CARDIO4Cities: A roadmap for improving urban cardiovascular health

Area of Science:

• Public Health
• Cardiovascular Medicine
• Urban Health

Background:

• Urbanization is increasing global cardiovascular disease burden.
• Cities often lack scalable models for cardiovascular risk reduction.
• CARDIO4Cities addresses this gap with a population-level, whole-of-city approach.

Purpose of the Study:

• To review the CARDIO4Cities approach for reducing cardiovascular risk and disease.
• To provide an implementation roadmap for city health officials.
• To demonstrate the model's adaptability and scalability across diverse urban settings.

Main Methods:

• Standardized population-health framework with locally adaptable pathways.
• Six reinforcing pillars: Care, Access, Reform, Data, Intersectoral collaboration, Ownership.
• Integration into existing health services and leveraging community/private sectors.

Main Results:

• Significant improvements in hypertension control and reduced cardiovascular events in initial cities (São Paulo, Dakar, Ulaanbaatar).
• Projected 2.7-7.9% reduction in premature deaths over a decade.
• Model demonstrated transferability across diverse economic and health-system contexts.

Conclusions:

• CARDIO4Cities is a replicable and scalable model for improving cardiovascular population health.
• The approach is adaptable for cities with varying resources and health-system maturity.
• Expanded to over 40 cities, providing operational guidance for evidence-based cardiovascular programs.