title: Review of community-based interventions for prevention of cardiovascular diseases in low- and middle-income countries.
abstract: BACKGROUND
  An increasing burden of cardiovascular disease (CVD) is occurring in low- and middle-income countries (LMICs) as a result of urbanisation and globalisation. Low rates of awareness and treatment of risk factors worsen the prognosis in these settings. Prevention of CVD is proven to be cost effective and should be the main intervention. Insight into prevention programmes in LMIC is important in addressing the rising levels of these diseases.
  
  
  OBJECTIVE
  To evaluate the effectiveness of the community-based interventions for CVD prevention programmes in LMIC.
  
  
  METHODS
  A literature review with searches in the databases of PubMed, EMBASE, CINAHL, LILACS, African Index Medicus and Google Scholar between 1990 and May 2012.
  
  
  RESULTS
  Twenty-six studies involving population-based and high-risk interventions have been included in this review. The content of the population intervention was mainly health promotion through media and health education, and the high-risk approach focused often on education of patients, training of health care providers and implementing treatment guidelines. A few studies had a single intervention on exercising or salt reduction. Most studies showed a significant reduction of cardiovascular risk ranging from lifestyle changes on diet, smoking and alcohol to biomedical outcomes like blood pressure, glucose levels or weight. Some studies showed improved management of risk factors like increased control of hypertension or adherence to medication.
  
  
  CONCLUSIONS
  There have been effective community-based programmes aimed at reducing cardiovascular risk factors in LMIC but these have generally been limited to the urban poor. Health education with a focus on diet and salt, training of health care providers and implementing treatment guidelines form key elements in successful programmes.
authors.affiliation: Department of Global Health, Academic Medical Centre, University of Amsterdam, Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands.
authors.forename: Steven
authors.initials: S
authors.lastname: van de Vijver
authors.forename: Samuel
authors.initials: S
authors.lastname: Oti
authors.forename: Juliet
authors.initials: J
authors.lastname: Addo
authors.forename: Ama
authors.initials: A
authors.lastname: de Graft-Aikins
authors.forename: Charles
authors.initials: C
authors.lastname: Agyemang
mesh_terms: D002318:Cardiovascular Diseases / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D003153:Community Health Services / Q000379:methods* / Q000706:statistics & numerical data; D003431:Cross-Cultural Comparison; D016206:Databases, Bibliographic; D003906:Developing Countries / Q000191:economics; D006266:Health Education; D006293:Health Promotion / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D008019:Life Style; D009043:Motor Activity; D012307:Risk Factors; D061217:Weight Reduction Programs / Q000379:methods* / Q000706:statistics & numerical data