Department of Global Health, Academic Medical Centre, University of Amsterdam, Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands.
Ethn Health. 2012;17(6):651-76. doi: 10.1080/13557858.2012.754409. Epub 2013 Jan 9.
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.
To evaluate the effectiveness of the community-based interventions for CVD prevention programmes in LMIC.
A literature review with searches in the databases of PubMed, EMBASE, CINAHL, LILACS, African Index Medicus and Google Scholar between 1990 and May 2012.
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.
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.
由于城市化和全球化的影响，心血管疾病（CVD）在中低收入国家（LMICs）的负担日益加重。这些地区的危险因素知晓率和治疗率较低，导致预后恶化。预防心血管疾病已被证明具有成本效益，应成为主要干预措施。深入了解 LMIC 中的预防计划对于解决这些疾病的高发水平至关重要。
评估基于社区的 CVD 预防计划干预措施在 LMIC 中的有效性。
对 1990 年至 2012 年 5 月期间在 PubMed、EMBASE、CINAHL、LILACS、非洲医学索引和 Google Scholar 数据库中进行的文献检索进行了综述。
本综述共纳入 26 项涉及人群干预和高危干预的研究。人群干预的内容主要是通过媒体和健康教育进行健康促进，而高危方法则侧重于对患者的教育、卫生保健提供者的培训和实施治疗指南。少数研究仅进行了单一的锻炼或减少盐摄入干预。大多数研究显示心血管风险显著降低，范围从饮食、吸烟和饮酒等生活方式改变到血压、血糖水平或体重等生物医学结果。一些研究显示出危险因素管理的改善，例如高血压控制的增加或药物治疗的依从性。
在 LMIC 中已经开展了针对降低心血管危险因素的有效的基于社区的计划，但这些计划通常仅限于城市贫困人口。以饮食和盐为重点的健康教育、卫生保健提供者的培训和实施治疗指南是成功计划的关键要素。
