Cardiovascular, respiratory, and related disorders: key messages from disease control priorities

Journal article


Prabhakaran, Dorairaj, Anand, Shuchi, Watkins, D. A., Gaziano, Thomas A., Wu, Yangfeng, Mbanya, Jean Claude, Nugent, Rachel, Ajay, Vamadevan S., Afshin, Ashkan, Adler, Alma, Ali, Mohammed K., Bateman, Eric, Bettger, Janet, Bonow, Robert O., Brouwer, Elizabeth, Bukhman, Gene, Bull, Fiona, Burney, Peter, Capewell, Simon, ... Jr, Anis Rassi. (2018) Cardiovascular, respiratory, and related disorders: key messages from disease control priorities. The Lancet. 391(10126), pp. 1224 - 1236. https://doi.org/10.1016/S0140-6736(17)32471-6
AuthorsPrabhakaran, Dorairaj, Anand, Shuchi, Watkins, D. A., Gaziano, Thomas A., Wu, Yangfeng, Mbanya, Jean Claude, Nugent, Rachel, Ajay, Vamadevan S., Afshin, Ashkan, Adler, Alma, Ali, Mohammed K., Bateman, Eric, Bettger, Janet, Bonow, Robert O., Brouwer, Elizabeth, Bukhman, Gene, Bull, Fiona, Burney, Peter, Capewell, Simon, Chan, Juliana, Chandrasekar, Eeshwar K., Chen, Jie, Criqui, Michael H., Dirks, John, Dugani, Sagar B., Engelgau, Michael, El Nahas, Meguid, Fall, Caroline H. D., Feigin, Valery, Fowkes, F. Gerald. R., Glassman, Amanda, Goenka, Shifalika, Gupta, Rajeev, Hasan, Babar, Hersch, Fred, Hu, Frank, Huffman, Mark D., Jabbour, Samer, Jarvis, Deborah, Jeemon, Panniyammakal, Joshi, Rohina, Kamano, Jemima H., Kengne, Andre Pascal, Kudesia, Preeti, Kumar, R. Krishna, Kumaran, Kalyanaraman, Lambert, Estelle V., Lee, Edward S., Li, Chaoyun, Luo, Rong, Magee, Matthew, Malik, Vasanti S., Marin-Neto, J. Antonio, Marks, Guy, Mayosi, Bongani, McGuire, Helen, Micha, Renata, Miranda, J. Jaime, Montoya, Pablo Aschner, Moran, Andrew E., Mozaffarian, Dariush, Naicker, Saraladevi, Naidoo, Nadraj G., Venkat Narayan, K. M., Nikolic, Irina, O'Donnell, Martin, Onen, Churchill, Osmond, Clive, Patel, Anushka, Perez-Padilla, Rogelio, Poulter, Neil, Pratt, Michael, Rabkin, Miriam, Rajan, Vikram, Rassi, Anis, Rassi, Rawal, Ishita, Remuzzi, Giuseppe, Riella, Miguel, Roth, Greg A., Roy, Ambuj, Rubinstein, Adolfo, Sakuma, Yuna, Sampson, Uchechukwu K. A., Siegel, Karen R., Sliwa, Karen, Suhrcke, Marc, Tandon, Nikhil, Thomas, Bernadette, Vaca, Claudia, Vedanthan, Rajesh, Verguet, St├ęphane, Webb, Michael, Weber, Mary Beth, Whitsel, Laurie, Wong, Gary, Yan, Lijing L., Yancy, Clyde W., Zhang, Ping, Zhao, Dong, Zhu, Yishan and Jr, Anis Rassi
Abstract

Summary Cardiovascular, respiratory, and related disorders (CVRDs) are the leading causes of adult death worldwide, and substantial inequalities in care of patients with CVRDs exist between countries of high income and countries of low and middle income. Based on current trends, the UN Sustainable Development Goal to reduce premature mortality due to CVRDs by a third by 2030 will be challenging for many countries of low and middle income. We did systematic literature reviews of effectiveness and cost-effectiveness to identify priority interventions. We summarise the key findings and present a costed essential package of interventions to reduce risk of and manage CVRDs. On a population level, we recommend tobacco taxation, bans on trans fats, and compulsory reduction of salt in manufactured food products. We suggest primary health services be strengthened through the establishment of locally endorsed guidelines and ensured availability of essential medications. The policy interventions and health service delivery package we suggest could serve as the cornerstone for the management of CVRDs, and afford substantial financial risk protection for vulnerable households. We estimate that full implementation of the essential package would cost an additional US$21 per person in the average low-income country and $24 in the average lower-middle-income country. The essential package we describe could be a starting place for low-income and middle-income countries developing universal health coverage packages. Interventions could be rolled out as disease burden demands and budgets allow. Our outlined interventions provide a pathway for countries attempting to convert the UN Sustainable Development Goal commitments into tangible action.

KeywordsCardiovascular; respiratory; and related disorders; Disease Control Priorities
Year2018
JournalThe Lancet
Journal citation391 (10126), pp. 1224 - 1236
PublisherLancet Publishing Group
ISSN0140-6736
Digital Object Identifier (DOI)https://doi.org/10.1016/S0140-6736(17)32471-6
Scopus EID2-s2.0-85032836840
Page range1224 - 1236
Research GroupMary MacKillop Institute for Health Research
Place of publicationUnited Kingdom
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