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Infrastructure, policy and regulatory interventions to increase physical activity to prevent cardiovascular diseases and diabetes: a systematic review

Durão, S.; Burns, J.; Schmidt, B. et al. BMC Public Health (2023) CC

Background Noncommunicable diseases are major contributors to morbidity and mortality worldwide. Modifying the risk factors for these conditions, such as physical inactivity, is thus essential. Addressing the context or circumstances in which physical activity occurs may promote physical activity a...t a population level. We assessed the effects of infrastructure, policy or regulatory interventions for increasing physical activity. Methods We searched PubMed, Embase and clinicaltrials.gov to identify randomised controlled trials (RCTs), controlled before-after (CBAs) studies, and interrupted time series (ITS) studies assessing population-level infrastructure or policy and regulatory interventions to increase physical activity. We were interested in the effects of these interventions on physical activity, body weight and related measures, blood pressure, and CVD and type 2 diabetes morbidity and mortality, and on other secondary outcomes. Screening and data extraction was done in duplicate, with risk of bias was using an adapted Cochrane risk of bias tool. Due to high levels of heterogeneity, we synthesised the evidence based on effect direction. Results We included 33 studies, mostly conducted in high-income countries. Of these, 13 assessed infrastructure changes to green or other spaces to promote physical activity and 18 infrastructure changes to promote active transport. The effects of identified interventions on physical activity, body weight and blood pressure varied across studies (very low certainty evidence); thus, we remain very uncertain about the effects of these interventions. Two studies assessed the effects of policy and regulatory interventions; one provided free access to physical activity facilities and showed that it may have beneficial effects on physical activity (low certainty evidence). The other provided free bus travel for youth, with intervention effects varying across studies (very low certainty evidence). Conclusions Evidence from 33 studies assessing infrastructure, policy and regulatory interventions for increasing physical activity showed varying results. The certainty of the evidence was mostly very low, due to study designs included and inconsistent findings between studies. Despite this drawback, the evidence indicates that providing access to physical activity facilities may be beneficial; however this finding is based on only one study. Implementation of these interventions requires full consideration of contextual factors, especially in low resource settings. more

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Prevention and management of CVD in LMICs: why do ethnicity, culture, and context matter?

Anand, S.; Bradshaw, C.; Prabhakaran, D. BMC Medicine (2020) CC

Background Low- and middle-income countries now experience the highest prevalence and mortality rates of cardiovascular disease. Main text While improving the availability and delivery of proven, effective therapies will no doubt mitigate this burden, we posit that studies evaluating cardiovasc... more

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Annual Report: Global Polio Eradication Initiative

World Health Organisation (WHO) (2024) CC

The key to a lasting world free of all forms of poliovirus lies in rapidly interrupting all remaining endemic transmission of WPV in the endemic areas of Pakistan and Afghanistan. This is the only way to ensure that such strains do not re-emerge globally through international spread. It lays the cor... more

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Risk communication and community engagement readiness and response toolkit: zika virus

World Health Organisation (WHO) (2024) C_WHO

Toolkit regarding Zika Virus

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Engaging health and care workers in health emergencies: implementation toolkit

World Health Organisation (WHO) (2024) C_WHO

The active participation and engagement of health and care workers (‎HCWs)‎ in health emergency preparedness, readiness and response is crucial to support risk communication, community engagement and infodemic management (‎RCCE-IM)‎ interventions during emergencies. HCWs hold unique position... more

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Socioeconomic status and risk of cardiovascular disease in 20 low-income, middle-income, and high-income countries: the Prospective Urban Rural Epidemiologic (PURE) study

Rosengren, A.; Smyth, A.; Rangarajan, S. et al. The Lancet Global Health (2019) CC

Socioeconomic status is associated with differences in risk factors for cardiovascular disease incidence and outcomes, including mortality. However, it is unclear whether the associations between cardiovascular disease and common measures of socioeconomic status—wealth and education—differ among... more

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Selection of essential medicines for the prevention and treatment of cardiovascular diseases in low and middle income countries

Bazargani, Y.T.; Ugurlu, M.; Leufkens, H.G.M. et al. BMC Cardiovascular Disorders (2018) CC

The incidence and mortality of cardiovascular diseases (CVDs) in low and middle income countries (LMICs) have been increasing, while access to CVDs medicines is suboptimal. We assessed selection of essential medicines for the prevention and treatment of CVDs on national essential medicines lists (NE... more

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The Global Burden of Disease Study at 30 years

Murray, C.J.L. nature medicine (2022) CC

The Global Burden of Disease Study (GBD) began 30 years ago with the goal of providing timely, valid and relevant assessments of critical health outcomes. Over this period, the GBD has become progressively more granular. The latest iteration provides assessments of thousands of outcomes for diseases... more

