HEARTS in the Americas: Targeting Health System Change to Improve Population Hypertension Control.

IF 3.9 2区 医学 Q1 PERIPHERAL VASCULAR DISEASE Current Hypertension Reports Pub Date : 2024-04-01 Epub Date: 2023-12-02 DOI:10.1007/s11906-023-01286-w
Pedro Ordunez, Norm R C Campbell, Donald J DiPette, Marc G Jaffe, Andres Rosende, Ramon Martinez, Angelo Gamarra, Cintia Lombardi, Natalia Parra, Libardo Rodriguez, Yenny Rodriguez, Jeffrey Brettler
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Abstract

Purpose of review: HEARTS in the Americas is the regional adaptation of Global Hearts, the World Health Organization initiative for cardiovascular disease (CVD) prevention and control. Its overarching goal is to drive health services to change managerial and clinical practice in primary care settings to improve hypertension control and CVD risk management. This review describes the HEARTS in the Americas initiative. First, the regional epidemiological situation of CVD mortality and population hypertension control trends are summarized; then the rationale for its main intervention components: the primary care-oriented management system and the HEARTS Clinical Pathway are described. Finally, the key factors for accelerating the expansion of HEARTS are examined: medicines, team-based care, and a system for monitoring and evaluation.

Recent findings: Thus far, 33 countries in Latin America and the Caribbean have committed to integrating this program across their primary healthcare network by 2025. The increase in hypertension coverage and control in primary health care settings compared with the traditional model is promising and confirms that the interventions under the HEARTS umbrella are feasible and acceptable to communities, patients, providers, decision-makers, and funders. This review highlights some cases of successful implementation. Scaling up effective treatment for hypertension and optimization of CVD risk management is a pragmatic way to accelerate the reduction of CVD mortality while strengthening primary healthcare systems to respond effectively, with quality, and equitably, to the challenge of non-communicable diseases, not only in low-middle income countries but in all communities globally.

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美洲的心脏:以卫生系统变革为目标,改善人群高血压控制。
审查目的:美洲的HEARTS是世界卫生组织心血管疾病(CVD)预防和控制倡议“全球心脏”的区域调整。其总体目标是推动卫生服务改变初级保健机构的管理和临床实践,以改善高血压控制和心血管疾病风险管理。本综述描述了美洲的HEARTS倡议。首先,总结了各地区心血管疾病死亡率和人群高血压控制趋势的流行病学情况;然后描述了其主要干预成分的基本原理:初级保健导向管理系统和HEARTS临床路径。最后,对加速扩大HEARTS的关键因素进行了审查:药物、以团队为基础的护理以及监测和评估系统。最近的发现:迄今为止,拉丁美洲和加勒比地区已有33个国家承诺到2025年将这一规划纳入其初级卫生保健网络。与传统模式相比,初级卫生保健机构高血压覆盖率和控制的增加是有希望的,并证实了HEARTS保护伞下的干预措施对社区、患者、提供者、决策者和资助者来说是可行和可接受的。这次审查突出了一些成功实施的案例。扩大对高血压的有效治疗和优化心血管疾病风险管理是一种务实的方式,可以加速降低心血管疾病死亡率,同时加强初级卫生保健系统,以有效、高质量和公平地应对非传染性疾病的挑战,不仅在中低收入国家,而且在全球所有社区。
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来源期刊
Current Hypertension Reports
Current Hypertension Reports 医学-外周血管病
CiteScore
10.50
自引率
0.00%
发文量
65
审稿时长
6-12 weeks
期刊介绍: This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of hypertension. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as antihypertensive therapies, associated metabolic disorders, and therapeutic trials. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.
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