Brazilian Society of Cardiology: letter from Rio de Janeiro - III Brazil Prevent / I Latin American Prevent

EDITORIAL

Brazilian Society of Cardiology: letter from Rio de Janeiro - III Brazil Prevent / I Latin American Prevent

Jadelson P. Andrade; Donna K. Arnett; Fausto Pinto; Daniel Piñeiro; Sidney C. Smith Jr; Luiz Alberto P. Mattos; Carlos Alberto Machado; Gláucia Maria M. Oliveira; Hans F. Dohmann; Stephan Gielen

Purpose

The final document will be published as a special article in the Arquivos Brasileiros de Cardiologia and as an editorial note in scientific journals of societies and their affiliates supporting this document

The document aims to provide an overview of cardiovascular diseases and outline strategic actions to reduce the prevalence of risk factors that contribute to high morbidity and mortality.

Acknowledging the Political Declaration of the United Nations High-Level Meeting on the Prevention and Control of Non-communicable Diseases (NCD's)¹.

Reaffirming the World Health Assembly Decision WHA 65.8 on follow-up to the United Nations High-Level Meeting on the Prevention and Control of NCD's and the adoption of the global target of a 25% reduction in premature mortality from non-communicable diseases by 2025¹.

Recognizing that in 2008, 36 million (63%) global deaths were caused by NCDs, 9 million of which occurred under the age of 60 years. Furthermore, almost 80% of the leading chronic diseases (29 million) occurred in low and middle income countries. Cardiovascular diseases will remain the number one global cause of death, accounting for 17.3 million deaths per year, a number that is expected to grow to > 23.6 million by 2030². In Latin America, 40% of cardiovascular deaths occur during an individual's most productive years³.

In Brazil, NCDs are a health problem of major magnitude, accounting for 72% of death causes, especially cardiovascular diseases (31.3%), cancer (16.3%), diabetes (5.2%) and chronic respiratory diseases (5.8%), affecting individuals of all socioeconomic levels and, more specifically, those belonging to vulnerable groups, such as the elderly and those with low educational level and income³.

It is worth noting that three hundred thousand Brazilians die annually due to cardiovascular diseases, such as infarction, stroke, heart and kidney failure, and sudden death, which means 820 deaths a day, 30 deaths per hour or one death every two minutes³.

It is estimated that beyond the lives saved and the life-years extended, reducing the mortality rate for ischemic heart disease and stroke by 10% would also reduce economic losses in low- and middle-income countries by an estimated US$ 25 billion per year^4,5.

The role of leading medical associations and professional societies as critical agents of change in addressing the global burden of cardiovascular diseases and stroke is widely recognized.

1. To work collectively in advocating all global targets* for the prevention and control of NCDs to cover all major risk factors, such as physical inactivity, hypertension, sodium reduction, tobacco use, saturated fat intake, obesity, alcohol consumption, cholesterol, and drug therapy to prevent heart attacks and strokes⁶;

2. To strengthen the development and implementation of public policies for the prevention and control of NCDs in the general population and specific population groups in Brazil and in the Americas to reach the global target of a 25% reduction in premature mortality from NCDs by 2025;

3. To collectively defend the control of NCDs, placing emphasis on these diseases, which should be included in discussions in reputable national and international forums;

4. To work together to reduce morbidity, disability and mortality caused by NCDs, through a set of preventive and health promotion actions, associated with early detection and treatment;

5. To provide the highest level of continuing medical education and scientific knowledge to primary care physicians, cardiologists, critical care nurses and other health professionals;

6. To act on the social determinants that influence risk factors for NCDs, through governmental policies to promote physical and social environments suitable to reduced risk exposure, facilitating the adoption of healthy behaviors by the population, in school environments, work and leisure, urban spaces and others;

7. Act with the governments seeking for the development and application of a Cardiovascular Prevention Program in the countries and establish ways to gauge the results of this movement along with the population;

8. Implement coaching and qualification of the health professionals in the treatment of the cardiac emergency and encourage lay people to obtain techniques/ competences in resuscitation using the established protocols by the Scientifics societies;

9. To develop collaborative projects that support a "life course" approach that emphasizes health promotion and disease prevention strategies to minimize the risk of NCDs, at every stage of life;

10. Encourage media to continuously inform the public about the importance of cardiovascular diseases, the main factors, prevention forms, enhance public education and communication to have more divulgation with the population about the best way to avoid its occurrence and the importance of early diagnosis to reduce mortality;

11. Implement actions for the acquisition of epidemiological information, including cardiovascular morbidity and mortality and the execution/maintenance records, existing in some of the signatories, aiming at developing strategies and promoting planning of the health actions;

12. To create a permanent international forum for discussion, monitoring and implementation of actions aimed for the prevention, diagnosis and treatment of cardiovascular risk factors in Latin America;

13. Establish cardiovascular prevention campaigns in order to promote consistent efforts to obtain a target reduction of 25% for the mortality rate until 2025. The campaigns should involve 7 cardiovascular risk factors: smoking, poor diet e.g. high salt intake, physical inactivity, obesity, hypertension, high cholesterol and diabetes, as specified by guidelines and WHO.

This document was prepared with the participation of Carlos Alberto Machado, Daniel Piñeiro, Donna K. Arnett, Fausto Pinto, Gláucia Maria M. Oliveira, Hans F. Dohmann, Jadelson P. Andrade, Luiz Alberto P. Mattos, Sidney C. Smith Jr. and Stephan Gielen.

The entities listed below support and recommend all terms contained in this document.

Brazilian Society of Cardiology (BSC), Interamerican Society of Cardiology (SIAC), American Heart Association (AHA), European Society of Cardiology (ESC), and World Heart Federation (WHF).

Signed by the Presidents of the Cardiology Societies:

Jadelson P. Andrade

BSC - President

Daniel Piñeiro

SIAC - President

Donna K. Arnett

AHA - President

Fausto Pinto

ESC - President-Elect

Sidney C. Smith, Jr

WHF - President

References

1. World Health Organization. 65th World Health Assembly document A65/54: Second report of Committee A. Published May 25, 2012. Disponível em: http://apps.who.int/gb/ebwha/pdf_files/WHA65/A65_54-en.pdf. Acessado em 4 de novembro de 2012.

2. World Health Organization, World Heart Federation, World Stroke Organization. Global atlas on cardiovascular disease prevention and control: policies, strategies, and interventions. Published 2011. Disponível em: http://www.who.int/cardiovascular_diseases/publications/atlas_cvd/en/. Acessado em 4 de novembro de 2012

3. Plano de ações estratégicas para o enfrentamento das doenças crônicas não transmissíveis no Brasil, 2011-2022. Ministério da Saúde - Secretaria de Vigilância à Saúde.

4. Lim SS, Gaziano TA, Gakidou E, Reddy KS, Farzadfar F, Lozano R Rodgers A. Prevention of cardiovascular disease in high-risk individuals in low-income and middle-income countries: health effects and costs. Lancet. 2007; 370:2054-2062.

5. Smith SC Jr, Collins A, Ferrari R, Holmes DR Jr, Logstrup S, McGhie DV, Ralston J, Sacco RL, Stam H, Taubert K, Wood DA, Zoghbi WA. Our time: a call to save preventable deaths from cardiovascular disease (heart disease and stroke). Disponível em: http://circ.ahajournals.org/content/early/2012/09/17/CIR.0b013e318267e99f.citation, Acessado em 4 de novembro de 2012.

Rio de Janeiro, November 30^th, 2012

Publication Dates

• Publication in this collection
  29 Jan 2013
• Date of issue
  Jan 2013