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Screening for cardiovascular disease risk and subsequent management in low and middle income countries: challenges and opportunities

Bovet, P.; Chiolero, A.; Paccaud, F. et al. Public Health Reviews (2015) CC

Background: Cardiovascular disease (CVD), mainly heart attack and stroke, is the leading cause of premature mortality in low and middle income countries (LMICs). Identifying and managing individuals at high risk of CVD is an important strategy to prevent and control CVD, in addition to multisector... more

HEARTS Technical package for cardiovascular disease management in primary health care: healthy-lifestyle counselling

World Health Organization WHO (2018) C_WHO

The risk factors for CVD include behavioural factors, such as tobacco use, an unhealthy diet, harmful use of alcohol and inadequate physical activity, and physiological (metabolic) factors, including high blood pressure (hypertension), high blood cholesterol and high blood sugar or glucose. Both kin... more

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HEARTS technical package for cardiovascular disease management in primary health care: risk based CVD management

World Health Organization WHO (2020) C_WHO

Development of cardiovascular disease (CVD) is influenced by risk factors such as: tobacco use, an unhealthy diet, physical inactivity, obesity (which can result from a combination of unhealthy diet, physical inactivity, and other factors), elevated blood pressure (hypertension), abnormal blood l... more

Cardiovascular heart disease

British Heart Foundation (2019) CC

Cardiovascular disease (CVD), also called heart and circulatory disease, is an umbrella name for conditions that affect your heart or circulation. These include high blood pressure, stroke and vascular dementia.

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World Health Organization cardiovascular disease risk charts: revised models to estimate risk in 21 global regions

The WHO CVD Risk Chart Working Group The Lancet Global Health (2019) CC

To help adapt cardiovascular disease risk prediction approaches to low-income and middle-income countries, WHO has convened an effort to develop, evaluate, and illustrate revised risk models. Here, we report the derivation, validation, and illustration of the revised WHO cardiovascular disease risk ... more

Cardiovascular disease

National Health Service UK (2022) CC

Cardiovascular disease (CVD) is a general term for conditions affecting the heart or blood vessels. It's usually associated with a build-up of fatty deposits inside the arteries (atherosclerosis) and an increased risk of blood clots. It can also be associated with damage to arteries in organs such... more

Cardiovascular diseases (CVDs)

World Health Organization WHO (2021) C_WHO

Key facts - Cardiovascular diseases (CVDs) are the leading cause of death globally. - An estimated 17.9 million people died from CVDs in 2019, representing 32% of all global deaths. Of these deaths, 85% were due to heart attack and stroke. - Over three quarters of CVD deaths take place in low- an... more

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A Roadmap on the Prevention of Cardiovascular Disease Among People Living With Diabetes

Mitchell, S.; Malanda, B.; Damasceno, A. et al. World Heart Federation (2019) CC

In 2014, the World Heart Federation (WHF) launched an initiative to develop a series of Roadmaps [1e6]. Their aim is to identify potential roadblocks on the pathway to effective prevention, detection, and management of cardiovascular disease (CVD), along with evidence-based solutions to overcome... more

ESC Clinical Practice Guidelines on Cardiovascular Disease Prevention in Clinical Practice: What Patients Need to Know

European Society of Cardiology (2022) CC

This guide for patients aims to provide you with an overview of the latest evidence-based recommendations for the prevention of cardiovascular disease. In particular, it should help you to understand: • how cardiovascular disease risk is assessed • the importance of lifestyle modifications for... more

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Promoting Cardiovascular Health in the Developing World

Institute of Medicine (2010) CC

Cardiovascular disease (CVD) is often thought to be a problem of wealthy, industrialized nations. The term “cardiovascular disease” is used throughout the report to refer to cardiac disease, vascular diseases of the brain and kidney, and peripheral vascular disease. The report’s main focus is ... more

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The Road to UHC: Why Integration of Circulatory Health Interventions in Primary Care is Essential

