Call to Action: Urgent Challenges in Cardiovascular Disease: A Presidential Advisory From the American Heart Association

Abstract

Although advances in care have spurred improvements in cardiovascular outcomes, cardiovascular disease remains the leading cause of death in the United States and around the world. Previous declines in cardiovascular disease mortality have slowed and even reversed for certain demographics. Further concerns exist with regard to cardiovascular drug innovation, quality of care, and healthcare costs. The Value in Healthcare Initiative–Transforming Cardiovascular Care, a collaboration of the American Heart Association and Duke University, Robert J. Margolis, MD, Center for Health Policy, aims to increase access to and affordability of cardiovascular treatment and to decrease barriers to care. The following Call to Action describes trends in cardiovascular care, identifies gaps in areas of cardiovascular disease prevention and treatment, highlights challenges with medical product innovation, and finally, outlines a series of learning collaboratives that will aid in the development of road maps for transforming cardiovascular care.

Reformulating Small Molecules for Cardiovascular Disease Immune Intervention: Low-Dose Combined Vitamin D/Dexamethasone Promotes IL-10 Production and Atheroprotection in Dyslipidemic Mice

“…Despite significant advances in the prevention and management of atherosclerotic CVD, they are expected to remain as the major cause of human mortality and disability worldwide (1)(2)(3). Whereas the public health situation and economic impact of CVD claims for novel therapies, vascular drug development has paradoxically declined in the last two decades owing to the intrinsic complexities of CVD, as compared to other lifethreatening and costly chronic diseases like cancer (3).…”

“…Despite significant advances in the prevention and management of atherosclerotic CVD, they are expected to remain as the major cause of human mortality and disability worldwide (1)(2)(3). Whereas the public health situation and economic impact of CVD claims for novel therapies, vascular drug development has paradoxically declined in the last two decades owing to the intrinsic complexities of CVD, as compared to other lifethreatening and costly chronic diseases like cancer (3). Although recent advances in the understanding of atherosclerosis highlight the complexity of the pathophysiological events underlying the development of atheromatous plaques and subsequent vascular complications, novel opportunities for therapeutic interventions have also been revealed (see editorial (2) and compendium articles therein).…”

Cardiovascular Disease among Syrian refugees: a descriptive study of patients in two Médecins Sans Frontières clinics in northern Lebanon

“…This is a significant gap, especially given that limited evidence shows that crises may actually increase CVD mortality, morbidity and risk factors [12,[16][17][18]. Commentators have noted the challenges that exist around identifying and treating ASCVD even in high-income, stable settings with ready access to medications and diagnostics [19].…”

Big data and data sharing: Opportunities for the urgent challenges in cardiovascular disease

“…As similar or even better outcomes may be reproduced at substantially lower costs in certain context, this raises questions about the suitability of CV healthcare spending . In light of this, the American Heart Association recently recognized six categories of missed opportunities to improve CV care and avoid unnecessary costs: (a) risk factor modifications; (b) patient engagement and involvement; (c) correct diagnosis; (d) adherence and proper use of first‐line treatments; (e) proper use of advance treatments; and (f) better use of supportive devices . The current challenge is then to address the shortfalls of existing treatments, also facing the continuous innovations in CV health management.…”

“…The current challenge is then to address the shortfalls of existing treatments, also facing the continuous innovations in CV health management. Similar to the European Heart Network, also the American Heart Association has recently established the Value in Health Care Initiative to increase awareness, access and affordability while eliminating barriers to necessary care …”