Cost effective interventions for the prevention of cardiovascular disease in low and middle income countries: a systematic review

Shroufi, Amir; Chowdhury, Rajiv; Anchala, Raghupathy; Stevens, Sarah; Blanco, Patricia; Han, Tha; Niessen, Louis; Franco, Oscar H.

doi:10.1186/1471-2458-13-285

Cited by 52 publications

(35 citation statements)

References 45 publications

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“…108 The urgent need to address lifestyle risk factors globally is recognized by the United Nations, 109 including in regions such as sub-Saharan Africa, where non-infectious diseases associated with a Western-type lifestyle are not yet the leading causes of death or illness. 110 Given the already increasing numbers of patients with heart failure in economically developing regions, governments should be encouraged to combine lifestylebased preventive measures with their programmes for tackling famine and pestilence.…”

Section: Patient Perspectivementioning

confidence: 99%

Heart failure: preventing disease and death worldwide

et al. 2014

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Executive Summary Heart failure is a life-threatening disease and addressing it should be considered a global health priority. At present, approximately 26 million people worldwide are living with heart failure. The outlook for such patients is poor, with survival rates worse than those for bowel, breast or prostate cancer. Furthermore, heart failure places great stresses on patients, caregivers and healthcare systems. Demands on healthcare services, in particular, are predicted to increase dramatically over the next decade as patient numbers rise owing to ageing populations, detrimental lifestyle changes and improved survival of those who go on to develop heart failure as the final stage of another disease. It is time to ease the strain on healthcare systems through clear policy initiatives that prioritize heart failure prevention and champion equity of care for all. Despite the burdens that heart failure imposes on society, awareness of the disease is poor. As a result, many premature deaths occur. This is in spite of the fact that most types of heart failure are preventable and that a healthy lifestyle can reduce risk. Even after heart failure has developed, premature deaths could be prevented if people were taught to recognize the symptoms and seek immediate medical attention. Public awareness campaigns focusing on these messages have great potential to improve outcomes for patients with heart failure and ultimately to save lives.

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Section: Patient Perspectivementioning

confidence: 99%

Heart failure: preventing disease and death worldwide

et al. 2014

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“…51 Where necessary, to assess priority interventions when evidence from LMICs was scarce, we referred to evidence from HICs. Some systematic reviews assessed the evidence of cost 51 and cost-effectiveness of interventions to tackle CVDs in LMICs specifically, 53,54 and found that although the cost-effectiveness evidence on CVD interventions in LMICs is increasing, it is modest in comparison to the evidence in HICs.…”

Section: Cost-effectiveness Of Interventions For Cvrdsmentioning

confidence: 99%

Cardiovascular, respiratory, and related disorders: key messages from Disease Control Priorities, 3rd edition

et al. 2018

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Cardiovascular, respiratory, and related disorders (CVRDs) are the leading causes of adult death worldwide, and substantial inequalities in care of patients with CVRDs exist between countries of high income and countries of low and middle income. Based on current trends, the UN Sustainable Development Goal to reduce premature mortality due to CVRDs by a third by 2030 will be challenging for many countries of low and middle income. We did systematic literature reviews of effectiveness and cost-effectiveness to identify priority interventions. We summarise the key findings and present a costed essential package of interventions to reduce risk of and manage CVRDs. On a population level, we recommend tobacco taxation, bans on trans fats, and compulsory reduction of salt in manufactured food products. We suggest primary health services be strengthened through the establishment of locally endorsed guidelines and ensured availability of essential medications. The policy interventions and health service delivery package we suggest could serve as the cornerstone for the management of CVRDs, and afford substantial financial risk protection for vulnerable households. We estimate that full implementation of the essential package would cost an additional US$21 per person in the average low-income country and $24 in the average lower-middle-income country. The essential package we describe could be a starting place for low-income and middle-income countries developing universal health coverage packages. Interventions could be rolled out as disease burden demands and budgets allow. Our outlined interventions provide a pathway for countries attempting to convert the UN Sustainable Development Goal commitments into tangible action.

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“…of these strategies involved participants, stakeholders from communities, health systems, providers and managers at various levels including local leaders, local institutions, and local, regional, and national authorities. Shroufi and colleagues conducted a systematic review of cost-effective interventions for the prevention of cardiovascular disease in low-and middle-income countries 18 and found that while more studies of cardiovascular preventive interventions were needed in lowand middle-income settings, a wide range of interventions for the prevention of cardiovascular disease are cost effective across all world regions, a finding also noted by others.…”

Section: Implementation Research To Address Hypertension -Peprah Et Almentioning

confidence: 73%

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

et al. 2016

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<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>

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Cost effective interventions for the prevention of cardiovascular disease in low and middle income countries: a systematic review

Cited by 52 publications

References 45 publications

Heart failure: preventing disease and death worldwide

Heart failure: preventing disease and death worldwide

Cardiovascular, respiratory, and related disorders: key messages from Disease Control Priorities, 3rd edition

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

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