World Heart Federation (2024) CC

The incidence of circulatory disorders is increasing worldwide, affecting both low- and middle-income countries and some high-income countries. There is evidence of rising incidence and prevalence rates, even among younger individuals, along with an increasing prevalence of risk factors such as high... more

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Use of statins for the prevention of cardiovascular disease in 41 low-income and middle-income countries: a cross-sectional study of nationally representative, individual-level data

Marcus, M.E.; Manne-Goehler, J.; Theilmann, M. (2022) CC

Background In the prevention of cardiovascular disease, a WHO target is that at least 50% of eligible people use statins. Robust evidence is needed to monitor progress towards this target in low-income and middle-income countries (LMICs), where most cardiovascular disease deaths occur. The objectiv... more

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Access to Cardiovascular Disease and Hypertension Medicines in Developing Countries: An Analysis of Essential Medicine Lists, Price, Availability, and Affordability

Husain, M.J.; Datta, B.K.; Kostova, D. et al. Journal of the American Heart Association (2020) CC

Background Access to medicines is important for long‐term care of cardiovascular diseases and hypertension. This study provides a cross‐country assessment of availability, prices, and affordability of cardiovascular disease and hypertension medicines to identify areas for improvement in access ... more

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Access to Medications for Cardiovascular Diseases in Low- and Middle-Income Countries

Wirtz, V.J.; Kaplan, W.A.; Kwan, G.F. Circulation (2016) CC

Cardiovascular diseases (CVD) represent the highest burden of disease globally. Medicines are a critical intervention used to prevent and treat CVD. This review describes access to medication for CVD from a health system perspective and strategies that have been used to promote access, including pro... more

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Cardiovascular diseases in Africa in the twenty-first century: Gaps and priorities going forward

Minja, N.W.; Nakagaayi, D.; Aliku, T. et al. Frontiers in Cardiovascular Medicine (2022) CC

In 2015, the United Nations set important targets to reduce premature cardiovascular disease (CVD) deaths by 33% by 2030. Africa disproportionately bears the brunt of CVD burden and has one of the highest risks of dying from non-communicable diseases (NCDs) worldwide. There is currently an epide...miological transition on the continent, where NCDs is projected to outpace communicable diseases within the current decade. Unchecked increases in CVD risk factors have contributed to the growing burden of three major CVDs—hypertension, cardiomyopathies, and atherosclerotic diseasesleading to devastating rates of stroke and heart failure. The highest age standardized disability-adjusted life years (DALYs) due to hypertensive heart disease (HHD) were recorded in Africa. The contributory causes of heart failure are changing—whilst HHD and cardiomyopathies still dominate, ischemic heart disease is rapidly becoming a significant contributor, whilst rheumatic heart disease (RHD) has shown a gradual decline. In a continent where health systems are traditionally geared toward addressing communicable diseases, several gaps exist to adequately meet the growing demand imposed by CVDs. Among these, high-quality research to inform interventions, underfunded health systems with high out-of-pocket costs, limited accessibility and affordability of essential medicines, CVD preventive services, and skill shortages. Overall, the African continent progress toward a third reduction in premature mortality come 2030 is lagging behind. More can be done in the arena of effective policy implementation for risk factor reduction and CVD prevention, increasing health financing and focusing on strengthening primary health care services for prevention and treatment of CVDs, whilst ensuring availability and affordability of quality medicines. Further, investing in systematic country data collection and research outputs will improve the accuracy of the burden of disease data and inform policy adoption on interventions. This review summarizes the current CVD burden, important gaps in cardiovascular medicine in Africa, and further highlights priority areas where efforts could be intensified in the next decade with potential to improve the current rate of progress toward achieving a 33% reduction in CVD mortality. more

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South African cardiovascular risk stratification guideline for non-cardiac surgery

Alphonsus, C.; Naidoo, N.; Motshabi, P. et al. South African Medical Journal (2021) CC

