Sethi Yashendra, Biondi-Zoccai Giuseppe
PearResearch, Dehradun, India -
Department of Medicine, Subharti Medical College, Meerut, UP, India -
Minerva Cardiol Angiol. 2025 Jul 2. doi: 10.23736/S2724-5683.25.06853-X.
Cardiovascular disease (CVD) remains a leading global health challenge, accounting for 32% of global deaths, with significant disparities in access to care and outcomes, particularly in low- and middle-income countries (LMICs). Despite advancements in prevention, diagnosis, and treatment, unmet needs persist across clinical management, technological integration, and health system barriers. This umbrella review synthesizes evidence on these unmet needs to provide a comprehensive framework for future research and policy interventions.
A systematic search was conducted across PubMed, Scopus, Google Scholar, and the Cochrane Library from 2010 to 2023, using keywords such as "unmet needs," "cardiovascular disease," and "health system barriers." Fifty systematic reviews, encompassing 580 studies, were included. Data extraction and quality assessment were performed using the Joanna Briggs Institute checklist, with findings categorized into clinical, technological, socioeconomic, and population-specific domains.
The review identified critical gaps in cardiovascular care, including limited access to specialized services, suboptimal adherence to clinical guidelines, and disparities in technological integration, particularly in LMICs. Socioeconomic factors, such as income inequality and gender disparities, significantly impact access to care and outcomes. Technological advancements, including telemedicine, wearable devices, and AI, show promise but face barriers to widespread adoption. Patient education and mental health integration emerged as essential components of comprehensive care models. Precision public policy was highlighted as a key strategy to address these disparities through targeted, data-driven interventions.
This review highlights the urgent need for multifaceted strategies to address unmet needs in cardiovascular care. Enhancing access to care, improving guideline adherence, integrating technology, and addressing socioeconomic disparities are critical to reducing the global burden of CVD. Collaborative efforts among policymakers, healthcare providers, and researchers are essential to develop equitable, patient-centered solutions. Precision public policy, tailored to the unique needs of diverse populations, offers a promising pathway to achieving these goals and improving cardiovascular health outcomes worldwide.
心血管疾病（CVD）仍然是一项重大的全球健康挑战，占全球死亡人数的32%，在获得医疗服务和治疗结果方面存在显著差异，尤其是在低收入和中等收入国家（LMICs）。尽管在预防、诊断和治疗方面取得了进展，但在临床管理、技术整合和卫生系统障碍方面，未满足的需求依然存在。本综述综合了有关这些未满足需求的证据，为未来的研究和政策干预提供了一个全面的框架。
2010年至2023年期间，在PubMed、Scopus、谷歌学术和Cochrane图书馆进行了系统检索，使用了“未满足的需求”、“心血管疾病”和“卫生系统障碍”等关键词。纳入了50篇系统评价，涵盖580项研究。使用乔安娜·布里格斯研究所清单进行数据提取和质量评估，研究结果分为临床、技术、社会经济和特定人群领域。
该综述确定了心血管护理方面的关键差距，包括获得专科服务的机会有限、对临床指南的依从性欠佳以及技术整合方面的差异，尤其是在低收入和中等收入国家。社会经济因素，如收入不平等和性别差异，对获得医疗服务和治疗结果有重大影响。包括远程医疗、可穿戴设备和人工智能在内的技术进步显示出前景，但在广泛应用方面面临障碍。患者教育和心理健康整合成为综合护理模式的重要组成部分。精准公共政策被强调为通过有针对性的数据驱动干预措施来解决这些差异的关键策略。
本综述强调迫切需要采取多方面策略来满足心血管护理中未满足的需求。增加获得医疗服务的机会、提高对指南的依从性、整合技术以及解决社会经济差异对于减轻全球心血管疾病负担至关重要。政策制定者、医疗服务提供者和研究人员之间的合作努力对于制定公平的、以患者为中心的解决方案至关重要。根据不同人群的独特需求量身定制的精准公共政策为实现这些目标和改善全球心血管健康结果提供了一条有希望的途径。
