia, and diabetes.

Cardiologists and specialists could collaborate with primary care on team-based, coordinated cardiovascular care models that improve access in rural and underserved areas.

Medical schools and nursing programs could dramatically expand training in lifestyle medicine, health equity, and cardiovascular prevention.

The American Heart Association, American College of Cardiology, and allied organizations could develop and widely disseminate updated guidelines, quality metrics, and public education campaigns.

Dietitians, exercise physiologists, and mental health professionals could be fully integrated into cardiovascular care teams and reimbursed appropriately.

3.6 Private Individuals and Families

While systemic change is essential, individual behavior remains a powerful determinant of cardiovascular health. Each person can take meaningful steps:

Diet and Nutrition

Adopt a heart-healthy dietary pattern—such as the Mediterranean, DASH, or whole-food plant-based diet—emphasizing vegetables, fruits, legumes, whole grains, fish, and healthy fats while minimizing processed foods, red and processed meats, refined carbohydrates, and excess sodium.

Cook at home more often and read nutrition labels to limit saturated fat, trans fat, sodium, and added sugar.

Maintain a healthy body weight; even modest weight loss of 5 to 10 percent significantly reduces blood pressure, cholesterol, and blood sugar.

Physical Activity

Aim for at least 150 minutes per week of moderate-intensity aerobic exercise (brisk walking, cycling, swimming) or 75 minutes of vigorous activity, plus muscle-strengthening activities on two or more days per week.

Reduce prolonged sitting by taking movement breaks every 30 to 60 minutes throughout the workday.

Engage children and family members in active recreation—hiking, sports, dancing—to establish lifelong habits.

Risk Factor Management

Know your numbers: blood pressure, total cholesterol, LDL, HDL, triglycerides, fasting blood glucose, and body mass index. Schedule regular check-ups and act on results.

Quit tobacco in all forms. Seek support through quitlines, behavioral counseling, and pharmacotherapy—all proven to increase cessation rates.

Limit alcohol to no more than one drink per day for women and two for men; reducing alcohol lowers blood pressure and cardiac arrhythmia risk.

Prioritize seven to nine hours of quality sleep per night; sleep deprivation is an independent cardiovascular risk factor.

Practice evidence-based stress reduction—mindfulness meditation, yoga, deep breathing, and social connection—to lower cortisol and sympathetic nervous system overactivity.

Take prescribed cardiovascular medications consistently and discuss any side effects or concerns openly with your healthcare provider rather than stopping medication unilaterally.

Community Engagement

Advocate for policies that create heart-healthy environments—safe parks, walkable streets, affordable healthy food, and clean air—in your community and through your elected representatives.

Learn Hands-Only CPR and how to use an automated external defibrillator (AED) to save lives during cardiac emergencies.

Share credible health information with family, friends, and social networks to amplify the reach of evidence-based cardiovascular guidance.

3.7 Schools and Educational Institutions

Incorporate cardiovascular health education—nutrition literacy, the benefits of physical activity, the harms of tobacco and substance use, and stress management—into K-12 curricula.

Ensure daily physical education that meets national standards and provide students with safe spaces for unstructured active play.

Serve nutritious, low-sodium, heart-healthy meals in school cafeterias and eliminate sugar-sweetened beverages from school vending and meal programs.

Universities and medical schools could train the next generation of clinicians with a strong foundation in preventive cardiology, lifestyle medicine, and health equity.

3.8 Faith-Based and Community Organizations

Faith communities that reach millions of Americans every week can host blood pressure clinics, promote health screenings, and deliver culturally relevant cardiovascular education programs.

Community organizations and nonprofits could partner with health departments to connect high-risk individuals to care, support medication adherence, and reduce social isolation—a significant CVD risk factor.

Philanthropic foundations could fund innovative, community-led cardiovascular prevention pilots in underserved and rural areas, with rigorous evaluation and scaling of what works.

Section 4. References

World Health Organization Cardiovascular Disease Program (www.who.int)

Centers for Disease Control and Prevention (www.cdc.gov)

National Institutes of Health National Heart Lung and Blood Institute (www.nhlbi.nih.gov)

American Heart Association (www.heart.org)

Organisation for Economic Co-operation and Development (OECD) Health Policy Studies (www.oecd.org)

Section 5: U.S. Organizations Advocating to Improve Heart Disease and Stroke

Section 6: Individuals Advocating to Improve Heart Disease and Stroke

Frequently Asked Questions

How does the US cardiovascular disease rate compare to other countries?

The US has a cardiovascular mortality rate of approximately 210 deaths per 100,000 people annually and does not rank among the top 35 countries with the lowest cardiovascular disease rates. Major contributing factors include high obesity prevalence, sedentary lifestyles, high sodium consumption, and unequal healthcare access.

What has Japan done to successfully lower its cardiovascular disease rate?

Japan implemented nationwide metabolic syndrome screenings for adults aged 40–74 through its Ministry of Health, Labour and Welfare, covering blood pressure, lipid, and diabetes risk evaluations. Local governments also fund public fitness facilities, senior exercise classes, and community walking programs to support heart health.

How has South Korea reduced cardiovascular disease among its population?

South Korea's National Health Insurance Service administers mandatory health screenings with cardiovascular risk assessments for nearly all adults. The government also reduced smoking rates significantly through tobacco taxation and strict smoke-free legislation.

What food labeling policies have helped other countries lower heart disease rates?

France introduced the Nutri-Score labeling system, which grades packaged foods by nutritional quality to encourage healthier consumer choices. This nutrition policy is integrated directly into France's broader cardiovascular disease prevention strategy.

What role can US corporations and private sector organizations play in reducing heart disease?

Corporations can implement workplace wellness programs, reduce sodium and unhealthy fats in food products, and expand access to preventive health screenings for employees. Private sector engagement in nutrition labeling reform and physical activity initiatives can also significantly reduce population-wide cardiovascular risk.

What steps can individual Americans take to lower their risk of heart disease and stroke?

Individuals can reduce risk by adopting heart-healthy diets low in sodium and saturated fats, engaging in regular physical activity, quitting smoking, and managing conditions like hypertension and diabetes with medical guidance. Routine health screenings to catch early warning signs are also critically important.

About the Author

Ronald Bonfilio has devoted his career to public service spanning more than five decades. His service began with the U.S. Army from 1966 to 1968, where he conducted medical laboratory research at Fort Detrick and at the Walter Reed Army Institute of Research. He subsequently held a distinguished series of federal positions, including roles with the National Cancer Institute, the National Institutes of Health, the U.S. Agency for International Development (Vietnam), the Special Inspector General for Iraq Reconstruction, and the U.S. State Department (Iraq), where he served as a Senior Economic Advisor and Agricultural Advisor. He also served 15 years with the U.S. Government Accountability Office as a Program Analyst and Auditor.

Ronald Bonfilio holds a degree in Economics from the University of Maryland, and degrees in Chemistry and a Master of Business Administration from the University of Massachusetts. He is a former Certified Public Accountant.