Beyond hypertension: integrated cardiovascular care as a path to comprehensive primary care

Beyond hypertension: integrated cardiovascular care as a path to comprehensive primary care Sandeep P Kishore, David J Heller & Ashwin Vasan a Arnhold Institute for Global Health, Icahn School of Medicine at Mount Sinai Health System, 1216 Fifth Avenue, Room 562, New York, New York 10029, United States of America (USA). b Department of Population and Family Health and Medicine, Columbia University Medical Center, New York, USA. Correspondence to Sandeep P Kishore (email: [email protected]). (Submitted: 2 June 2017 – Revised version received: 8 November 2017 – Accepted: 14 November 2017 – Published online: 20 December 2017) At the United Nations General Assembly in 2016, the World Health Organization (WHO) and the Centers for Disease Control and Prevention in the United States of America launched Global Hearts, an initiative that includes the HEARTS technical package for cardiovascular disease management in primary health care. 1 Building on WHO’s package of essential noncommunicable disease interventions, Global Hearts focuses on the noncommunicable disease burden due to atherosclerotic cardiovascular disease and its risk factors. The initiative also provides a simple framework that enables front-line health clinics to implement WHO’s longstanding call to integrate cardiovascular disease care into primary disease prevention. 2 In addition, Global Hearts includes the building blocks for ending vertical, disease-specific approaches to cardiovascular conditions. Instead, it guides the organization and delivery of cardiovascular disease care for the whole patient through better screening, treatment and prevention. Given that cardiovascular disease is the principal cause of death worldwide and is increasingly common, tackling the disease is crucial for achieving meaningful primary care. However, to do so successfully, the initiative needs to extend cardiovascular disease care to include conditions such as heart failure and rheumatic heart disease. More importantly, Global Hearts must be incorporated into existing health-care delivery systems and into the public health laws and policy crucial for primary disease prevention.