World Heart Federation Roadmap for Secondary Prevention of Cardiovascular Disease: 2023 Update

Health Behavior 610 cvd 03 medical and health sciences 0302 clinical medicine Risk Factors 616 Secondary Prevention Diseases of the circulatory (Cardiovascular) system Humans /dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_being; name=SDG 3 - Good Health and Well-being fixed combination therapy Cardiovascular Diseases/epidemiology influenza vaccination name=SDG 3 - Good Health and Well-being Diet cardiac rehabilitation Cardiovascular Diseases RC666-701 Whf Roadmap /dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_being Public aspects of medicine RA1-1270 secondary prevention polypill
DOI: 10.5334/gh.1278 Publication Date: 2024-01-22T12:17:41Z
ABSTRACT
Secondary prevention lifestyle and pharmacological treatment of atherosclerotic cardiovascular disease (ASCVD) reduce a high proportion of recurrent events and mortality. However, significant gaps exist between guideline recommendations and usual clinical practice.Describe the state of the art, the roadblocks, and successful strategies to overcome them in ASCVD secondary prevention management.A writing group reviewed guidelines and research papers and received inputs from an international committee composed of cardiovascular prevention and health systems experts about the article's structure, content, and draft. Finally, an external expert group reviewed the paper.Smoking cessation, physical activity, diet and weight management, antiplatelets, statins, beta-blockers, renin-angiotensin-aldosterone system inhibitors, and cardiac rehabilitation reduce events and mortality. Potential roadblocks may occur at the individual, healthcare provider, and health system levels and include lack of access to healthcare and medicines, clinical inertia, lack of primary care infrastructure or built environments that support preventive cardiovascular health behaviours. Possible solutions include improving health literacy, self-management strategies, national policies to improve lifestyle and access to secondary prevention medication (including fix-dose combination therapy), implementing rehabilitation programs, and incorporating digital health interventions. Digital tools are being examined in a range of settings from enhancing self-management, risk factor control, and cardiac rehab.Effective strategies for secondary prevention management exist, but there are barriers to their implementation. WHF roadmaps can facilitate the development of a strategic plan to identify and implement local and national level approaches for improving secondary prevention.
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