Review of cardiovascular disease prevention and control programs: international experience and challenges in China
DOI:
https://doi.org/10.17987/icfj.v6i0.247Keywords:
Cardiovascular diseases, Policy, Prevention, Review, ChinaAbstract
Major cardiovascular risk factors in China, such as hyperlipidemia, hypertension, dietary factors, exposure to tobacco, diabetes, obesity and physical inactivity, have contributed to deteriorating trends in cardiovascular disease (CVD) deaths. In past years, a number of CVD prevention programs have been initiated in European and American countries and successfully brought down CVD related death rate by involving various parties such as physicians, patients, government agencies and payers. However, there is rare published literature that systemically reviewed such experience, which would be highly valuable for China and other countries with high CVD burden. In this article, we review the published literature on CVD prevention and control programs and report on interviews of local and foreign experts to provide recommendations for China-specific CVD prevention and control programs. In order to provide practical suggestions, we describe the type of programs as patient, physician, pharmacist, nurse, or payer-focused. Based on this evidence and identified challenges in China, programs focusing on disease management, treatment adherence, physician/health care provider education, financial incentives, and integrated healthcare are recommended for the prevention and control of CVD in China.
References
G. Yang, Y. Wang Y, Y. Zeng, G.F. Gao, X. Liang, M. Zhou, et al., Rapid health transition in China, 1990-2010: findings from the Global Burden of Disease Study 2010. Lancet. 381 (2013) 1987-2015. DOI: 10.1016/S0140-6736(13)61097-1.
E.S. Ford, U.A. Ajani, J.B. Croft, J.A. Critchley, D.R. Labarthe, T.E. Kottke, et al., Explaining the decrease in U.S. deaths from coronary disease, 1980-2000. N. Engl. J. Med. 356 (2007) 2388-2398. DOI: 10.1056/NEJMsa053935.
S.S. Hu, L.Z. Kong, R. L. Gao, M.L. Zhu, W. Wang, Y.J. Wang, et al., Outline of the report on cardiovascular disease in China, 2010. Biomed. Environ. Sci. 25 (2012) 251-256. DOI: 10.3967/0895-3988.2012.03.001.
Z.J. Yang, J. Liu, J.P. Ge, L. Chen, Z.G. Zhao, W.Y. Yang, et al., Prevalence of cardiovascular disease risk factor in the Chinese population: the 2007-2008 China National Diabetes and Metabolic Disorders Study, Eur. Heart. J. 33 (2012) 213-220. DOI: 10.1055/s-0033-1341520.
A. Moran, D. Gu, D. Zhao, P. Coxson, Y.C. Wang, C.S. Chen , et al., Future cardiovascular disease in China: markov model and risk factor scenario projections from the coronary heart disease policy model-china. Circ. Cardiovasc. Qual. Outcomes. 3 (2010) 243-252. DOI: 10.1161/CIRCOUTCOMES.109.910711.
N. Wang, D. Zhao, J. Liu, J. Liu, C.M. Yu, W. Wang, et al., Impact of heart failure on in-hospital outcomes of acute coronary syndrome patients in China - results from the Bridging the Gap on CHD Secondary Prevention in China (BRIG) project, Int. J. Cardiol. 160 (2012) 15-19. DOI: 10.1016/j.ijcard.2011.03.010.
D, Hu, J. Li, X. Li; China Cholesterol Education Program, Investigation of blood lipid levels and statin interventions in outpatients with coronary heart disease in China: the China Cholesterol Education Program (CCEP), Circ. J. 72 (2008) 2040-2045. DOI: 10.1253/circj.CJ-08-0417.
X. Li, Y. Xu, J. Li, D. Hu, The gender differences in baseline characteristics and statin intervention among outpatients with coronary heart disease in China: the China Cholesterol Education Program, Clin. Cardiol. 32 (2009) 308-314. DOI: 10.1002/clc.20514.
S. Saha, U.G. Gerdtham, P. Johansson, Economic evaluation of lifestyle interventions for preventing diabetes and cardiovascular diseases, Int. J. Environ. Res. Public. Health. 7 (2010) 3150-3195. DOI: 10.3390/ijerph7083150.
