Focus on: Promoting Cardiovascular Health (I)Promoting Cardiovascular Health Worldwide: Strategies, Challenges, and OpportunitiesPromoción de la salud cardiovascular global: estrategias, retos y oportunidades
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INTRODUCTION
The world population continues to grow at an unstoppable rate. Simultaneously, the population is aging and we are witnessing an alarming increase in specific cardiovascular risk factors (CVRF), like bad nutrition habits and obesity, with an unquestionable impact on the state of health of the population at large. And so we find ourselves facing a cardiovascular disease (CVD) pandemic that has complex multi-factor causes in which different sectors of society are implicated. Cardiovascular health
GLOBAL DIMENSION OF CARDIOVASCULAR DISEASE: IMPACT ON HEALTH CARE AND THE ECONOMY
The health of the world population is at serious risk, given the universal presence of CVRF. The consumer society we live in does not encourage healthy living and the consequences of this are even more devastating if we bear in mind the social inequalities, economic context, and demographic explosion of the last 20 or more years. The growth of bad nutrition habits, obesity, and high blood pressure increasingly contributes to the expanding CVD epidemic. The factors influencing this deterioration
CARDIOVASCULAR DISEASE IN LOW–MIDDLE INCOME COUNTRIES
According to a study published in The Lancet, 80% of the burden of chronic diseases and 70% of deaths due to NCD in individuals aged < 70 years occur in only 23 countries.18 To illustrate what is behind this trend, let us take the example of India, where more than 1 billion inhabitants have rates of cardiovascular morbidity and mortality that are increasing more rapidly and affecting younger individuals than in the western countries.19 The country's economic growth, with rates among the highest
STRATEGIES AND OPPORTUNITIES IN CONTROLLING THE CARDIOVASCULAR DISEASE EPIDEMIC: CARDIOVASCULAR HEALTH PROMOTION
Cardiovascular prevention can be focused on the individual or the population. At the individual level, a stratification strategy is used, in which individuals undergo a study of the presence of risk factors and those identified as being above a cutoff point receive treatment. The advantage of this strategy is that the subject receives individualized treatment that optimizes the risk:benefit ratio. However, screening costs are very high and the risk prediction of most of the tools currently used
THE “POLYPILL”: A WORLDWIDE OPPORTUNITY IN SECONDARY PREVENTION
In the developed world, access to quality health care systems and therapies of proven effectiveness in reducing cardiovascular mortality has successfully mitigated the consequences of CVD and has increased survival. However, the worldwide reality is quite different. Half of all the world's patients with acute myocardial infarction do not receive cardioprotective therapy to avoid the recurrence of cardiovascular events, and only 13% of those in low–middle-income countries receive treatment.28
CONCLUSIONS
The scientific societies are under an obligation to use their knowledge and experience in the worldwide fight against CVD and chronic conditions. Recently-proposed innovations include strategies to control tobacco and reduce dietary sodium, which could prevent > 1 million deaths per year in the emerging countries, at a cost of approximately $0.50 per person per year.37, 38
The use of cheap, safe pharmacologic therapies in fixed combinations, like the “polypill”, represents another promising
CONFLICTS OF INTEREST
None declared.
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