Punta Cana, Dominican Republic. 15 May 2019. With the addition of the Dominican Republic, there are now nine countries in the Region of the Americas implementing the HEARTS Initiative. This program seeks to reduce the illness, disability, and deaths caused by cardiovascular diseases by applying best practices for the prevention, control, and treatment of hypertension.
Hypertension is the principal risk factor for premature death from a cardiovascular event. It is the world’s second leading cause of disability and disproportionately affects low- and middle-income countries. With a view to addressing this reality, HEARTS emerged as the leading global initiative to prevent and control cardiovascular disease (CVD).
To support the smooth and progressive incorporation of this model into existing health services, a technical package has been developed, currently consisting of five modules and an implementation guide.
HEARTS is promoted by the World Health Organization and includes the participation of the United States Centers for Disease Control and Prevention (CDC), the Resolve to Save Lives initiative, the International Society of Nephrology and International Society of Hypertension, the World Hypertension League, the International Diabetes Federation, and the World Heart Federation, among others. In the Region of the Americas, the Ministries of Health lead the initiative with support and technical coordination from the Pan American Health Organization/World Health Organization (PAHO/WHO).
Under this initiative, PAHO/WHO organized the second HEARTS regional workshop in the Americas from 14 to 17 May in Punta Cana. Participants included representatives of the Ministries of Health and PAHO/WHO offices in the countries that are implementing HEARTS: Argentina, Barbados, Chile, Colombia, Cuba, Ecuador, Panama, Trinidad and Tobago, and the host country. Mexico, Peru, and Saint Lucia also participated in the workshop, since they plan to join the program soon.
The opening session was led by Alma Morales Salinas, PAHO/WHO Representative in the Dominican Republic; Chanel Rosa Chupany, executive director of the National Health Services; Anselm Hennis, director of PAHO’s Department of Noncommunicable Diseases and Mental Health; Patricia Richter, Noncommunicable Diseases Branch Chief in the Division of Global Health Protection of the CDC; and Marc Jaffe, Vice-President of Resolve to Save Lives.
According to Dr. Morales Salinas, “Initiatives such as HEARTS promote an innovative approach to noncommunicable diseases. It forces to us to look for new partners and to understand that commitment and action do not only come from the health sector. PAHO invites all the countries here to take ownership of this workshop and implement the initiative, with our sights set on Universal Health and closing the gap in health services access and coverage.”
Dr. Hennis stressed that the HEARTS initiative is an example of moving from words to action. He urged the attendees to keep strengthening their commitment, passion, and dedication, because “we should realize that this effort aims to save lives both in the Region of the Americas and worldwide.”
Dr. Chanel Rosa Chupany said that around 34% of deaths in the country are from cardiovascular diseases. This warrants a comprehensive response by the sectors involved and requires public policies to fight and prevent these diseases.
The Regional HEARTS Workshop was held during the Inter-American Congress of Cardiology (SIAC), with which there will be a joint meeting of the HEARTS participating countries to discuss common critical issues and hypertension as a global priority. The gathering took place on World Hypertension Day, celebrated annually on 17 May.
Components of HEARTS
Implementation of the HEARTS initiative revolves around five fundamental elements: the establishment of an algorithm for standardized treatment; the adoption of a core set of drugs whose effectiveness is backed by evidence; the use of clinical records to monitor patients; and performance evaluation according to established indicators. The fifth element is reorganization of the roles and responsibilities of the different members of the health team, including not just doctors and nurses, but also health promoters, nutritionists, and pharmacy staff, among others.
A key issue is to establish guidelines for prescribing different sets of drugs based on the best clinical evidence available and their availability and affordability. This is accompanied by patient counseling on lifestyle changes such as getting more exercise, eating better, and quitting smoking, which are the main risk factors.