In August, all 11 hospitals within New York City-based NYC Health + Hospitals were recognized by the American Heart Association for providing quality cardiovascular and stroke care.
Of those 11 hospitals, five received the association’s new Commitment to Quality award. The award recognizes hospitals that achieved silver level or higher in at least three of the AHA’s Get with the Guidelines programs for 2025.
At the center of the care quality efforts at NYC Health + Hospitals/Bellevue is Norma Keller, MD, chief of cardiology. Dr. Keller has been with Bellevue since her internship.
She spoke to Becker’s about what is means for a public hospital such as NYC Health + Hospitals/Bellevue to be one of only 158 hospitals nationwide to earn the Commitment to Quality award, the role of GLP-1s in cardiovascular care and why her biggest concern for the future of cardiac medicine lies with the country’s youths.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: What do you wish more large systems across the country understood about NYC Health + Hospitals?
Dr. Norma Keller: Yes, public systems face financial challenges. But if you have the right people at the table, you can build impactful programs. We’ve done it at Bellevue with ECMO, cardiac rehab, structural heart and adult congenital care. These programs are hard to stand up — space, staffing and funding are real issues — but it can be done.
Some services are centralized here at Bellevue because of the coordination, specialists and financial resources they require but all patients in our system can access them, regardless of where they initially present.
We cover a large swath of New York City and our population is extremely diverse, including a large number of vulnerable groups who face higher cardiovascular risk and poorer outcomes. It’s actually very liberating to be a physician at Bellevue. You can provide whatever a patient needs. I can’t imagine working somewhere that doesn’t have the mission we have.
Q: Bellevue was recently recognized with the American Heart Association’s new Commitment to Quality award. What does this recognition signify for your team and for the patients you serve?
NK: It’s really impactful for our patients and our providers. Bellevue has a long history of firsts in cardiology, and we work hard to stay at the forefront of care, delivering the highest quality care possible.
Our team really believes in Bellevue’s mission: to provide care regardless of any social determinant. That’s not always easy, because our patients often have high cardiovascular risk and face additional barriers to care. This kind of recognition shows them that they matter to us, that we’re striving for excellence, and that we want to partner with them in their cardiovascular health.
Q: We’re seeing a lot of national attention on GLP-1 therapies for obesity and diabetes. How do you see these drugs intersecting with cardiovascular care?
NK: I think they’re a really important part of the prevention toolbox. Obesity is an independent risk factor for cardiovascular disease, so cardiologists absolutely need to be involved in treating patients with obesity, especially with new agents like these coming out.
We need to become comfortable with them to understand their benefits, limitations and how they interact with other modifiable risk factors. This should be a key part of preventive cardiology, not just for primary prevention but after cardiovascular events as well.
It would be shortsighted not to include GLP-1s in prevention programs. Cardiologists can help guide their use in a broader, multidisciplinary way.
Q: Despite advances in care, heart disease remains the leading cause of death in the U.S. From your vantage point at Bellevue, what trends concern you most about the current and future cardiovascular burden?
NK: One big concern for me is our youth. They’re less active than before, there’s less organized activity in schools, more screen time and higher obesity levels. Adolescents are still starting to smoke. We’ve raised awareness, but we really need to focus on youth and promote heart-healthy habits early, especially in lower-income populations, where these trends are even more pronounced.
Another concern is women’s health. We’ve raised awareness through initiatives like Go Red for Women, but cardiovascular disease remains a serious risk. In New York City, maternal health is a particular concern. We’re working closely with community groups to address cardiovascular risks in and around pregnancy.
Q: Looking forward, what area of opportunity do you see as most promising for improving heart health in complex, safety-net populations?
NK: Prevention is huge, especially in vulnerable populations. But access to care is also critical and has been a major issue over the past few years. Some people are afraid to seek care, others can’t afford to. We need boots-on-the-ground, community-based approaches. Partnerships with local organizations are key to building trust and improving engagement.
One major opportunity is increasing participation in clinical research. Patients in public hospital systems are often underrepresented in trials. But we recently conducted a study on follow-up and compliance, and it showed that our patients can participate in research when given the opportunity. We also need to study these populations because much of our existing data, especially in genetics, is based on European ancestry.
We have a cardio-genetics program at Bellevue with hundreds of patients, and we’re planning to publish on it. This kind of work can have a global impact for patients with diverse backgrounds.
Another area is integrated care. For example, with obesity, it’s not enough to just refer a patient to bariatrics. You need to treat other risk factors, prescribe medications like GLP-1s when appropriate, offer nutrition support and address emotional and psychological needs. That’s true for many conditions.
Q: Anything else you’d like to add about the direction you see cardiovascular care heading in public systems?
NK: We need to think practically: Simplify medications, address food insecurity and apply a social determinant of health lens to everything we do. We need to move toward a more proactive model of care with more prevention and more sustained support for heart-healthy living. That might sound funny coming from an interventional cardiologist, but it’s where we need to go.
