Author: Norm R C Campbell1, Pedro Ordunez2, Gloria Giraldo2, Yenny A Rodriguez Morales2, Cintia Lombardi2, Taskeen Khan3, Raj Padwal4, Ross T Tsuyuki5, Cherian Varghese3
Affiliation: <sup>1</sup> Department of Medicine, University of Calgary, Calgary, Alberta, Canada. Electronic address: ncampbel@ucalgary.ca.
<sup>2</sup> Department of Non-Communicable Diseases and Mental Health, Pan American Health Organisation, Washington, DC, USA.
<sup>3</sup> Department of Non-Communicable Diseases, World Health Organisation, Geneva, Switzerland.
<sup>4</sup> Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
<sup>5</sup> Departments of Pharmacology and Medicine (Cardiology) and EPICORE Centre, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
Conference/Journal: Can J Cardiol
Date published: 2021 May 1
Other:
Volume ID: 37 , Issue ID: 5 , Pages: 744-755 , Special Notes: doi: 10.1016/j.cjca.2020.12.004. , Word Count: 249
Globally, cardiovascular diseases (CVDs) are the leading cause of death. Viewed as a threat to the global economy, the United Nations included reducing noncommunicable diseases, including CVDs, in the 2030 sustainable development goals, and the World Health Assembly agreed to a target to reduce noncommunicable diseases 25% by the year 2025. In response, the World Health Organisation led the development of HEARTS, a technical package to guide governments in strengthening primary care to reduce CVDs. HEARTS recommends a public health and health system approach to introduce highly simplified interventions done systematically at a primary health care level and has a focus on hypertension as a clinical entry point. The HEARTS modules include healthy lifestyle counselling, evidence-based treatment protocols, access to essential medicines and technology, CVD risk-based management, team-based care, systems for monitoring, and an implementation guide. There are early positive global experiences in implementing HEARTS. Led by the Pan American Health Organisation, many national governments in the Americas are adopting HEARTS and have shown early success. Unfortunately, in Canada hypertension control is declining in women since 2010-2011 and the dramatic reductions in rates of CVD seen before 2010 have flattened when age adjusted and increased for rates that are not age adjusted, and there are marked increases in absolute numbers of Canadians with adverse CVD outcomes. Several steps that Canada could take to enhance hypertension control are outlined, the core of which is to implement a strong governmental nongovernmental collaborative strategy to prevent and control CVDs, focusing on HEARTS.
PMID: 33310142 DOI: 10.1016/j.cjca.2020.12.004