Chile’s public healthcare sector hypertension control rates before and during the pandemic and HEARTS implementation

Abstract

Hypertension (arterial blood pressure ≥ 140/90 mmHg) is a risk factor for cardiovascular diseases, with the greatest burden of attributable deaths in Chile, having a national prevalence of 27.6%. In 2018, the implementation of HEARTS begun in primary health care centers of the Public Health System, with the aim of achieving increase in control rates, by raising the proportion of hypertensive individuals who meet blood pressure goals (< 140/90 mmHg for individuals 15–79 years old and of 150/90 mmHg for individuals 80 years and older), and thus contributing to reduce cardiovascular morbidity and mortality associated with this condition. This is a descriptive study that follows average treatment and control rates from the Public Health System between 2017–2021 obtained from health centers statistics reports during HEARTS implementation. Treatment and control rates remained at 57% and 39% respectively between 2017-2019. Between 2020 and 2021, in the context of the SARS-CoV-2 pandemic, treatment and control rates decreased very significantly, reaching 46% and 26%, respectively, in December 2021, even though the number of centers reporting the implementation of HEARTS increased from 227 to 387 in this same period. Prior to the pandemic, during the last quarter of 2019, a decrease in cardiovascular health controls was already observed as a result of social protests. In light of the results, the technical pillars of the HEARTS Initiative have an important role in helping to recover the population control rates reached in 2019 and increasing the speed to achieve better hypertension control rates.

Disruption to diabetes and hypertension care during the COVID-19 pandemic in Latin America and the Caribbean and mitigation approaches: A Scoping Review

“…Few studies provided quantitative data on treatment or control rates of diabetes and hypertension compared to periods before the pandemic. A Chilean study examined national clinical data from sites implementing the World Health Organization HEARTS Technical Package 16 and reported a 12% and a 14% reduction in treatment and control rates of hypertension, respectively, in 2021 vs. 2017-2019. Similarly, social security data representing more than half of Mexico’s population 17 demonstrated a decrease in hypertension control rates from 68% to 55%.…”

HEARTS en las Américas: impulsar el cambio en el sistema de salud para mejorar el control de la hipertensión en la población

“…El uso de esfigmomanómetros validados clínicamente ha ido aumentando rápidamente, sustituyendo así a los manómetros aneroides. En estos países ha aumentado la cifra absoluta de personas en tratamiento y la de personas tratadas en las que se logra controlar la hipertensión [68][69][70]. En Chile, el modelo HEARTS está resultando superior a la atención tradicional: se observa un mejor control en las personas tratadas (65% frente al 40%), un menor tiempo transcurrido hasta alcanzar una PA inferior a 140/90 mmHg (31 días frente a 92 días) y una mejor adherencia y persistencia tras un año de tratamiento (71% y 20%, respectivamente) [71].…”