Cardiovascular Health Program Research Articles

Urban Food Deserts and Cardiovascular Health: Evaluating the Impact of Nutritional Inequities on Elderly Populations in Santiago

This study examines the link between food deserts and cardiovascular health in older adults in Santiago’s Metropolitan Region, Chile. As the population ages and chronic diseases rise, understanding the impact of food accessibility on health is essential. Using multiscale geographically weighted regression, we analyzed data from the Cardiovascular Health Program, socioeconomic indicators, and food desert maps, sourced from the Chilean Ministry of Health and other databases. Spatial analysis, including Voronoi diagrams, assessed the influence of food deserts on health outcomes. Findings show a significant correlation between limited access to healthy foods and higher cardiovascular disease rates, especially in economically disadvantaged areas. The regression model is significant to contribute to the explanation of disease prevalence, emphasizing the impact of food availability on health. This study highlights the importance of considering spatial factors in urban planning and public health policies. By showcasing the role of food environments in health disparities, it advocates for integrated health interventions. Targeted urban planning to address food deserts can enhance access to healthy foods, improving cardiovascular health and well-being among Santiago’s elderly. The findings provide insights for policymakers to create healthier urban environments and stress the need for sustainable food systems to support public health.

Evaluation of a 4-week interdisciplinary primary care cardiovascular health programme: impact on knowledge, Mediterranean Diet adherence and biomarkers

BackgroundCardiovascular disease (CVD) is the second-leading cause of death among Canadians. Clinical practice guidelines suggest that improvements to lifestyle, including dietary intake, can reduce the risk of CVD.ObjectivesThe primary aim...

Epidemiological profile of patients with cardiovascular morbidity in an insular population in Chile: Report from the Juan Fernández Archipelago

To characterize the biosocial profile of the population enrolled in the Cardiovascular Health Program (CHP) of the Juan Fernández archipelago and then compare them to the national dataset. A retrospective, descriptive, and longitudinal study using data collected from 269 patients over 15 years enrolled in the Juan Fernández CHP until March 31, 2022. Prevalence of cardiovascular disease and risk factors were obtained by reviewing a sheet database provided by the Juan Fernández Rural Health Care Center. They were contrasted to the latest national health survey, using the Z Test to determine statistical significance. We found significantly lower prevalences for hypertension (20.4% vs 27.6%), tobacco use (8.5% vs 33.3%), overweight (10% vs 39.8%), obesity (13% vs 31.2%), and myocardial infarction (0.7% vs 3.2%). Chronic kidney disease presents at earliest stages than national data. We observed a better cardiovascular profile in the Juan Fernández Archipelago than nationwide. These findings not only provide a basis for future public health actions but also inspire and motivate new lines of research that can bring context to these results and further our understanding of cardiovascular health.

Quaternary prevention in the Cardiovascular Health Program Rational use of complementary exams: A narrative review

The Cardiovascular Health Program (PSCV), founded by the Ministry of Health of Chile (Minsal), is focused on the global cardiovascular risk of people with the purpose of preventing and reducing morbidity, disability and premature death caused by cardiovascular diseases, in congruence with its sanitary aims. Quaternary Prevention is defined as "actions taken to protect individuals from medical interventions that are likely to cause more harm than good". The PSVC's 2017 technical guidelines establish a battery of 11 complementary exams to request upon entering the program, however, neither the scientific evidence that supports them nor the periodicity of their request was mentioned. The aim of this revision is to evaluate the rationality of exams request, based on updated evidence, as a strategy for quaternary prevention and potential economic savings for the sanitary system. A narrative review was conducted through searches on databases, updated clinical guidelines and international recommendations about 11 complementary exams on the follow-up of Type 2 Diabetes and Hypertension. Based on the data analysis, recommendations were made according to the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system. It was concluded that the costs of widely requested complementary exams could be reduced through a more efficient management guided by updated evidence. Our proposal entails changes in some processes and in the evaluation of fulfillment of the PSCV, as well as a deeper cost-effectiveness analysis of the recommendations in order to optimize the management of resources in primary health care.

Cardiovascular health program with university students based on e-TEORISC: protocol for a clinical trial.

