Global Heart RSS feed: Current Issue. Global Heart seeks to provide a forum for dialogue and education on matters that relate foremost to the prevention and control of cardiovascular diseases worldwide, with a special focus on countries with middle and lower economies. With the main focus being on prevention, manuscripts should address not only the extent or epidemiology of the problem, but also describe interventions to effectively control and prevent cardiovascular diseases and their antecedent factors. The emphasis should be on approaches that can be applied in settings with limited resources. Economic evaluations of successful interventions will be particularly welcome. Important negative findings will also be considered. While reports of hospital or clinic-based treatments will not necessarily be rejected, particularly if they have broad implications for cost-effective disease control or prevention, manuscripts that address community-based activities will be preferred. Submissions on cardiovascular surveillance and health policies, professional education, ethical issues and technological innovations particularly those related to prevention are encouraged. WHF Members and personal subscribers can access the journal online here http://www.globalheart-journal.com/?rss=yesElsevier Inc.en © 2011 World Heart Federation (Geneva). Published by Elsevier Inc. All rights reserved. Global Heart2211-816064December 2011 © 2011 World Heart Federation (Geneva). Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.globalheart-journal.com/article/PIIS2211816011000822/abstract?rss=yesThe World Heart Federation applauds the launch of Global Heart at what is sure to be a watershed moment in the story of global cardiovascular disease (CVD). After years of advocacy and persistent effort by the World Heart Federation and our partners to bring greater attention and resources to CVD as a problem across all countries and economies, the United Nations is hosting the first ever High Level Meeting on the Prevention and Control of Noncommunicable Diseases (NCDs), generally referred to as the Summit, to take place just prior to the General Assembly on September 19 and 20, 2011. As defined in the World Health Organization Action Plan for the Global Strategy for the Prevention and Control of Noncommunicable Diseases , CVD is, along with cancer, diabetes and chronic respiratory disease, responsible for the lion’s share of the global NCD and total disease burden; as an individual category, CVD represents the highest morbidity and mortality of any disease, communicable or not. Because of the shared risk factors of tobacco, physical inactivity, poor nutrition and harmful use of alcohol, the international federations representing these disease groups joined forces in 2009 as the NCD Alliance, and since that time have played a key role in securing support for the resolution calling for the Summit, and in mobilizing the voice of civil society to ensure that the meeting, outcomes document and next steps are as strong as possible.A Pivotal Moment for Global Cardiovascular Disease: The World Heart Federation and the UN NCD SummitSidney C. Smith, Johanna Ralston10.1016/j.gheart.2011.07.007Global Heart 6, 4 (2011)2011-08-29Global Heart2011-08-2964S2211-8160(11)X0005-4Preface125126http://www.globalheart-journal.com/article/PIIS2211816011000883/abstract?rss=yesWith the September 2011 United Nations High Level Meeting on Noncommunicable Diseases, the world’s attention is turning to the critically important issue of chronic diseases. The global community is on the threshold of what could be a major change leading to progress in the control of chronic diseases worldwide – progress that could be achieved as a contribution to improving global health overall, rather than as a competition with other diseases that persist as important health challenges in low and middle income countries. This inaugural issue of Global Heart brings together a series of articles and commentaries reflecting some of the key elements that are needed to successfully achieve the promise of progress that the U.N. meeting brings.Potential for Global Progress in Control of Chronic Diseases: A Turning Point in 2011Bridget Kelly, Kathleen C. Ostapkovich, Collin Weinberger, Valentin Fuster10.1016/j.gheart.2011.08.004Global Heart 6, 4 (2011)2011-08-31Global Heart2011-08-3164S2211-8160(11)X0005-4Editorial127132http://www.globalheart-journal.com/article/PIIS221181601100086X/abstract?rss=yesCardiovascular disease (CVD) is often thought to be a problem of wealthy, industrialized nations. In fact, as the leading cause of death worldwide, CVD now has a major impact not only on developed nations but also on low and middle income countries, where it accounts for nearly 30% of all deaths. The increased prevalence of risk factors for CVD and related chronic diseases in developing countries, including tobacco use, unhealthy dietary changes, reduced physical activity, increasing blood