World Heart Day, observed annually on September 29th, serves as a powerful reminder of the critical importance of cardiovascular health. As we approach World Heart Day 2024, it’sessential to reflect on the current state of heart health globally and in specific regions, understand the challenges we face, and explore the actions being taken to combat cardiovascular diseases (CVDs).

The Global Burden of Cardiovascular Diseases

Cardiovascular diseases remain the leading cause of death worldwide. According to the American Heart Association’s 2024 Heart Disease and Stroke Statistics report, CVDs continue to pose a significant threat to global health. Let’s explore some key statistics and findings[1][2][3][4]:

1. Mortality Rates:

• CVDs are responsible for a substantial portion of global deaths.

• In the South-East Asia region alone, CVDs account for 3.9 million annual deaths, representing 30% of all deaths in the area.

• Premature Deaths:

• Alarmingly, almost half (48%) of CVD-related deaths in the South-East Asia region occur prematurely, affecting individuals aged 30 to 70 years.

• This high rate of premature deaths imposes significant socio economic burdens on families, communities, and countries.

• Risk Factors: The main contributors to the CVD burden include modifiable lifestyle factors:

• Tobacco use

• Alcohol consumption

• Unhealthy diets, especially those high in salt

• Lack of physical activity

• Raised blood pressure

• Elevated blood glucose levels

• Prevalence of Risk Factors:

• One in four adults in the South-East Asia region has raised blood pressure.

• One in ten adults in the region has diabetes.

• Less than 15% of those with these conditions are receiving effective treatment.

Regional Focus: South-East Asia

The World Health Organization’s South-East Asia Region, home to a quarter of the world’s population, faces a particularly high burden of noncommunicable diseases (NCDs), including CVDs. Dr. Poonam Khetrapal Singh, WHO Regional Director for South-East Asia, highlights the region’s challenges and initiatives[1]:

1. NCD Flagship Priority:

• Since 2014, NCDs have been identified as a Regional Flagship priority in South-East Asia.
  • In 2022, the region adopted the ‘Implementation Roadmap for accelerating the prevention and control of NCD in South-East Asia 2022–2030.’

• SEAHEARTS Initiative:

• The SEAHEARTS (WHO HEARTS package adaptation to South-East Asia Region) initiative brings together measures to reduce risk factors and improve hypertension and diabetes management in primary health care.
  • This initiative aligns with the World Heart Day 2023 theme “Use Heart, Know Heart” and offers countries a roadmap to scale up their efforts within broader NCD prevention and control strategies.

• Progress in Tobacco Control:

• Tobacco use prevalence in the region is declining due to the implementation of WHO Framework Convention on Tobacco Control measures.

• Trans-Fatty Acid Elimination:

• Bangladesh, India, Sri Lanka, and Thailand have taken steps to eliminate trans-fatty acids from their national food supplies.
  • These efforts have the potential to benefit over 1.7 billion people in the region.

• National Targets:

• Several countries in the region, including Bangladesh, Bhutan, India, Nepal, and Timor-Leste, have set national targets to enhance hypertension and diabetes management in primary health care by 2025.
  • These targets align with the SEAHEARTS initiative’s goal of placing 100 million people with hypertension and/or diabetes on protocol-based management by 2025.

• India’s target of reaching 75 million people with hypertension and diabetes under standard care by 2025 is the largest coverage of NCDs for primary health care in the world.

Global Cardiovascular Health: A Comprehensive Overview

To gain a broader perspective on cardiovascular health worldwide, let’s examine some key findings from the American Heart Association’s 2024 Heart Disease and Stroke Statistics report[2]:

1. Scope of the Report: The AHA report provides up-to-date statistics on:

• Heart disease

• Stroke

• Cardiovascular risk factors

• Core health behaviors (smoking, physical activity, nutrition, sleep, and obesity)

• Health factors (cholesterol, blood pressure, glucose control, and metabolic syndrome)

• Comprehensive Coverage: The report presents the latest data on a range of major clinical heart and circulatory disease conditions, including:

