Table 1.
Features of global initiatives and programmes for hypertension treatment
| Initiative or programme | Target regions | Key areas of action |
|---|---|---|
| Global Hearts (WHO) | NA | HEARTS (six technical packages for the prevention and control of cardiovascular disease): training health-care workers to counsel on behavioural risk factors and healthy lifestyles; simple, standardized and evidence-based treatment protocols for hypertension and diabetes mellitus; ensuring access to essential medicines and technology; risk-based approach to the management of cardiovascular disease, including country-specific risk charts; implementing team-based care and task shifting; and improved monitoring system with standardized indicators (for example, hypertension control rate) and data collection tools |
| WHF Hypertension Roadmap | NA | Opportunistic screening; promoting use of inexpensive, good-quality generic medications for hypertension; education on adherence to lifestyle modification and medication use |
| Pan-African Society of Cardiology Roadmap | Sub-Saharan Africa | A ten-point action plan for African ministries of health, including: creating or adopting simple and practical clinical evidence-based hypertension management guidelines; annual monitoring and report of the detection, treatment and control rates of hypertension, with a clear target for improvement by 2025, with use of the WHO STEPwise approach to surveillance; integrating hypertension management within existing health services such as disease-specific vertical programmes (for example, HIV and tuberculosis); task-sharing with trained community health workers; and ensuring availability of essential equipment and medicines |
| Resolve To Save Lives | China, India, Thailand | Practical treatment protocols with specific medications, dosages and steps to take if blood pressure is not controlled; adopting community-based care and task sharing; ensuring supply of medications; adopting easy-to-take medicine regimens, using free or low-cost medications and follow-up visits, and making blood pressure monitoring readily available; and leveraging technology to develop information systems that allow for continuous, real-time improvement |
| Global Standardization of Hypertension Treatment Project | Barbados, Malawi | Using nationally relevant, evidence-based and implementable treatment protocols that are endorsed by key stakeholders; identifying a core set of widely available medications that are safe and effective; ensuring the quality, safety and consistent supply of the core set of medications; developing hypertension registries and monitoring targets (for example, blood pressure control) within a care system or programme to evaluate the efficacy of the system or programme and make adjustments accordingly; empowering patients by involving them in decisions related to their treatment, creating a physician–patient relationship on the basis of mutual respect, and utilizing educational materials and peer-support groups to improve the knowledge, attitude and adherence to treatment of the patients; use of team‐based care that coordinates care delivery within the team (task sharing) and ensures continuity of care; and use of community-based settings for services such as blood pressure checks and education and engaging community partners (for example, civil society organizations and media) |
NA, not applicable; WHF, World Heart Federation.