The Council was
begun in 1978 as the Maine High Blood Pressure Council in response
to rising awareness that elevated blood pressure was a major risk
factor for heart disease. It was felt that a coordinated effort
could result in a significant reduction in uncontrolled hypertension
among the adult population of Maine. At that time, there were no
published guidelines for treatment of elevated blood pressure, few
efforts to screen for it, and little training for proper methods of
measurement or for calibration of measurement instruments. There
were few efforts to educate the public about this “silent killer”
which could be controlled through behavior changes and medication.
Formation of the
Council was led by a Portland based family physician, several
cardiologists and internists who were interested in the problem ,
the Maine Division of the American Heart Association and Medical
Care Development, which had been formed in 1966 to improve care in
Maine for heart disease, cancer and stroke. The founders of the
Council felt that better coordination of efforts, more public
education and professional training, guidelines which could be
adopted by all practitioners, and expanded detection and follow-up
could reduce the percentage of the adult population with
uncontrolled hypertension.
With funding from
the Maine Heart Association, a coordinator was employed part time in
1979. That same year, the National Heart, Lung and Blood Institute
(NHLBI) issued an RFP for states to organize demonstrations to test
whether improved coordination of high blood pressure control
resources could result in a major (33%) reduction in uncontrolled
hypertension and reduce mortality due to hypertensive diseases.
Maine’s proposal was prepared by the Council Coordinator and staff
at MCD and Maine was selected as one of seven states to participate
in this collaborative research project.
The State of Maine
contracted with Medical Care Development to implement the five year
project, which included a scientific survey of the adult population
in years one and five to determine the actual results of the
project. The MHBPC was expanded as the central coordinating body
for control activities. Council physicians developed some of the
first guidelines in the US for hypertension control and the
guidelines were introduced throughout the state to physicians and
hospitals by Council physician members. Training programs were
offered on blood pressure measurement, follow up and equipment
calibration. A public information campaign was initiated to raise
awareness of the problem. The results were spectacular! Maine was
one of three states, out of seven, which achieved the goal of a 33%
reduction in the rate of uncontrolled hypertension in the adult
population through improved coordination of resources. Through its
efforts, the MHBPC had demonstrated that it could serve as a
voluntary management structure for assuring that separate providers
and provider agencies could work together effectively toward a
common goal.
When the NHLBI
grant funding ended in 1985, the Council felt it was important to
continue to coordinate hypertension control activities. The Maine
Bureau of Health provided a small amount of funding and MCD provided
office space and administrative support. The Council Coordinator,
Lisa Miller, who had been the project director for the NHLBI
project, continued to provide part time support for several years.
In 1989, in recognition that other risk factors for heart disease
also needed to be addressed, the Council changed its name to The
Maine Cardiovascular Health Council.
In 1994, the
Council and the Bureau of Health jointly prepared and published the
first strategic plan for improving cardiovascular health in Maine -
“Cardiovascular Health in Maine: A Prescription for Prevention.”
By 1997, the Council Board recognized that there were many new
approaches to control and prevention of Cardiovascular Disease that
needed to be adopted widely in Maine. The Council and MCD organized
the first “Governor’s Summit on Cardiovascular Health.” This
Summit, which has been held each year since 1997, aims to present
information to Maine providers about the latest research on methods
for improving control of behavioral and biological risk factors and
reducing both the human and cost burdens of cardiovascular disease.
Subsequent to the 1997 Summit, a number of health plans, health
systems, private foundations and The Maine Medicaid program provided
funding for a new CVD Prevention initiative to improve health
systems and the prevention environment related to CVD in Maine.
From 1997 until 2001, this initiative provided
mini-grants and technical assistance for community prevention
projects; organized and supported ME Cares, a hospital-based
nurse-physician support system for patients with cardiovascular
disease and congestive heart failure; expanded training for
detection and counseling related to cardiovascular disease risk
factors; helped to publicize the problems of cardiovascular disease
in the Maine population; and produced a community guidebook to
assist new coalitions in developing strong prevention programs.
The Council
continued to offer hands-on training workshops to provide skills for
community screening programs. The workshops have offered blood
pressure training; nutrition, physical activity, smoking cessation
counseling techniques; and cholesterol information and screening
skills.
In the year 2000,
the Council assisted the Bureau of Health to secure major CDC
funding to improve Cardiovascular Health in Maine. Since this time,
the Council has served in an advisory role to the Maine
Cardiovascular Health Program, helping with updating strategic
plans, continuing to offer educational programs, and providing
several committees and work groups to guide the Maine program.
In 2005, MCHC
spearheaded the formation of a chronic care collaborative, now named
“Chronic Disease Partners of Maine.” This effort was in recognition
of the related efforts, possibly duplicative of the several disease
specific control efforts being carried out in Maine. Building on
the successful experience of the Council’s coordination activities
related to CVD, the expectation is that improved coordination of all
chronic disease prevention and control activities will result in
greater improvement in the health of Maine’s people.