• Stroke

• Brain health

• Complications of pregnancy

• Kidney disease

• Congenital heart disease

• Rhythm disorders

• Sudden cardiac arrest

• Subclinical atherosclerosis

• Coronary heart disease

• Cardiomyopathy

• Heart failure

• Valvular disease

• Venous thromboembolism

• Peripheral artery disease

• Associated Outcomes: The report also covers:

• Quality of care

• Procedures

• Economic costs related to cardiovascular diseases

• Data Collection and Analysis:

• The AHA, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States and globally.
  • The 2024 AHA Statistical Update is the product of a full year’s effort in 2023 by dedicated volunteer clinicians and scientists, committed government professionals, and AHA staff members.

• Focus on Health Equity:

• The AHA strives to further understand and help heal health problems inflicted by structural racism, recognizing it as a public health crisis.
  • This year’s edition includes additional global data and information on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains.

The Importance of World Heart Day

World Heart Day serves as a crucial platform for raising awareness about heart health and accelerating actions to prevent, detect, and manage cardiovascular diseases. Here’s why this day is so significant:

1. Global Call to Action:

• World Heart Day provides an opportunity for the World Health Organization, its Member States, and various stakeholders to join forces in promoting cardiovascular health.
  • It serves as a reminder of the urgent need to address the growing burden of CVDs worldwide.

• Awareness and Education:

• The day helps educate the public about the risk factors associated with CVDs and the importance of maintaining a heart-healthy lifestyle.
  • It encourages individuals to take proactive steps in managing their cardiovascular health.

• Policy Influence:

• World Heart Day can influence policymakers to prioritize cardiovascular health in national health agendas.
  • It promotes the implementation of evidence-based policies and interventions to reduce the burden of CVDs.

• Healthcare System Focus:

• The day highlights the need for strengthening healthcare systems to better prevent, detect, and manage CVDs.

• It emphasizes the importance of accessible and affordable cardiovascular care for all.

• Research and Innovation:

• World Heart Day can spark discussions about the latest advancements in cardiovascular research and treatment.
  • It encourages investment in innovative approaches to tackle CVDs.

Challenges in Cardiovascular Health

Despite ongoing efforts, several challenges persist in the fight against cardiovascular diseases[2]:

1. High Prevalence of Risk Factors:

• The continued high prevalence of modifiable risk factors such as tobacco use, unhealthy diets, and physical inactivity poses a significant challenge.
  • Addressing these risk factors requires sustained efforts in health promotion and disease prevention.

• Inequities in Access to Care:

• There are significant disparities in access to quality cardiovascular care, both within and between countries.
  • Socioeconomic factors, geographical barriers, and health system weaknesses contribute to these inequities.

• Premature Mortality:

• The high rate of premature deaths due to CVDs, particularly in low- and middle-income countries, remains a major concern.
  • Reducing premature mortality requires comprehensive strategies addressing both prevention and treatment.

• Economic Burden:

• The economic costs associated with CVDs, including healthcare expenditure and loss of productivity, place a significant burden on individuals, families, and health systems.
  • Sustainable financing mechanisms are needed to support cardiovascular health initiatives.

• Comorbidities:

• The growing prevalence of comorbidities, such as diabetes and obesity, complicates the management of CVDs.
  • Integrated approaches to managing multiple chronic conditions are essential.

• Awareness and Health Literacy:

• Low levels of awareness about CVD risk factors and symptoms in some populations hinder early detection and timely treatment.
  • Improving health literacy and promoting heart-healthy behaviors remain ongoing challenges.

Strategies for Improving Cardiovascular Health

To address these challenges and improve cardiovascular health globally, several key strategies are being implemented:

1. Comprehensive Policy Approaches:

• Implementing comprehensive policies that address the social, economic, and environmental determinants of cardiovascular health.
  • Examples include tobacco control laws, regulations on trans-fatty acids, and policies promoting physical activity.

• Strengthening Primary Health Care:

• Enhancing the capacity of primary health care systems to prevent, detect, and manage CVDs.
  • Implementing initiatives like SEAHEARTS to improve hypertension and diabetes management at the primary care level.

