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

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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, Afshin, Ashkan, Adler, Alma, Ali, Mohammed K, Bateman, Eric, Bettger, Janet, Bonow, Robert O, Brouwer, Elizabeth, Bukhman, Gene, Bull, Fiona, Burney, Peter, Capewell, Simon, Chan, Juliana, Chandrasekar, Eeshwar K, Chen, Jie, Criqui, Michael H, Dirks, John, Dugani, Sagar B, Engelgau, Michael, El Nahas, Meguid, Fall, Caroline HD, Feigin, Valery, Fowkes, F Gerald R, Glassman, Amanda, Goenka, Shifalika, Gupta, Rajeev, Hasan, Babar, Hersch, Fred, Hu, Frank, Huffman, Mark D, Jabbour, Samer, Jarvis, Deborah, Jeemon, Panniyammakal, Joshi, Rohina, Kamano, Jemima H, Kengne, Andre Pascal, Kudesia, Preeti, Kumar, R Krishna, Kumaran, Kalyanaraman, Lambert, Estelle V, Lee, Edward S, Li, Chaoyun, Luo, Rong, Magee, Matthew, Malik, Vasanti S, Marin-Neto, J Antonio, Marks, Guy, Mayosi, Bongani, McGuire, Helen, Micha, Renata, Miranda, J Jaime, Montoya, Pablo Aschner, Moran, Andrew E, Mozaffarian, Dariush, Naicker, Saraladevi, Naidoo, Nadraj G, Narayan, KM Venkat, Nikolic, Irina, O'Donnell, Martin, Onen, Churchill, Osmond, Clive, Patel, Anushka, Perez-Padilla, Rogelio, Poulter, Neil, Pratt, Michael, Rabkin, Miriam, Rajan, Vikram, Rassi, Anis, Rassi, Anis, Rawal, Ishita, Remuzzi, Giuseppe, Riella, Miguel, Roth, Greg A, Roy, Ambuj, Rubinstein, Adolfo, Sakuma, Yuna, Sampson, Uchechukwu KA, Siegel, Karen R, Sliwa, Karen, Suhrcke, Marc, Tandon, Nikhil, Thomas, Bernadette, Vaca, Claudia, Vedanthan, Rajesh, Verguet, Stéphane, Webb, Michael, Weber, Mary Beth, Whitsel, Laurie, Wong, Gary, Yan, Lijing L, Yancy, Clyde W, Zhang, Ping, Zhao, Dong, Zhu, Yishan·2018·The Lancet

DOI 10.1016/s0140-6736(17)32471-6PMC PMC5996970

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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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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
ORCID: Prabhakaran, Dorairaj
Anand, Shuchi
Watkins, David
Gaziano, Thomas
Wu, Yangfeng
Mbanya, Jean Claude
Nugent, Rachel
Ajay, Vamadevan S
Afshin, Ashkan
Adler, Alma
Ali, Mohammed K
Bettger, Janet
Bonow, Robert O
Brouwer, Elizabeth
Bukhman, Gene
Bull, Fiona
Burney, Peter
Chan, Juliana
Chandrasekar, Eeshwar K
Chen, Jie
Criqui, Michael H
Dugani, Sagar B
Fall, Caroline HD
Feigin, Valery
Goenka, Shifalika
Gupta, Rajeev
Hasan, Babar
Hersch, Fred
Hu, Frank
Huffman, Mark D
Jabbour, Samer
Jarvis, Deborah
Jeemon, Panniyammakal
Joshi, Rohina
Kamano, Jemima H
Kumaran, Kalyanaraman
Lambert, Estelle V
Lee, Edward S
Li, Chaoyun
Luo, Rong
Magee, Matthew
Malik, Vasanti S
Marks, Guy
Mayosi, Bongani
McGuire, Helen
Micha, Renata
Miranda, J Jaime
Montoya, Pablo Aschner
Moran, Andrew E
Mozaffarian, Dariush
Naicker, Saraladevi
O'Donnell, Martin
Osmond, Clive
Patel, Anushka
Poulter, Neil
Pratt, Michael
Rabkin, Miriam
Remuzzi, Giuseppe
Riella, Miguel
Roy, Ambuj
Rubinstein, Adolfo
Siegel, Karen R
Sliwa, Karen
Suhrcke, Marc
Tandon, Nikhil
Vaca, Claudia
Vedanthan, Rajesh
Verguet, Stéphane
Weber, Mary Beth
Whitsel, Laurie
Wong, Gary
Yan, Lijing L
Yancy, Clyde W
Zhang, Ping
Zhao, Dong
Zhu, Yishan
Venue: The Lancet
Publisher: Elsevier BV
Published: 2018-03
Volume: 391
Issue: 10126
Pages: 1224-1236
ISSN: 0099-5355 (ISSN-L)
0140-6736
DOI: 10.1016/s0140-6736(17)32471-6
PMC: PMC5996970
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: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (am, 206 d)
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
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › 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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