Global Inequalities in Access to Cardiovascular Health Care

Abstract

Cardiovascular disease (CVD) was the leading cause of death globally in 2005, responsible for 17.5 million deaths, more than 80% of which occurred in low- and middle-income countries (LMIC). In these regions, CVD occurs at a much younger age than in high-income countries, thereby contributing disproportionately to lost potential years of healthy life as well as lost economic productivity. Many effective interventions for CVD prevention and management are now affordable for all but the very poorest countries, but large treatment gaps still exist because of poor prescribing practices, limited availability of medicines, and lack of appropriately skilled health care providers. Despite the increasing awareness of the growing epidemic of CVD in LMIC, this public health priority has received little attention from those who determine the international health agenda. Although the burden of CVD is already enormous in developing countries, there exists a window of opportunity to prevent the epidemic reaching its full potential magnitude. This requires the rapid deployment of strategies already proven to be effective in high-income countries. Such strategies need to be tailored for LMIC for them to be affordable, effective, and accessible to disadvantaged groups and the burgeoning middle classes. Ideally, the control of CVD in these countries would involve a dual approach in which evidence-based clinical strategies for CVD prevention and treatment are complemented by evidence-based population level strategies. We propose that upgrading primary health care services is a central requirement for the control of the CVD epidemics facing the developing world.

The impact of social determinants on cardiovascular disease

“…This pattern has been repeatedly observed in many developing countries. For example, body mass index and blood cholesterol levels have dramatically increased in the Chinese population, likely due to a sharp increase in fat consumption; it is expected that China will soon experience a rapid escalation of coronary artery disease, surpassing the current one-third of total lives that it claims each year (13,17). Even with China's booming economic growth, health care costs are currently unsustainable -the impact of which has been detrimental to the poor.…”

“…Even with China's booming economic growth, health care costs are currently unsustainable -the impact of which has been detrimental to the poor. Health care is less accessible while the health care system is inundated, having to cope with the double burden of infectious and chronic disease in an excessively large population (13,17).…”

The Impact of Mobile Health Interventions on Chronic Disease Outcomes in Developing Countries: A Systematic Review

“…1 By 2030, it has been estimated that 23 million people will die annually from cardiovascular disease, with approximately 85% happening in LMIC. 2 In addition, chronic conditions have become a marker of the increasing health inequalities in LMIC, highlighting the urgent need to implement more effective and cost-effective interventions. 2 Morbidity and mortality due to chronic disease are largely preventable through counseling, risk factor modification, and medication adherence, but implementation of these interventions is difficult in resource-limited settings.…”

“…2 In addition, chronic conditions have become a marker of the increasing health inequalities in LMIC, highlighting the urgent need to implement more effective and cost-effective interventions. 2 Morbidity and mortality due to chronic disease are largely preventable through counseling, risk factor modification, and medication adherence, but implementation of these interventions is difficult in resource-limited settings. 3 These interventions need to be integrated into primary healthcare systems and tailored for LMIC for them to be affordable, effective, and accessible, especially for disadvantaged groups.…”

Optimization of fibrinolytic protease production from Bacillus subtilis I-2 using agro-residues

“…Cardiovascular diseases (CVDs) have emerged as the number one cause of global deaths claiming 17.3 million lives in 2008 and the figure is predicted to rise to 23.6 million by 2030 (Joshi et al 2008). Thrombosis, manifested in the form of embolism, myocardial infarction, stroke and other cardiac disorders is one of the major causes of CVDs (Mahajan et al 2012).…”