Lamelas Pablo M, Yusuf Salim, Schwalm J D
The Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Curr Opin Cardiol. 2017 Sep;32(5):557-566. doi: 10.1097/HCO.0000000000000433.
Describe the global burden of cardiovascular disease (CVD), highlight barriers to evidence-based care and propose effective interventions based on identified barriers.
The global burden of CVD is increasing worldwide. This trend is steeper in lower income countries, where CVD incidence and fatality remains high. Risk factor control, around the world, remains poor, especially in lower and middle-income countries. Barriers at the patient, healthcare provider and health system have been identified. The use of multifaceted interventions that target identified contextual barriers to care, including increasing awareness of CVD and related risk, improving health policy (i.e. taxation of tobacco), improving the availability and affordability of fixed-dose combined medications and task-shifting of healthcare responsibilities are potential solutions to improve the global burden of CVD.
There is a need to address identified barriers using evidence-based and multifaceted interventions. Global initiatives, led by the World Heart Federation and the WHO, to facilitate the implementation of such interventions are underway.
描述心血管疾病（CVD）的全球负担，强调循证护理的障碍，并根据已确定的障碍提出有效的干预措施。
全球范围内，心血管疾病的全球负担正在增加。这种趋势在低收入国家更为明显，这些国家的心血管疾病发病率和死亡率仍然很高。世界各地的危险因素控制情况仍然很差，尤其是在低收入和中等收入国家。已确定患者、医疗服务提供者和卫生系统方面存在的障碍。针对已确定的护理背景障碍采取多方面干预措施，包括提高对心血管疾病及相关风险的认识、改善卫生政策（如烟草税）、提高固定剂量复方药物的可及性和可承受性以及医疗责任的任务转移，是改善心血管疾病全球负担的潜在解决方案。
需要采用循证且多方面的干预措施来解决已确定的障碍。由世界心脏联盟和世界卫生组织牵头的全球倡议正在推动此类干预措施的实施。
