Science in Action for Better Cardiovascular Health. The cases of Cuba and Mexico

Science in Action for Better Cardiovascular Health. The cases of Cuba and Mexico

The Pan American Health Organization invites you to participate on a new HEARTS in the Americas webinar, titled  "Science in Action for Better Cardiovascular Health. The cases of Cuba and Mexico", that will take place on Thursday, 9 September 2021. 




Cardiovascular diseases (CVD) are the leading causes of death globally. Viewed as a threat to the global economy, the United Nations included reducing the noncommunicable diseases (NCD) burden, including CVD, in the 2030 sustainable development goals. In response, the World Health Organisation led the development of HEARTS, a technical package to guide governments in strengthening primary care to reduce CVDs.

Over 20 years ago, two large prospective cohort studies in Cuba and Mexico were established. Each recruited around 150k adults, collected questionnaire and physical measurement data, and tracked the participants for cause-specific mortality. Over the next two decades, higher systolic blood pressure (SBP) at recruitment was associated with higher CVD mortality, with an approximate doubling in CVD mortality risk during middle-age for each 20 mmHg higher SBP (consistent with what is seen in high-income countries). In both studies, overweight and obesity were also associated with higher CVD risk. In Mexico, diabetes was common and was associated with a much worse prognosis than seen in most previously studied populations; those with diabetes had quadruple the mortality rate in middle-age compared with those without diabetes. Although there was little diabetes in Cuba at the time of recruitment, it was still associated with a doubling in CVD mortality risk. These findings are relevant to design and customize the HEARTS interventions.

By 2025, the HEARTS will be the model for cardiovascular disease risk management, including hypertension, diabetes, and dyslipidemia in primary health care in the Americas. HEARTS in the Americas will be the front-line program to strengthen, integrate, and improve the quality of care for NCD in primary health care in the post-COVID 19 recovery. The Initiative is currently being implemented in 16 countries, with 739 primary health care centers participating within an aggregate catchment area of over 8 million people.




  • Primary Health Care Providers from all institutions, including centers implementing HEARTS.
  • Professional Societies of Cardiology, Hypertension, Family Medicine and others.
  • Ministry of Health personnel including the areas of Primary Care, Noncommunicable Diseases, Health Technologies.


How to participate


  • DATE: Thursday, 9 September 2021
  • TIME: 2:00 - 4:00 pm (EDT) [see time correspondence below]
    • After registering, you will receive a confirmation email with information on how to join the webinar.
    • If the capacity of the virtual room is exceeded, you can follow the session on the PAHO YouTube channel in the following links: 
  • LANGUAGE: The session will be in English, Spanish and Portuguese with simultaneous translation, as well as close caption. 






Moderator: Dr. Pedro Ordúñez  –  Regional Advisor on Noncommunicable Diseases. HEARTS Program in the Americas. (PAHO)

First Section. The Science

Prospective cohort studies in Cuba and Mexico

  • Scope and methodology. Dr. Jonathan Emberson PhD. Professor of Medical Statistics and Epidemiology, University of Oxford
  • The findings. 
    • Blood pressure and CVD mortality in Cuba. Dr. Nurys B Armas Rojas MD. National Institute of Cardiology and Cardiovascular Surgery, Havana, Cuba
    • Blood Pressure and Cause-Specific Mortality in Mexico. Dr. Jesus Alegre-Díaz MD. National Autonomous University of Mexico
  • Policy Implications/Key messages. Dr. Sarah Lewington DPhil. Professor of Epidemiology and Medical Statistics, University of Oxford

Q and A

Second Section. The response

Learning from two successful implementation cases of HEARTS in the Americas

  • Cuba. Dr. Yamile Valdes Gonzalez, MD, MSc. Coordinador. HEARTS in Cuba.
  • Mexico. Dr. Ruiz Lopez Ridaura. MD. General Director of the National Center for Disease Control and Preventive Programs

Q and A


Time correspondence 


  • 12:00 pm. – Belmopan, Guatemala City, Managua, San José (CR), San Salvador, Tegucigalpa
  •  1:00 pm. – Kingston, Mexico City, Panamá City
  •  2:00 pm. – Bridgetown, Castries, Georgetown, Nassau, Port-au-Prince, Port of Spain, San Juan, Washington DC
  •  3:00 pm. – Brasilia, Paramaribo
  •  8:00 pm. – Geneva, Madrid

For other cities, check the time in the following link

Links of interest:





  1. Campbell NRC, Ordunez P, Giraldo G, Rodriguez Morales YA, Lombardi C, Khan T, Padwal R, Tsuyuki RT, Varghese C. WHO HEARTS: A Global Program to Reduce Cardiovascular Disease Burden: Experience Implementing in the Americas and Opportunities in Canada. Can J Cardiol. 2021 May;37(5):744-755.
  2. Armas Rojas NB, Lacey B, Soni M, Charles S, Carter J, Varona-Pérez P, Burrett JA, Martínez MC, Lorenzo-Vázquez E, Constantén SB, Taylor H, Sherliker P, Rigau JMM, Ross S, Massa MS, López OJH, Islam N, Morales MÁM, Alomá IA, Estupiñan FA, González MD, Muñoz NR, Asencio MC, Díaz-Diaz O, Iglesias-Marichal I, Emberson J, Peto R, Lewington S. Body-mass index, blood pressure, diabetes and cardiovascular mortality in Cuba: prospective study of 146,556 participants. BMC Public Health. 2021 May 27;21(1):963.
  3. Tapia-Conyer R, Alegre-Díaz J, Gnatiuc L, Wade R, Ramirez-Reyes R, Herrington WG, Lewington S, Clarke R, Collins R, Peto R, Kuri-Morales P, Emberson J. Association of Blood Pressure With Cause-Specific Mortality in Mexican Adults. JAMA Netw Open. 2020 Sep 1;3(9):e2018141.
  4. Valdés González Y, Campbell NRC, Pons Barrera E, Calderón Martínez M, Pérez Carrera A, Morales Rigau JM, Afonso de León JA, Pérez Jiménez V, Landrove Rodríguez O, DiPette DJ, Giraldo G, Orduñez P. Implementation of a community-based hypertension control program in Matanzas, Cuba. J Clin Hypertens (Greenwich). 2020 Feb;22(2):142-149