The South African (SA) guidelines for cardiac patients for non-cardiac surgery were developed to address the need for cardiac risk assessment and risk stratification for elective non-cardiac surgical patients in SA, and more broadly in Africa. The guidelines were developed by updating the Canadian ...Cardiovascular Society Guidelines on Perioperative Cardiac Risk Assessment and Management for Patients Who Undergo Non-cardiac Surgery, with a search of literature from African countries and recent publications. The updated proposed guidelines were then evaluated in a Delphi consensus process by SA anaesthesia and vascular surgical experts. The recommendations in these guidelines are: 1. We suggest that elective non-cardiac surgical patients who are 45 years and older with either a history of coronary artery disease, congestive cardiac failure, stroke or transient ischaemic attack, or vascular surgical patients 18 years or older with peripheral vascular disease require further preoperative risk stratification as their predicted 30-day major adverse cardiac event (MACE) risk exceeds 5% (conditional recommendation: moderate-quality evidence). 2. We do not recommend routine non-invasive testing for cardiovascular risk stratification prior to elective non-cardiac surgery in adults (strong recommendation: low-to-moderate-quality evidence). 3. We recommend that elective non-cardiac surgical patients who are 45 years and older with a history of coronary artery disease, or stroke or transient ischaemic attack, or congestive cardiac failure or vascular surgical patients 18 years or older with peripheral vascular disease should have preoperative natriuretic peptide (NP) screening (strong recommendation: high-quality evidence). 4. We recommend daily postoperative troponin measurements for 48 - 72 hours for non-cardiac surgical patients who are 45 years and older with a history of coronary artery disease, or stroke or transient ischaemic attack, or congestive cardiac failure or vascular surgical patients 18 years or older with peripheral vascular disease, i.e. (i) a baseline risk >5% for MACE 30 days after elective surgery (if no preoperative NP screening), or (ii) an elevated B-type natriuretic peptide (BNP)/N-terminal-prohormone B-type natriuretic peptide (NT-proBNP) measurement before elective surgery (defined as BNP >99 pg/mL or a NT-proBNP >300 pg/mL) (conditional recommendation: moderate-quality evidence). Additional recommendations are given for the management of myocardial injury after non-cardiac surgery (MINS) and medications for comorbidities. more

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Cardiac Arrhythmias in Africa: Epidemiology, Management Challenges, and Perspectives

Bonny, A.; Ngantcha, M.; Scholtz, W. et al. Journal of the American College of Cardiology (2019) CC

Africa is experiencing an increasing burden of cardiac arrhythmias. Unfortunately, the expanding need for appropriate care remains largely unmet because of inadequate funding, shortage of essential medical expertise, and the high cost of diagnostic equipment and treatment modalities. Thus, patients ... more

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Cardiac arrhythmias in low- and middle-income countries

Mkoko, P.; Bahiru, E.; Ajijola, O.A. et al. Cardiovascular Diagnosis and Therapy (2019) CC

Many low- and middle-income countries (LMICs) are undergoing an epidemiological transition. With an improvement in socioeconomic conditions and an aging population, cardiovascular diseases (CVDs), like cardiac arrhythmias, are expected to increase in these countries. However, there are limited studi... more

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Cardiovascular disease risk profile and management practices in 45 low-income and middle-income countries: A cross-sectional study of nationally representative individual-level survey data

Peiris, D.; Ghosh, A.; Manne-Goehler, J. et al. PLoS Medicine (2021) CC

Global cardiovascular disease (CVD) burden is high and rising, especially in low-income and middle-income countries (LMICs). Focussing on 45 LMICs, we aimed to determine (1) the adult population’s median 10-year predicted CVD risk, including its variation within countries by socio-demographic char... more

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Cardiovascular Diseases in Sub-Saharan Africa Compared to High-Income Countries: An Epidemiological Perspective

Yuyun, M.F.; Sliwa, K.; Kengne, A.P. et al. Global Heart (2020) CC

Non-communicable diseases (NCDs) are the second common cause of death in sub-Saharan Africa (SSA) accounting for about 35% of all deaths, after a composite of communicable, maternal, neonatal, and nutritional diseases. Despite prior perception of low NCDs mortality rates, current evidence suggests t... more