Candidate Interventions for Integrating Hypertension and Cardiovascular-Kidney-Metabolic Care in Primary Health Settings: HEARTS 2.0 Phase 1

Autores
Rosende, Andres; Romero, Cesar; DiPette, Donald J.; Brettler, Jeffrey; Van der Stuyft, Patrick; Satheesh, Gautam; Perel, Pablo; Chapman, Niamh; Moran, Andrew E.; Schutte, Aletta E.; Sharman, James E.; Irazola, Vilma; Huffman, Mark D.; Campbell, Norm R. C.; Salam, Abdul; Lanas, Fernando; Coca, Antonio; Garcia Zamora, Sebastian; Ferreiro, Alejandro; Lopez Jaramillo, Patricio; Rico Fontalvo, Jorge; Ridley, Emily; Picone, Dean; Flood, David; Piñeiro, Daniel José; Ojeda, Carolina Neira; Rodriguez, Gonzalo; Wellmann, Irmgardt A.; Orias, Marcelo; Rivera, Marcela; Reyes, Matías Villatoro; Onuma, Oyere; Ramroop, Shaun; Khan, Taskeen; Gonzalez, Yamile Valdes; Barroso, Weimar Kunz Sebba; Plavnik, Frida L.; Zuniga, Eric; Grassani, Ana María; Tajer, Carlos; Zaidel, Ezequiel; Marin, Marcos J.; Cyr Philbert, Shana; Amorin, Ignacio; Diaz Aguilera, Miguel Angel; Bortolotto, Luiz; Avezum, Alvaro; Ribeiro, Antonio Luiz P.; Tobe, Sheldon; Aumala, Teresa; Angell, Sonia; Lavados, Pablo; Martins, Sheila Ouriques; Echeverri, Ana Munera; Jaffe, Marc G.; Prabhakaran, Dorairaj; Parati, Gianfranco; Zhang, Xin Hua; Rodgers, Anthony; Yusuf, Salim; Whelton, Paul K.; Ordunez, Pedro
Año de publicación
2025
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Background: HEARTS in the Americas is the regional adaptation of the WHO Global HEARTS Initiative, aimed at helping countries enhance hypertension and cardiovascular disease (CVD) risk management in primary care settings. Its core implementation tool, the HEARTS Clinical Pathway, has been adopted by 28 countries. To improve the care of hypertension, diabetes, and chronic kidney disease (CKD), HEARTS 2.0 was developed as a three-phase process to integrate evidence-based interventions into a unified care pathway, ensuring consistency across fragmented guidelines. This paper focuses on Phase 1, highlighting targeted interventions to improve and update the HEARTS Clinical Pathway.Methods: First, the coordinating group defined the project´s scope, objectives, principles, methodological framework, and tools. Second, international experts from different disciplines proposed interventions to enhance the HEARTS Clinical Pathway. Third, the coordinating group harmonized these proposals into unique interventions. Fourth, experts appraised the appropriateness of the proposed interventions on a 1-to-9 scale using the adapted RAND/UCLA Appropriateness Method. Finally, interventions with a median score above 6 were deemed appropriate and selected as candidates to enhance the HEARTS Clinical Pathway.Results: Building on the existing HEARTS Clinical Pathway, 45 unique interventions were selected, including community-based screening, early detection and management of risk factors, lower blood pressure thresholds for diagnosing hypertension in high-CVD-risk patients, reinforcement of single-pill combination therapy, inclusion of sodium-glucose cotransporter-2 inhibitors for patients with diabetes, CKD, or heart failure, expanded roles for non-physician health workers in team-based care, and strengthened clinical documentation, monitoring, and evaluation.Conclusion: HEARTS 2.0 Phase 1 identifies key interventions to integrate and improve hypertension and cardiovascular-kidney-metabolic care within primary care, enabling their seamless incorporation into a unified and effective clinical pathway. This process will inform an update to the HEARTS Clinical Pathway, optimizing resources, reducing care fragmentation, improving care delivery, and advancing health equity, thereby supporting global efforts to combat the leading causes of death and disability.
