Primary care: The major force in early diagnosis and management of CVD

Cardiovascular disease

• Cardiovascular diseases (CVDs) are the leading cause of death globally.
• An estimated 17.9 million people died from CVDs in 2019, representing 32% of all global deaths. Of these deaths, 85% were due to heart attack and stroke.
• Over three quarters of CVD deaths take place in low- and middle-income countries.
• Out of the 17 million premature deaths (under the age of 70) due to noncommunicable diseases in 2019, 38% were caused by CVDs.
• Most cardiovascular diseases can be prevented by addressing behavioural risk factors such as tobacco use, unhealthy diet and obesity, physical inactivity and harmful use of alcohol.
• It is important to detect cardiovascular disease as early as possible so that management with counselling and medicines can begin.`

Primary care and Cardiovascular diseases

The fast majority of patients (estimate of 90%) are diagnosed and managed in primary care settings.

With an estimate of 1/3 of all patients an average primary care professional consults on a daily basis. While many of the international guidelines are developed by specialist societies it is the perception that implementation of these guidelines is often delayed, as concluded in a recent meeting of the EPCCS Council. The most important behavioural risk factors of heart disease and stroke are unhealthy diet, physical inactivity, tobacco use and harmful use of alcohol. The effects of behavioural risk factors may show up in individuals as raised blood pressure, raised blood glucose, raised blood lipids, and overweight and obesity. These “intermediate risks factors” can be measured in primary care facilities and indicate an increased risk of heart attack, stroke, heart failure and other complications.

Cessation of tobacco use, reduction of salt in the diet, eating more fruit and vegetables, regular physical activity and avoiding harmful use of alcohol have been shown to reduce the risk of cardiovascular disease. Health policies that create conducive environments for making healthy choices affordable and available are essential for motivating people to adopt and sustain healthy behaviours.

Early identifying those at highest risk of CVDs and ensuring they receive appropriate treatment can prevent premature deaths. Access to noncommunicable disease medicines and basic health technologies in all primary health care facilities is essential to ensure that those in need receive treatment and counselling