Challenges and Opportunities to Scale Up Cardiovascular Disease Secondary Prevention in Latin America and the Caribbean

Effectivity of Health Education with Telenursing on the Self-care Ability of Coronary Artery Disease Patients: A Systematic Review

BACKGROUND: Coronary artery disease (CAD) develops chronically and progressively, causes recurrence and premature death, so a good knowledge of changes in self-care behavior by patients is needed. Telenursing can be a medium for health education to allow patients to receive information and for nurses to follow up on health conditions without being obstructed by distance, place, time, and carried out sustainably. So far, telenursing has not been reviewed as a recent intervention to deliver education to CAD patients. AIM: This systematic review aimed to determine the effectiveness of health education interventions with telenursing on the self-care of CAD patients based on the implementation media. METHODS: Systematic reviews were conducted based on items found in CINAHL EBSCO, PubMed, ScienceDirect, and Google Scholar from 2008 to 2019. The combination of keywords used Indonesian and English language. All articles were assessed using the Joanna Briggs Institute critical appraisal tool for randomized controlled trial (RCT) and quasi-experiment. After that, the study found was synthesized narratively. RESULTS: A total of 11.319 titles were identified, and seven studies met inclusion criteria with 3313 participants. Six studies were RCT studies, and one was a quasi-experimental study. The results of the narrative synthesis conducted on seven articles showed that health education by telenursing was effective in improving self-care ability, such as maintaining blood pressure, body mass index, hemoglobin A1c levels, fasting blood glucose, and low-density lipoprotein within normal limits. In addition, there was also an increase in physical activity, dietary compliance (consumption of fruits, vegetables and fish), control of salt intake, smoking, and alcohol cessation. The media used were phone calls and text messages. CONCLUSION: This review provides evidence that health education interventions effectively improve the self-care abilities of CAD patients with the media used are text messages and telephone calls.

World Heart Federation Roadmap for Hypertension - A 2021 Update

The World Heart Federation (WHF) Roadmap series covers a large range of cardiovascular conditions. These Roadmaps identify potential roadblocks and their solutions to improve the prevention, detection and management of cardiovascular diseases and provide a generic global framework available for local adaptation. A first Roadmap on raised blood pressure was published in 2015. Since then, advances in hypertension have included the publication of new clinical guidelines (AHA/ACC; ESC; ESH/ISH); the launch of the WHO Global HEARTS Initiative in 2016 and the associated Resolve to Save Lives (RTSL) initiative in 2017; the inclusion of single-pill combinations on the WHO Essential Medicines' list as well as various advances in technology, in particular telemedicine and mobile health. Given the substantial benefit accrued from effective interventions in the management of hypertension and their potential for scalability in low and middle-income countries (LMICs), the WHF has now revisited and updated the 'Roadmap for raised BP' as 'Roadmap for hypertension' by incorporating new developments in science and policy. Even though cost-effective lifestyle and medical interventions to prevent and manage hypertension exist, uptake is still low, particularly in resource-poor areas. This Roadmap examined the roadblocks pertaining to both the demand side (demographic and socio-economic factors, knowledge and beliefs, social relations, norms, and traditions) and the supply side (health systems resources and processes) along the patient pathway to propose a range of possible solutions to overcoming them. Those include the development of population-wide prevention and control programmes; the implementation of opportunistic screening and of out-of-office blood pressure measurements; the strengthening of primary care and a greater focus on task sharing and team-based care; the delivery of people-centred care and stronger patient and carer education; and the facilitation of adherence to treatment. All of the above are dependent upon the availability and effective distribution of good quality, evidence-based, inexpensive BP-lowering agents.

Digital Health Approaches for the Assessment and Optimisation of Hypertension Care Provision

Although many aspects of our lives have been transformed by digital innovation, widespread adoption of digital health advancements within the health care sector in general, and for hypertension care specifically, has been limited. However, it is likely that, over the next decade, material increases in the uptake of digital health innovations for hypertension care delivery will be seen. In this narrative review, we summarise those innovations thought to have the greatest chance for impact in the next decade. These include provision of virtual care combined with home blood pressure (BP) telemonitoring, use of digital registries and protocolised care, leveraging continuous BP measurement to collect vast amounts of individual and population-based BP data, and adoption of digital therapeutics to provide low-cost scalable interventions for patients with or at risk for hypertension. Of these, home BP telemonitoring is likely the most ready for implementation, but it needs to be done in a way that enables efficient guideline-concordant care in a cost-effective manner. In addition, efforts must be focused on implementing digital health solutions in a manner that addresses the major challenges to digital adoption. This entails ensuring that innovations are accessible, usable, secure, validated, evidence based, cost-effective, and integrated into the electronic systems that are already used by patients or providers. Increasing the use of broader digital innovations such as artificial/augmented intelligence, data analytics, and interactive voice response is also critically important. The digital revolution holds substantial promise, but success will depend on the ability of collaborative stakeholders to adopt and implement innovative, usable solutions.

Manejo interprofesoral de las enfermedades cardiovasculares

Se conocen como enfermedades cardiovasculares (ECV) al infarto agudo de miocardio (IAM), el accidente cerebrovascular (ACV) isquémico o hemorrágico y la enfermedad vascular periférica, también conocidas como enfermedades vasculares ateroscleróticas, pues tienen en común que el proceso fisiopatológico básico es el desarrollo de aterosclerosis en la vasculatura que irriga a los órganos afectados. El IAM y ACV son eventos agudos que se deben principalmente a obstrucciones en los vasos, las cuales se presentan cuando se produce ruptura de una placa aterosclerótica ocasionando un cuadro de atero-trombosis, fenómeno que explica la sintomatología de los eventos agudos. Actualmente las ECV se constituyen en la primera causa de morbi-mortalidad en todo el mundo, ocasionando que cada año mueran más personas por estas enfermedades que por cualquier otra causa. Según la Organización Mundial de la Salud (OMS), anualmente 17,5 millones de personas en el mundo, es decir el 31% de las defunciones totales mueren a causa de alguna ECV, siendo que 7,4 millones se debe a IAM y 6,7 millones AVC.  Las ECV son consideradas al momento como una epidemia global que afecta a individuos de todos los países, independientemente de sus ingresos económicos, pero que han tenido un gran incremento en los países de ingresos medianos y bajos, afectando casi por igual a ambos sexos. Actualmente las ECV en su conjunto son la principal causa de muerte en Colombia, con el IAM ocasionando el 17% de la mortalidad general, tanto en hombres como en mujeres, seguida por el ACV y las enfermedades hipertensivas.Como citar este artículo: Lopez-Jaramillo P, Rueda-García D. Manejo interprofesoral de las enfermedades cardiovasculares. Rev Cuid. 2019; 10(2): e756. http://dx.doi.org/10.15649/cuidarte.v10i2.756