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Quality of stroke guidelines in low- and middle-income countries: a systematic review

Yaria, J.; Gil, A.; Makanjuola, A. et al. Bulletin of the World Health Organization (2021) C_WHO

Objective: To identify gaps in national stroke guidelines that could be bridged to enhance the quality of stroke care services in low- and middle-income countries. Methods: We systematically searched medical databases and websites of medical societies and contacted international organizations. Co... more

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Epidemiology of Peripheral Artery Disease and Polyvascular Disease

Aday A.W.; Matsushita, K. Circulation Research (2021) CC

Atherosclerotic lower-extremity peripheral artery disease (PAD) is increasingly recognized as an important cause of cardiovascular morbidity and mortality that affects more than 230 million people worldwide. Traditional cardiovascular risk factors, including advanced age, smoking, and diabetes, are ... more

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Public knowledge of cardiovascular disease and response to acute cardiac events in three municipalities in Brazil

Bartlett, E. S.; Flor, L.S.; Souto Medeiros, D. et al. Open Heart (2020) CC

Objective: To conduct a landscape assessment of public knowledge of cardiovascular disease risk factors and acute myocardial infarction symptoms, cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) awareness and training in three underserved communities in Brazil. Metho... more

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Cardiac arrhythmias in low- and middle-income countries

Mkoko, P.; Bahiru, E.; Ajijola, O.A. et al. Cardiovascular Diagnosis and Therapy (2019) CC

Many low- and middle-income countries (LMICs) are undergoing an epidemiological transition. With an improvement in socioeconomic conditions and an aging population, cardiovascular diseases (CVDs), like cardiac arrhythmias, are expected to increase in these countries. However, there are limited studi... more

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A Roadmap on the Prevention of Cardiovascular Disease Among People Living With Diabetes

Mitchell, S.; Malanda, B.; Damasceno, A. et al. World Heart Federation (2019) CC

In 2014, the World Heart Federation (WHF) launched an initiative to develop a series of Roadmaps [1e6]. Their aim is to identify potential roadblocks on the pathway to effective prevention, detection, and management of cardiovascular disease (CVD), along with evidence-based solutions to overcome... more

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Environmental Determinants of Cardiovascular Disease

Bhatnagar, A. Circulation Research (2018) CC

Many features of the environment have been found to exert an important influence on cardiovascular disease (CVD) risk, progression, and severity. Changes in the environment due to migration to different geographic locations, modifications in lifestyle choices, and shifts in social policies and cultu... more

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Challenges in management and prevention of ischemic heart disease in low socioeconomic status people in LLMICs

Gupta, R.; Yusuf, S. BMC Medicine (2019) CC

Cardiovascular diseases, principally ischemic heart disease (IHD), are the most important cause of death and disability in the majority of low- and lower-middle-income countries (LLMICs). In these countries, IHD mortality rates are significantly greater in individuals of a low socioeconomic status (... more

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World Heart Federation Cholesterol Roadmap 2022

Ray, K.K.; Ference, B.A.; Séverin, T. et al. World Heart Federation (2022) CC

Background: Atherosclerotic cardiovascular diseases (ASCVD) including myocardial infarction, stroke and peripheral arterial disease continue to be major causes of premature death, disability and healthcare expenditure globally. Preventing the accumulation of cholesterol-containing atherogenic lipopr... more

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2020 Heart Failure Society of South Africa perspective on the 2016 European Society of Cardiology Chronic Heart Failure Guidelines

Hitzeroth, J.; Mpe, M.; Klug, E. et al. The South African Medical Journal (2020) CC

Heart failure with a reduced ejection fraction (HFrEF) is a condition frequently encountered by healthcare professionals and, in order to achieve the best outcomes for patients, needs to be managed optimally. This guideline document is based on the European Society of Cardiology Guidelines for the t... more

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HEARTS. Tool for the development of a consensus protocol for treatment of hypertension

World Health Organization WHO, et al. (2018) C_WHO

Technical package for cardiovascular disease management in primary health care.

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Advocation for Cholesterol control: A world heard federation toolkit

World Heart Federation (2022) CC

The World Heart Federation (WHF) is a leading global advocate for stronger legislation and policies regarding cardiovascular disease (CVD) and its risk factors, including raised cholesterol. The present Cholesterol Advocacy Toolkit 2022 provides WHF member organizations with information as well as p... more

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From emergency response to long-term COVID-19 disease management - Ending the COVID-19 emergency and transitioning from emergency phase to longer-term disease management: Guidance on calibrating the r

World Health Organization WHO (2023) C_WHO

The key actions, activities, and approaches in this document are organized within each of the 5Cs (see Table 1 in the PDF) and those of the Strategic preparedness and response plan (SPRP) pillars as follows: National action plan key activities, prioritized for the current context and the current ... more