lipids, and hypertension, reflects significant global changes in behavior and lifestyle. These changes now threaten once-low-risk regions, a shift that is accelerated by industrialization, urbanization, and globalization. The potentially devastating effects of these trends are magnified by a deleterious economic impact on nations and households, where poverty can be both a contributing cause and a consequence of chronic diseases. The accelerating rates of unrecognized and inadequately addressed CVD and related chronic diseases in both men and women in low and middle income countries are cause for immediate action.Summary of the Institute of Medicine Report: Promoting Cardiovascular Health in the Developing WorldValentin Fuster, Bridget Kelly10.1016/j.gheart.2011.08.002Global Heart 6, 4 (2011)2011-08-31Global Heart2011-08-3164S2211-8160(11)X0005-4Recommendations & Guidelines133142http://www.globalheart-journal.com/article/PIIS2211816011000858/abstract?rss=yesThe many interrelated risk factors that influence cardiovascular health involve aspects of economies and societies that extend far beyond public health and health systems. This underscores the complexity of any undertaking to promote cardiovascular health and to prevent and manage cardiovascular disease (CVD). In addition to being complex, CVD is also a long-term problem. It cannot be addressed through a singular, time-limited commitment but rather requires long-term interventions and sustainable solutions.A Conceptual Strategy to Address CVD and Related Chronic Diseases in the Developing WorldValentin Fuster, Bridget Kelly, On behalf of Institute of Medicine Committee on Preventing the Global Epidemic of Cardiovascular Disease: Meeting the challenges in developing countries10.1016/j.gheart.2011.08.001Global Heart 6, 4 (2011)2011-08-31Global Heart2011-08-3164S2211-8160(11)X0005-4Editorial Viewpoint143147http://www.globalheart-journal.com/article/PIIS2211816011000871/abstract?rss=yesThe actions needed to prevent and treat cardiovascular disease (CVD) in individuals are at first glance beguilingly simple. People should follow healthful balanced diets, remain active throughout their lives, never smoke, and seek health care regularly. Declarations have called on governments to invest more in CVD, to develop laws and policies to protect the health of people, and to provide health services that respond to the CVD needs of people. International conference recommendations have demanded that companies restrict the marketing of certain products such as tobacco and unhealthful foods and beverages to children; eliminate trans-fats, reduce salt, and introduce healthful oils in their products; and make healthful foods more affordable and available to communities.A Framework for Action to Promote Cardiovascular Health in the Developing WorldValentin Fuster, Bridget Kelly, On behalf of Institute of Medicine Committee on Preventing the Global Epidemic of Cardiovascular Disease: Meeting the challenges in developing countries.10.1016/j.gheart.2011.08.003Global Heart 6, 4 (2011)2011-08-31Global Heart2011-08-3164S2211-8160(11)X0005-4Viewpoint149177http://www.globalheart-journal.com/article/PIIS2211816011000810/abstract?rss=yesThe burden of non-communicable diseases (NCDs) worldwide accounts for an ever-greater absolute number and relative fraction of years of life lost prematurely. In low-income and middle-income countries, cardiovascular diseases (CVDs) now account for 30% of deaths; these deaths constitute over 80% of all CVD deaths globally . Despite these trends, health systems in high-income, middle-income, and low-income countries lag in adapting the care they provide. In most countries that are less economically developed, healthcare systems have never been considered robust; moreover, the complexity of NCDs requires health systems much more sophisticated than those traditionally prevalent. Such systems must be capable of delivering care that goes far beyond that needed for most acute health conditions.Transforming the Education of Health Professionals to Confront the Burden of NCD: Commission on Education of Health Professionals for the 21st CenturyPatrick W. Kelley10.1016/j.gheart.2011.07.006Global Heart 6, 4 (2011)2011-08-31Global Heart2011-08-3164S2211-8160(11)X0005-4Recommendations & Guidelines179181http://www.globalheart-journal.com/article/PIIS2211816011000779/abstract?rss=yesPrevious investments in public health research and education played major roles in improving population health and increasing life expectancy . In the early 1900s, amidst efforts to eliminate hookworm from the southern United States (US), Welch and Flexner recognized the need to train public health leaders. They proposed a freestanding public health school affiliated with, but independent from, the university and medical school, charged with training a public health workforce to improve the lifespan and “health span” of populations . We now stand at a similar junction as