The global cardiovascular professional associations issued a joint call to action to implement steps to reduce preventable death from cardiovascular disease (CVD) globally on Sept. 17. Representatives of the World Heart Federation, American Heart Association, American College of Cardiology (ACC), European Heart Network and European Society of Cardiology jointly authored the call to action, which appeared simultaneously in several journals, including Circulation and the Journal of the American College of Cardiology.
The societies made this call to action to mark the first anniversary of a United Nations (UN) Political Declaration calling for a 25 percent reduction in preventable deaths from non-communicable disease (NCD) by 2025. The authors noted that deaths from CVD make up nearly half of the preventable deaths from NCD worldwide, so reducing mortality from CVD is necessary if the goal the UN established is to be realized.
Corresponding author William A. Zoghbi, MD, president of the ACC, explained to Cardiovascular Business that a global effort is necessary at this time because 80 percent of preventable deaths from CVD now occur in low and middle income countries. Many of these deaths are attributable to smoking, sodium intake and lack of blood pressure control, he said.
"By increasing awareness and emphasizing risk factor reduction, we have cut the incidence of preventable death from CVD in the U.S. by perhaps 40 percent over the past four or five decades," he said. "So this global push among all the societies aiming for a reduction in risk factors may be very effective."
The authors encouraged government health officials to adopt the WHO's list of interventions targeted toward reducing specific risk factors. The authors called some of these risk factors "best buys," because they offer the greatest potential reduction in preventable death and CVD at the lowest cost. The best buys are:
- Increasing physical activity;
- Controlling high blood pressure;
- Reducing sodium intake;
- Smoking cessation;
- Limiting saturated fat intake;
- Reducing excessive alcohol use; and
- Implementing drug therapy to prevent heart attack and stroke (aspirin, statins).
The authors conceded that targeted risk reduction efforts carry a cost. The call to action estimated that implementing the best buys will cost $11.4 billion annually in low and middle income countries, which the authors claim translates to less than $1 per person per day in low income countries and less than $3 per person per day in middle income countries. The authors noted the high cost of preventable death from CVD, which tends to occur in heads of households ages 40-60 in these countries. Thus, the social cost of not reducing preventable death in low and middle income countries is high.
"We are very excited about this global collaboration to take on the common cause of reducing CVD and preventable death by targeting major risk factors," Zoghbi said. “The last time there was this sort of global push to manage a disease was in response to the AIDs epidemic. All the societies have joined together to take on a major challenge going forward, and we are very excited about it.”