Effective policies on prevention and control of cardiovascular diseases in different countries: A realistic review

Cardiovascular diseases (CVDs) are responsible for 60% of deaths from noncommunicable diseases worldwide. Iran's CVD control and prevention program faces challenges that have limited its effectiveness and efficiency. This study aimed to identify effective programs, policies, and interventions for the prevention and control of CVDs in Iran. The realistic review method was used to conduct this research. Original peer-reviewed studies published in the field of policies and interventions for the prevention and control of CVDs between 2000 and July 22, 2024, were collected in PubMed, Scopus, Web of Science, and Persian databases such as Iranmedex, MagIran, irandoc, and Scientific Information Database (SID). Articles that met the inclusion criteria were analyzed using the framework analysis using MAXQDA 10 software. A total of 61 effective interventions and policies were identified for the CVD control and prevention program. The most important effective policies included primary and secondary prevention interventions, nutritional interventions, lifestyle modification, tobacco control policies, and blood pressure control. A total of 56 contextual factors were identified in this program, the most important of which were the availability of appropriate primary care, access to health centers, doctors and medicines, the private sector, insurance funds, and subsidized services. A total of 36 intervention mechanisms were identified, the most important of which were public education through mass media, social participation, participation of experts, and nongovernmental organizations. Finally, 22 outcomes were identified in this study, the most important of which included reducing disease risk factors, improving nutritional habits, and reducing disease prevalence. This review shows that effective programs and interventions for the prevention and control of CVDs can be implemented in each country with an appropriate mechanism to reduce the burden of the disease, taking into account the political, social, economic, and sociocultural context, and based on the experiences of other countries, interventions that are more compatible with our country's conditions can be introduced to policymakers and decision-makers in the country's health system for selection and implementation.