WHO HEARTS: A Global Program to Reduce Cardiovascular Disease Burden: Experience Implementing in the Americas and Opportunities in Canada

Campbell, Norm R.C.; Ordúñez, Pedro; Giraldo, Gloria; Morales, Yenny A. Rodríguez; Lombardi, Cíntia; Khan, Taskeen; Padwal, Raj; Tsuyuki, Ross T.; Varghese, Cherian

doi:10.1016/j.cjca.2020.12.004

Cited by 56 publications

(96 citation statements)

References 36 publications

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“…Coronary heart disease (CHD) is a major cause of death across the world ( 1 ), as well as in China ( 2 ), and hypercholesterolemia is recognized as an important risk factor for CHD ( 3 ). Oats and oat products have demonstrated an ability to reduce cholesterol, with recent meta-analysis confirming that oat β-glucan having a significant lowering effect on low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), and other markers of CHD ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

The Prebiotic Effects of Oats on Blood Lipids, Gut Microbiota, and Short-Chain Fatty Acids in Mildly Hypercholesterolemic Subjects Compared With Rice: A Randomized, Controlled Trial

Feng²,

Chu

et al. 2021

Front. Immunol.

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Phytochemicals derived from oats are reported to possess a beneficial effect on modulating dyslipidemia, specifically on lowering total and LDL cholesterol. However, deeper insights into its mechanism remain unclear. In this randomized controlled study, we assigned 210 mildly hypercholesterolemic subjects from three study centers across China (Beijing, Nanjing, and Shanghai) to consume 80 g of oats or rice daily for 45 days. Plasma lipid profiles, short chain fatty acids (SCFAs), and fecal microbiota were measured. The results showed that total cholesterol (TC) and non-high-density lipoprotein cholesterol (non-HDL-C) decreased significantly with both oats and rice intake after 30 and 45 days. The reduction in TC and non-HDL-C was greater in the participants consuming oats compared with rice at day 45 (p = 0.011 and 0.049, respectively). Oat consumption significantly increased the abundance of Akkermansia muciniphila and Roseburia, and the relative abundance of Dialister, Butyrivibrio, and Paraprevotella, and decreased unclassified f-Sutterellaceae. In the oat group, Bifidobacterium abundance was negatively correlated with LDL-C (p = 0.01, r = −0.31) and, TC and LDL-C were negatively correlated to Faecalibacterium prausnitzii (p = 0.02, r = −0.29; p = 0.03, r = −0.27, respectively). Enterobacteriaceae, Roseburia, and Faecalibacterium prausnitzii were positively correlated with plasma butyric acid and valeric acid concentrations and negatively correlated to isobutyric acid. HDL-C was negatively correlated with valeric acid (p = 0.02, r = −0.25) and total triglyceride (TG) was positively correlated to isovaleric acid (p = 0.03, r = 0.23). Taken together, oats consumption significantly reduced TC and LDL-C, and also mediated a prebiotic effect on gut microbiome. Akkermansia muciniphila, Roseburia, Bifidobacterium, and Faecalibacterium prausnitzii, and plasma SCFA correlated with oat-induced changes in plasma lipids, suggesting prebiotic activity of oats to modulate gut microbiome could contribute towards its cholesterol-lowering effect.

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Section: Introductionmentioning

confidence: 99%

The Prebiotic Effects of Oats on Blood Lipids, Gut Microbiota, and Short-Chain Fatty Acids in Mildly Hypercholesterolemic Subjects Compared With Rice: A Randomized, Controlled Trial

Feng²,

Chu

et al. 2021

Front. Immunol.

