The World Heart Federation’s (WHF) Cholesterol Roadmap was previewed at the American Heart Association (AHA) Scientific Sessions 2016 in an effort to achieve 25% reduction in cardiovascular disease by 2025.

The initiative is latest in series aimed at reducing cholesterol in secondary and primary prevention of cardiovascular disease and in patients with familial hypercholesterolaemia, at the AHA Scientific Sessions, which took place from November 12-16, 2016 in New Orleans, USA.

In the Roadmap the WHF calls for more awareness of healthier lifestyles and diet, increased screening and testing for cholesterol in communities; more effective initiation of statin treatment and adherence to drug treatments in primary and secondary prevention of CVD.

The initiative also calls for better detection and treatment of patients with familial hypercholesterolaemia, better physician education and support, and reform of drug availability as well as affordability.

The Cholesterol Roadmap forms part of a series produced by WHF to help meet targets set by the World Health Organization (WHO) to reduce premature deaths from non-communicable diseases, including cardiovascular disease (CVD), by 25% by 2025.

Reducing the risk of cholesterol-related CVD has an essential role to play in achieving this goal. Previous WHF Roadmaps have focused on secondary prevention, hypertension (primary prevention), tobacco control, rheumatic heart disease and non-valvular atrial fibrillation, the most common form of cardiac arrhythmia.

Professor David Wood, President Elect of the World Heart Federation, said: “Our Roadmap initiative aims to help international efforts to beat cardiovascular disease. We have focused on the main CVD risk areas and produced the Roadmaps to help support individual countries in implementing appropriate health measures.”

Cholesterol is a fat-like substance that is found in all cells of the body. If too much bad LDL (Low Density Lipoprotein) cholesterol builds up in the arteries, it can restrict blood flow to the heart, brain and the rest of the body, increasing the risk of heart attack and stroke.

Cholesterol levels vary enormously between populations around the world, a result of both diet and genetic predisposition, and the traditional Mediterranean diet will lower average cholesterol levels.

For primary prevention WHO recommends a total risk approach to identify people at high risk of having a heart attack and stroke, taking account of all the major risk factors including blood cholesterol, but most people are unaware of their cholesterol levels or their overall cardiovascular risk.

For patients who have already developed CVD reducing cholesterol is central to secondary prevention. But a large treatment gap exists in proportions of patients achieving national targets for cholesterol lowering despite the overwhelming evidence that statins reduce risk and improve life expectancy.

Carlos Castro, Executive Director of the patients’ heart health association, PACO said: “There are more than 17 million deaths caused by cardiovascular disease each year. High levels of cholesterol are known to increase the risk of heart attacks and strokes. We hope by tackling the ‘roadblocks’ with the solutions set out in this Roadmap we can reduce the number of deaths.”

The number of deaths from non-communicable diseases is increasing globally, particularly in low-and middle-income countries (LMICs) where health resources are scarce. The World Heart Federation Roadmap Initiative identifies priority, cost-effective interventions that are essential for planning effective health system responses to CVD and related conditions. This will help early detection of cardiovascular diseases and prevent costly hospitalisations and deaths. Roadmaps for addressing gaps in secondary prevention, hypertension (primary prevention) and non-valvular atrial fibrillation have been published and are in the implementation phase.

The Cholesterol Roadmap details a number of roadblocks and solutions in order to improve detection rates, treatment and management of cholesterol on an international level. They are lack of awareness among physicians about the importance of universal screening, low access to health facilities among poor or remote populations and no facilities for testing blood samples in primary care. Others include no lab facilities in remote rural populations, lack of education/training among physicians regarding statin treatment as well as high cost of statins for patients.

The WHF wants national cholesterol roadmaps to be developed within “multi-sectoral” partnerships, including inter-governmental organizations, heart health advocacy foundations, cardiovascular scientific organizations, healthcare leaders, providers from primary and specialized care, private-sector partners and people affected by CVD (including patients and caregivers). To be successful, they will also require effective advocacy towards policy makers and politicians in national governments.

The World Heart Federation is dedicated to leading the global fight against cardiovascular disease (CVD), including heart disease and stroke. We are the only global advocacy and leadership organization bringing together the CVD community to drive the CVD agenda and help people live longer, better, more heart-healthy lives. Working with more than 200 member organizations in over 100 countries, the organisation strive for a 25% reduction by 2025 in premature deaths from cardiovascular disease around the world.

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