A Global Perspective on Using Implementation Research to Address Hypertension-Associated Target Organ Damage

Abstract

<p>Hypertension, a major risk factor for cardiovascular disease, imposes a significant public health burden and challenge to address it worldwide. Scaling up delivery of proven, effective interventions for hypertension could significantly advance the goal of reducing the global burden. Although significant progress has been made in many countries, some lament that large-scale initiatives focused on reducing blood pressure in global populations have not effectively addressed this challenge. Late-stage implementation research plays a critical role in determining effective and sustainable scale-up of these initiatives. In this article, we briefly discuss some of the global initiatives that have been funded by the National Heart, Lung, and Blood Institute of the US National Institutes of Health. Intervention delivery strategies in low resource settings must have demonstrated effectiveness and consideration for the social, cultural and physical context (eg, access, affordability, and availability of medications) in which a program is being delivered in order to be sustainable nationally and globally. Hence, the use of implementation research is central to determining sustainable delivery of evidence-based and tailored interventions focused on hypertension control. The sustained control of hypertension in global populations holds tremendous potential for reducing morbidity, premature mortality, and the adverse economic impact of cardiovascular disease in all regions. <em>Ethn Dis. </em>2016; 26(3):395-398; doi:10.18865/ ed.26.3.395 </p>

Gender differences and determinants of prevalence, awareness, treatment and control of hypertension among adults in China and Sweden

“…Cross-national intervention design, implementation and evaluation can provide a better understanding of how an effective intervention works well in one setting but not in the other, thereby providing new knowledge that can be used to help in developing and tailoring an effective health intervention for another context. Such implementation research needs to be promoted to achieve better implementation of hypertension prevention and control programmes globally [ 47 ].…”

Reducing major risk factors for chronic kidney disease

“…Screening and early intervention when CKD is detected were shown to reduce ESKD and be costeffective. 40,[59][60][61] Nephrotoxins as risk factors for AKI and CKD Nephrotoxic agents can cause both AKI and CKD. 62 Nephrotoxin exposure is common in hospitalized patients and may account for up to 25% of AKI cases.…”