Improving health equity and patient outcomes in Latin America
Cardiovascular disease (CVD) is the leading cause of deaths, including premature deaths, among both men and women. The World Health Organization (WHO) has reported that 17.9 million people died from CVD in 2019, translating to 31 percent of all deaths which is nearly every third death in that year. More than 75% of CVD deaths occur in low- and middle-incomes countries and 85% of deaths are caused by heart attack and stroke. The number of CVD deaths are expected to increase to over 23 million by 2030 and the resulting economic burden of the disease to also increase from an estimated USD 30.9bn in 2015 in Latin America alone. There is clearly an urgent call for action, given the prevalence and significant socio-economic impact of CVD.
Cardiovascular diseases (CVD) are a group of disorders of the heart and blood vessels. Atherosclerotic Cardiovascular Disease (ASCVD) specifically, is caused by the build-up of fats, cholesterol, and other substances on the inner walls of arteries, causing them to narrow or harden, and reducing or blocking the flow of blood to the heart or brain. This build up is called plaque and can lead to blood clots, heart attacks and strokes. ASCVD is a major cause of premature deaths and disability from CVD. Early diagnosis and treatment can stop atherosclerosis from worsening and ending in medical emergencies or death.
Excessive medication and unnecessary interventions put a strain on the public health system that has a limited budget to work with. A lack of quaternary prevention facilitates hypermedication and excessive interventions, especially in primary health care, for example a patient that doesn’t need it takes a highly efficient statin, overloading the system, then another patient suffers a stroke and there is no thrombolytic in place
Former Secretary of Primary Health Care/ Ministry of Health Brazil, physician specialized in Preventive Medicine and Public Health
The number 1 cause of death worldwide
The challenges in combating CVD differ in nature between countries, given the differing characteristics and maturity of their healthcare systems and socio-economic conditions. This report looks at the impact of CVD challenges, focused on ASCVD and the silent killer of heart attacks and stroke. There is significant opportunity for improved CVD secondary prevention care in the Latin America region, specifically looking at five countries: Argentina, Brazil, Chile, Colombia, and Mexico, accelerating and enhancing existing initiatives, sharing best practices, and building new initiatives.
In Latin America, despite a trend in reducing CVD deaths in the 1990s, CVD now accounts for 38% of deaths from non-communicable diseases and is the leading cause of death with 1.6 million deaths per year. More specifically, coronary heart disease and stroke were seen to cause 42.5% and 28.8%, respectively of the CVD mortality in the region. The trend is now pointing upwards for cardiovascular disease deaths resulting from demographic, economic and social changes in recent years. The poorest population sectors are seen to be disproportionally affected by the disease due to unequal health care access to manage and treat CVD risk factors.
Improving heart health is clearly a priority that is already being acted upon across the Latin American region. However, there is still a long way to go in changing the behaviours of the patients, healthcare providers, health policy and guideline executers and in implementing effective solutions that create a sustainable health care system to reduce CVD mortality and co-morbidity rates.
To summarise, below are the proposed short to medium term focus areas for key solutions that will both complement the ongoing work and initiate new actionable and impactful change, which will in turn help the countries achieve their heart health goals.