To describe a study protocol to compare the difference between the risk of impaired cardiovascular function (00311) among university students as mediated by standard nursing consultation, when compared with nursing consultations mediated by the e-TEORISC. Randomized, controlled and blinded clinical trial protocol. People with the NANDA-I nursing diagnosis of risk of impaired cardiovascular function (00311) will be included. Participants will be distributed, according to paired randomization by gender and number of etiological factors in nursing diagnosis 00311, into an intervention group (consultation and software based on the nursing theory studied) and a control group (standard nursing consultation). The main outcome will be the reduction of two or more etiological factors of the nursing diagnosis. The proposal was registered with the Brazilian Registry of Clinical Trials under number RBR-8y3qx39. The implementation of the care program through e-TEORISC is expected to encourage the target audience to adhere to health services and allow care plans to be drawn up that reduce the etiological factors of the nursing diagnosis.

Analysis of the Compensation Levels of Patients from the Cardiovascular Health Program: Application of a Primary Health Care Center in Chile

Analysis of the Compensation Levels of Patients from the Cardiovascular Health Program: Application of a Primary Health Care Center in Chile

Strategies on critical levels and nodes to improve self-management in people with cardiovascular risk factors in COVID-19 pandemic conditions

Chile faced the Sars-Cov-2 pandemic, which coexisted with food-nutritional problems related to non-communicable diseases (NCDs). Due to this context, individuals with chronic conditions had less chance to receive medical attention due to the restructuring of the public health system. The present study aimed to identify strategies that integrate the individual, community, and structural levels to improve health control in habitual and critical situations. The study included individuals attending the Cardiovascular Health Program (Programa de Salud Cardiovascular) at the primary care level in the capital city of Santiago during the COVID-19 pandemic. Nine hundred forty individuals attending the Cardiovascular Health Program answered a 40-question telephonic interview. With the results of the analysis (convergence analyses, the complement of quantitative and qualitative results), we performed a seminar with key stakeholders from the Ministry of Health and the primary care level. Our study describes integrative strategies that include the individual level, the community level, and structural aspects. These strategies may improve healthcare management among people with NCDs and could be helpful to face interruptions of health benefits and improve health control in everyday and critical situations. The strategies include three levels: 1) Cardiovascular Health Program redesign; 2) facing health attendance discontinuities, and 3) structural measures. It is necessary to re-evaluate primary care policies in light of these proposed strategies for sharing responsibility and empowering users about their abilities.

Local Application of Scientific Research Practices Builds Student Engagement in Science and Environmental Health.

The University of Montana's Research Education on Air and Cardiovascular Health (REACH) Program works with teachers to engage high school juniors and seniors in rudimentary real-world scientific research with the goals of improving their understanding of and interest in science, and to increase their interest in science careers. To evaluate the program, mixed-method approaches based on surveys that include both fixed-response and free-response questions for students has been used. Thematic analysis of student written responses to free-response questions provided evaluators with unanticipated student-centered information that was not targeted by the fixed-response questions. The analysis of student responses to free-response questions over a three to four-year period are the focus of this manuscript along with the implications such a STEM outreach program has to environmental and science education.

Study protocol: Evaluation of the ‘real-world’ Farmers Have Hearts – Cardiovascular Health Program

Premature cardiovascular disease (CVD) mortality among men represents a public health concern worldwide. In Ireland, male farmers are a ‘high-risk’ group for CVD mortality compared to normative values for Irish males. Despite this, they are perceived to be a ‘hard-to-reach’ (HTR) group to engage with health interventions. Primary prevention measures, including health screening and health behavior change interventions, are key strategies in addressing CVD yet often do not reach HTR groups such as male farmers.The Farmers Have Hearts – Cardiovascular Health Program (FHH-CHP) is a unique large-scale (n = 868) workplace health intervention specifically targeted at Irish male livestock farmers. It included a baseline and Week 52 health check and a health behavior change intervention with three delivery methods: ‘health coach by phone’ and/or mobile (M)-health by text message. The program adopted gender-specific and strengths-based methods to maximize participant engagement. It integrated a multi-actor approach and was trialed in a ‘real world’ practice outside of confined health care settings. Data collection comprised health check results (baseline, Week 52) and self-report measures (baseline, Week 26, Week 52).The FHH-CHP is the first targeted health intervention adopting gender-specific methods to reach and engage male livestock farmers in their cardiovascular health. Documenting the FHH-CHP study protocol is important therefore and will benefit practitioners attempting to apply gender-specific approaches to engage at-risk and HTR groups of men with targeted health interventions. Meeting men outside of clinical health settings and adopting gender competency standards are needed to address inequities in health outcomes experienced by men.