in 1900, confronted with a vastly different set of growing health burdens: chronic non-communicable diseases (NCDs) . These diseases cause significant mortality and morbidity on their own, but also exacerbate existing population health issues. For example, diabetes can increase the risk for tuberculosis ; anti-retrovirals given to HIV/AIDs patients can increase cardio metabolic risk ; under-nutrition in utero or during early childhood increases risks of NCDs later in life . Here, we argue that the university community (UC), with its key constituents (institution leaders plus faculty and students derived from all disciplines), can be leveraged to improve 21st century public health.Preparing the University Community to Respond to 21st Century Global Public Health NeedsSandeep Kishore, Karen R. Siegel, Bridget Kelly, Rajesh Vedanthan, Mohammed K. Ali, Jeffrey Koplan, K.M. Venkat Narayan, Valentin Fuster10.1016/j.gheart.2011.07.002Global Heart 6, 4 (2011)2011-08-31Global Heart2011-08-3164S2211-8160(11)X0005-4Viewpoint183190http://www.globalheart-journal.com/article/PIIS2211816011000834/abstract?rss=yesNon-communicable, chronic diseases (NCDs) account for 70% of morbidity and over 60% of mortality worldwide . Previously thought to be simply a normative consequence of aging, NCDs are largely preventable through maintenance of healthy behaviors and optimizing risk factors such as smoking, body weight, blood pressure, cholesterol, and glucose throughout the lifespan. However, in current modern environments, few individuals are able to maintain an ideal set of health behaviors and the subsequent optimal risk factor profile throughout their lives. In fact, precursors of cardiovascular disease, diabetes, and certain cancers are increasingly common in children, adolescents, and young adults .Trans-Disciplinary Education and Training for NCD Prevention and ControlKaren R. Siegel, Sandeep P. Kishore, Mark D. Huffman, Amina Aitsi-Selmi, Phillip Baker, Asaf Bitton, Modi Mwatsama, Eric L. Ding, Andrea B. Feigl, Shweta Khandelwal, Nikka Rapkin, Benjamin Seligman, Rajesh Vedanthan10.1016/j.gheart.2011.07.008Global Heart 6, 4 (2011)2011-08-31Global Heart2011-08-3164S2211-8160(11)X0005-4News & Novel Programs191193http://www.globalheart-journal.com/article/PIIS2211816011000846/abstract?rss=yesThe drivers of non-communicable, chronic diseases (NCDs) are complex, and include urbanization and migration, economic, agricultural and energy policies, and education and access to health care. Such a diverse array of causes has led to uncoordinated and insufficient political, financial, and social investments to combat the rising NCD epidemic . Health professionals are crucial players in a successful response to NCDs, not only in terms of providing health services; they can also help to inform, monitor and advocate for the necessary policies and structures that facilitate NCD prevention and control by addressing the drivers that lie outside the health sector.Non-Communicable, Chronic Disease Training and Education Needs in IndiaShweta Khandelwal, Mark D. Huffman, Seema Shah, Sandeep Kishore, Karen Siegel10.1016/j.gheart.2011.07.009Global Heart 6, 4 (2011)2011-08-31Global Heart2011-08-3164S2211-8160(11)X0005-4Viewpoint195199http://www.globalheart-journal.com/article/PIIS2211816011000809/abstract?rss=yesNon-communicable diseases (NCDs), including cancers, heart disease, chronic respiratory illnesses, diabetes mellitus, and mental disorders, are leading causes of mortality and morbidity globally. A landmark publication by the World Health Organization (WHO) in 2005 reported that these diseases caused 35 million deaths (60% of total mortality) that year . Despite many presumptions to the contrary, NCDs are not exclusive to older individuals; approximately one-third of global NCD deaths occur prematurely in individuals less than 60 years, leading to 20.5 million potentially productively years of life lost in Brazil, South, Africa, Russia, India, and China in 2000 alone . Moreover, 70% of global disability-adjusted life-years (DALYs), a marker of morbidity, are due to NCDs. These figures suggest that NCDs are not only significantly reducing people’s longevity, but also their quality of life and capacity to work.Youth Manifesto on Non-Communicable DiseasesSandeep P. Kishore, Karen R. Siegel, Aria Ahmad, Amina A. Aitsi-Selmi, Mohammed K. Ali, Phillip Baker, Sanjay Basu, Asaf Bitton, Gerald S. Bloomfield, Gene Bukhman, Eleanor Emery, Andrea B. Feigl, Karen Grepin, Mark D. Huffman, Kiti Kajana, Shweta Khandelwal, Kavitha Kolappa, Chenhui Liu, Naaznin Lokhandwala, Vishal Marwah, Modi Mwatsama, Nicole Novak, Shantanu Nundy, Paul H. Park, Cristina Parsons Perez, Matthew R. Price, Nikka Rapkin, Hester Rice, Ben Seligman, Sumit Shah, Joao da Silva, Devi Sridhar, David Stuckler, Rajesh Vedanthan, Justin Zaman, The Young Professionals’ Chronic Disease Network10.1016/j.gheart.2011.07.005Global Heart 6, 4 (2011)2011-08-31Global