title: Stroke and cardiovascular diseases: the need for a global approach for prevention and drug development.
abstract: BACKGROUND
  Research into the prevention and treatment of stroke and cardiovascular disease has focused primarily on the needs of high-income countries (HIC). However, the majority of all stroke and cardiovascular deaths occurs in low- and middle-income countries (LMIC), with further rises in these countries predicted.
  
  
  RESULTS
  In HIC, proven strategies for the treatment of stroke and cardiovascular disease are well established and cost-effective. Developing strategies to include LMIC is therefore crucial to curb the global epidemic of stroke and cardiovascular disease. For example, pharmaceutical companies are being encouraged to make certain drugs more affordable in low- and middle-income companies, and the same principle could be applied to drugs for the prevention of stroke. Furthermore, centers from LMIC are now often included in clinical trials, resulting in trials that are more globally relevant and affordable and that enhance the participation of healthcare professionals from a broad range of countries.
  
  
  CONCLUSIONS
  More cost-effective drug development processes and affordable prices, while protecting intellectual property rights, will prevent the ever-increasing burden of stroke becoming unmanageable in LMIC.
authors.affiliation: Boehringer Ingelheim Pharmaceuticals Inc., Department of General Medicine, Ridgefield, CT, USA. hilbrich@rdg.boehringer-ingelheim.com
authors.forename: Lutz
authors.initials: L
authors.lastname: Hilbrich
authors.forename: Thomas
authors.initials: T
authors.lastname: Truelsen
authors.forename: Salim
authors.initials: S
authors.lastname: Yusuf
mesh_terms: D002318:Cardiovascular Diseases / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D002986:Clinical Trials as Topic / Q000941:ethics; D017281:Cost of Illness; D019049:Developed Countries / Q000191:economics; D003906:Developing Countries / Q000191:economics; D014943:Global Health; D006801:Humans; D007391:International Cooperation; D020521:Stroke / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*