Control of cardiovascular diseases in Developing countries : research, development, and institutional strengthening / Committee on Research, Development and Institutional Strengthening for Control of Cardiovascular Diseases in Developing Countries, Board on International Health, Institute of Medicine ; Christopher P. Howson ... [et al.], editors.

Format:

Book

Contributor:

Howson, Christopher Paul.

Institute of Medicine (U.S.). Committee on Research, Development, and Institutional Strengthening for Control of Cardiovascular Diseases in Developing Countries.

Language:

English

Subjects (All):

Cardiovascular system--Diseases--Epidemiology.

Cardiovascular system.

Cardiovascular system--Diseases--Prevention.

Physical Description:

xvi, 86 p. : ill.

Edition:

1st ed.

Other Title:

Cardiovascular diseases in developing countries

Place of Publication:

Washington, D.C. : National Academy Press, 1998.

Language Note:

English

Summary:

Cardiovascular diseases (CVD) are increasing in epidemic proportions in developing countries. CVD already accounts for almost 10 percent of the developing world's burden of disease and is likely to become the developing world's leading cause of death. There is reason for hope, however, given that huge potential exists for applying R&D to control this emerging epidemic--both in creating powerful new interventions such as vaccines and dietary supplements and in guiding behavior. In addition, a considerable body of evidence suggests that current risk-factor prevention programs and low-cost case management of CVD offer feasible, cost-effective ways to reduce CVD mortality and disability in developing country populations. Large-scale CVD control efforts are lacking, however, and thus governments and individuals are left to make choices about health and health care services without the benefit of appropriate knowledge. This report was designed to promote a policy dialogue on CVD based on informed knowledge of R&D opportunities that offer effective, affordable, and widely applicable responses in developing countries. The report examines (a) the emerging burden of CVD in developing countries, (b) the future worldwide burden of CVD, (c) current prevention and treatment of CVD in developing countries, (d) R&D to support CVD control, (e) opportunities and priorities for R&D, and the need for institutional arrangements for collaboration in facing the epidemic.

Contents:

Control of Cardiovascular Diseases in Developing Countries

Copyright

Preface

PROJECT CHARGE

ORGANIZATION OF THE REPORT

Acknowledgments

Contents

Control of Cardiovascular Diseases in Developing Countries

Executive Summary

RECOMMENDATIONS

Determine the Magnitude of the CVD Burden in Developing Countries

Develop Targeted, Effective Primordial and Primary Prevention StrategiesUsing Case-Control Studies

Reduce Tobacco Use

Detect and Treat High Blood Pressure

Initiate Pilot Studies to Evaluate Essential Vascular Packages of Effective, Low-Cost Drugs

Develop and Assess Algorithms of Affordable Clinical Care for CVD

Build the Capacity to Conduct R&amp

D Activities

Develop Institutional Mechanisms for Facilitating CVD Prevention and Control

1 The Current Burden of Cardiovascular Diseases in Developing Countries

ECONOMIC DEVELOPMENT BRINGS CHANGES

ATHEROSCLEROSIS AS THE UNDERLYING DISEASE PROCESS

Risk Factors for Atherosclerotic Disease

THE GLOBAL BURDEN

Cardiovascular Disease as the Leading Cause of Death

Another Measure of Disease Burden

Regional Differences

Attributable Risk

CONCLUSIONS

2 The Future Burden of Cardiovascular Diseases in Developing Countries

PROJECTIONS OF THE FUTURE BURDEN

Future Impact of Tobacco

Future Effects of Other CVD Risk Factors

CAN DEVELOPING COUNTRIES AVOID THE FUTURE BURDEN?

Cardiovascular Disease Prevention Strategies

Efficacy of Current Interventions

ECONCOMIC CONSEQUENCES

COST-EFFECTIVENESS OF PREVENTION AND TREATMENT

3 Prevention and Treatment of Cardiovascular Diseases in Developing Countries

DIFFICULTIES IN ASSESSING PATTERNS

THE ROLE OF INTERNATIONALLY SPONSORED PROGRAMS

THE ROLE OF THE PRIVATE SECTOR

ZAMBIA: A CASE STUDY

FUTURE DIRECTIONS.

4 Current Research and Development in Developing Countries

5 Priorities for Global Research and Development

CONTEXT

RESEARCH PRIORITIES

Improve Knowledge of the Size of the CVD Burden in Developing Countries

Vital Registration

Cause-of-Death Statistics

Disability Estimates

Establishing the Levels, Determinants, and Consequences of Risk Factors

Cross-Sectional Surveys

Analytic Studies

Public Health Interventions

Randomized Trials

Clinical Interventions

Essential Vascular Package

Algorithms for Effective Diagnosis and Clinical Management

Randomized Trials of Other Low-Cost Treatments

Inclusion of Developing Countries in International Collaborative Clinical Trials

Other Public Health Interventions

RESEARCH TO CONTROL SPECIFIC RISK FACTORS

Tobacco Use

Hypertension

Diet and Physical Activity

HEALTH SERVICES RESEARCH

Review of Patterns of Clinical Practice

The Economic Burden and Cost-Effectiveness of Interventions

GOVERNMENT'S POLICY ROLE

Tobacco Control Policy

Food and Nutrition Policy

Pharmaceutical Policy

Private-Sector Participation

BUILDING CAPACITY FOR RESEARCH AND DEVELOPMENT

6 Institutional Arrangements for Research and Development

EFFECTIVE RESEARCH AND DEVELOPMENT AT LOCAL OR NATIONAL, REGIONAL, AND GLOBAL LEVELS

MODELS OF INTERNATIONAL COLLABORATION

The Special Programme for Research and Training in Tropical Diseases

The MONICA Project

DEVELOPMENT OF AN INSTITUTIONAL MECHANISM FOR CARDIOVASCULAR RESEARCH AND DEVELOPMENT

Epilogue

ECONOMIC IMPACT

ETHICAL CONCERN: THE CONCEPT OF HEALTH FOR ALL

NATIONAL RELEVANCE

SCIENTIFIC DISCOVERY

GLOBAL HEALTH ISSUES

References

Appendix A Five Steps for Setting Research Priorities

STEP 1: DETERMINE THE SIZE OF THE CVD BURDEN

STEP 2: IDENTIFY THE REASONS FOR THE CVD BURDEN.

STEP 3: EVALUATE THE ADEQUACY OF THE CURRENT KNOWLEDGE BASE

STEP 4: EVALUATE THE PROMISE OF R&amp

D EFFORTS

STEP 5: ASSESS THE ADEQUACY OF THE CURRENT LEVEL OF EFFORT

Appendix B Glossary of Cardiologic and Epidemiologic Terms

CLINICAL MANIFESTATIONS OF ATHEROSCLEROTIC CARIOVASCULAR DISEASE

Diseases That May Be Due to Effects of Hypertension on the Cardiovascular System

CARIOVASCULAR RISK FACTORS

EPIDEMIOLOGIC TERMS AND CONCEPTS.

Notes:

Bibliographic Level Mode of Issuance: Monograph

Includes bibliographical references (p. 69-75).

ISBN:

9786610186778

9780309173810

0309173817

9781280186776

1280186771

9780309592079

0309592070

9780585037554

0585037558

OCLC:

923262422