World Health Organization, Cardiovascular diseases 2015: http://www.wpro.who.int/china/mediacentre/factsheets/cvd/en/08-21-2015.
F.B. Hu, Y. Liu, W.C. Willett, Preventing chronic diseases by promoting healthy diet and lifestyle: public policy implications for China, Obes. Rev. 12 (2011) 552-559. (DOI: 10.1111/j.1467-789X.2011.00863.x).
F. Chan, S. Adamo, P. Coxson, L. Goldman, D. Gu, D. Zhao, et al., Projected impact of urbanization on cardiovascular disease in China, Int. J. Public. Health. 57 (2012) 849-854. DOI: 10.1007/s00038-012-0400-y.
Million Hearts, Call for Nominations: 2015 Million Hearts Hypertension Control Challenge!: http://millionhearts.hhs.gov/index.html08-21-2015.
E.S. Ford, U.A. Ajani, J.B. Croft, J.A. Critchley, D.R. Labarthe, T.E. Kottke, et al., Explaining the decrease in U.S. deaths from coronary disease, 1980-2000, N. Engl. J. Med. 356 (2007) 2388-2398. DOI: 10.1056/NEJMsa053935.
J. Critchley, J. Liu, D. Zhao, W. Wei, S. Capewell, Explaining the increase in coronary heart disease mortality in Beijing between 1984 and 1999, Circulation. 110 (2004) 1236-1244. DOI: 10.1161/01.CIR.0000140668.91896.AE.
M. Ezzati, A.D. Lopez, A. Rodgers, S. Vander Hoorn, C.J. Murray; Comparative Risk Assessment Collaborating Group, Selected major risk factors and global and regional burden of disease, Lancet. 360 (2002) 1347-1360. DOI: 10.1016/S0140-6736(02)11403-6.
R. Jackson, C.M. Lawes, D.A. Bennett, R.J. Milne, A. Rodgers, Treatment with drugs to lower blood pressure and blood cholesterol based on an individual's absolute cardiovascular risk, Lancet. 365 (2005) 434-441. DOI: 10.1016/S0140-6736(05)17833-7.
P.S. Sever, B. Dahlöf, N.R. Poulter, H. Wedel, G. Beevers, M. Caulfield, et al., Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcomes Trial--Lipid Lowering Arm (ASCOT-LLA): a multicentre randomised controlled trial, Lancet. 361 (2003) 1149-1158. DOI: 10.1016/S0140-6736(03)12948-0.
H.M. Colhoun, M.J. Thomason, M.I. Mackness, S.M. Maton, D.J. Betteridge, P.N. Durrington, et al., Design of the Collaborative AtoRvastatin Diabetes Study (CARDS) in patients with type 2 diabetes, Diabet. Med. 19 (2002) 201-211. DOI: 10.1046/j.1464-5491.2002.00643.x.
H.M. Colhoun, D.J. Betteridge, P.N. Durrington, G.A. Hitman, H.A. Neil, S.J. Livingstone, et al., Primary prevention of cardiovascular disease with atorvastatin in type 2 diabetes in the Collaborative Atorvastatin Diabetes Study (CARDS): multicentre randomised placebo-controlled trial, Lancet. 364 (2004) 685-696. DOI: 10.1016/S0140-6736(04)16895-5.
Z.J. Yang, J. Liu, J.P. Ge, L. Chen, Z.G. Zhao, W.Y. Yang, et al., Prevalence of cardiovascular disease risk factor in the Chinese population: the 2007-2008 China National Diabetes and Metabolic Disorders Study. Eur. Heart. J. 33 (2012) 213-220. DOI: 10.1093/eurheartj/ehr205.
X. Zhang, Y. Zhang, L. Liu, A. Zanchetti, Which risk factors are important for endpoint cardiovascular events in the fever study? A practical application of roc curves in clinical trials, J. Hypertens. 33 Suppl 1 (2015) e123. DOI: 10.1097/01.hjh.0000467682.54801.ba.
World Health Organization, Reducing Risks, Promoting Healthy Life: http://www.who.int/whr/2002/en/08-21-2015.
