Cited by 170Cardiovascular Health and Risk FactorsGlobal Public Health Policies and EpidemiologyHealth Promotion and Cardiovascular Prevention

Cardiovascular, respiratory, and related disorders: key messages from Disease Control Priorities, 3rd edition

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Prabhakaran, Dorairaj, Anand, Shuchi, Watkins, David, Gaziano, Thomas, Wu, Yangfeng, Mbanya, Jean Claude, Nugent, Rachel, Ajay, Vamadevan S +93 more·2018·The Lancet

Abstract

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.

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  1. [59]Ali MK Siegel KR Chandrasekar E Chapter 12 Prabhakaran D Gaziano T Anand S Mbanya J-C Wu Y Nugent R Disease control priorities, 3rd edn. Volume 5: cardiovascular, respiratory, and related disorders Washington, DC World Bank 2017 (in press) 30212054
  2. [71]Mock C Kobusingye O Nugent R Smith KR Disease control priorities, 3rd edn. Volume 7: Injury prevention and environmental health Washington, DC World Bank 2017 (in press) 30212056
  3. [75]Afshin A Micha R Webb M Chapter 6 Prabhakaran D Gaziano T Anand S Mbanya J-C Wu Y Nugent R Disease control priorities, 3rd edn. Volume 5: cardiovascular, respiratory, and related disorders Washington, DC World Bank 2017 (in press) 30212054
  4. [76]Bull F Goenka S Lambert V Pratt M Chapter 5 Prabhakaran D Gaziano T Anand S Mbanya J-C Wu Y Nugent R Disease control priorities, 3rd edn. Volume 5: cardiovascular, respiratory, and related disorders Washington, DC World Bank 2017 (in press)
  5. [77]Mock CN Kobusingye O Nugent R Smith KR Disease control priorities, 3rd edn. Volume 7: injury prevention and environmental health Washington, DC World Bank 2017 (in press) 30212056

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Authors
Prabhakaran, D., Anand, S., Watkins, D., Gaziano, T., Wu, Y., Mbanya, J. C., Nugent, R., Ajay, V. S., Afshin, A., Adler, A., Ali, M. K., Bateman, E., Bettger, J., Bonow, R. O., Brouwer, E., Bukhman, G., Bull, F., Burney, P., Capewell, S., Chan, J., Chandrasekar, E. K., Chen, J., Criqui, M. H., Dirks, J., Dugani, S. B., Engelgau, M., El Nahas, M., Fall, C. H., Feigin, V., Fowkes, F. G. R., Glassman, A., Goenka, S., Gupta, R., Hasan, B., Hersch, F., Hu, F., Huffman, M. D., Jabbour, S., Jarvis, D., Jeemon, P., Joshi, R., Kamano, J. H., Kengne, A. P., Kudesia, P., Kumar, R. K., Kumaran, K., Lambert, E. V., Lee, E. S., Li, C., Luo, R., Magee, M., Malik, V. S., Marin-Neto, J. A., Marks, G., Mayosi, B., McGuire, H., Micha, R., Miranda, J. J., Montoya, P. A., Moran, A. E., Mozaffarian, D., Naicker, S., Naidoo, N. G., Narayan, K. V., Nikolic, I., O'Donnell, M., Onen, C., Osmond, C., Patel, A., Perez-Padilla, R., Poulter, N., Pratt, M., Rabkin, M., Rajan, V., Rassi, A., Rassi, A., Rawal, I., Remuzzi, G., Riella, M., Roth, G. A., Roy, A., Rubinstein, A., Sakuma, Y., Sampson, U. K., Siegel, K. R., Sliwa, K., Suhrcke, M., Tandon, N., Thomas, B., Vaca, C., Vedanthan, R., Verguet, S., Webb, M., Weber, M. B., Whitsel, L., Wong, G., Yan, L. L., Yancy, C. W., Zhang, P., Zhao, D., & Zhu, Y.
Affiliations
  • Emory University (US)
  • Stanford Medicine (US)
  • University of Washington (US)
  • Brigham and Women's Hospital (US)
  • Peking University (CN)
  • Université de Yaoundé I (CM)
  • RTI International (US)
  • The George Institute for Global Health (GB)
  • Public Health Foundation of India (IN)
Corresponding author
Prabhakaran, Dorairaj
Venue
The Lancet
Publisher
Elsevier BV
Published
2018-03
Volume
391
Issue
10126
Pages
1224-1236
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
OpenAlex
W2765097496
Cited by
162
References
86
Citations by year
2026: 15 · 2025: 7 · 2024: 23 · 2023: 34 · 2022: 18 · 2021: 17 · 2020: 16 · 2019: 15 · 2018: 16
FWCI
1.80
Type
journal article
Language
en
Open access
Locations
  • The Lancet (acceptedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • UWA Profiles and Research Repository (UWA) (submittedVersion, other-oa)
  • ePrints Soton (University of Southampton) (submittedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
  • LSHTM Research Online (London School of Hygiene and Tropical Medicine) (submittedVersion)
  • CONICET Digital (CONICET) (submittedVersion, cc-by-nc-nd)
Funders
  • Bill and Melinda Gates Foundation
  • American Heart Association
  • National Institute of Diabetes and Digestive and Kidney Diseases (K-23 5K23DK101826-03)
  • Medtronic Foundation
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
  • Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Global Public Health Policies and Epidemiology
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
Keywords
disease control priorities, cost-effectiveness, tobacco taxation, trans fat ban, primary care, health policy, universal health coverage, Sustainable Development Goal 3, premature mortality, low- and middle-income countries, health disparities, financial protection
MeSH terms
Cardiovascular Diseases, Developing Countries, Health Priorities, Humans, Respiratory Tract Diseases

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