This measure would express the Legislatures support for the creation of policies to decrease the rising number of deaths of Americans as a result of atherosclerotic cardiovascular disease (ASCVD). The measure would declare the importance of enhanced public awareness of comprehensive cardiovascular screening programs to allow for earlier identification of patients at risk of cardiovascular events. The measure would also declare the importance of collaboration on statewide cardiovascular planning to accelerate quality improvements in care rendered to these patients.

This measure would express the Legislatures support for the creation of policies to decrease the rising number of deaths of Americans as a result of atherosclerotic cardiovascular disease (ASCVD). The measure would declare the importance of enhanced public awareness of comprehensive cardiovascular screening programs to allow for earlier identification of patients at risk of cardiovascular events. The measure would also declare the importance of collaboration on statewide cardiovascular planning to accelerate quality improvements in care rendered to these patients.

This measure would express the Legislatures support for the creation of policies to decrease the rising number of deaths of Americans as a result of atherosclerotic cardiovascular disease (ASCVD). The measure would urge state agencies to expand declare the importance of enhanced public awareness of comprehensive cardiovascular screening programs to allow for earlier identification of patients at risk of cardiovascular events. The measure would also urge state agencies to explore ways to collaborate with federal and national agencies and organizations to establish or expand comprehensive cardiovascular screening programs. declare the importance of collaboration on statewide cardiovascular planning to accelerate quality improvements in care rendered to these patients.

This measure would express the Legislatures support for the creation of policies to decrease the rising number of deaths of Americans as a result of atherosclerotic cardiovascular disease (ASCVD). The measure would urge state agencies to expand comprehensive cardiovascular screening programs to allow for earlier identification of patients at risk of cardiovascular events. The measure would also urge state agencies to explore ways to collaborate with federal and national agencies and organizations to establish or expand comprehensive cardiovascular screening programs.

WHEREAS, Cardiovascular disease is the leading cause of death in the United States; and

WHEREAS, In the United States, approximately 21,000,000 patients have been diagnosed with atherosclerotic cardiovascular disease (ASCVD) and are at risk of a cardiovascular event according to the United States Census Bureau; and

WHEREAS, The Mayo Clinic states that ASCVD is linked to the buildup of cholesterol in the arteries, and that the risk of associated events can be modified by lowering low-density lipoprotein cholesterol (LDL-C); and

WHEREAS, In 2016, nearly 70,000,000 adults in the United States had elevated LDL-C levels; and

WHEREAS, Currently 43,100,000 people in the United States are treated with lipid-lowering therapies to manage cardiovascular risk; and

WHEREAS, Only 20 percent of people with ASCVD who are taking statins, one of the leading lipid-lowering therapies, actually achieve healthy levels of LDL-C; and

WHEREAS, The total direct and indirect cost of ASCVD in the U.S. was $555 billion in 2016, and is projected to climb to $1.1 trillion by 2035 according to the American Heart Association; and

WHEREAS, In California, 2,008,100 adults have been told by a health professional that they had angina, a stroke, a heart attack, or coronary heart disease, which are some of the manifestations of ASCVD; and

WHEREAS, In California in 2019, 39,767 people had ASCVD as an underlying cause of death; and

WHEREAS, In California in 2019, 960,900 adults reported experiencing a heart attack in their lifetime and 801,800 adults reported experiencing a stroke in their lifetime; and

WHEREAS, California spends an estimated $11.74 billion on direct medical expenses for ASCVD care each year; now, therefore, be it

Resolved by the Assembly of the State of California, the Senate thereof concurring, That the Legislature hereby declares the importance of enhanced public awareness of comprehensive cardiovascular screening programs to allow for earlier identification of patients at risk of cardiovascular events; and be it further

Resolved, That the Legislature further declares the importance of collaboration on statewide cardiovascular planning to accelerate quality improvements in the care rendered to these patients such that screening, treatment, monitoring, and improved health outcomes are achieved; and be it further

Resolved, That the Legislature supports the creation of policies to decrease the rising number of deaths of Americans as a result of ASCVD; and be it further

Resolved, That the Chief Clerk of the Assembly transmit copies of this resolution to the author for appropriate distribution.

