Bueno Héctor, Seara Germán, Rosario Azcutia María, Jesús Rodríguez-García María, Peláez Sonia, Agra Yolanda, Dueñas Carla A, Gullón Pedro, Aparicio Azcárraga Pilar
Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain; Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain.
Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.
Rev Esp Cardiol (Engl Ed). 2025 Jul;78(7):628-636. doi: 10.1016/j.rec.2024.11.009. Epub 2024 Dec 5.
Cardiovascular disease (CVD) remains the leading cause of death in most countries; however, few specific political actions have been implemented to improve cardiovascular health at both national and international levels. We aimed to describe the methodology used for the development and initial rollout of Spain's Cardiovascular Health Strategy of the National Health System (ESCAV, Estrategia en Salud Cardiovascular del Sistema Nacional de Salud).
A multidisciplinary team comprising diverse stakeholders developed a national strategy to reduce the burden of CVD in Spain. The team used qualitative methodologies to identify and select priorities and design strategic map models.
The strategy was structured around a matrix with 6 cross-cutting themes (citizen empowerment; health promotion, prevention, and early CVD detection; comprehensive management of acute and chronic CVD; health care coordination; equity; and knowledge management) and 4 longitudinal lines (ischemic heart disease, heart failure, arrhythmias, and valve disease). The framework was further supported by 3 overarching axes: continuity of care, patient safety, and leveraging of information systems. A total of 27 critical points were selected, leading to the definition of 99 strategic objectives (32 general and 67 specific) and 136 actions through iterative reviews and prioritization. Strategic maps were developed for the overall strategy and for each action line, incorporating 61 indicators to facilitate and monitor the development of the strategy.
ESCAV represents one of the most ambitious initiatives aimed at transforming a nation's cardiovascular health. The methods and steps undertaken in this process could serve as a valuable reference for other countries seeking to establish similar initiatives. Furthermore, it may act as a catalyst to advance efforts toward establishing a European plan for cardiovascular health.
在大多数国家，心血管疾病（CVD）仍是主要死因；然而，在国家和国际层面，为改善心血管健康而采取的具体政治行动却寥寥无几。我们旨在描述西班牙国家卫生系统心血管健康战略（ESCAV，Estrategia en Salud Cardiovascular del Sistema Nacional de Salud）制定及初步推行所采用的方法。
一个由不同利益相关者组成的多学科团队制定了一项旨在减轻西班牙心血管疾病负担的国家战略。该团队采用定性方法来确定和选择优先事项，并设计战略地图模型。
该战略围绕一个矩阵构建，包含6个贯穿各领域的主题（公民赋权；健康促进、预防及心血管疾病早期检测；急性和慢性心血管疾病的综合管理；医疗协调；公平性；知识管理）以及4条纵向主线（缺血性心脏病、心力衰竭、心律失常和瓣膜病）。该框架还得到3个总体轴的支持：医疗连续性、患者安全和信息系统的利用。通过反复审查和确定优先次序，共选定了27个关键点，进而确定了99项战略目标（32项总体目标和67项具体目标）以及136项行动。为总体战略和每条行动线制定了战略地图，纳入61项指标以促进并监测战略的实施。
ESCAV是旨在改变一个国家心血管健康状况的最具雄心的举措之一。这一过程中所采用的方法和步骤可为其他寻求开展类似举措的国家提供宝贵参考。此外，它可能会推动制定欧洲心血管健康计划的努力。
