The mass scale-up of a pilot hypertension project sponsored by the U.S. Centers for Disease Control and Prevention (CDC) and the Pan American Health Organization/World Health Organization (PAHO/WHO) could significantly advance the global target of reducing hypertension prevalence by 25% by 2025 and could prevent millions of cardiovascular deaths worldwide, according to CDC officials writing in a recent issue of The Lancet.
A recent Lancet article cites the joint initiative as a model for countries around the world
Washington, D.C., 6 March 2015 (PAHO/WHO) — The mass scale-up of a pilot hypertension project sponsored by the U.S. Centers for Disease Control and Prevention (CDC) and the Pan American Health Organization/World Health Organization (PAHO/WHO) could significantly advance the global target of reducing hypertension prevalence by 25% by 2025 and could prevent millions of cardiovascular deaths worldwide, according to CDC officials writing in a recent issue of The Lancet.
The Global Standardized Hypertension Treatment (GSHT) project was launched by CDC and PAHO/WHO in 2013 and is currently being piloted in Barbados and Malawi. The project seeks to increase access to diagnosis and treatment of hypertension and to improve the quality of treatment. Its methods draw heavily on experiences in HIV treatment and tuberculosis (TB) control.
Central elements of the GSHT project include (1) standardized drug regimens, (2) integrated multidisciplinary teams delivering patient-centered care, (3) increased access and availability for patients to effective low-cost medicines with simplified dosing and refills, (4) monitoring of patients' blood pressure control and progress under treatment.
Also key is support from the PAHO Strategic Fund, a procurement mechanism that allows participating PAHO/WHO member countries to buy essential medicines and supplies at reduced cost. After the GSHT project was launched, the fund negotiated purchasing agreements for five of the project's six recommended hypertension drugs.
Scale-up efforts in HIV and TB control show what can be done
CDC officials Sonia Angell and Kevin De Cock and CDC Director Tom Frieden argue in a "Viewpoint" article in The Lancet's Feb. 28 issue that the GSHT project provides a model for improving hypertension treatment and control that could be replicated in low- and middle-income countries (LMICs) around the world. The success of similar efforts to scale up TB control and antiretroviral treatment for HIV provide strong evidence that "rapid expansion of treatment and control of hypertension in LMICs should be achievable," the authors say.
WHO estimates that some 1 billion people globally suffer from hypertension, the leading risk factor for cardiovascular disease. According to a study cited the Lancet article, only an estimated 13% of those 1 billion sufferers have their hypertension adequately controlled. The authors estimate that treating just half of all hypertension sufferers globally would avert 10 million heart attacks and strokes over 10 years.
Going forward, PAHO/WHO and CDC plan to engage new partners to implement GSHT in other countries of Latin America and the Caribbean and eventually in other regions of the world.
"Hypertension affects some 250 million people in the Americas, and in most countries rates of blood pressure control are unacceptably low," said PAHO Director Carissa F. Etienne. "Scaling-up the GSHT project holds tremendous potential for reducing premature mortality and the adverse economic impact of cardiovascular disease in our region and around the world."
Links:
— A public health approach to global management of hypertension (abstract)
— The Global Standardized Hypertension Treatment Project (CDC website)
— Hypertension (PAHO website)
