Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Sep 10;16(1):63.
doi: 10.5334/gh.1066. eCollection 2021.

World Heart Federation Roadmap for Hypertension - A 2021 Update

Panniyammakal Jeemon  1 , Tania Séverin  2 , Celso Amodeo  3 , Dina Balabanova  4 , Norm R C Campbell  5 , Dan Gaita  6 , Kazuomi Kario  7 , Taskeen Khan  8 , Rita Melifonwu  9 , Andrew Moran  10 , Elijah Ogola  11 , Pedro Ordunez  12 , Pablo Perel  13 , Daniel Piñeiro  14 , Fausto J Pinto  15 , Aletta E Schutte  16 , Fernando Stuardo Wyss  17 , Lijing L Yan  18 , Neil R Poulter  19 , Dorairaj Prabhakaran  4   20
Affiliations
Review

World Heart Federation Roadmap for Hypertension - A 2021 Update

Panniyammakal Jeemon et al. Glob Heart. .

Abstract

The World Heart Federation (WHF) Roadmap series covers a large range of cardiovascular conditions. These Roadmaps identify potential roadblocks and their solutions to improve the prevention, detection and management of cardiovascular diseases and provide a generic global framework available for local adaptation. A first Roadmap on raised blood pressure was published in 2015. Since then, advances in hypertension have included the publication of new clinical guidelines (AHA/ACC; ESC; ESH/ISH); the launch of the WHO Global HEARTS Initiative in 2016 and the associated Resolve to Save Lives (RTSL) initiative in 2017; the inclusion of single-pill combinations on the WHO Essential Medicines' list as well as various advances in technology, in particular telemedicine and mobile health. Given the substantial benefit accrued from effective interventions in the management of hypertension and their potential for scalability in low and middle-income countries (LMICs), the WHF has now revisited and updated the 'Roadmap for raised BP' as 'Roadmap for hypertension' by incorporating new developments in science and policy. Even though cost-effective lifestyle and medical interventions to prevent and manage hypertension exist, uptake is still low, particularly in resource-poor areas. This Roadmap examined the roadblocks pertaining to both the demand side (demographic and socio-economic factors, knowledge and beliefs, social relations, norms, and traditions) and the supply side (health systems resources and processes) along the patient pathway to propose a range of possible solutions to overcoming them. Those include the development of population-wide prevention and control programmes; the implementation of opportunistic screening and of out-of-office blood pressure measurements; the strengthening of primary care and a greater focus on task sharing and team-based care; the delivery of people-centred care and stronger patient and carer education; and the facilitation of adherence to treatment. All of the above are dependent upon the availability and effective distribution of good quality, evidence-based, inexpensive BP-lowering agents.

Keywords: WHF; World Heart Federation; hypertension; policy; raised BP; raised blood pressure.

PubMed Disclaimer

Conflict of interest statement

Panniyammakal Jeemon is supported by the Wellcome Trust through a Wellcome Trust/DBT India Alliance Clinical and Public Health Intermediate Fellowship [IA/CPHI/14/1/501497]. Neil Poulter has received financial support from several pharmaceutical companies which manufacture BP-lowering agents, for consultancy fees (Servier), research projects, and staff (Servier, Pfizer) and for arranging and speaking at educational meetings (AstraZeneca, Lri Therapharma, Napi, Servier, Sanofi, Eva Pharma and Pfizer). He holds no stocks and shares in any such companies. Norman Campbell reports personal fees from Resolve to Save Lives (RTSL) outside the submitted work and is an unpaid member of World Action on Salt, Sugar and Health and an unpaid consultant on dietary sodium and hypertension control to numerous governmental and non-governmental organizations. Kazuomi Kario received research grant from A &D Co., Omron Helthcare Co., Fukuda Denshi Co., MSD K.K., Astellas Pharma Inc., Eisai Co., Otsuka Pharmaceutical Co., Otsuka Holdings Co., Sanofi K.K., Shionogi & Co., Sanwa Kagaku Kenkyusho Co., Daiichi Sankyo Co., Taisho Pharmaceutical Co., Ltd, Sumitomo Dainippon Pharma Co., Takeda Pharmaceutical Co., Mitsubishi Tanabe Pharma Co., Teijin Pharma, Boehringer Ingelheim Japan Inc., Pfizer Japan Inc., Fukuda Lifetec Co., Fukuda Lifetec Kanto Co., Bristol-Myers Squibb K.K., Mylan Co., Mochida Pharmaceutical Co., Roche Diagnostics K.K. and honoraria from Idorsia Pharmaceuticals Japan, Omron Healthcare Co., Daiichi Sankyo Company, Limited, Takeda Pharmaceutical Co., Terumo Corporation, Mylan EPD. Taskeen Khan is a staff member of the World Health Organization. The authors alone are responsible for the views expressed in this publication, and they do not necessarily represent those of the World Health Organization. Pedro Ordunez is a staff member of the Pan American Health Organization. The authors alone are responsible for the views expressed in this publication, and they do not necessarily represent those of the Pan American Health Organization. Aletta E Schutte has received speaker honoraria from Omron Healthcare, Servier, Takeda, Novartis and advisory board fees from Abbott, outside the submitted work.

