Global Cardiovascular Health Promotion and Disease Prevention

Abstract

As part of a series of reports on cardiovascular disease (CVD) prevention, this review provides a global perspective on the needs and opportunities for effective public health action. The global burden, disparities, and costs of CVD have been a mounting concern in recent decades, with repeated calls for action to arrest and reverse this global epidemic. Over the past decade, attention to the challenge and opportunity for meaningful intervention has grown. This is due in part to improved estimates of the magnitude of the problem; forecasts of its increasing adverse impact not only on health but also on social and economic development, especially in low- and middle-income countries; and assessments of the cost-effectiveness of feasible interventions. The case for CVD prevention and long-established intervention strategies are reviewed as background to recent developments. An extensive review and recommendations reported by the Institute of Medicine in 2010 signaled important potential changes in approaches to CVD prevention globally. In the current context of global health, CVD is seen not in isolation but as a major component of the leading noncommunicable diseases (NCDs): CVDs, cancers, chronic respiratory diseases, and diabetes mellitus. Accordingly, the broader arena of NCD prevention and control has come to predominate over CVD alone. From this viewpoint, 3 recent developments are of central importance: the United Nations' Millennium Development Goals (MDGs; which omitted reference to NCDs), the global response that led to the historic High-Level Meeting of the United Nations General Assembly (UNGA) on NCDs in September 2011, and currently proposed policies and recommendations on NCD prevention. The charge from the UNGA to the World Health Organization (WHO) in the declaration from the September 2011 meeting establishes an aggressive timeline for progress. Options for intervention are to be presented by the end of 2012, and an extensive review of progress is …