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World Heart Federation outlines roadmaps to reduce CVD globally
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Widespread implementation of strategies to improve CV secondary prevention, hypertension and tobacco control is essential to achieve the World Heart Federation goal of achieving a 25% reduction in premature deaths from CVD worldwide by 2025, according to a new editorial in Global Heart.
During the past century, economic and nutritional improvements in many countries have significantly reduced premature deaths due to infection, undernutrition and poverty, “However, with the aging of the population and improved economic growth, diseases of undernutrition have been replaced by diseases of overnutrition in many countries, with increases in obesity, hypertension and related metabolic diseases such as CVD, diabetes and cancers — collectively termed noncommunicable diseases,” wrote World Heart Federation president Salim Yusuf, MD, of McMaster University in Hamilton, Ontario, Canada; president-elect David Wood, MSc, of Imperial College London; Pablo Perel, MD, PhD, of the World Heart Federation and the London School of Hygiene and Tropical Medicine; and Cardiology Today Editorial Board member Jagat Narula, MD, of Icahn School of Medicine at Mount Sinai Hospital, New York.
Jagat Narula
In recent years, several strategies have emerged that could help combat CVD worldwide, including medications to control hypertension or prevent secondary CV events and social interventions such as policies to reduce tobacco use.
A worldwide concern
Data from the large Prospective Urban Rural Epidemiology (PURE) study indicate that 20% of CVD events that occur in the population are in the 5% of the population with a history of CAD or stroke. Moreover, 66% of these events occur in the 40% of the population with hypertension (BP > 140/90 mm Hg) and 30% of these events occur in the 20% of the population that smokes. Because these are prominent subgroups that comprise 55% of the worldwide population, the World Heart Federation recommends implementation of effective strategies that target these three groups.
“Reducing the burden of CVD by targeting these three easily identified subgroups of a population is relative efficient and if secondary prevention, hypertension control and tobacco avoidance increases by one-third or more, a 25% reduction in CVD can be reasonably expected,” the authors wrote.
Adoption of roadmaps
During the next 2 years, the World Heart Federation’s global roadmaps for secondary CV prevention, hypertension control and smoking cessation will be the basis of developing region-specific roadmaps involving an alliance of cardiologists, government organizations, regional health groups, and industry, advocacy and patient groups, among others, according to a press release. The approach to implementation at a national or regional level may include situational analysis, the CVD roadmaps, policy dialogues and tailored solutions.
Salim Yusuf
“A range of local expertise is needed — which includes knowledge of cardiology, prevention, health promotion, health systems, economics, governmental priorities, and cultural and social contexts — to develop and effectively implement country specific roadmaps,” the authors wrote.
However, although the roadmaps outline general guidance, each region or country is encouraged to customize the strategy for the varying structures of health care systems worldwide, according to the editorial. The World Heart Federation microsite, cvdroadmaps.org, was developed to support countries in their local adaption and implementation of the roadmaps. The microsite includes links to the relevant roadmaps, the ability to build and discuss potential solutions, and toolkits for conducting situation analyses and policy dialogues, according to the release.
The World Heart Federation plans to introduce the roadmaps in regions where the targeted interventions are most needed. Upcoming meetings are scheduled to take place in Brazil, Chile, China, India, Tunisia and the United Arab Emirates. According to the World Heart Federation, these countries have a very high and growing burden of CVD.
In addition, the World Heart Federation will introduce future roadmaps to address other common cardiac conditions such as atrial fibrillation, cholesterol, HF and rheumatic heart disease.
“This is an extraordinary moment in history for the global CVD community whereby we can all work toward reducing CVD globally by building upon a common vision and aligned goals to reduce premature mortality for CVD globally by 25% by 2025,” the authors wrote. – by Jennifer Byrne
For more information:
World Heart Federation Global CVD Roadmaps. Available at: www.cvdroadmaps.org.
Disclosure: The authors report no relevant financial disclosures.
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