WHEREAS, Cardiovascular disease is the leading cause of death in the United States; and

WHEREAS, In the United States, approximately 21,000,000 patients have been diagnosed with atherosclerotic cardiovascular disease (ASCVD) and are at risk of a cardiovascular event according to the United States Census Bureau; and

WHEREAS, The Mayo Clinic states that ASCVD is linked to the buildup of cholesterol in the arteries, and that the risk of associated events can be modified by lowering low-density lipoprotein cholesterol (LDL-C); and

WHEREAS, In 2016, nearly 70,000,000 adults in the United States had elevated LDL-C levels; and

WHEREAS, Currently 43,100,000 people in the United States are treated with lipid-lowering therapies to manage cardiovascular risk; and

WHEREAS, Only 20 percent of people with ASCVD who are taking statins, one of the leading lipid-lowering therapies, actually achieve healthy levels of LDL-C; and

WHEREAS, The total direct and indirect cost of ASCVD in the U.S. was $555 billion in 2016, and is projected to climb to $1.1 trillion by 2035 according to the American Heart Association; and

WHEREAS, In California, 2,008,100 adults have been told by a health professional that they had angina, a stroke, a heart attack, or coronary heart disease, which are some of the manifestations of ASCVD; and

WHEREAS, In California in 2019, 39,767 people had ASCVD as an underlying cause of death; and

WHEREAS, In California in 2019, 960,900 adults reported experiencing a heart attack in their lifetime and 801,800 adults reported experiencing a stroke in their lifetime; and

WHEREAS, California spends an estimated $11.74 billion on direct medical expenses for ASCVD care each year; now, therefore, be it

Resolved by the Assembly of the State of California, the Senate thereof concurring, That the Legislature hereby declares the importance of enhanced public awareness of comprehensive cardiovascular screening programs to allow for earlier identification of patients at risk of cardiovascular events; and be it further

Resolved, That the Legislature further declares the importance of collaboration on statewide cardiovascular planning to accelerate quality improvements in the care rendered to these patients such that screening, treatment, monitoring, and improved health outcomes are achieved; and be it further

Resolved, That the Legislature supports the creation of policies to decrease the rising number of deaths of Americans as a result of ASCVD; and be it further

Resolved, That the Chief Clerk of the Assembly transmit copies of this resolution to the author for appropriate distribution.

WHEREAS, Cardiovascular disease is the leading cause of death in the United States; and

WHEREAS, In the United States, approximately 21,000,000 patients have been diagnosed with atherosclerotic cardiovascular disease (ASCVD) and are at risk of a cardiovascular event according to the United States Census Bureau; and

WHEREAS, The Mayo Clinic states that ASCVD is linked to the buildup of cholesterol in the arteries, and that the risk of associated events can be modified by lowering low-density lipoprotein cholesterol (LDL-C); and

WHEREAS, In 2016, nearly 70,000,000 adults in the United States had elevated LDL-C levels; and

WHEREAS, Currently 43,100,000 people in the United States are treated with lipid-lowering therapies to manage cardiovascular risk; and

WHEREAS, Only 20 percent of people with ASCVD who are taking statins, one of the leading lipid-lowering therapies, actually achieve healthy levels of LDL-C; and

WHEREAS, The total direct and indirect cost of ASCVD in the U.S. was $555 billion in 2016, and is projected to climb to $1.1 trillion by 2035 according to the American Heart Association; and

WHEREAS, In California, 2,008,100 adults have been told by a health professional that they had angina, a stroke, a heart attack, or coronary heart disease, which are some of the manifestations of ASCVD; and

WHEREAS, In California in 2019, 39,767 people had ASCVD as an underlying cause of death; and

WHEREAS, In California in 2019, 960,900 adults reported experiencing a heart attack in their lifetime and 801,800 adults reported experiencing a stroke in their lifetime; and

WHEREAS, California spends an estimated $11.74 billion on direct medical expenses for ASCVD care each year; now, therefore, be it

Resolved by the Assembly of the State of California, the Senate thereof concurring, That the Legislature urges state agencies to expand hereby declares the importance of enhanced public awareness of comprehensive cardiovascular screening programs to allow for earlier identification of patients at risk of cardiovascular events; and be it further

Resolved, That the Legislature urges the state to develop a cardiovascular plan further declares the importance of collaboration on statewide cardiovascular planning to accelerate quality improvements in the care rendered to these patients such that screening, treatment, monitoring, and improved health outcomes are achieved; and be it further

Resolved, That the Legislature supports the creation of policies to decrease the rising number of deaths of Americans as a result of ASCVD; and be it further

Resolved, That the Chief Clerk of the Assembly transmit copies of this resolution to the author for appropriate distribution.