D. Gu, K. Reynolds, X. Wu, J. Chen, X. Duan, R.F. Reynolds, et al., Prevalence of the metabolic syndrome and overweight among adults in China, Lancet. 365 (2005) 1398-1405. DOI: 10.1016/S0140-6736(05)66375-1.
J. Liu, Y. Hong, R.B. Sr D'Agostino, Z. Wu, W. Wang, J. Sun, et al., Predictive value for the Chinese population of the Framingham CHD risk assessment tool compared with the Chinese Multi-Provincial Cohort Study, JAMA. 291 (2004) 2591-2599. DOI: 10.1001/jama.291.21.2591.
T.R. Bates, V.M. Connaughton, G.F. Watts, Non-adherence to statin therapy: a major challenge for preventive cardiology, Expert. Opin. Pharmacother. 10 (2009) 2973-2985. DOI: 10.1517/14656560903376186.
M.H. Davidson, Differences between clinical trial efficacy and real-world effectiveness, Am. J. Manag. Care. 12 (2006) S405-S411.
M.J. Vale, M.V. Jelinek, J.D. Best, A.M. Dart, L.E. Grigg, D.L. Hare, et al., Coaching patients On Achieving Cardiovascular Health (COACH): a multicenter randomized trial in patients with coronary heart disease, Arch. Intern. Med. 163 (2003) 2775-2783. DOI: 10.1001/archinte.163.22.2775.
M.J. Bloch, D.S. Armstrong, L. Dettling, A. Hardy, K. Caterino, S. Barrie, Partners in lowering cholesterol: comparison of a multidisciplinary educational program, monetary incentives, or usual care in the treatment of dyslipidemia identified among employees, J. Occup. Environ. Med. 48 (2006) 675-681. DOI: 10.1097/01.jom.0000205997.18143.6c.
M. Naito, T. Nakayama, T. Okamura, K. Miura, M. Yanagita, Y. Fujieda, et al., Effect of a 4-year workplace-based physical activity intervention program on the blood lipid profiles of participating employees: the high-risk and population strategy for occupational health promotion (HIPOP-OHP) study, Atherosclerosis. 197 (2008) 784-790. DOI: 10.1016/j.atherosclerosis.2007.07.026.
M.A. Fritsch, J. Montpellier, C. Kussman, Worksite wellness: a cholesterol awareness program, AAOHN. J. 57 (2009) 69-76 quiz 77-78.
L. Mosca, A.H. Linfante, E.J. Benjamin, K. Berra, S.N. Hayes, B.W. Walsh, et al., National study of physician awareness and adherence to cardiovascular disease prevention guidelines, Circulation. 111 (2005) 499-510. DOI: 10.1161/01.CIR.0000154568.43333.82.
P.C. Smith, N. York, Quality incentives: the case of U.K. general practitioners, Health. Aff (Millwood). 23 (2004) 112-118. DOI: 10.1377/hlthaff.23.3.112.
T. Doran, E. Kontopantelis, J.M. Valderas, S. Campbell, M. Roland, C. Salisbury, et al., Effect of financial incentives on incentivised and non-incentivised clinical activities: longitudinal analysis of data from the UK Quality and Outcomes Framework, BMJ. 342 (2011) d3590. DOI: 10.1136/bmj.d3590.
K. Khunti, R. Gadsby, C. Millett, A. Majeed, M. Davies, Quality of diabetes care in the UK: comparison of published quality-of-care reports with results of the Quality and Outcomes Framework for Diabetes, Diabet. Med. 24 (2007) 1436-1441. DOI: 10.1111/j.1464-5491.2007.02276.x.
A. Downing, G. Rudge, Y. Cheng, Y.K. Tu, J. Keen, M.S. Gilthorpe, Do the UK government's new Quality and Outcomes Framework (QOF) scores adequately measure primary care performance? A cross-sectional survey of routine healthcare data, BMC. Health. Serv. Res. 7 (2007) 166. DOI: 10.1186/1472-6963-7-166.
