Washington, April 11, 2002 (PAHO) - Cardiovascular diseases (CVD) will cause three times more deaths and disability in South America and the Caribbean than infectious diseases over the next 20 years, and health systems in the Region are not adequately prepared.

"Demographic problems, such as the growing proportion of elderly people, and reduced mortality from acute coronary cases will lead to a general increase in the total number of people with heart disease in the population," says Dr. Pedro Ordúñez of the Pan American Health Organization (PAHO).

Statistics on diagnosis and treatment of hypertension show services are reaching a minority of the people who need them. While coverage in Latin America and the Caribbean is still inadequate, considerable infrastructure is already in place, currently giving 75 percent of the population of the Region of the Americas some access to health services, he says.

"However, data from demographic surveys in Chile and Cuba revealed that 37 percent and 39 percent, respectively, of the people with hypertension were not aware that they had it. And, more serious still, a high percentage of them (between 15 percent and 19 percent of hypertensives) knew they had it but were not receiving treatment for it," notes Dr. Ordúñez.

According to a PAHO report, the two most significant cardiovascular diseases are ischemic heart disease and cerebrovascular disease. Both can be prevented by controlling and avoiding primary risk factors, the most important of which are smoking, an inadequate diet, lack of physical activity, obesity, hypertension, and high cholesterol.

Accounting for 30 percent of deaths worldwide in 1999, cardiovascular diseases constitute one of the leading causes of death in both the developed and the developing countries. According to Dr. Ordúñez, in 1990, 63 percent of the deaths attributed to cardiovascular diseases--that is, 8 million to 9 million--occurred in developing countries, including South America and the Caribbean, versus 5.3 million in the developed countries.

"CVD, coronary and cerebrovascular disease need effective programs for prevention, diagnosis, and control. Strategically, controlling hypertension is the best choice for the initial component of an integrated program for CVD control in developing countries," says Dr. Ordúñez.

Primary prevention through a program based on the association between CVD and the lifestyle of the population, as well as effective and economically viable methods of detecting and managing the disease, are complementary approaches in the struggle against CVD, he says.

"The existing medical infrastructure must be reoriented to deal with the emerging challenge of CVD and at the same time should prepare the community through health education," says Dr. Ordúñez.

Prevention and control of cardiovascular disease can be improved with an integrated approach to the health of the population. Within this approach some interventions target individuals; others, the environment in which they live; and still others, the health system, to make it more efficient.

"We are approaching the problem from this population-based health perspective to ensure the resources allocated have the greatest impact in terms of reducing morbidity and mortality among the population as a whole. This type of approach helps to identify health promotion needs, direct how health promotion is to be carried out, and determine whether the desired outcomes were obtained," says Dr. Ordúñez.

PAHO, officially established in 1902, has been working with all the countries of the Americas for 100 years to improve health and raise living standards. It also serves as the Regional Office for the Americas of the World Health Organization.