Fighting America’s No. 1 killer
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American Heart Month offers a prime opportunity to assess where we stand and determine what can and needs to be done to beat back America’s No. 1 killer—heart disease. 

In its comprehensive study released just last year, the American Heart Association found that, if left unchecked, the number of Americans with cardiovascular disease (CVD) will rise to 131.9 million people by 2035—an astonishing 45 percent of the adult population.  This represents a dramatic increase from the last report, published in 2011, which estimated that 100 million Americans would suffer from CVD by 2030. 


Not only does CVD extract a devastating human toll, it is also the costliest disease in America, resulting in a $555 billion impact in 2015. It is estimated that, by 2035, the cost of heart disease will nearly double to $1.1 trillion. That cost is borne in no small part by the American taxpayer, with stroke and heart failure topping spending by Medicare Fee-For-Service. 

Raising Awareness and Dollars:

The Congressional Coalition on Heart and Stroke, which I co-founded in 1996, is working hard to raise awareness of the seriousness of cardiovascular diseases and to act as a resource center for heart and stroke issues, including research, quality and availability of care, health promotion and disease. The bipartisan, bicameral coalition, which I now co-chair with Rep. Joyce BeattyJoyce Birdson BeattyBen Carson sends Oreos to Democrat who quizzed him on REOs Ben Carson endures Dem grilling over minority inclusion office Dem rep says lower tax refunds are 'bad news' for the economy MORE (D-Ohio), continues to push for increased funding for critical programs at the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC). For Fiscal Year (FY) 2018, the Coalition requested: $3.4 billion dollars for the National Heart, Lung, and Blood Institute; $1.9 billion for the National Institute of Neurological Disorders and Stroke; and $36 billion for NIH overall.

On paper it looks like we’ve had some success, but more support is needed. Despite the $2 billion increases in funding for NIH in FY 2016 and in FY 2017, NIH’s purchasing power last year was almost 20 percent less than in FY 2003. We need to restore our purchasing power for NIH and capitalize on investments to improve health, and spur economic growth, innovation, and advances in science.

Our Coalition also advocates for funding of CDC’s Heart Disease and Stroke Prevention Program, which supports State Public Health Actions on Heart Disease and Stroke Prevention as well as efforts to prevent obesity and diabetes. And we continue to highlight the benefits of the CDC’s Million Hearts and WISEWOMAN (Well-Integrated Screening and Evaluation for Women across the Nation) programs which offer preventative health services, referrals to local health care providers, and lifestyle programs and health counseling tailored to identified risk factors which are unique to women.

The Bipartisan Budget Act, passed by Congress and signed into law on Feb. 9, 2018, offers new opportunities to reach these unmet needs. The $63 billion increase in non-defense spending for FY 2018, with an additional $14 billion increase on top of that in 2019, gives us room to fight for added funding to be directed toward our nation’s premiere medical research facility, the NIH. The Act also allows physician assistants to supervise cardiac and pulmonary rehabilitation under Medicare, a move which directly expands access to care.

Congress must ensure that increased funding caps translate into significant increases in NIH funding, and must continue to look for ways to expand access to care under Medicare and Medicaid.

The No. 1 killer of women:

While cardiovascular disease is often erroneously thought of as a man’s disease, it is the No. 1 cause of death among women in the U.S., and almost 415,000 women succumb to this disease annually. Nearly 27 years ago, I wrote an op-ed published in the Asbury Park Press entitled “Shutting women out: Misinformation is harming their medical care,” to underscore the shortcomings in federally-funded research that did not properly represent women in the study groups. As a result of these shortcomings, there is a lack of understanding about how cardiovascular disease presents differently in women, if diagnostic methods are effective in detecting CVD in women, and if women react similarly as men do to different therapeutic treatments. 

Research has improved since then, but the push for consistent, representative analysis is ongoing, since cardiovascular disease continues to uniquely impact women, particularly African-American women.

On Feb. 28, the American Heart Association and WomenHeart: The National Coalition for Women with Heart Disease, will be hosting a briefing entitled “African-American Women and Heart Diseases: A Guide to Staying Heart Healthy,” in coordination with the Congressional Heart and Stroke Coalition. I encourage those interested to join in the Rayburn House Office Building room 2075 from noon-1:00pm.

Those suffering from cardiovascular disease, as well as their loved ones and caregivers, need vocal advocates on Capitol Hill to ensure access to quality care and treatments and comprehensive research that does not overlook vulnerable populations. The life-saving work of researchers, medical professionals and advocacy groups across the nation, like the American Heart Association, underscore that if we are to effectively combat the leading cause of death among adults in the U.S., we must make combatting heart disease a priority not just this month, but every month of the year.

Smith has represented New Jersey’s 4th District since 1981. He is a co-founder and co-chair of the Congressional Coalition on Heart and Stroke.