HEALTH: Simple Steps Can Rein in Cardiovascular Disease – WHO

By Gustavo Capdevila Reprint | | Print |

Gustavo Capdevila

GENEVA, Oct 18 2002 (IPS) - Cardiovascular diseases and strokes, which cause the deaths of 12 million people worldwide each year, could be brought under control relatively quickly with simple preventive actions, said the World Health Organisation (WHO) here Friday.

WHO director-general Gro Harlem Brundtland stated that more than 50 percent of deaths and disability from heart disease could be prevented “by a combination of simple, cost-effective, national efforts”, and by individual actions.

It would not take much to reduce the major risk factors behind heart disease and stroke, such as high blood pressure, high cholesterol, obesity and smoking, she said, stressing that “the savings in terms of lives could be enormous.”

Brundtland presented the WHO report on cardiovascular diseases Friday at a public meeting of the United Nations agency as it debates in Geneva the draft text of an international convention to control tobacco use.

The chapter of the report on strokes and heart diseases forms part of the “World Health Report 2002: Reducing Risks, Promoting Healthy Life”, which the WHO is to release in London on Oct 30. The final version is to present the principal global risk factors and the simple and effective measures for reducing them.

These straightforward actions, in the case of cardiovascular ailments, can produce results within five years because the progress of these diseases can be halted relatively easily.

However, inaction in this area means the current trend will continue, and by 2020 heart diseases will cause the loss worldwide of 25 percent more years of healthy living.

The World Heart Federation, an independent Geneva-based organisation, supports the WHO report and urges countries to launch campaigns in areas like reducing salt in processed foods, curbing consumption of saturated fat, encouraging exercise and diets with more fruits and vegetables, and dramatically reducing smoking rates.

WHO chief Brundtland stressed that the report shows how “most of the global burden due to cardiovascular risks occurs in the developing world.”

“This is a result of already high and increasing risk factor levels – such as high cholesterol – and large and ageing populations,” she added.

In the industrialised countries, meanwhile, tobacco, high blood pressure and cholesterol are the leading risk factors, “together accounting for more than a quarter of lost healthy life years,” said the UN official.

But those factors are also prominent among the leading health risks in middle-income countries and are even beginning to appear among the poorer developing countries, says the study.

One of the report’s authors, Anthony Rodgers, of the University of Auckland, New Zealand, commented that the world had begun to see cardiovascular diseases as a problem of the Western world. But it is clear that this is no longer the case, he said.

“The need to control cardiovascular disease is especially important in poor countries,” noted Brundtland, explaining that “it places a double burden on national health systems… because these countries already have to deal with infectious diseases,” such as diarrhoea, malaria, HIV/AIDS, tuberculosis and measles.

In what the WHO chief described as the “new mega-cities of the developing world,” massive illness – due to poor nutrition – exists side by side with poor cardiovascular health.

The report states that the trend towards increased cardiovascular disease in the developing world is likely to be particularly hazardous for the poorest countries and communities

In contrast, there was a time when cardiovascular disease disproportionately affected the wealthier populations of industrialised countries. But that trend was reversed over the past few decades, seen as the result of greater dissemination of information about the causes of these ailments.

The WHO predicts that if this tendency is repeated in developing countries, “the very poorest of the world’s poor will be the ones most at risk.”

“Modern-day conditions frequently mean that individuals, particularly the poor in developing world cities, have little control themselves over the major risk factors,” says the UN agency.

The report cites the example that the urban poor often have high-fat and high-salt processed foods available to purchase. Many processed foods, including breads, soups and meats, have salt concentrations “approaching or even exceeding those found in seawater.”

The WHO laments the fact that few governments so far have developed successful collaboration efforts with the food industry to reduce salt and high fat content in processed food.

The agency, with 192 member states, says that even in the poorest countries there are several ways to manage cardiovascular health risks that comply fully with international norms as far as effectiveness and cost efficiency.

Christopher Murray, a WHO expert, cited cigarette and tobacco taxes as one such example.

The countries that dramatically increase their tobacco taxes see an almost immediate reduction in tobacco use and corresponding improvements in cardiovascular health, he said.

“A seven-dollar pack of cigarettes will go a long way toward persuading smokers to quit and non-smokers not to start,” commented Murray.

WHO director-general Brundtland remarked that governments, industry and civil society should work together to facilitate the behavioural changes necessary to reduce cardiovascular health risks throughout entire populations.

“The best approaches will differ from country to country, but the benefits for all will be great… potentially saving millions of lives,” she stated.