Trevor A Hassell

Improved Blood Pressure Control to Reduce Cardiovascular Disease Morbidity and Mortality: The Standardized Hypertension Treatment and Prevention Project

Hypertension is the leading remediable risk factor for cardiovascular disease, affecting more than 1 billion people worldwide, and is responsible for more than 10 million preventable deaths globally each year. While hypertension can be successfully diagnosed and treated, only one in seven persons with hypertension have controlled blood pressure. To meet the challenge of improving the control of hypertension, particularly in low‐ and middle‐income countries, the authors developed the Standardized Hypertension Treatment and Prevention Project, which involves a health systems–strengthening approach that advocates for standardized hypertension management using evidence‐based interventions. These interventions include the use of standardized treatment protocols, a core set of medications along with improved procurement mechanisms to increase the availability and affordability of these medications, registries for cohort monitoring and evaluation, patient empowerment, team‐based care (task shifting), and community engagement. With political will and strong partnerships, this approach provides the groundwork to reduce high blood pressure and cardiovascular disease‐related morbidity and mortality.

Chronic Disease Challenges in the Caribbean

Highlights The Caribbean sub-region has the highest premature mortality from NCD in the Americas. Sustained political leadership and multisectoral action to prevent and control NCD is required. Scale-up of technical and financial support to SIDS by the international community is needed.

Control of NCD: A Caribbean Perspective

Caribbean political leaders have, over the past four decades, shown significant leadership in responding to the health and development challenges posed by chronic diseases, also known as noncommunicable diseases or NCDs. In 2007, Heads of Government of Caribbean countries (CARICOM) held a Summit on NCDs in Port of Spain, Trinidad, to discuss the impact of NCDs on the people of the region [1]. The meeting concluded with the issuance of a series of recommendations aimed at reducing the burden of NCDs through comprehensive and integrated preventive and control strategies and a multisectoral, collaborative approach. Caribbean leaders subsequently contributed to efforts which have led to the planned United Nations High Level Meeting (UNHLM) on noncommunicable diseases. Health nongovernmental organizations (NGOs) in many Caribbean countries have contributed to the NCD response for many years. The upcoming UNHLM catalyzed their efforts, and integrated and multi-sectoral approaches resulted in several countries. This paper describes three examples of such approaches; the Caribbean Tobacco Control Project (CTCP); formation of the Healthy Caribbean Coalition (HCC) and subsequent launch of a mobile text based advocacy and educational campaign; and the implementation of a population Salt Reduction Program. It concludes by highlighting desired outcomes from the UNHLM necessary to allow for these and other regional initiatives to be further developed.