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“… 3 In response to the unmet need to detect, treat, and control high BP, the Pan American Health Organization (PAHO) with partner organizations and ministries of health have developed the HEARTS in the Americas initiative, a regional adaptation of the WHO HEARTS technical package, to enhance hypertension management and reduce CVD. 12 , 13 …”

Section: The Global Hearts Initiative and The Hearts In The Americas ...mentioning

confidence: 99%

“… 12 , 20 , 21 The program is focused on a hypertension treatment cascade approach that seeks to achieve increased awareness, treatment, and control of hypertension to reduce relevant ‘care gaps’. 12 , 13 , 22 The pillars of the HEARTS in the Americas initiative are (1) use of standardized diagnostic and treatment protocols, (2) accurate reproducible BP measurement with recently trained and preferably certified observers who use accuracy validated automated BP devices, (3) standardized training for team-based patient-centred care, (4) standardized data collection to monitor, evaluate and report on the overall program, health regions, clinic and clinician performance, (5) the use of implementation research methods to guide program implementation and evolution and (6) innovation in patient-centred team-based health care ( Figure 1 ). 12 HEARTS in the Americas is currently being implemented in 20 countries and is the major model of care for CVD risk management in this region.…”

Section: The Global Hearts Initiative and The Hearts In The Americas ...mentioning

confidence: 99%

2021 World Health Organization guideline on pharmacological treatment of hypertension: Policy implications for the region of the Americas

Campbell

Paccot

Angell

et al. 2022

The Lancet Regional Health - Americas

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“…More recently, the WHO has provided information about the diagnosis and management of hypertension in the Global HEARTS Initiative including the HEARTS Technical Package and the HEARTS in the Americas Program. 10 , 11 However, these too provide general practical information and not specific guidelines and recommendations. The WHO Essential Medicines List includes ACE (angiotensin-converting enzyme) inhibitors, calcium channel blockers, angiotensin receptor blockers, and thiazide diuretics for management of hypertension.…”

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confidence: 99%

Hypertension Pharmacological Treatment in Adults: A World Health Organization Guideline Executive Summary

et al. 2022

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Hypertension is a major cause of cardiovascular disease and deaths worldwide especially in low- and middle-income countries. Despite the availability of safe, well-tolerated, and cost-effective blood pressure (BP)-lowering therapies, <14% of adults with hypertension have BP controlled to a systolic/diastolic BP <140/90 mm Hg. We report new hypertension treatment guidelines, developed in accordance with the World Health Organization Handbook for Guideline Development. Overviews of reviews of the evidence were conducted and summary tables were developed according to the Grading of Recommendations, Assessment, Development, and Evaluations approach. In these guidelines, the World Health Organization provides the most current and relevant evidence-based guidance for the pharmacological treatment of nonpregnant adults with hypertension. The recommendations pertain to adults with an accurate diagnosis of hypertension who have already received lifestyle modification counseling. The guidelines recommend BP threshold to initiate pharmacological therapy, BP treatment targets, intervals for follow-up visits, and best use of health care workers in the management of hypertension. The guidelines provide guidance for choice of monotherapy or dual therapy, treatment with single pill combination medications, and use of treatment algorithms for hypertension management. Strength of the recommendations was guided by the quality of the underlying evidence; the tradeoffs between desirable and undesirable effects; patient’s values, resource considerations and cost-effectiveness; health equity; acceptability, and feasibility consideration of different treatment options. The goal of the guideline is to facilitate standard approaches to pharmacological treatment and management of hypertension which, if widely implemented, will increase the hypertension control rate world-wide.

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WHO HEARTS: A Global Program to Reduce Cardiovascular Disease Burden: Experience Implementing in the Americas and Opportunities in Canada

Cited by 56 publications

References 36 publications

The Prebiotic Effects of Oats on Blood Lipids, Gut Microbiota, and Short-Chain Fatty Acids in Mildly Hypercholesterolemic Subjects Compared With Rice: A Randomized, Controlled Trial

The Prebiotic Effects of Oats on Blood Lipids, Gut Microbiota, and Short-Chain Fatty Acids in Mildly Hypercholesterolemic Subjects Compared With Rice: A Randomized, Controlled Trial

2021 World Health Organization guideline on pharmacological treatment of hypertension: Policy implications for the region of the Americas

Hypertension Pharmacological Treatment in Adults: A World Health Organization Guideline Executive Summary

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