New UN pocket-charts will save lives by predicting heart attack and stroke

Health workers around the world will be able to more easily identify those at risk of heart attacks and strokes and save some of the estimated 20 million lives lost to these diseases annually by prescribing the most appropriate treatment, thanks to a new book of pocket-charts launched by the United Nations health agency today.

“This is a real breakthrough,” UN World Health Organization (WHO) Director-General Margaret Chan said. “Now, health care workers everywhere – whether they are in a high-tech medical centre in a big city or riding a bicycle to visit patients in the countryside – can use a simple assessment and treatment tool to prevent heart attacks and strokes.”

“Primary health care workers now have a new tool to assess and manage people at risk of heart attacks and strokes. This brings cardiovascular care to the places and people who need it most,” she added of the book, which contains charts on such risk factors as age, sex, tobacco use, blood pressure, diabetes and blood cholesterol.

It incorporates management recommendations in such areas as smoking cessation, dietary changes, physical activity, weight control, alcohol consumption, anti-hypertensive drugs, lipid lowering drugs, anti-platelet drugs, anti-coagulant treatment and vascular surgery.

The “Pocket Guidelines for Assessment and Management of Cardiovascular Risk,” available in six languages, contains easy-to-use charts and is the first cardiovascular disease risk-prediction system that can be used worldwide, including in low-resource settings. It is an important innovation that will help health workers to target limited health care resources at people who are at higher risk of developing heart attacks and strokes.

“We are never prepared for the sudden death of a family member or a friend from a heart attack or stroke,” WHO Assistant Director-General for Noncommunicable Diseases and Mental Health Catherine Le Galès-Camus said.

“Cardiovascular diseases are increasing towards epidemic proportions in developing countries – they already account for one-third of global deaths, and almost 10 per cent of the global burden of disease, and are likely to become the developing world’s leading cause of death in 2010,” she added.

“There is reason for hope, however, given that huge potential exists to control this emerging epidemic. These risk charts are a major new tool for providing the best health care to all the world’s people.”

WHO will be collaborating with national Health Ministries and nongovernmental organizations in setting up “training of trainers” workshops and distribution of the guide.

Cardiovascular disease is the number one cause of death globally, causing one third of all deaths. In 2005, 11.8 million people died of heart attacks and other heart diseases, and 5.7 million died of stroke. Around 80 per cent of these deaths were in low- and middle-income countries. By 2015, an estimated 20 million people will die from CVD annually, mainly from heart attacks and strokes.

Until now, individuals have often been assessed and treated based on a single risk factor such as high blood pressure, high blood lipids or diabetes. This approach can result in committing a patient who has only a small risk to many years of drug therapy or, conversely, neglecting to treat those with an overall higher risk.

Most importantly, the single risk factor approach is not cost effective and is not affordable for many low-income and middle-income countries.

The guides are available in hard copy and on the WHO website.