Detección de Nuevas Tecnologías Sanitarias Para Mejorar el Control Metabólico de Pacientes Con Diabetes Tipo 2 Atendidos en el Programa de Salud Cardiovascular de Chile

ObjectivesIn Chile, > 900,000 people with type 2 diabetes mellitus (DM2) are controlled in the Cardiovascular Health Program (PSCV). Even though the PSCV includes a set of interventions for the control of patients with DM2, the results are still insufficient, generating a high human, economic, and social cost. This study aimed to identify and select new health technologies for the control of patients with DM2 not currently incorporated into the PSCV to be proposed as candidates for an economic evaluation in the Chilean context. MethodsFor the identification of new health technologies, consultations with key informants and an umbrella review of updated scientific evidence were used as sources of information. In a second step, selection among those technologies was conducted based on the effectiveness of the intervention, target population, nature of the intervention, and international evidence of cost-effectiveness antecedents. ResultsKey informants identified 12 candidate health technologies not currently incorporated into the PSCV. From the umbrella review, an additional 9 health technologies were identified that were not identified by the key informants. Of the 21 new health technologies identified, finally 8 health technologies were selected (structured group education, pedometer use, periodontal treatment, cognitive-behavioral therapy, telemonitoring, sitagliptin, canagliflozin, and insulin degludec). ConclusionsThe health technologies detected have a high potential to be studied through economic evaluations that allow guiding decision making around improving the health outcomes of patients with DM2 in Chile.

SARS-CoV-2 humoral immune response in patients with cardiovascular risk factors: the COmmunity Cohort Study protocol

IntroductionThe COmmunity Cohort Study aims to determine, after natural exposure to SARS-CoV-2 or anti-SARS-CoV-2 vaccines deployed in Chile to prevent COVID-19 in the context of the current pandemic, the strength...

Epidemiological features of patients ascribed to a primary care cardiovascular health program in Santiago, Chile

Hypertension and diabetes are highly prevalent conditions in Chilean adults. To describe the demographic and clinical profiles, risk factors and complications associated with arterial hypertension (AH) and diabetes mellitus (DM) in patients ascribed to a cardiovascular health program at a public primary health care center in Santiago. Review of medical records of 583 patients aged 37 to 95 years (56% women). Gender, age, smoking habits, blood pressure, glycated hemoglobin levels, LDL cholesterol and triglycerides levels, nutritional status in the last control carried out, and associated cardiovascular complications were recorded. Thirty four percent (201 participants) and 36% (210 participants) had a decompensated DM and AH, respectively. Dyslipidemia was the main associated cardiovascular risk factor. The prevalence of obesity was 43% (249 participants). Twenty percent had chronic kidney disease and 13% had diabetic retinopathy. These patients have a high frequency of obesity, dyslipidemia, and chronic kidney disease.

Abstract 13694: Remote Cardiovascular Health Program Improved Risk Factor Control in Patients With Diabetes

Introduction: Patients with diabetes are at significantly increased risk of developing future cardiovascular events. Systematic approaches to optimally control cholesterol and blood pressure (BP) can reduce the morbidity and mortality associated with diabetes. Methods: The Digital Care Transformation (DCT) program screens and refers patients for remote cholesterol and hypertension management and subsequently educates, starts and titrates medications and monitors laboratory values through expert-designed algorithms. Patients referred into the DCT program who had established diabetes were assessed to understand therapy decisions and BP and cholesterol outcomes. Results: 3,294 patients with known diabetes have been enrolled from the DCT program. 249 patients have completed only BP management, 951 completed only cholesterol management and 58 completed both programs. ~26% of patients in both programs also had ASCVD. Mean office BP measurements were146/79 mmHg. Patients without white coat hypertension had a weekly average home BP of 134/77 mmHg. Patients in BP management who were hypertensive on home monitoring and completed the program attained a mean BP fall of 9.3/5.4 mmHg, with a mean 2.9 medication changes over an average of 3.9 months. Patients in cholesterol management had a mean baseline LDL cholesterol of 118 mg/dL. These patients underwent 1.5 medication changes to attain a mean 50.6 mg/dL LDL-c reduction over an average of 4.2 months. Conclusions: A population health management tool implemented by an algorithm-based medication management approach can appropriately prescribe therapy and improve hypertension and cholesterol control in patients with diabetes. Patients at high risk of developing a future cardiovascular events can reduce their risk through the DCT program. Further study is warranted to assess the cost-effectiveness of these interventions at scale.