Fil: Rosende, Andres. Pan American Health Organization; Estados Unidos
Fil: Romero, Cesar. University of Emory; Estados Unidos
Fil: DiPette, Donald J.. No especifíca;
Fil: Brettler, Jeffrey. Kaiser Permanente; Estados Unidos
Fil: Van der Stuyft, Patrick. Ghent University; Bélgica
Fil: Satheesh, Gautam. The George Institute For Global Health; Australia
Fil: Perel, Pablo. No especifíca;
Fil: Chapman, Niamh. University Of Sydney; Australia
Fil: Moran, Andrew E.. Columbia University; Estados Unidos
Fil: Schutte, Aletta E.. The George Institute For Global Health; Australia
Fil: Sharman, James E.. Menzies Institute For Medical Research; Australia
Fil: Irazola, Vilma. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
Fil: Huffman, Mark D.. No especifíca;
Fil: Campbell, Norm R. C.. No especifíca;
Fil: Salam, Abdul. No especifíca;
Fil: Lanas, Fernando. No especifíca;
Fil: Coca, Antonio. No especifíca;
Fil: Garcia Zamora, Sebastian. No especifíca;
Fil: Ferreiro, Alejandro. No especifíca;
Fil: Lopez Jaramillo, Patricio. No especifíca;
Fil: Rico Fontalvo, Jorge. No especifíca;
Fil: Ridley, Emily. No especifíca;
Fil: Picone, Dean. No especifíca;
Fil: Flood, David. No especifíca;
Fil: Piñeiro, Daniel José. No especifíca;
Fil: Ojeda, Carolina Neira. No especifíca;
Fil: Rodriguez, Gonzalo. No especifíca;
Fil: Wellmann, Irmgardt A.. No especifíca;
Fil: Orias, Marcelo. No especifíca;
Fil: Rivera, Marcela. No especifíca;
Fil: Reyes, Matías Villatoro. No especifíca;
Fil: Onuma, Oyere. No especifíca;
Fil: Ramroop, Shaun. No especifíca;
Fil: Khan, Taskeen. No especifíca;
Fil: Gonzalez, Yamile Valdes. No especifíca;
Fil: Barroso, Weimar Kunz Sebba. No especifíca;
Fil: Plavnik, Frida L.. No especifíca;
Fil: Zuniga, Eric. No especifíca;
Fil: Grassani, Ana María. No especifíca;
Fil: Tajer, Carlos. No especifíca;
Fil: Zaidel, Ezequiel. No especifíca;
Fil: Marin, Marcos J.. No especifíca;
Fil: Cyr Philbert, Shana. No especifíca;
Fil: Amorin, Ignacio. No especifíca;
Fil: Diaz Aguilera, Miguel Angel. No especifíca;
Fil: Bortolotto, Luiz. No especifíca;
Fil: Avezum, Alvaro. No especifíca;
Fil: Ribeiro, Antonio Luiz P.. No especifíca;
Fil: Tobe, Sheldon. No especifíca;
Fil: Aumala, Teresa. No especifíca;
Fil: Angell, Sonia. No especifíca;
Fil: Lavados, Pablo. No especifíca;
Fil: Martins, Sheila Ouriques. No especifíca;
Fil: Echeverri, Ana Munera. No especifíca;
Fil: Jaffe, Marc G.. No especifíca;
Fil: Prabhakaran, Dorairaj. No especifíca;
Fil: Parati, Gianfranco. No especifíca;
Fil: Zhang, Xin Hua. No especifíca;
Fil: Rodgers, Anthony. No especifíca;
Fil: Yusuf, Salim. No especifíca;
Fil: Whelton, Paul K.. No especifíca;
Fil: Ordunez, Pedro. No especifíca;
Materia
Cardiovascular Diseases
Chronic
Primary Health Care
Renal Insufficiency
Stroke
diabetes mellitus
hypertension
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/291158
Acceder
id CONICETDig_5aa2e412b58e9d08e83147eb43ae439b
oai_identifier_str oai:ri.conicet.gov.ar:11336/291158
