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Implementation of Global Hearts Hypertension Control Programs in 32 Low- and Middle-Income Countries: JACC

Andrew E Moran1, Reena Gupta2,

  • 1Resolve to Save Lives, New York, New York, USA; Columbia University Irving Medical Center, New York, New York, USA.

Journal of the American College of Cardiology
|September 21, 2023
PubMed

Insights

The World Health Organization

Area of Science:

  • Public Health
  • Cardiovascular Disease Management
  • Global Health Initiatives

Background:

  • The World Health Organization (WHO) and Resolve to Save Lives launched the HEARTS initiative in 2017.
  • The HEARTS hypertension services package was designed for low- and middle-income countries (LMICs).

Purpose of the Study:

  • To assess the feasibility and outcomes of scaling up hypertension services in LMICs.
  • To evaluate the effectiveness of the WHO HEARTS package in primary care settings.

Main Methods:

  • Implementation of the WHO HEARTS package across 32 LMICs, involving 165,000 primary care facilities.
  • Monitoring facility-based performance indicators including patient enrollment, treatment, blood pressure control, and follow-up.
  • Analysis of hypertension control rates at both facility and population levels.

Main Results:

  • By 2022, 12.2 million patients were treated through HEARTS programs.
  • Median facility-based hypertension control reached 48% (range 5%-86%), with an overall rate of 38%.
  • In four countries with a digital health system, facility-based control improved from 18% to 46% over 48 months. Population-based control was estimated at a median of 11.0%.

Conclusions:

  • The Global Hearts initiative demonstrates that hypertension can be effectively managed in primary care settings within LMICs.
  • Scaling up standardized hypertension services packages is feasible and can improve control rates.
  • Digital health information systems show promise in enhancing hypertension control program effectiveness.

Keywords:
hypertensionimplementationlow- and middle-income countriespublic health

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