A collaborative, computer-assisted, psycho-educational intervention for depressed patients with chronic disease at primary care: protocol for a cluster randomized controlled trial

BackgroundDepression and chronic diseases are frequently comorbid public health problems. However, clinical guidelines often fail to consider comorbidities. This study protocol describes a cluster randomized trial (CRT) aimed to compare the effectiveness of a collaborative, computer-assisted, psycho-educational intervention versus enhanced usual care (EUC) in the treatment of depressed patients with hypertension and/or diabetes in primary care clinics (PCC) in Santiago, Chile.MethodsTwo-arm, single-blind, CRT carried out at two municipalities in Santiago, Chile. Eight PCC will be randomly assigned (1:1 ratio within each municipality, 4 PCC in each municipality) to the INTERVENTION or EUC. A total of 360 depressed patients, aged at least 18 years, with Patient Health Questionnaire-9 Item [PHQ-9] scores ≥15, and enrolled in the Cardiovascular Health Program at the participating PCC. Patients with alcohol/substance abuse; current treatment for depression, bipolar disorder, or psychosis; illiteracy; severe impairment; and resident in long-term care facilities, will be excluded. Patients in both arms will be invited to use the Web page of the project, which includes basic health education information. Patients in the INTERVENTION will receive eight sessions of a computer-assisted, psycho-educational intervention delivered by trained therapists, a structured telephone calls to monitor progress, and usual medical care for chronic diseases. Therapists will receive biweekly and monthly supervision by psychologist and psychiatrist, respectively. A monthly meeting will be held between the PCC team and a member of the research team to ensure continuity of care. Patients in EUC will receive depression treatment according to clinical guidelines and usual medical care for chronic diseases. Outcome assessments will be conducted at 3, 6, and 12 months after enrollment. The primary outcome will be depression improvement at 6 months, defined as ≥50% reduction in baseline PHQ-9 scores. Intention-to-treat analyses will be performed.DiscussionThis study will be one of the first to provide evidence for the effectiveness of a collaborative, computer-assisted, psycho-educational intervention for depressed patients with chronic disease at primary care in a Latin American country.Trial registrationretrospectively registered in ClinicalTrials.gov, first posted: November 3, 2020, under identifier: NCT04613076.

Transitioning a cardiovascular health and rehabilitation programme to a virtual platform during covid 19

Abstract Funding Acknowledgements Type of funding sources: None. OnBehalf Our Hearts Our Minds Purpose Can a virtual cardiovascular prevention and rehabilitation programme be as effective as face-to-face programme. Background The Our Hearts Our Minds (OHOM) prevention and rehabilitation programme rapidly transitioned to a virtual platform in the covid era. Here we compare if a virtual programme potentially could offer the same standard of the nursing intervention (education, smoking cessation, medical risk factor management and psychosocial health) as the previous face to face programme Methods Both the initial assessment (IA) and end of programme (EOP) assessments were conducted via telephone/video as per patient preference. The following measures were recorded at both time points (home blood pressure (BP) monitors were provided) Smoking (self report) BP/Heart rate, Lipids/HbA1c (facilitated by phlebotomy hub), cardio protective drugs (doses, adherence), Hospital Anxiety and Depression score, EuroQoL Nursing Intervention Smoking cessation counselling and pharmacotherapy where appropriate Weekly meeting with cardiologist to optimise BP and lipid management and up titration cardio protective drugs Bimonthly virtual coaching consultation for monitoring/goal resetting Bimonthly group video education sessions Results From April to November 2020, of the 432 referrals received 400 were eligible with 377 accepting the offer of an IA (94% response rate). 262 have had an IA with the remaining 115 awaiting an assessment date. Of the completed IA’s 257 were willing to attend the programme (98% uptake). 120 had been offered an end of programme assessment with 114 attending (96% of those offered). The results for the virtual programme were then compared to the same period one year previously when the programme was fully face to face and are outlined in the table below. The comparison of results delivered via remote delivery are remarkably similar to those achieved in the previous year delivered via face to face. Conclusion Initial data has shown that virtual delivery of the nursing component of the OHOM prevention/rehabilitation programme was highly acceptable to patients and was as effective as that of the traditional face to face service. Table 1 below exhibits the clinical and patient-reported outcomes.

