1. Strategic Priorities of the WHO Cardiovascular Disease Programme

7/31/2019 1. Strategic Priorities of the WHO Cardiovascular Disease Programme

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Strategic Priorities of theWHO Cardiovascular

Disease Programme

Dr. Rina Amelia, MARS

Dept of Community Medicine

Block: Cardiovascular


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The WHO Programme on Cardiovascular Diseases

(CVD) is concerned with prevention, managementand monitoring of CVD globally.

It aims to develop global strategies to reduce theincidence, morbidity and mortality of CVD by

effectively reducing CVD risk factors and their determinants

developing cost effective and equitable health care

innovations for management of CVD monitoring trends of CVD and their risk factors


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CVD is the name for the group of disorders

of the heart and blood vessels and include:

Hypertension (high blood pressure)

Coronary heart disease (heart attack)

Cerebrovascular disease (stroke)

Peripheral vascular disease

Heart failure

Rheumatic heart disease Congenital heart disease

Cardiomyopathies


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Facts

In 1999 CVD contributed to a third of globaldeaths.

In 1999, low and middle income countries

contributed to 78% of CVD deaths.By 2010 CVD is estimated to be the leading

cause of death in developing countries.

Heart disease has no geographic, gender orsocio-economic boundaries.


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CVD in developing countries

Economic transition urbanisation, industrialisation andglobalisation bring about lifestyle changes that promoteheart disease.

These risk factors include tobacco use, physicalinactivity, unhealthy diet.

Life expectancy in developing countries is rising sharplyand people are exposed to these risk factors for longer

periods. Newly merging CVD risk factors like low birth weight,

folate deficiency and infections are also more frequentamong the poorest in low and middle income countries.


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Social and economic consequences

Clinical care of CVD is costly and prolonged.

These direct costs divert the scarce family and societal

resources to medical care.

CVD affects individuals in their peak mid life years disrupting

the future of the families dependant on them and

undermining the development of nations by depriving

valuable human resources in their most productive years.

In developed countries lower socioeconomic groups have

greater prevalence of risk factors, higher incidence of disease

and higher mortality.

In developing countries as the CVD epidemic matures the

burden will shift to the lower socioeconomic groups.


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To effectively control CVD risk factors and

to reduce the burden of the fast growing

cardiovascular disease (CVD) epidemic

particularly in developing countries.

Goal of the WHO Global Strategy


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Key areas of work

Reduce major CVD risk factors and their social and

economic determinants through community based

programmes for integrated prevention of NCDs.

Development of standards of care and cost-effective case

management for CVD.

Global action to enhance the capacity of countries to meet

the health care needs of CVD.

Developing feasible surveillance methods to assess the

pattern and trends of major CVDs and risk factors and to

monitor prevention and control initiatives.

Developing effective inter-country, interregional and global

networks and partnerships for concerted global action.


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Integrated Management

of Cardiovascular Risk

Cardiovascular disease (CVD) is a leading cause of mortality andis responsible for one-third of all global deaths. Nearly 85% ofthe global mortality and disease burden from CVD is borne bylow- and middle-income countries.

In India, for example, approximately 53% of CVD deaths are inpeople younger than 70 years of age; in China, the correspondingfigure is 35%. The majority of the estimated 32 million heartattacks and strokes that occur every year are caused by one or

more cardiovascular risk factorshypertension, diabetes,smoking, high levels of blood lipids, and physical inactivityandmost of these CVD events are preventable if meaningful actionis taken against these risk factors.


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CVD is an important cause of global morbidity

and in five of the six WHO Regions it is the

leading cause of mortality.


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Cardiovascular Risk

Risk factors i.e. smoking, unhealthy diet andphysical inactivity are expressed as hypertension,diabetes, obesity and high blood lipid levels, and

together contribute to the total cardiovascularrisk and are the root causes of the global CVDepidemic

Risk factors account for 75% of the CVDepidemic worldwide


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Heart attacks and strokes are leading causes of death and

disability, they represent only the tip of an iceberg.


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CVDs are responsible for the deaths of 17

million people each year, or approximately

onethird of global deaths annually.

Hypertension is the most prevalent CVD,

affecting at least 600 million people, and is an

important contributor to cardiovascular

mortality and morbidity


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Hypertension as an entry point to cardiovascular

risk management About 15%37% of the adult population worldwide is

afflicted with hypertension

In general, hypertension prevalence is higher in urban settingscompared to rural settings

Data from World Health Report 2002 indicate thathypertension is the third most important contributor to theglobal disease burden among the six risk factors:underweight, unsafe sex, hypertension, unsafe water, tobaccoand alcohol.

treating hypertension has been associated with a 35%40%reduction in the risk of stroke and a reduction of at least 15%in the risk of myocardial infarction.


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a paradigm shift from treatment of hypertension

to management of comprehensive cardiovascular

risk. Cost-effectiveness of treating hypertension is

also determined by the overall cardiovascular riskand not by blood pressure alone


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Barriers to cardiovascular risk

management Health policy

The overriding barrier to CVD risk-management programmes in low- andmiddle-income countries is that there are no formal policies that targetCVD as a major health issue.

In 2001, a survey of 167 countries in the six WHO Regions found that57% of the countries lacked a noncommunicable disease policy, and 65%had no CVD plan

Health-care systems under equipped health facilities; a lack of continuity between primary

health care and the secondary- and tertiary-care sectors; poorly-developedinformation systems; a lack of awareness of the potential health benefitsand cost savings of CVD programmes; and the influence of commercialinterests on resource allocation.


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Barriers to cardiovascular risk

management Health-care providers

the lack of personnel with appropriate training and skills, and an alreadyoverburdened workforce.

In the WHO global capacity assessment survey, healthcare professionalsreceived no training in the management of noncommunicable diseases in

about one-half of the 167 countries surveyed.

Patients, families and the community A comprehensive CVD risk-management programme relies upon

individual patients adhering to daily drug treatments, accepting lifestyleadvice, and returning for follow-up assessments

Patient adherence needs to be enhanced through the support of familymembers and the community

Families and communities need to be empowered to actively participatein patient care, through health education and through communitymobilization programmes.


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Menurut Menkes CVD telah menjadi salah satu

masalah penting kesehatan masyarakat dan

penyebab kematian utama

WHO, memperkirakan pa tahun 2030, 23,6 juta

orang meninggal karena CVD

Riskesdas (2007), menunjukkan prevalensi

penyakit jantung 7,2%

Penyakit jantung Iskemik : 5,1% dari seluruh

penyebab kematian dan penyakit jantung 4,6%

dari seluruh kematian

1. Strategic Priorities of the WHO Cardiovascular Disease Programme

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