Institute of Medicine Study
Committee on Preventing the Global Epidemic of Cardiovascular Disease: Meeting the Challenges in Developing Countries
A study sponsored by the NHLBI concludes that better control of cardiovascular disease in developing countries is eminently possible, but will require sustained efforts,strong leadership, collaboration among multiple sectors, and investment of financial, technical, and human resources.
The study was conducted by an independent committee convened by the Institute of Medicine (IOM) of the National Academies. The committee’s March 2010 report, "Promoting Cardiovascular Health in the Developing World -- A Critical Challenge to Achieve Global Health" notes that more than 30 percent of worldwide deaths are attributable to cardiovascular disease, with more than 80 percent of all cardiovascular disease-related deaths occurring in low- and middle-income countries.
Noncommunicable diseases, led by cardiovascular disease and stroke, are now the leading causes of premature death globally. Cardiovascular disease follows urbanization and advances in prevention and treatment of other causes of premature mortality, such as infectious diseases.
The IOM committee identified several steps to catalyze action to reduce the global burden of cardiovascular disease worldwide, and in particular, in developing countries. The group recommends that the NHLBI, development agencies, nongovernmental organizations, and governments work toward two essential goals:
- Creating environments that promote heart-healthy lifestyle choices and help reduce the risk of chronic diseases.
- Building public health infrastructure and health systems with the capacity to implement programs that will effectively detect and reduce risk and manage cardiovascular disease.
Meeting these goals, says the committee, will involve improving cooperation and collaboration; implementing effective and feasible strategies; and informing efforts through research and health surveillance. The committee urges the global cardiovascular community to engage policymakers and global health colleagues to integrate attention to cardiovascular disease and related chronic diseases within existing global health missions and efforts, rather than competing against other global health and development priorities.
According to the IOM report, locally relevant solutions, as well as better population data through improved health surveillance systems, are needed to help determine which strategies are likely to be more effective for specific populations. Because many developing countries have limited capacity to rapidly develop and implement comprehensive disease reduction plans, and the cardiovascular disease burden continues to rise rapidly, the committee recommends prioritizing short-term strategies shown to be effective in developed countries. These strategies include reducing tobacco use, lowering salt consumption, and improving delivery of clinical prevention in high-risk patients.
The NHLBI commissioned the study in July 2008 to analyze the evolving global epidemic of cardiovascular disease, and to seek recommendations to improve cardiovascular control. The resulting report is intended to help initiate global dialogue, align global forces, draw public attention, and lead to concerted global and international actions.
The 16-month study was led by Valentin Fuster, M.D., Ph.D., director of Mount Sinai Heart, Mount Sinai Medical Center, New York City. Arun Chockalingam, M.S., Ph.D., served on the committee when he was director of continuing public health education at the Faculty of Health Sciences at the Simon Fraser University in British Columbia, where he was also professor and director of global health. He is now director of the NHLBI Office of Global Health.
Last Updated: December 2013