PAHO launches roadmap to improve high blood pressure control and save lives

The Pan Amer­i­can Health Or­ga­ni­za­tion (PA­HO) said Mon­day it has launched the new HEARTS Qual­i­ty Frame­work, which it says coun­tries can use im­me­di­ate­ly to en­hance hy­per­ten­sion and car­dio­vas­cu­lar risk man­age­ment, pre­vent heart at­tacks and strokes, and de­liv­er bet­ter care through pri­ma­ry health care clos­er to peo­ple’s homes.

PA­HO said that the HEARTS ap­proach is al­ready trans­form­ing hy­per­ten­sion and car­dio­vas­cu­lar risk care. It said com­mu­ni­ties in Colom­bia, Mex­i­co, Trinidad and To­ba­go, and oth­ers have sim­i­lar­ly in­creased con­trol rates af­ter adopt­ing HEARTS stan­dards.

In the Do­mini­can Re­pub­lic, HEARTS is a gov­ern­ment pri­or­i­ty, pro­vid­ing free treat­ment to mil­lions. El Sal­vador ex­pand­ed HEARTS across its pri­ma­ry health care net­work, achiev­ing con­trol rates of near­ly 70 per cent and Mex­i­co has al­so ini­ti­at­ed large-scale im­ple­men­ta­tion na­tion­wide.

“These re­sults show that hy­per­ten­sion con­trol and car­dio­vas­cu­lar risk man­age­ment at scale is pos­si­ble,” said Dr. Es­te­ban Lon­doño, lead au­thor and PA­HO in­ter­na­tion­al con­sul­tant in non­com­mu­ni­ca­ble dis­eases.

“Pri­ma­ry health care equipped with stan­dard­ized clin­i­cal path­ways, re­li­able med­i­cines, team-based care, and qual­i­ty-im­prove­ment tools can gen­er­ate life-sav­ing im­pact for mil­lions.”

In launch­ing the frame­work pub­lished in The Lancet Re­gion­al Health – Amer­i­c­as, PA­HO said in the Amer­i­c­as, in­clud­ing the Caribbean, heart dis­ease and strokes claim more than 2.2 mil­lion lives each year, and many of the vic­tims are peo­ple in their most pro­duc­tive years.

It said that high blood pres­sure, known as the “silent killer, is the lead­ing risk fac­tor, af­fect­ing near­ly four in ten adults across the re­gion. De­spite the avail­abil­i­ty of af­ford­able and ef­fec­tive treat­ments, on­ly one in three peo­ple with hy­per­ten­sion cur­rent­ly has it un­der con­trol.

“Hy­per­ten­sion re­mains the world’s dead­liest but al­so one of the most man­age­able health threats,” said Dr. Jar­bas Bar­bosa, PA­HO Di­rec­tor.

“This Frame­work is not just an­oth­er pol­i­cy doc­u­ment—it’s the play­book al­ready sav­ing lives in thou­sands of neigh­bour­hood clin­ics. If coun­tries adopt and scale it up, we can pre­vent mil­lions of heart at­tacks and strokes over the next decade.”

The new HEARTS Qual­i­ty Frame­work trans­lates re­al-world ex­pe­ri­ences in­to a test­ed blue­print for over­com­ing bar­ri­ers that keep mil­lions from get­ting the care they need. These in­clude in­ac­cu­rate blood pres­sure mea­sure­ments due to out­dat­ed equip­ment, lim­it­ed avail­abil­i­ty of es­sen­tial med­i­cines, in­con­sis­tent treat­ment across providers, and un­nec­es­sary month­ly vis­its to re­new pre­scrip­tions.

PA­HO said HEARTS in the Amer­i­c­as is the world’s largest adap­ta­tion of the World Health Or­ga­ni­za­tion’s (WHO) glob­al HEARTS ini­tia­tive and is now ac­tive in 33 coun­tries, reach­ing near­ly 10,000 pri­ma­ry health care fa­cil­i­ties and putting more than six mil­lion peo­ple on treat­ment.

It said where the pro­gramme is ful­ly im­ple­ment­ed, six in 10 pa­tients achieve blood pres­sure con­trol, al­most dou­ble the re­gion­al av­er­age.

“The frame­work turns these proven suc­cess­es in­to a struc­tured mod­el that any coun­try can adopt and tai­lor to its needs. It lays out con­crete strate­gies, such as man­dat­ing the use of re­li­able, au­to­mat­ic blood pres­sure mon­i­tors, en­sur­ing a steady sup­ply of qual­i­ty med­i­cines at af­ford­able prices through bulk re­gion­al pur­chas­ing, en­abling mul­ti-month pre­scrip­tions, and em­pow­er­ing trained nurs­es to ad­just med­ica­tion dos­es. It al­so pro­pos­es sim­ple month­ly mon­i­tor­ing tools so clin­ics can track per­for­mance and make rapid im­prove­ments.”

PA­HO said com­bined, these strate­gies sup­port the “80-80-80 tar­get” for blood pres­sure con­trol: 80 per cent of peo­ple with hy­per­ten­sion di­ag­nosed, 80 per cent of those di­ag­nosed treat­ed, and 80 per­cent of those treat­ed get­ting blood pres­sure un­der con­trol.

“Reach­ing this goal could pre­vent more than 400,000 deaths and 2.4 mil­lion hos­pi­tal­i­sa­tions by 2030 in the Amer­i­c­as,” ex­plained Dr Pe­dro Or­duñez, the cor­re­spond­ing au­thor and PA­HO Se­nior Ad­vi­sor for Car­dio­vas­cu­lar Dis­ease.

“We urge min­istries of health, pol­i­cy­mak­ers, and health-care providers to adopt the HEARTS Qual­i­ty Frame­work,” said Dr Anselm Hen­nis, Di­rec­tor of the De­part­ment of Non­com­mu­ni­ca­ble Dis­eases and Men­tal Health at PA­HO.

“By com­mit­ting to this mod­el, we can de­liv­er bet­ter care for NCDs, save mil­lions of lives and strength­en pri­ma­ry health care across the Amer­i­c­as.” —WASH­ING­TON, D.C. (CMC)