WHEREAS, Cardiovascular disease is the leading cause of death in the United States; and

WHEREAS, In the United States, approximately 21,000,000 patients have been diagnosed with atherosclerotic cardiovascular disease (ASCVD) and are at risk of a cardiovascular event according to the United States Census Bureau; and

WHEREAS, The Mayo Clinic states that ASCVD is linked to the buildup of cholesterol in the arteries, and that the risk of associated events can be modified by lowering low-density lipoprotein cholesterol (LDL-C); and

WHEREAS, In 2016, nearly 70,000,000 adults in the United States had elevated LDL-C levels; and

WHEREAS, Currently 43,100,000 people in the United States are treated with lipid-lowering therapies to manage cardiovascular risk; and

WHEREAS, Only 20 percent of people with ASCVD who are taking statins, one of the leading lipid-lowering therapies, actually achieve healthy levels of LDL-C; and

WHEREAS, The total direct and indirect cost of ASCVD in the U.S. was $555 billion in 2016, and is projected to climb to $1.1 trillion by 2035 according to the American Heart Association; and

WHEREAS, In California, 2,008,100 adults have been told by a health professional that they had angina, a stroke, a heart attack, or coronary heart disease, which are some of the manifestations of ASCVD; and

WHEREAS, In California in 2019, 39,767 people had ASCVD as an underlying cause of death; and

WHEREAS, In California in 2019, 960,900 adults reported experiencing a heart attack in their lifetime and 801,800 adults reported experiencing a stroke in their lifetime; and

WHEREAS, California spends an estimated $11.74 billion on direct medical expenses for ASCVD care each year; now, therefore, be it

Resolved by the Assembly of the State of California, the Senate thereof concurring, That the Legislature urges state agencies to expand comprehensive cardiovascular screening programs to allow for earlier identification of patients at risk of cardiovascular events; and be it further

Resolved, That the Legislature urges state agencies to explore ways to collaborate with federal agencies and national organizations to establish or expand comprehensive cardiovascular screening programs; and be it further

Resolved, That the Legislature urges the state to develop a cardiovascular plan to accelerate quality improvements in the care rendered to these patients such that screening, treatment, monitoring, and improved health outcomes are achieved; and be it further

Resolved, That the Legislature supports the creation of policies to decrease the rising number of deaths of Americans as a result of ASCVD; and be it further

Resolved, That the Chief Clerk of the Assembly transmit copies of this resolution to the author for appropriate distribution.

 THIRD READING 

Bill No: ACR 67

Author: Waldron (R), et al.

Amended: 6/19/23 in Assembly

Vote: 21

ASSEMBLY FLOOR: 78-0, 6/27/23 (Consent) - See last page for vote

SUBJECT: Atherosclerotic cardiovascular disease (ASCVD)

SOURCE: Novartis Services, Inc.

DIGEST:

This resolution supports the creation of policies to decrease the rising number of deaths of Americans as a result of Atherosclerotic cardiovascular disease (ASCVD).

ANALYSIS: This resolution makes the following legislative findings:

1. Cardiovascular disease is the leading cause of death in the United States. n the United States, approximately 21,000,000 patients have been diagnosed with atherosclerotic cardiovascular disease (ASCVD) and are at risk of a cardiovascular event according to the United States Census Bureau.
2. The Mayo Clinic states that ASCVD is linked to the buildup of cholesterol in the arteries, and that the risk of associated events can be modified by lowering low-density lipoprotein cholesterol (LDL-C). In 2016, nearly 70,000,000 adults in the United States had elevated LDL-C levels.
3. Currently 43,100,000 people in the United States are treated with lipid-lowering therapies to manage cardiovascular risk. Only 20 percent of people with ASCVD who are taking statins, one of the leading lipid-lowering therapies, actually achieve healthy levels of LDL-C.
4. In California, 2,008,100 adults have been told by a health professional that they had angina, a stroke, a heart attack, or coronary heart disease, which are some of the manifestations of ASCVD. California spends an estimated $11.74 billion on direct medical expenses for ASCVD care each year.

This resolution:

1. Declares the importance of enhanced public awareness of comprehensive cardiovascular screening programs to allow for earlier identification of patients at risk of cardiovascular events.
2. Declares the importance of collaboration on statewide cardiovascular planning to accelerate quality improvements in the care rendered to these patients such that screening, treatment, monitoring, and improved health outcomes are achieved.
3. Supports the creation of policies to decrease the rising number of deaths of Americans as a result of ASCVD.

