ucm_305449_sized.jpg The number-one killer of Americans each year isn't cancer or car crashes--it's heart disease. The most recent report from the American Heart Association found that heart disease accounts for more than one-third of annual deaths in the U.S. Another 33.5 percent of Americans live with hypertension, a major risk factor for more serious health risks.

Nancy Brown, the AHA's chief executive officer, has spent 25 years with the AHA advocating for the treatment and prevention of cardiovascular disease through a combination of innovative prevention strategies and increased access to high-quality and affordable health care. She recently announced the AHA's 2020 "impact goal": improve the cardiovascular health of all Americans by 20 percent by 2020 while also reducing deaths related to stroke and cardiovascular disease by 20 percent. Here, Brown talks about healthcare reform, rising medical costs, and the Black Eyed Peas.

What do you say when people ask, "What do you do?"

I manage one of the largest nonprofit organizations dedicated to saving lives and improving the cardiovascular health of all Americans.

What new idea or innovation is having the most significant impact on medicine?

Major improvements in patient outcomes have already been made and I expect many more from building systems that support and assure that the care provided is of the highest and best quality.

A new quality-improvement program that we launched with the American Cancer Society and American Diabetes Association, called The Guideline Advantage, will give physicians and other healthcare providers the ability to measure and improve the quality of outpatient care for preventing and treating cardiovascular diseases, cancer, and diabetes.

What's something that most people just don't understand about your field?

Despite being the number one killer of all Americans, cardiovascular disease is largely preventable through lifestyle choices such as increased physical activity and better nutrition. It is deceptively simple. The big challenge is in motivating people to make lifestyle changes and removing environmental barriers that hinder them.

What's an emerging trend that you think will shake up the health world?

Healthcare reform. A year after the Affordable Care Act was enacted, the prospects for a healthier future have improved dramatically for heart disease and stroke patients. Patients have more options and protections for getting quality, affordable healthcare. For example, many families and Medicare beneficiaries now have access to preventive services. Lifetime limits on coverage are banned. Young adults can stay on their parents' insurance plan until age 26. Children with medical conditions can no longer be denied coverage. And no American can be dropped from coverage because of sickness. The new law is revamping a broken healthcare system that too often didn't meet the needs of patients.

What's a health trend that you wish would go away?

The rising cost of healthcare. By 2030, direct medical costs for cardiovascular disease-related illnesses are expected to triple--from $273 billion to $818 billion. If you combine direct and indirect costs, the total by 2030 is expected to reach $1.3 trillion. The American Heart Association is addressing this through a strategic goal to improve the cardiovascular health of all Americans by 20 percent by the year 2020.

What's an idea you became fascinated with but that ended up taking you off track?

Using a computer-based system to improve planning. Although it was conceptually a great idea, getting key stakeholders engaged face to face, at least at the beginning of a process, provided more "ownership" in the end plan.

Who are three people in the fields of medicine or public health that you'd put in a Hall of Fame?

The first is a team of researchers: Watson, Crick, and Franklin for discovering the basis of the genetic code.

Thomas Strasser for the concept of "primordial" prevention.

Tom Frieden for his bold approach to public health in [New York City], a city that models many of the problems of large and complex populations. He now is leading the CDC to new, bold, innovative approaches to improving the health status of people in this country.

What other field or occupation did you consider going into?

I wanted to be a television news anchor.

What website or app most helps you do your job on a daily basis?

I use Lose It! to track daily diet/nutritional intake and exercise.

What song's been stuck in your head lately?

"Let's Get It Started," by the Black Eyed Peas, was an early inspiration when the American Heart Association was launching its Start! Campaign, which promotes workplace walking programs to help Americans lead longer, stronger, heart-healthier lives.

Image: Courtesy of the American Heart Association

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