COUNTRIES SHOULD FORMULATE GUIDELINES FOR PREVENTION, CONTROL OF CARDIOVASCULAR DISEASE
COUNTRIES SHOULD FORMULATE GUIDELINES FOR PREVENTION, CONTROL OF CARDIOVASCULAR DISEASE
2-6 September 2006, World Congress of Cardiology, Barcelona - Countries should formulate national and regional guidelines for the prevention and control of cardiovascular disease using 10 principles developed by the World Heart Federation, say the authors of an editorial in the September 2006 Nature Clinical Practice Cardiovascular Medicine.
Cardiovascular disease (CVD) is the world’s biggest killer, cutting short 17.5 million lives in 2005, according to the World Health Organization.1
The editorial was written by three officers of the World Heart Federation: Chairman of the Scientific Advisory Board Sidney Smith, Chief Executive Officer Janet Voûte and President Valentin Fuster.2
“As 80% of CVD-related mortality now occurs in countries with developing economies, it is imperative that governments work in partnership with national societies of health-care providers and foundations to develop guidelines that reflect national or regional priorities and resources,” said Dr Smith, Ms Voûte and Dr Fuster.
Although the causes of the global epidemic of cardiovascular disease involve the same risk factors, one size does not fit all when it comes to developing guidelines for a specific country.
The authors emphasized that “the approaches to [CVD] control and prevention can differ in each geographic region because of the cultural, social, medical and economic circumstances.”
The most cost-effective approach is to treat patients at “high short-term risk, whether that risk is based on a previous CVD event or determined by high global risk,” and to encourage people at “lower short-term” risk to adopt healthier diets, to be more physically active and to avoid tobacco, they said.
“The health-care budget for each nation should reflect a thoughtful determination to assess the specific benefits for primary and secondary prevention programs based on local epidemiologic factors,” they said. “Importantly, every effort should be made to address financial constraints placed upon the health-care system.”
Countries have an imperative to act immediately. The authors stressed, “If we are to succeed in our efforts to curb the increasing burden of CVD worldwide, health-care providers, national societies and foundations and governments must act now in partnership to implement guideline-based programs and legislation directed toward the prevention of CVD.”
The principles for the development of clinical guidelines were developed by the World Heart Federation’s World Heart and Stroke Forum in 20043.
1 World Health Organization, Preventing Chronic Diseases: a vital investment, 2005.
2 Dr Fuster directs the Zena and Michael A. Wiener Cardiovascular Institute and the Marie-Josée and Henry R. Kravis
Center for Cardiovascular Health at the Mount Sinai School of Medicine in New York. Dr Smith directs the Center for
Cardiovascular Science and Medicine at the University of North Carolina at Chapel Hill.
3 Circulation, 2004;109:3112-3121.
The 10 principles are as follows:
I. Governments, national societies and foundations should collaborate to develop clinical and public health guidelines for CVD prevention that target risk factors;
II. Evidence-based guidelines should incorporate professional judgment on the translation of such evidence into effective and efficient care, addressing all areas of CVD risk.
III. The assessment of total CVD risk should be based on epidemiological risk factor data appropriate to the population to which it is applied;
IV. Policy recommendations and guidelines should emphasize the importance of a total risk reduction for
CVD prevention.
V. The intensity of interventions should be a function of the total CVD risk, with lower treatment thresholds for higher-risk patients than for low-risk patients.
VI. National cardiovascular societies and foundations should promote routine, prospective collection of
validated national vital statistics on the causes of CVD and outcomes of patients with CVD for use in the
development of national policies.
VII. National professional societies should inform policy makers of risk factor targets and drug therapies for CVD prevention that are culturally and financially appropriate to their nation, and ask their governments to incorporate CVD prevention into legislation whenever relevant;
VIII. National professional societies and foundations should facilitate CVD prevention through education and training programs for health-care professionals;
IX. National professional societies should assess the achievement of lifestyle, risk factor and therapeutic targets defined in the national guidelines.
X. Health-care professionals should include CVD prevention as an integral part of their daily clinical practice.
- Ends -
About the World Heart Federation
The World Heart Federation, a nongovernmental organization based in Geneva, Switzerland, is committed to helping the global population achieve a longer and better life through prevention and control of heart disease and stroke, with a particular focus on low- and middle-income countries. It is comprised of 189 member societies of cardiology and heart foundations from over 100 countries covering the regions of Asia-Pacific, Europe, the Americas and Africa. To find out more about The World Heart Federation visit www.worldheart.com.
Principles for National and Regional Guidelines on Cardiovascular Disease Prevention: A Scientific Statement from the World Heart and Stroke Forum can be viewed at:
http://circ.ahajournals.org/cgi/content/full/109/25/3112
The web site of Nature Clinical Practice Cardiovascular Medicine is http://www.nature.com/ncpcardio/index.htm
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