Coverage rates of eye fundus examinations among Chilean patients with diabetes mellitus

Timely eye fundus examinations are essential to prevent the consequences of retinopathy among patients with type 2 diabetes mellitus. To assess the coverage rate (CR) of eye fundus examination in the Chilean diabetic population, between 2011 and 2019. Analysis of monthly statistical summaries of the Cardiovascular Health Program published online by the Chilean Ministry of Health. The number of patients aged 15 years or more with a diagnosis of Type 2 diabetes mellitus and the number of those who had an eye fundus examination within the same year, were obtained. Data was analyzed at a national and regional level. The national eye fundus examination CR was 19.1% in 2011. In 2016, the figures became significantly higher, reaching 32.5%. In 2019, the highest value of 36.5% was recoded although not significantly different from 2016. The highest average annual CR was observed in Ñuble Health Service (49.5%), and the lowest in Central Metropolitan Service (15%). The highest CR positive absolute and relative variation between 2011 and 2019 was observed in Viña del Mar Quillota Health Service (38.9 and 489% respectively), and the lowest negative variation was observed in Araucania Norte Health Service (-8.42 and -24.21% respectively). There is a low eye fundus examination CR in Chile, with important differences between regional health services.

AFTER 20 YEARS OF SUSTAINED REDUCTION, RECENT TRENDS IN CARDIOVASCULAR DISEASE BURDEN HAVE STAGNATED OR REVERSED TO INCREASE IN THE REGION OF THE AMERICAS

Objective: To assess the levels, trends, and socio-demographic inequalities of the Cardiovascular diseases (CVD) burden in countries of the Americas, with the ultimate purpose of providing evidence to guide programmatic interventions and health system responses in the context of the World Health Organization's HEARTS Initiative, and the Resolve To Save Life's Global Cardiovascular Health Program. Design and method: This descriptive population-based study used data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017. We examined disability-adjusted life-years (DALYs), years lived with disabilities (YLDs), years of life lost (YLLs) due to premature mortality from all-CVDs, and cause-specific CVDs using crude, age-specific, and age-standardized rates per 100,000 population by sex in 37 countries of the Americas. We assessed trends of outcome measures by estimating the average annual percentage change from 1990 to 2017 and quantified cross-country social-demographic inequalities in CVD burden. Results: In the Region of the Americas, age-standardized DALYs due to CVD decreased by -1.9% per year (95% UI -2.0 to -1.7) from 5,263.7 years (95% UI 5,143.1–5,390.0) per 100,000 population in 1990 to 3,159.4 years (3,047.1–3,280.4) in 2017. YLLs accounted for 87% of DALYs. Despite this progress, reduction rates decelerated in 2007–2013 and stagnated to -0.1% per year (95% UI -0.5 to 0.3) in 2013–2017. Ischemic heart disease (IHD) and stroke accounted for 80% of all-CVD DALYs. IHD exhibited similar trend patterns, but stroke showed an increasing trend since 2015. In 2017, CVD burden varied across countries from 1,812 years/100 000 (1,594–2,033) in Peru to 8,662 years/100 000 (7,404–10,029) in Haiti. From 2010 to 2017, reduction rates decelerated in all countries but Peru, trends stagnated in 8 countries and reversed to upward in 10 countries. Conclusions: The deceleration of decreasing trends in CVD burden in 18 countries, and the stagnation and reversed to increasing trends in 18 out of 37 countries of the Americas in recent years, indicates the need for reinvigorated efforts to reduce the CVD burden. The socio-demographic inequalities across countries pose challenges to these efforts. Countries with less favorable progress should be targeted for strengthening their national programs.

Results of a prospective cardiovascular disease prevention program.

