Strategies and interventions for achieving cardiovascular disease risk factor control in low- and middle-income countries: a review of the literature

Abstract

AbstractCardiovascular diseases (CVDs) are the leading cause of morbidity and mortality globally, with increasing rates in low- and low-middle-income countries (LMICs), particularly sub-Saharan Africa (SSA). These occur due to exposure to various risk factors, such as tobacco smoking, physical inactivity, hypertension, and diabetes. There are unique features in LMICs that contribute to the risk factor profile and quality of care offered in these countries. These include cultural influences on diet (carbohydrate-dense diet, use of salt-based spices and preservatives), the lack of dedicated spaces for physical activity, and perceptions of desirable body sizes. The attendant complications affect individuals, families and the community at large. Furthermore, there is a dearth of research to inform change at both the individual and policy level in LMICs. Lifestyle modification is the cornerstone of risk factor control and requires engaging relevant stakeholders in healthcare to enforce sustainable behaviour change among individuals. This includes measures from the individual level to national leadership and requires multisectoral collaboration to ensure sustainability. Such methods include building health worker capacity through a task shifting approach, strengthening the health worker-patient relationship, employing digital/technological applications, and engaging families and communities to serve as accountability partners in the management of CVD and related risk factors. There is a need for increased contextually relevant research output to inform contemporary methods to improve CVD and risk factor control in LMICs.