Abstract
Non-communicable diseases (NCDs) are the world’s leading causes of death and disability, with cardiovascular disease (CVD) accounting for half of NCD deaths. An ambitious global target established by the United Nations Sustainable Development Goals – indicator 3.4.1 – aims to reduce the risk of premature death among people aged 30–69 years from CVD, cancer, diabetes, and chronic lung disease by one third by 2030. This article reviews the science and practice informing what is required to achieve this target, identifying seven interventions that can accelerate progress: 1) tobacco control; 2) treatment to reduce cardiovascular risk; 3) reduction of dietary sodium; 4) reduction of household air pollution; 5) elimination of artificial trans fat; 6) reduction of alcohol use; and 7) prevention, detection, and treatment of cancers. Achieving the target is possible – there has already been progress in some areas, particularly related to CVD reduction – but only if there is faster, more concerted action.
Highlights
Cardiovascular disease (CVD) and other non-communicable diseases (NCDs) are the world’s leading causes of death and disability, are the main driver of increasing health care costs, and undermine the economic stability of individuals, families, communities, and countries [1, 2]
CVD kills more people than any other cause, but most CVD deaths are preventable with currently available interventions
Many opportunities to prevent disease, disability, and death are being missed, and, in the US and some other high-income countries, the decrease in CVD that has driven the increase in life expectancy has stalled or begun to reverse in recent years [3]
Summary
Cardiovascular disease (CVD) and other non-communicable diseases (NCDs) are the world’s leading causes of death and disability, are the main driver of increasing health care costs, and undermine the economic stability of individuals, families, communities, and countries [1, 2]. There are well-established treatment regimens with inexpensive, well-tolerated, and readily available generic medications that have been standard-of-care in high-income countries for half a century, many people are not screened and many who are diagnosed are not on effective treatment, with the result that more than 85% of people in the world with hypertension, and approximately 50% of people in the United States, do not have it controlled to less than 140/90 mm Hg. Globally, several approaches have been proposed to reduce cardiovascular risk with medications. A substantial increase in the proportion of people who would benefit from cardiovascular medications need to receive them, and whatever approach is needed will require improvements in primary care This is a daunting challenge, other public health programs provide hope and a potential model [31]. Progress can be accelerated by applying a rigorous monitoring framework to ensure accurate, timely measurement of and increased attention to and accountability for the actions needed as well as the impact these measures have on risk factors and deaths
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