• Risk Factor Reduction:

• Implementing evidence-based interventions to reduce key risk factors, such as:

• Tobacco control measures (WHO MPOWER package)

• Salt reduction strategies (WHO SHAKE technical package)

• Elimination of trans-fatty acids (WHO REPLACE technical package)

• Improving Access to Essential Medicines and Technologies:

• Ensuring the availability and affordability of essential cardiovascular medicines and technologies.
  • Promoting the use of fixed-dose combination therapies for easier management of multiple risk factors.

• Health System Strengthening:

• Investing in health workforce development, infrastructure, and health information systems to improve cardiovascular care delivery.
  • Implementing quality improvement initiatives in cardiovascular care.

• Promoting Health Literacy:

• Developing and implementing effective health education programs to improve public understanding of cardiovascular health.
  • Leveraging digital technologies and mass media for wider reach of health information.

• Research and Innovation:

• Investing in research to better understand cardiovascular disease patterns, risk factors, and effective interventions.
  • Promoting innovation in prevention, diagnosis, and treatment of CVDs.

• Multisectoral Collaboration:

• Fostering partnerships between health and non-health sectors to create environments conducive to cardiovascular health.
  • Engaging communities, civil society organizations, and the private sector in cardiovascular health promotion efforts.

The Role of Digital Health in Cardiovascular Care

Digital health technologies are playing an increasingly important role in improving cardiovascular care:

1. Telemedicine:

• Telemedicine platforms are enhancing access to cardiovascular specialists, particularly in remote and underserved areas.
  • Virtual consultations can facilitate timely diagnosis and management of CVDs.

• Mobile Health (mHealth) Applications:

• Smartphone apps are being used for risk assessment, medication reminders, and lifestyle modifications.
  • These tools can support self-management of cardiovascular conditions.

• Wearable Devices:

• Wearable technologies, such as smartwatches and fitness trackers, can monitor heart rate, physical activity, and sleep patterns.
  • These devices can provide valuable data for both patients and healthcare providers.

• Artificial Intelligence (AI) and Machine Learning:

• AI algorithms are being developed to improve the accuracy of cardiovascular risk prediction and diagnosis.

• Machine learning models can assist in interpreting medical imaging and electrocardiograms.

• Electronic Health Records (EHRs):

• EHRs facilitate better coordination of care and enable more effective management of cardiovascular conditions.
  • They can also support clinical decision-making and quality improvement initiatives.

• Big Data Analytics:

• Analysis of large-scale health data can provide insights into CVD patterns, risk factors, and treatment outcomes.
  • This can inform policy decisions and guide resource allocation.

Global Initiatives and Collaborations

Several global initiatives and collaborations are working towards improving cardiovascular health[1][4]:

1. WHO Global Hearts Initiative:

• This initiative supports governments in strengthening CVD prevention and control.

• It includes technical packages for tobacco control, salt reduction, and primary health care.

• World Heart Federation (WHF) Initiatives:

• The WHF leads various global campaigns and programs to promote heart health.

• It advocates for policies to reduce the burden of CVDs globally.

• NCD Alliance:

• This global network works towards reducing the burden of noncommunicable diseases, including CVDs.
  • It promotes collaborative advocacy, accountability, and knowledge exchange.

• Global Alliance for Chronic Diseases (GACD):

• The GACD funds and coordinates research on chronic diseases, including CVDs, in low-and middle-income countries.
  • It focuses on implementation research to improve disease prevention and management.

• Resolve to Save Lives:

• This global health organization works to prevent 100 million deaths from cardiovascular disease and epidemics.
• It focuses on strategies such as eliminating artificial trans fats and reducing high blood pressure.

The Way Forward: Priorities for Action

As we approach World Heart Day 2024, several key priorities emerge for accelerating progress in cardiovascular health:

1. Strengthen Primary Prevention:

• Intensify efforts to reduce modifiable risk factors through population-wide interventions.

• Implement comprehensive strategies for tobacco control, promoting healthy diets, and increasing physical activity.