Background

According to the National Heart, Lung and Blood Institute at the National Institutes of Health, ASCVD or atherosclerosis is a common condition that develops when a sticky substance called plaque builds up inside the arteries. Disease linked to ASCVD is the leading cause of death in the United States. About half of Americans between ages 45 and 84 have ASCVD and don’t know it. ASCVD develops slowly as cholesterol, fat, blood cells and other substances in the blood form plaque. When the plaque builds up, it causes the arteries to narrow. This reduces the supply of oxygen-rich blood to tissues of vital organs in the body. Atherosclerosis can affect most of the arteries in the body, including arteries in the heart, brain, arms, legs, pelvis, and kidneys. It has different names based on which arteries are affected:

• Coronary artery disease is plaque buildup in the arteries of the heart;
• Peripheral artery disease most often is plaque buildup in the arteries of the legs, but it can also build up in the arms or pelvis;
• Carotid artery disease is plaque buildup in the neck arteries. This reduces blood flow to the brain;
• Renal artery stenosis is plaque buildup in the arteries that supply blood to the kidneys;
• Vertebral artery disease is atherosclerosis in the arteries that supply blood to the back of the brain. This area of the brain controls body functions that are needed to keep a person alive; and,
• Mesenteric artery Ischemia is plaque buildup in the arteries that supply the intestines with blood.

Reduced blood flow can lead to symptoms such as angina. If a plaque bursts, a blood clot may form that may block the artery completely or travel to other parts of the body. Blockages, either complete or incomplete, can cause complications, including heart attack, stroke, vascular dementia, erectile dysfunction, or limb loss. Atherosclerosis can cause death and disability.

Comments

According to the author, “Atherosclerotic cardiovascular disease (ASCVD) related conditions remain the leading cause of death in the United States and many people do not have adequate access to cardiovascular screening programs. Policies related to early identification and intervention of cardiovascular events are needed in the Legislature and among state agencies.”

FISCAL EFFECT: Appropriation: No Fiscal Com.: No Local: No

SUPPORT: (Verified 7/3/23)

Novartis Services, Inc.

OPPOSITION: (Verified 7/3/23)

None received

ASSEMBLY FLOOR: 78-0, 6/27/23

AYES: Addis, Aguiar-Curry, Alanis, Alvarez, Arambula, Bains, Bauer-Kahan, Bennett, Berman, Boerner, Bonta, Bryan, Calderon, Juan Carrillo, Wendy Carrillo, Cervantes, Chen, Connolly, Megan Dahle, Davies, Dixon, Essayli, Flora, Mike Fong, Vince Fong, Friedman, Gabriel, Gallagher, Garcia, Gipson, Grayson, Haney, Hart, Holden, Hoover, Irwin, Jackson, Jones-Sawyer, Kalra, Lackey, Lee, Low, Lowenthal, Maienschein, Mathis, McCarty, McKinnor, Muratsuchi, Stephanie Nguyen, Ortega, Pacheco, Papan, Jim Patterson, Joe Patterson, Pellerin, Petrie-Norris, Quirk-Silva, Ramos, Reyes, Luz Rivas, Robert Rivas, Rodriguez, Blanca Rubio, Sanchez, Santiago, Schiavo, Soria, Ta, Ting, Valencia, Villapudua, Waldron, Wallis, Ward, Weber, Wicks, Wood, Rendon

NO VOTE RECORDED: Wilson, Zbur

Prepared by: Jonas Austin / SFA / (916) 651-1520

7/5/23 14:55:56

**** END ****

Date of Hearing: June 13, 2023

ASSEMBLY COMMITTEE ON HEALTH

Jim Wood, Chair

ABPCA Bill Id:ACR 67

Author:(Waldron) – As Introduced Ver:April 25, 2023

SUBJECT: Atherosclerotic cardiovascular disease (ASCVD).

SUMMARY: Urges the expansion of comprehensive cardiovascular screening programs and the creation of policies to decrease the number of deaths of Americans as a result of Atherosclerotic cardiovascular disease (ASCVD). Specifically, this resolution:

1. Urges state agencies to expand comprehensive cardiovascular screening programs to allow for earlier identification of patients at risk of cardiovascular events;
   
2. Urges state agencies to explore ways to collaborate with federal agencies and national organizations to establish or expand comprehensive cardiovascular screening programs;
   
3. Urges the state to develop a cardiovascular plan to accelerate quality improvements in the care rendered to these patients such that screening, treatment, monitoring, and improved health outcomes are achieved; and,
   
4. States that the Legislature supports the creation of policies to decrease the rising number of deaths of Americans as a result of ASCVD.
   

