Chile's public healthcare sector hypertension control rates before and during the pandemic and HEARTS implementation
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Published on: September 26, 2018
Francisca Barake1, Mélanie Paccot1, Marcela Rivera2
1Ministry of Health Santiago Chile Ministry of Health, Santiago, Chile.
Insights
Hypertension control rates in Chile decreased significantly due to the pandemic and social unrest. The HEARTS Initiative
Area of Science:
- Public Health
- Cardiovascular Disease Epidemiology
- Health Systems Management
Background:
- Hypertension is a major cardiovascular disease risk factor in Chile, with a 27.6% national prevalence.
- The HEARTS Initiative was implemented in 2018 to improve hypertension control rates in primary care.
- Cardiovascular disease poses the greatest mortality burden in Chile.
Purpose of the Study:
- To evaluate the impact of the HEARTS Initiative on hypertension treatment and control rates in Chile.
- To assess changes in control rates before, during, and after the SARS-CoV-2 pandemic.
- To identify factors influencing hypertension control rates within the Chilean Public Health System.
Main Methods:
- A descriptive study analyzing average treatment and control rates from 2017-2021.
- Data obtained from health center statistics reports during HEARTS implementation.
- Comparison of rates before and during the SARS-CoV-2 pandemic and social protests.
Main Results:
- Treatment and control rates were stable at 57% and 39% from 2017-2019.
- Rates significantly decreased to 46% (treatment) and 26% (control) by December 2021.
- Despite an increase in HEARTS implementation sites, rates declined during 2020-2021, with a prior dip in late 2019 due to social unrest.
Conclusions:
- The SARS-CoV-2 pandemic and social unrest severely impacted hypertension control rates.
- The HEARTS Initiative's technical pillars are crucial for recovering and improving population control rates.
- Strategic interventions are needed to mitigate disruptions and enhance hypertension management in primary care.
Abstract:
Hypertension (arterial blood pressure ≥ 140/90 mmHg) is a risk factor for cardiovascular diseases, with the greatest burden of attributable deaths in Chile, having a national prevalence of 27.6%. In 2018, the implementation of HEARTS begun in primary health care centers of the Public Health System, with the aim of achieving increase in control rates, by raising the proportion of hypertensive individuals who meet blood pressure goals (< 140/90 mmHg for individuals 15-79 years old and of 150/90 mmHg for individuals 80 years and older), and thus contributing to reduce cardiovascular morbidity and mortality associated with this condition. This is a descriptive study that follows average treatment and control rates from the Public Health System between 2017-2021 obtained from health centers statistics reports during HEARTS implementation. Treatment and control rates remained at 57% and 39% respectively between 2017-2019. Between 2020 and 2021, in the context of the SARS-CoV-2 pandemic, treatment and control rates decreased very significantly, reaching 46% and 26%, respectively, in December 2021, even though the number of centers reporting the implementation of HEARTS increased from 227 to 387 in this same period. Prior to the pandemic, during the last quarter of 2019, a decrease in cardiovascular health controls was already observed as a result of social protests. In light of the results, the technical pillars of the HEARTS Initiative have an important role in helping to recover the population control rates reached in 2019 and increasing the speed to achieve better hypertension control rates.
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