Heart2011-08-3164S2211-8160(11)X0005-4Recommendations & Guidelines201210http://www.globalheart-journal.com/article/PIIS2211816011000780/abstract?rss=yesCaribbean political leaders have, over the past four decades, shown significant leadership in responding to the health and development challenges posed by chronic diseases, also known as noncommunicable diseases or NCDs.Control of NCD: A Caribbean PerspectiveTrevor A. Hassell, Deborah Chen10.1016/j.gheart.2011.07.003Global Heart 6, 4 (2011)2011-08-31Global Heart2011-08-3164S2211-8160(11)X0005-4News & Novel Programs211213http://www.globalheart-journal.com/article/PIIS2211816011000792/abstract?rss=yesNon-communicable diseases (NCDs) in South Africa (SA) are rising at an alarming rate. NCDs are currently featuring prominently in the top 10 causes of premature mortality and, as a cluster, are the second leading cause of deaths after HIV/AIDS. The World Health Organisation estimated 28% of all deaths in 2002 in South Africa were due to NCDs .United Nations High Level Meeting and NCD in South AfricaVash Mungal-Singh10.1016/j.gheart.2011.07.004Global Heart 6, 4 (2011)2011-08-31Global Heart2011-08-3164S2211-8160(11)X0005-4News & Novel Programs215217http://www.globalheart-journal.com/article/PIIS2211816011000767/abstract?rss=yesThe health workforce challenge in sub-Saharan Africa has gained prominence because of the pivotal place that it plays in health care delivery and development in the continent . Several workshops and conferences by the WHO and other interested global partners have been held to address this challenge. Unless this serious short fall in the healthcare workforce is addressed, global health disparities between the developed and the developing world will continue to hamper the implementation of plans that are resourced and funded through well-meaning initiatives. The Medical Education Partnership Initiative (MEPI) has been lauded as an intervention that begins to address this challenge . Zimbabwe, one of the countries with a serious health workforce shortage, is a beneficiary of this initiative.Health Workforce Development with a Focus on CVD in Zimbabwe: CHRIS Program, a Medical Education Partnership InitiativeJames Gita Hakim, Jonathan Arthur Matenga, Edward Havranek, David Koa10.1016/j.gheart.2011.07.001Global Heart 6, 4 (2011)2011-08-31Global Heart2011-08-3164S2211-8160(11)X0005-4News & Novel Programs219220http://www.globalheart-journal.com/article/PIIS2211816011000895/abstract?rss=yesCardiovascular diseases remain the number one cause of morbidity and mortality, both in the developed and developing countries, and in men and women alike. It is expected that these numbers will continue to increase in the coming decades due to escalating proportions of obesity and the aging population, especially in the low and middle income group countries. The magnitude of this health care problem calls for innovative measures to improve cardiovascular health at population level. HAPPY (Heart Attack Prevention Program for You) program was started in March 2007 with the objective of cost-effective mass screening for the likelihood of adverse cardiovascular events, mass communication for educating the community for prevention of cardiovascular disease and recommendation of therapeutic intervention wherever appropriate (www.happyglobally.com). The first program was started in The Netherlands.Mass Screening and Intervention by Mass Communication: The HAPPY ProgramLeonard Hofstra, Eduard Laufer, Froukje Dijk, Marja van Dieijen, Hein J.J. Wellens, Jagat Narula10.1016/j.gheart.2011.08.005Global Heart 6, 4 (2011)2011-08-31Global Heart2011-08-3164S2211-8160(11)X0005-4Letter to the Editor221222http://www.globalheart-journal.com/article/PIIS2211816011000901/abstract?rss=yesCardiovascular diseases are the leading cause of death and disability worldwide with the majority of the victims living in low and low-middle income countries. This disproportionately increasing burden in the developing countries is believed to be due to dramatic lifestyle changes in the last century. Collectively referred to as epidemiological transition, these changes have been brought about by numerous developments in science and technology that now affect every facet of human existence. Most human societies have moved from agrarian diets and active lives to fast foods and sedentary habits. Combined with increasing tobacco use, these changes have fuelled the epidemic of obesity, diabetes, hypertension, dyslipidemia and cardiovascular diseases. Further while developed nations witnessed these changes over several decades due to a long period of epidemiological transition, the alterations in developing countries are occurring at an accelerated pace calling into focus creative and innovative solutions for combating the consequences.Globally Yours…Jagat Narula, Dorairaj Prabhakaran10.1016/j.gheart.2011.08.006Global Heart 6, 4 (2011)2011-08-31Global Heart2011-08-3164S2211-8160(11)X0005-4Editor's Page223224