Figures

Figure 1
Figure 1
Ten key actions recommended by the Lancet Commission of Hypertension [46]. Reprinted from The Lancet, 388, Olsen MH, Angell SY, Asma S, Boutouyrie P, Burger D, Chirinos JA, et al. A call to action and a lifecourse strategy to address the global burden of raised blood pressure on current and future generations: the Lancet Commission on hypertension., 2665–712, Copyright (2016), with permission from Elsevier.
Figure 2
Figure 2
The ideal patient pathway for hypertension, referred to as the Continuum of Care on Page 9 © World Heart Federation.
Figure 3
Figure 3
Selected roadblocks on the way to the ideal patient journey © World Heart Federation.
Figure 4
Figure 4
PASCAR Roadmap on Hypertension with a 10-point action plan. Reprinted from Global Heart, 13(1), Dzudie A, Rayner B, Ojji D, Schutte AE, Twagiramukiza M, Damasceno A et al, Roadmap to Achieve 25% Hypertension Control in Africa by 2025, pp. 45–59, 2018, with permission from Ubiquity Press.
Figure 5
Figure 5
The Call to Action agreed in Kenya, reprinted from ‘Accelerating Cardiovascular Health and Care in Kenya’, available at https://www.world-heart-federation.org/wp-content/uploads/2019/01/WHF-Care-in-Kenya-brochure_WEB.pdf, with permission from WHF.
Figure 6
Figure 6
Hypertension Management Protocol for Primary Health Care Settings, reproduced with permission from Resolve to Save Lives.
See this image and copyright information in PMC

References

    1. Adler AJ, Prabhakaran D, Bovet P, Kazi DS, Mancia G, Mungal-Singh V, et al. Reducing Cardiovascular Mortality Through Prevention and Management of Raised Blood Pressure: A World Heart Federation Roadmap. Glob Heart. 2015; 10(2): 111–22. DOI: 10.1016/j.gheart.2015.04.006 - DOI - PubMed
    1. Grainger Gasser A, Welch C, Arora M, Greenland R, Bhatti L, Sanda L, et al. Reducing Cardiovascular Mortality Through Tobacco Control: A World Heart Federation Roadmap. Glob Heart. 2015; 10(2): 123–33. DOI: 10.1016/j.gheart.2015.04.007 - DOI - PubMed
    1. Murphy A, Banerjee A, Breithardt G, Camm AJ, Commerford P, Freedman B, et al. The World Heart Federation Roadmap for Nonvalvular Atrial Fibrillation. Glob Heart. 2017; 12(4): 273–84. DOI: 10.1016/j.gheart.2017.01.015 - DOI - PubMed
    1. Murphy A, Faria-Neto JR, Al-Rasadi K, Blom D, Catapano A, Cuevas A, et al. World Heart Federation Cholesterol Roadmap. Glob Heart. 2017; 12(3): 179–97.e5. DOI: 10.1016/j.gheart.2017.03.002 - DOI - PubMed
    1. Palafox B, Mocumbi AO, Kumar RK, Ali SKM, Kennedy E, Haileamlak A, et al. The WHF Roadmap for Reducing CV Morbidity and Mortality Through Prevention and Control of RHD. Glob Heart. 2017; 12(1): 47–62. DOI: 10.1016/j.gheart.2016.12.001 - DOI - PubMed