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Review
. 2023 Nov 7;82(19):1868-1884.
doi: 10.1016/j.jacc.2023.08.043. Epub 2023 Sep 19.

Implementation of Global Hearts Hypertension Control Programs in 32 Low- and Middle-Income Countries: JACC International

Andrew E Moran  1 , Reena Gupta  2 ; Global Hearts Initiative Collaborators
Collaborators, Affiliations
Free article
Review

Implementation of Global Hearts Hypertension Control Programs in 32 Low- and Middle-Income Countries: JACC International

Andrew E Moran et al. J Am Coll Cardiol. .
Free article

Abstract

In 2017, the World Health Organization (WHO) and Resolve to Save Lives partnered with country governments and other stakeholders to design, test, and scale up the WHO HEARTS hypertension services package in 32 low- and middle-income countries. Facility-based HEARTS performance indicators included number of patients enrolled, number treated and with blood pressure controlled, number who missed a scheduled follow-up visit, and number lost to follow-up. By 2022, HEARTS hypertension control programs treated 12.2 million patients in 165,000 primary care facilities. Hypertension control was 38% (median 48%; range 5%-86%). In 4 HEARTS countries using the same digital health information system, facility-based control improved from 18% at baseline to 46% in 48 months. At the population level, median estimated population-based hypertension control was 11.0% of all hypertension patients (range 2.0%-34.7%). The Global Hearts experience of implementing WHO HEARTS demonstrates the feasibility of controlling hypertension in low- and middle-income country primary care settings.

Keywords: hypertension; implementation; low- and middle-income countries; public health.

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Conflict of interest statement

Funding Support and Author Disclosures This study was supported by Resolve to Save Lives. Resolve to Save Lives is funded by Bloomberg Philanthropies, the Bill & Melinda Gates Foundation (award OPP1175906), the Chan Zuckerberg Initiative, Atria, Founder's Pledge, Lydia Hill Philanthropies, and Tambourine. The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

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