Challenges and Opportunities to Scale Up Cardiovascular Disease Secondary Prevention in Latin America and the Caribbean.pdf

HHS Public Access Author manuscript Author Manuscript Glob Heart. Author manuscript; available in PMC 2021 December 01. Published in final edited form as: Glob Heart. 2018 June ; 13(2): 83–91. doi:10.1016/j.gheart.2017.05.002. Challenges and Opportunities to Scale Up Cardiovascular Disease Secondary...

HHS Public Access Author manuscript Author Manuscript Glob Heart. Author manuscript; available in PMC 2021 December 01. Published in final edited form as: Glob Heart. 2018 June ; 13(2): 83–91. doi:10.1016/j.gheart.2017.05.002. Challenges and Opportunities to Scale Up Cardiovascular Disease Secondary Prevention in Latin America and the Caribbean Author Manuscript Álvaro Avezum*, Pablo Perel†, Gustavo B. F. Oliveira*, Patricio Lopez-Jaramillo‡, Gustavo Restrepo§, Fleetwood Loustalot‖, Andrea Srur¶, Reinaldo de La Noval#, Kenneth I. Connell**, Salvador Cruz-Flores††, Lenildo de Moura‡‡, Gabriela Castellac§§, Antonio C. Mattos*, Pedro Ordunez‡‡ *Dante Pazzanese Institute of Cardiology, São Paulo, Brazil; †World Heart Federation, Geneva, Switzerland; ‡Latin American Society of Hypertension, Bucaramanga, Colombia; §Inter-American Society of Cardiology, Mexico City, Mexico; ‖Centers for Disease Prevention and Control, Atlanta, GA, USA; ¶Ministry of Health, Chile, Santiago, Chile; #Ministry of Health, Havana, Cuba; Author Manuscript **Caribbean Public Health Agency Hypertension Guidelines Committee, Port of Spain, Trinidad and Tobago; ††American ‡‡Pan Heart Association, Dallas, TX, USA; American Health Organization,Washington, DC, USA; §§Ministry of Health, Rio de Janeiro, Brazil. Cardiovascular disease (CVD) is the leading cause of death throughout the world; however, a reduction of 21% (age-standardized cardiovascular mortality rates per 100,000 inhabitants) was observed between 1990 and 2010, with more substantial reductions in CVD mortality evident in high-income countries (~42% reduction in CVD deaths) (Table 1) [1,2]. Author Manuscript Correspondence: Álvaro Avezum ([email protected]). The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Pan American Health Organization or the U.S. Centers for Disease Control and Prevention. This paper is a product of a joint consultation meeting with important contributions from several international organizations (Pan American Health Organization, World Heart Federation, Latin American Society of Hypertension, Inter-American Society of Cardiology, Caribbean Public Health Agency, Center for Disease Prevention and Control) and representatives of Ministries of Health of selected countries (Brazil, Chile, Cuba) held in São Paulo, Brazil at the end of 2015. The authors report no relationships that could be construed as a conflict of interest. Avezum et al. Page 2 Author Manuscript CARDIOVASCULAR DISEASE BURDEN IN LATIN AMERICA AND THE CARIBBEAN Author Manuscript In the Americas, CVD represents about 38% of noncommunicable disease (NCD) deaths and is the leading cause of death, with 1.6 million deaths per year, one-half million occurring before age 70. Although mortality due to CVD in the Americas declined 19.2% from 2000 to 2007, higher median CVD mortality was found in low-income (242 per 100,000) and medium-income (186 per 100,000) countries, compared with high-income countries (154 per 100,000). Between 2000 and 2010, premature CVD mortality (