F. Gao, Y.J. Zhou, da. Y. Hu, Y.X. Zhao, Y.Y. Liu, Z.J. Wang, et al., Contemporary management and attainment of cholesterol targets for patients with dyslipidemia in China, PLoS. One. 8 (2013) e47681. DOI: 10.1371/journal.pone.0047681.
G. Xie, M.J. Zaman, P.K. Myint, L. Liang, L. Zhao, Y. Wu, Factors associated with compliance to lipid-lowering treatment in China, Eur. J. Prev. Cardiol. 20 (2013) 229-237. DOI: 10.1177/2047487312438847.
T.L. Charrois, M. Zolezzi, S.L. Koshman, G. Pearson, M. Makowsky, T. Durec, et al., A systematic review of the evidence for pharmacist care of patients with dyslipidemia, Pharmacotherapy. 32 (2012) 222-233. DOI: 10.1002/j.1875-9114.2012.01022.x.
V. Santschi, A. Chiolero, B. Burnand, A.L. Colosimo, G. Paradis, Impact of pharmacist care in the management of cardiovascular disease risk factors: a systematic review and meta-analysis of randomized trials, Arch. Intern. Med. 171 (2011) 1441-1453. DOI: 10.1001/archinternmed.2011.399.
R. Lowrie, S.M. Lloyd, A. McConnachie, J. Morrison, A cluster randomised controlled trial of a pharmacist-led collaborative intervention to improve statin prescribing and attainment of cholesterol targets in primary care, PLoS. One. 9 (2014) e113370. DOI: 10.1371/journal.pone.0113370.
C.D. Evans, D.T. Eurich, J.G. Taylor, A.J. Remillard, Y.M. Shevchuk, D.F. Blackburn, A pragmatic cluster randomized trial evaluating the impact of a community pharmacy intervention on statin adherence: rationale and design of the Community Pharmacy Assisting in Total Cardiovascular Health (CPATCH) study, Trials. 11 (2010) 76. DOI: 10.1186/1745-6215-11-76.
H.R. Voogdt-Pruis, J.W. Van Ree, A.P. Gorgels, G.H. Beusmans, Adherence to a guideline on cardiovascular prevention: a comparison between general practitioners and practice nurses, Int. J. Nurs. Stud. 48 (2011) 798-807. DOI: 10.1016/j.ijnurstu.2010.11.008.
H.T. Jorstad, C. von Birgelen, A.M. Alings, A. Liem, J.M. van Dantzig, W. Jaarsma, et al., Effect of a nurse-coordinated prevention programme on cardiovascular risk after an acute coronary syndrome: main results of the RESPONSE randomised trial, Heart. 99 (2013) 1421-1430. DOI: 10.1136/heartjnl-2013-303989.
G. Cicolini, V. Simonetti, D. Comparcini, I Celiberti, M. Di Nicola, L.M. Capasso, et al., Efficacy of a nurse-led email reminder program for cardiovascular prevention risk reduction in hypertensive patients: a randomized controlled trial, Int. J. Nurs. Stud. 51 (2014) 833-843. DOI: 10.1016/j.ijnurstu.2013.10.010.
D.A. Wood, K. Kotseva, S. Connolly, C. Jennings, A. Mead, J. Jones, et al., Nurse-coordinated multidisciplinary, family-based cardiovascular disease prevention programme (EUROACTION) for patients with coronary heart disease and asymptomatic individuals at high risk of cardiovascular disease: a paired,cluster-randomised controlled trial, Lancet. 371 (2008) 1999-2012. DOI: 10.1016/S0140-6736(08)60868-5.
C. Jennings, K. Kotseva, D. De Bacquer, A. Hoes, J. de Velasco, S. Brusaferro, et al., Effectiveness of a preventive cardiology programme for high CVD risk persistent smokers: the EUROACTION PLUS varenicline trial, Eur. Heart. J. 35 (2014) 1411-1420. DOI: 10.1093/eurheartj/ehu051.
H.H. Fischer, S.L. Eisert, R.M. Everhart, M.J. Durfee, S.L. Moore, S. Soria, et al., Nurse-run, telephone-based outreach to improve lipids in people with diabetes, Am. J. Manag. Care. 18 (2012) 77-84.