The Cardiovascular Health Program (CHP) Registry is a 12-month, prospective study of therapeutic lifestyle change (TLC). Adult participants received comprehensive assessment of health behaviors and cardiovascular disease (CVD) risk factors. Personalized TLC action plans addressed modifiable health behaviors for diet, exercise, stress management, and sleep. Participants attended a half-day interactive workshop and met face-to-face with certified health coaches four times over 6 months. Monthly telephonic coaching for 6 more months completed the intervention. Measured outcomes included adherence to behavioral prescriptions, anthropometrics, CVD-relevant laboratory tests, and for a subset of participants, carotid intima-media thickness (CIMT). Of 965 participants, 648 (67%) completed the program and were included in the analysis. Participants were of mean age 55.4 ± 12.5 years, 57% women, and racially diverse. Adherence to prescribed TLC was substantial: dietary behaviors at goal rose from 53% to 86%, exercise 44% to 66%, perceived stress 65% to 79%, and sleep quality 28% to 49%. For participants with abnormal anthropometrics at baseline, there were improvements in body mass index in 63%, waist circumference (men 71%, women 74%), systolic BP 69%, and diastolic BP 71%. For participants with abnormal laboratory values at baseline, there were improvements in total cholesterol in 74%, LDL-cholesterol 65%, triglycerides 86%, fasting glucose 72%, and insulin resistance 71%. Improvements were not driven by prescribed medications. CIMT improved or showed no change in 70% of those measured, associated with significant improvements in sleep quality and longer total sleep time. Longer trials incorporating controls and major adverse CVD events are warranted.

Current Nutrition Practice in Cardiac Rehabilitation Programs.

This study sought to determine current practice regarding nutrition care within cardiac rehabilitation (CR) programs, including perceived barriers and facilitators to providing nutrition care in this setting. A cross-sectional survey was conducted in October and November 2019. Potential participants were program coordinators, identified through the Australian Cardiovascular Health and Rehabilitation Association program directory and invited to participate via e-mail. Forty-nine respondents (response rate: 13%) are included in this analysis. Programs provided group (n = 42, 86%) and/or individual (n = 25, 51%) nutrition education, and most were supported by a dietitian (63%). However, the availability of dietitians and nutrition care provided at CR was variable. For example, individual education was consistently provided at 13 programs and usually by health professionals other than dietitians. Eight programs (16%) used a formal behavior change framework for nutrition care. Generally, respondents were positive about the role of nutrition; CR coordinators perceived nutrition as a valuable component of the program, and that they had good nutrition knowledge. An identified barrier was the financial resources available to support the provision of nutrition care. To ensure that patients receive the benefits of evidence-based nutrition care, program staff may require additional support, particularly regarding the use of evidence-based behavior change techniques. Key facilitators that may be leveraged to achieve this include the high value and priority that CR program coordinators place on nutrition care.

OP139 Attaining Universal Electrocardiographic Diagnosis Coverage Through Telemedicine

IntroductionInnovative health technologies, like telemedicine, offer advantageous telediagnostic apps that can improve the health care of populations in remote regions. However, evidence on how these developments can enhance universal coverage for electrocardiographic (ECG) diagnosis to support a cardiovascular disease prevention program is limited. The utility of telemedicine for attaining universal coverage for ECG diagnosis according to the national cardiovascular disease prevention program in Paraguay was investigated.MethodsThis cross-sectional survey included adults (aged 19 to 80 years) and children (aged 1 to 18 years) with a medical prescription. The study was carried out by the Telemedicine Unit to evaluate the utility of a telemedicine net for a countrywide detection and prevention program for cardiovascular disease. The results obtained by the tele-ECG net, which was implemented in sixty public hospitals countrywide, were analyzed and used to verify adherence to the cardiovascular prevention program.ResultsBetween 2014 and 2019, 331,418 remote ECG diagnoses were performed. Of these, eighty-two percent (n = 270,539) were in adults and eighteen percent (n = 60,879) were in children. Among the adult diagnoses, the majority (52%) were pathological and included sinus bradycardia (13%), right bundle branch block (6%), left ventricular hypertrophy (5%), and ventricle repolarization disorder (5%). Among the children, only twenty percent of diagnoses pathological and included sinus bradycardia (11%) and sinus tachycardia (4%). The mean rate of adherence to the prevention program was 38.2 per 1,000 diagnoses performed.ConclusionsThe results showed that telemedicine can significantly enhance coverage for universal ECG diagnosis to support cardiovascular disease prevention and health programs. However, before carrying out the systematic implementation of such a program contextualization using the regional epidemiological profile must be performed.