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AN EMPHA SIS ON E VIDENCEBA SED GUIDELINES HA S YIELDED IMPROVEMENT IN CARDIOVA SCUL AR OUTCOMES IN RECENT YE ARS. HOWE VER, WITH HE ART DISE A SE CONTINUING TO CL AIM THE LIVES OF HUNDREDS OF THOUSANDS OF AMERICANS ANNUALLY, E VEN THE MOST OPTIMISTIC CLINICIANS ARE NOT LIKELY TO UNFURL THE VICTORY FL AG. STATE STATE of the HEART HEART BY STEVE BARRETT IN PERSPECTIVE Though cancer is a close second, heart disease remains the biggest killer of Americans, with deaths outnumbering all those from chronic lower respiratory diseases, accidents, stroke, Alzheimer's disease and diabetes combined, according to the CDC. GLOBAL SCOURGE Worldwide, strokes and heart attacks cause four out of fi ve deaths related to cardiovascular disease. LINKING HEAD AND HEART Among users of angiotensin II receptor blockers Among users of diuretics More than 26% of Medicare Part D benefi ciaries — nearly 5 million people — fail to adhere to their prescribed antihypertensive medication regimens, according to an analysis by the Centers for Medicare & Medicaid Services and the CDC. There are signifi cant demographic and other disparities in adherence rates. Of more than 115,000 women in a 2016 study in The BMJ, approximately 17,500 were diagnosed with migraine. Over 20 years of follow-up, that group was found to be at greater risk for major cardiovascular disease, myocardial infarction, stroke and cardiovascular disease mortality than women who were not diagnosed with migraine. The researchers recommended that clinicians evaluate the vascular risk of women with migraine and that additional research be conducted to develop strategies for reducing car- diovascular risk among migraine patients. ■ Sources: CDC, Centers for Medicare & Medicaid Services, World Health Organization, The BMJ NUMBER OF DEATHS IN 2015 FOR EACH OF THE LEADING CAUSES OF DEATH IN THE UNITED STATES PRESCRIPTION FOR POOR OUTCOMES NONADHERENCE BY REGION NONADHERENCE BY MEDICATION NONADHERENCE BY ETHNIC GROUP MIDWEST NORTHEAST WEST WHITE BLACK AMERICAN INDIAN ASIAN HISPANIC SOUTH CORE 06 contents ON THE COVER /////// FEBRUARY 2017 Support, structure and advanced technology are at the heart of the work being done at the University of Minnesota Health C.O.R.E. Clinic. 12 14 FE ATURES PERSONALIZED CARE AT THE C.O.R.E. CLINIC FOR HEART FAILURE MANAGEMENT 06 Medica l professiona ls with the University of Minnesota Hea lth C.O.R .E. Clinic help patients with heart failure live longer, higher-qua lity lives. SPECIAL CLINICAL SECTION: CARDIOLOGY OBESITY EPIDEMIC AMONG YOUTHS MAY PRESAGE HEART FAILURE CRISIS, STUDY SUGGESTS 12 Swedish researchers found that many young men who are within norma l BMI range nonetheless face greater heart failure risk once they reach middle age. DEPARTMENTS FINANCE 15 BUSINESS OF MEDICINE 16 DIAGNOSTICS 18 HEALTHCARE NEWS 19

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