EXISTING LAW: Establishes the Department of Public Health (DPH) and sets forth its powers and duties, including, but not limited to, disease prevention and health promotion. [Health and Safety Code §104100-106036]

FISCAL EFFECT: Unknown. This resolution has not yet been analyzed by a fiscal committee

COMMENTS:

1. PURPOSE OF THIS RESOLUTION. According to the author, ASCVD related conditions remain the leading cause of death in the United States and many people do not have adequate access to cardiovascular screening programs. Policies related to early identification and intervention of cardiovascular events are needed in the Legislature and among state agencies.
2. BACKGROUND. According to the National Heart, Lung and Blood Institute at the National Institutes of Health, ASCVD or atherosclerosis is a common condition that develops when a sticky substance called plaque builds up inside the arteries. Disease linked to ASCVD is the leading cause of death in the United States. About half of Americans between ages 45 and 84 have ASCVD and don’t know it. ASCVD develops slowly as cholesterol, fat, blood cells and other substances in the blood form plaque. When the plaque builds up, it causes the arteries to narrow. This reduces the supply of oxygen-rich blood to tissues of vital organs in the body. Atherosclerosis can affect most of the arteries in the body, including arteries in the heart, brain, arms, legs, pelvis, and kidneys. It has different names based on which arteries are affected:
3. Coronary artery disease is plaque buildup in the arteries of the heart;
4. Peripheral artery disease most often is plaque buildup in the arteries of the legs, but it can also build up in the arms or pelvis;
5. Carotid artery disease is plaque buildup in the neck arteries. This reduces blood flow to the brain;
6. Renal artery stenosis is plaque buildup in the arteries that supply blood to the kidneys;
7. Vertebral artery disease is atherosclerosis in the arteries that supply blood to the back of the brain. This area of the brain controls body functions that are needed to keep a person alive; and,
8. Mesenteric artery Ischemia is plaque buildup in the arteries that supply the intestines with blood.
   
   Reduced blood flow can lead to symptoms such as angina. If a plaque bursts, a blood clot may form that may block the artery completely or travel to other parts of the body. Blockages, either complete or incomplete, can cause complications, including heart attack, stroke, vascular dementia, erectile dysfunction, or limb loss. Atherosclerosis can cause death and disability.
   
   Plaque often starts to build up during childhood and gets worse with age. Risk factors include unhealthy cholesterol levels, unhealthy lifestyle habits, and your genes. Most people can prevent or delay the initiation and progression of atherosclerosis by following steps for heart-healthy living. Heart-healthy living — never smoking, eating healthy, and being physically active — starting in childhood and continuing throughout life can prevent atherosclerosis and its complications. Help your kids follow a heart-healthy lifestyle and encourage them to not smoke or vape.

According to DPH, from 2015 to 2019, 1.7 million (5.9%) of adults in California are estimated to have been told by a health professional that they had some form of Cardiovascular disease (CVD) which describes all types of diseases that affect the heart or blood vessels, including coronary heart disease (clogged arteries), which can cause heart attacks, stroke, heart failure, and peripheral artery disease. Among California adults 18 years of age or older, men were more likely than women to have CVD (6.6% vs. 5.2%). However, CVD continues to be the leading factor to all-cause mortality in both genders. A greater proportion of older age groups reported having a CVD condition. Individuals 65 years of age or older reported the highest prevalence of CVD (19.3%) compared to other age groups. Prevalence varies by race and ethnicity with white individuals reporting the highest prevalence of CVD (7.9%), well above the lowest prevalence reported by Asian and Pacific Islander individuals (2.5%). CVD was also more common in homes that reported lower annual incomes.

1. AMENDMENTS. The author has agreed to amend to clarify the role of the state in cardiovascular screening programs by deleting lines 26-39 and replacing with the following:

Resolved by the Assembly of the State of California, the Senate thereof concurring, that the Legislature hereby declares the importance of expanding comprehensive cardiovascular screening programs to allow for earlier identification of patients at risk of cardiovascular events; and be it further

Resolved, that the Legislature encourages collaboration between the state and federal agencies and cardiovascular organizations to establish or expand comprehensive cardiovascular screening programs; and be it further

Resolved, That the Legislature encourages the state to develop a cardiovascular plan to accelerate quality improvements in the care rendered to these patients such that screening, treatment, monitoring, and improved health outcomes are achieved; and be it further

REGISTERED SUPPORT / OPPOSITION:

Support

None on file.

Opposition

None on file.

Analysis Prepared by: Rosielyn Pulmano / HEALTH / (916) 319-2097