J.P. New, J.M. Mason, N. Freemantle, S. Teasdale, L.M. Wong, N.J. Bruce, et al., Specialist nurse-led intervention to treat and control hypertension and hyperlipidemia in diabetes (SPLINT): a randomized controlled trial, Diabetes. Care. 26 (2003) 2250-2255. DOI: 10.2337/diacare.26.8.2250.
S. Greb, A. Focke, F. Hessel, J. Wasem, Financial incentives for disease management programmes and integrated care in German social health insurance, Health. Policy. 78 (2006) 295-305. DOI: 10.1016/j.healthpol.2005.11.011.
A. Scott, S. Schurer, P.H. Jensen, P. Sivey, The effects of an incentive program on quality of care in diabetes management, Health. Econ. 18 (2009) 1091-1108. DOI: 10.1002/hec.1536.
C. Lenfant, A new challenge for America: the National Cholesterol Education Program, Circulation. 73 (1986) 855-856.
National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III), Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report, Circulation. 106 (2002) 3143-3421.
S. Thiengwiboonwong, R. Chongsuwat, P. Temcharoen, W. Pandii, P. Pavadhgul, Efficacy of dietary modification following the National Cholesterol Education Program (NCEP) recommendation on lipid profiles among hyperlipidemia subjects, J. Med. Assoc. Thai. 96 (2013) 1257-1267.
P. Puska, J. Salonen, A. Nissinen, J. Tuomilehto, The North Karelia project, Prev. Med. 12 (1983) 191-195.
P. Pietinen, A. Nissinen, E. Vartiainen, A. Tuomilehto, U. Uusitalo, A. Ketola, et al., Dietary changes in the North Karelia Project (1972-1982), Prev. Med. 17 (1988) 183-193.
N.B. Record, D.K. Onion, R.E. Prior, D.C. Dixon, S.S. Record, F.L. Fowler, et al., Community-wide cardiovascular disease prevention programs and health outcomes in a rural county, 1970-2010, JAMA. 313 (2015) 147-155. DOI: 10.1001/jama.2014.16969.
S. Sylvia, Y. Shi, H. Xue, X. Tian, H. Wang, Q. Liu, et al., Survey using incognito standardized patients shows poor quality care in China's rural clinics, Health. Policy. Plan. 30 (2015) 322-333. DOI: 10.1093/heapol/czu014.
H. Jin, S. Zhu, J.W. Wei, J. Wang, M. Liu, Y. Wu, et al., Factors associated with prehospital delays in the presentation of acute stroke in urban China, Stroke. 43 (2012) 362-370. DOI: 10.1161/STROKEAHA.111.623512.
H. Fischer, T. Mackenzie, K. McCullen, R. Everhart, R.O. Estacio, Design of a nurse-run, telephone-based intervention to improve lipids in diabetics, Contemp. Clin. Trials. 29 (2008) 809-816. DOI: 10.1016/j.cct.2008.05.011.
E. Vermeire, H. Hearnshaw, P. Van Royen, J. Denekens, Patient adherence to treatment: three decades of research. A comprehensive review, J. Clin. Pharm. Ther. 26 (2001) 331-342. DOI: 10.1046/j.1365-2710.2001.00363.x.
J.G. Cleland, K. Swedberg, F. Follath, M. Komajda, A. Cohen-Solal, J.C. Aguilar, et al., The EuroHeart Failure survey programme-- a survey on the quality of care among patients with heart failure in Europe. Part 1: patient characteristics and diagnosis, Eur. Heart. J. 24 (2003) 442-463. DOI: 10.1016/S0195-668X(02)00823-0.
Shewan LG, Coats AJS, Henein M. Requirements for ethical publishing in biomedical journals. InternationalCardiovascular Forum Journal 2015;2:2 DOI: 10.17987/icfj.v2i1.4.
Additional Files
Published
Issue
Section
License
Authors who publish with this journal agree to the following terms:
a. The authors will retain copyright under a Creative Commons Attribution License (CC-BY 4.0) that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
b. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
c. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
