WHO warns of heart disease threat to developing world

The number of people who die or are disabled by heart disease and strokes could be halved with wider use of a combination of drugs that costs just $14 (£9; €14) a year, the World Health Organization has said.

Every year 12 million people worldwide die from cardiovascular disease, according to the WHO, with most of them in the developing world. The organisation will be focusing on heart disease when it publishes its annual report at the end of the month.

The report shows for the first time that the main risk factors for cardiovascular disease—high blood pressure, high cholesterol level, and smoking—which are traditionally linked to an affluent lifestyle, are now being seen in middle income and poorer countries.

But if everyone at high risk of having a heart attack or stroke was given a combination of a statin for lowering cholesterol, a low dose blood pressure lowering drug, and aspirin then this number could be cut by 50% More people in the developed world should be given this treatment, says the report, while new resources should be found to treat people in countries where the combination is unaffordable.

The WHO also calls for more measures to reduce cardiovascular risk in the population as a whole. It argues that there is increasing evidence to show that it is not just people whose blood pressure or cholesterol level is above a given “threshold” who are at risk of cardiovascular disease. In fact, most people would benefit from lowering their blood pressure and cholesterol level, and national education programmes should tackle these issues.

“Prevention is the key to lowering the global disease burden of heart attacks and strokes,” says Dr Gro Harlem Brundtland, director general of the WHO. “The ideal strategy for many countries would be to devote many more resources to introduce broad measures that can benefit whole populations and at the same time target those at elevated risk with the combination of pills.”

The report highlights how government campaigns have led to less salt being used in manufactured foods in the United Kingdom, better blood pressure management in Japan, and a fall in saturated fat intake in the United States.

“If we consider the dramatic improvement in cardiovascular health that, for example, the Japanese and the Finns have experienced in the last few decades, we can see that entire populations have been able to significantly improve their situations without any change in their gene pool,” said Dr Christopher Murray, executive director of the cluster on evidence and information policy at the WHO.

“Clearly diet, exercise, and a reduction in tobacco and alcohol are the most important factors to consider,” he added.