CHDS faculty Thomas Gaziano presented Meeting the United Nations Goal of Reducing Premature Cardiovascular Disease Mortality: Global trends, policies and implementation at a seminar sponsored jointly by the Department of Global Health and Population and the Harvard Center for Population and Development Studies.
The UN goal for cardiovascular disease (CVD), set in 2012, is 25% reduction in premature deaths from CVD by 2025. To achieve that there would need to be about a 3% reduction per year. In the US, there has been an overall reduction in age-adjusted total and CVD mortality from the 1970s to about 2010 of about 3%. However, we have had a slowing of this improvement with an actual increase during the COVID-19 pandemic for total mortality. Further with regards to CVD, we actually observed rates begin to tick back up even before the pandemic and there has been a steady decline in the rates of blood pressure control.
Gaziano spoke about the need to translate the science into policy in order to reach the UN goals and laid out a series of steps to improve prevention: identify a screening tool, train users to use the tool, ensure that those people screened are seen by an appropriate health provider, have facilities prescribe appropriate therapy, have medicines available, and adherence to the medicines be achieved.
Gaziano gave the example of two bright spots from his research, South Africa and Argentina. In South Africa, national regulation of salt in processed foods was enacted in 2013. Gaziano and colleagues have been studying the effect on blood pressure control of a decentralized medication distribution system of people-centered care within local communities. In Argentina, Gaziano and colleagues are evaluating a project that trains community health workers as first-line screeners. A clinical decision support tool generates guidelines-based treatment recommendations authored by a medical doctor, which can also be used by a nurse or pharmacist to prescribe treatment, with the ability to reach out to the medical doctor if they have any question.
Learn more: Read the article, Protocol: Implementation Evaluation of a Combination Intervention for Sustainable Blood Pressure Control in Rural KwaZulu-Natal, South Africa (IMPACT BP): A Three-are, Unblinded, Parallel Group Individually Randomized Clinical Trial
Learn more: Read about the UN Sustainable Development Goals
Learn more: Read about the WHO data for the specific UN Goal for Non-Communicable Diseases
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