title: Cardiovascular risk assessment in low-resource settings: a consensus document of the European Society of Hypertension Working Group on Hypertension and Cardiovascular Risk in Low Resource Settings.
abstract: The Global Burden of Diseases, Injuries, and Risk Factors Study 2010 confirms ischemic heart disease and stroke as the leading cause of death and that hypertension is the main associated risk factor worldwide. How best to respond to the rising prevalence of hypertension in resource-deprived settings is a topic of ongoing public-health debate and discussion. In low-income and middle-income countries, socioeconomic inequality and cultural factors play a role both in the development of risk factors and in the access to care. In Europe, cultural barriers and poor communication between health systems and migrants may limit migrants from receiving appropriate prevention, diagnosis, and treatment. To use more efficiently resources available and to make treatment cost-effective at the patient level, cardiovascular risk approach is now recommended. In 2011, The European Society of Hypertension established a Working Group on 'Hypertension and Cardiovascular risk in low resource settings', which brought together cardiologists, diabetologists, nephrologists, clinical trialists, epidemiologists, economists, and other stakeholders to review current strategies for cardiovascular risk assessment in population studies in low-income and middle-income countries, their limitations, possible improvements, and future interests in screening programs. This report summarizes current evidence and presents highlights of unmet needs.
authors.affiliation: aDepartment of Clinical and Experimental Medicine, University of Florence, Florence bCentro Cardiologico Monzino, IRCCS, Milan, Italy cDepartment of Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands dUniversity of California, San Francisco, California, USA eINSERM UMR S1116, Université de Lorraine, Vandoeuvre-les-Nancy, Nancy, France fUniversity of Warwick, Warwick Medical School, and University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK gInstitut d'Investigacions Biomèdiques August Pi i Sunyer IDIBAPS, and Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Barcelona, Spain hSection of Metabolic Diseases and Diabetes, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy iMakerere University, Kampala, Uganda jThe Conway Institute, University College Dublin, Dublin, Ireland kBenedict Medical Center, Kampala, Uganda lClinica Medica II, University of Pavia, Pavia mInstitute of Clinical Physiology, CNR, Pisa nDepartment of Internal Medicine, University of Perugia, Perugia oIRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri', Bergamo, Italy pDepartment of Sociology, University of Oxford, Oxford, UK qFaculty of Medicine and Health Sciences, Heymans Institute of Pharmacology, Ghent University, Ghent, Belgium rDepartment of Geriatrics, CHU Nancy, Nancy, France sBeijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing Anzhen Hospital, Beijing, China tDepartment of Health Sciences, University of Milano-Bicocca uDepartment of Cardiology, S. Luca Hospital, IRCCS Istituto Auxologico Italiano, Milan, Italy.
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mesh_terms: D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000517:prevention & control; D003906:Developing Countries; D005060:Europe; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000517:prevention & control; D040841:Resource Allocation; D018570:Risk Assessment; D012955:Societies, Medical