• Enhance Early Detection and Management:

• Improve screening programs for hypertension, diabetes, and other CVD risk factors.

• Ensure timely and appropriate management of these conditions in primary care settings.

• Improve Access to Essential Medicines and Technologies:

• Work towards universal access to affordable, quality-assured essential cardiovascular medicines and basic health technologies.
  • Support the development and implementation of national essential medicines lists and health benefit packages that include cardiovascular care.

• Address Health Inequities:

• Develop targeted interventions to reach underserved populations and address social determinants of cardiovascular health.
  • Implement policies that promote health equity and reduce disparities in CVD outcomes.

• Invest in Health Systems:

• Strengthen health systems to deliver integrated, people-centered cardiovascular care.

• Invest in health workforce development, particularly in primary care and specialist cardiovascular services.

• Promote Research and Innovation:

• Increase funding for cardiovascular research, with a focus on implementation science and context-specific interventions.
  • Support the development and scale-up of innovative technologies for CVD prevention, diagnosis, and management.

• Foster Multisectoral Action:

• Engage sectors beyond health, such as education, urban planning, and agriculture, in creating heart-healthy environments.
  • Develop and implement “health-in-all-policies” approaches to address the broader determinants of cardiovascular health.

• Enhance Surveillance and Monitoring:

• Strengthen national and global surveillance systems for CVDs and their risk factors.

• Improve data collection and analysis to inform policy decisions and evaluate the impact of interventions.

• Leverage Digital Health:

• Scale up the use of digital health technologies to improve access to cardiovascular care and support self-management.
  • Ensure appropriate governance and ethical use of digital health solutions.

1. Empower Communities:

• Engage communities in designing and implementing cardiovascular health initiatives.

• Support community-based organizations in promoting heart-healthy behaviors and improving health literacy.

Conclusion: A Call to Action for World Heart Day 2024

As we commemorate World Heart Day 2024, it’s clear that cardiovascular diseases remain a significant global health challenge. However, the concerted efforts of governments, healthcare providers, researchers, and communities worldwide are making a difference.

The theme of World Heart Day 2023, “Use Heart, Know Heart,” continues to resonate, emphasizing the importance of understanding our hearts and taking action to protect them. As we look towards 2024 and beyond, this message takes on even greater significance.

World Heart Day 2024 presents an opportunity to:

• Renew our commitment to cardiovascular health

• Celebrate the progress made in preventing and managing CVDs

• Mobilize resources and political will to address ongoing challenges

• Inspire individuals and communities to take charge of their heart health

By working together, we can create a world where every heart beats strong and healthy. Let’s use this World Heart Day to recommit ourselves to this vital cause, ensuring that hearts around the globe continue to beat with strength, resilience, and hope for generations to come.

Remember, every action counts. Whether it’s making a heart-healthy choice in your daily life, advocating for better cardiovascular care in your community, or supporting global initiatives, you have the power to make a difference. This World Heart Day, let’s unite in our efforts to build a healthier, heart-stronger world for all.

References:

• World. “World Heart Day.” Who.int, World Health Organization: WHO, 28 Sept. 2023, www.who.int/southeastasia/news/detail/28-09-2023-world-heart-day-2023.

• Martin, Seth S., et al. “2024 Heart Disease and Stroke Statistics: A Report of US and Global Data from the American Heart Association.” Circulation, vol. 149, no. 8, Lippincott Williams & Wilkins, Feb. 2024, https://doi.org/10.1161/cir.0000000000001209.

[3]‌ Narula, Jagat, et al. “World Heart Day 2023: Knowing Your Heart.” Indian Journal of Medical Research, vol. 158, no. 3, Medknow, Jan. 2023, pp. 213–13, https://doi.org/10.4103/ijmr.ijmr_1689_23.

[4]‌ Laranjo, Liliana et al. “World Heart Federation Roadmap for Secondary Prevention of Cardiovascular Disease: 2023 Update.” Global heart vol. 19,1 8. 22 Jan. 2024, doi:10.5334/gh.1278