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Candidate Interventions for Integrating Hypertension and Cardiovascular-Kidney-Metabolic Care in Primary Health Settings: HEARTS 2.0 Phase 1Rosende, AndresRomero, CesarDiPette, Donald J.Brettler, JeffreyVan der Stuyft, PatrickSatheesh, GautamPerel, PabloChapman, NiamhMoran, Andrew E.Schutte, Aletta E.Sharman, James E.Irazola, VilmaHuffman, Mark D.Campbell, Norm R. C.Salam, AbdulLanas, FernandoCoca, AntonioGarcia Zamora, SebastianFerreiro, AlejandroLopez Jaramillo, PatricioRico Fontalvo, JorgeRidley, EmilyPicone, DeanFlood, DavidPiñeiro, Daniel JoséOjeda, Carolina NeiraRodriguez, GonzaloWellmann, Irmgardt A.Orias, MarceloRivera, MarcelaReyes, Matías VillatoroOnuma, OyereRamroop, ShaunKhan, TaskeenGonzalez, Yamile ValdesBarroso, Weimar Kunz SebbaPlavnik, Frida L.Zuniga, EricGrassani, Ana MaríaTajer, CarlosZaidel, EzequielMarin, Marcos J.Cyr Philbert, ShanaAmorin, IgnacioDiaz Aguilera, Miguel AngelBortolotto, LuizAvezum, AlvaroRibeiro, Antonio Luiz P.Tobe, SheldonAumala, TeresaAngell, SoniaLavados, PabloMartins, Sheila OuriquesEcheverri, Ana MuneraJaffe, Marc G.Prabhakaran, DorairajParati, GianfrancoZhang, Xin HuaRodgers, AnthonyYusuf, SalimWhelton, Paul K.Ordunez, PedroCardiovascular DiseasesChronicPrimary Health CareRenal InsufficiencyStrokediabetes mellitushypertensionhttps://purl.org/becyt/ford/3.3https://purl.org/becyt/ford/3Background: HEARTS in the Americas is the regional adaptation of the WHO Global HEARTS Initiative, aimed at helping countries enhance hypertension and cardiovascular disease (CVD) risk management in primary care settings. Its core implementation tool, the HEARTS Clinical Pathway, has been adopted by 28 countries. To improve the care of hypertension, diabetes, and chronic kidney disease (CKD), HEARTS 2.0 was developed as a three-phase process to integrate evidence-based interventions into a unified care pathway, ensuring consistency across fragmented guidelines. This paper focuses on Phase 1, highlighting targeted interventions to improve and update the HEARTS Clinical Pathway.Methods: First, the coordinating group defined the project´s scope, objectives, principles, methodological framework, and tools. Second, international experts from different disciplines proposed interventions to enhance the HEARTS Clinical Pathway. Third, the coordinating group harmonized these proposals into unique interventions. Fourth, experts appraised the appropriateness of the proposed interventions on a 1-to-9 scale using the adapted RAND/UCLA Appropriateness Method. Finally, interventions with a median score above 6 were deemed appropriate and selected as candidates to enhance the HEARTS Clinical Pathway.Results: Building on the existing HEARTS Clinical Pathway, 45 unique interventions were selected, including community-based screening, early detection and management of risk factors, lower blood pressure thresholds for diagnosing hypertension in high-CVD-risk patients, reinforcement of single-pill combination therapy, inclusion of sodium-glucose cotransporter-2 inhibitors for patients with diabetes, CKD, or heart failure, expanded roles for non-physician health workers in team-based care, and strengthened clinical documentation, monitoring, and evaluation.Conclusion: HEARTS 2.0 Phase 1 identifies key interventions to integrate and improve hypertension and cardiovascular-kidney-metabolic care within primary care, enabling their seamless incorporation into a unified and effective clinical pathway. This process will inform an update to the HEARTS Clinical Pathway, optimizing resources, reducing care fragmentation, improving care delivery, and advancing health equity, thereby supporting global efforts to combat the leading causes of death and disability.Fil: Rosende, Andres. Pan American Health Organization; Estados UnidosFil: Romero, Cesar. University of Emory; Estados UnidosFil: DiPette, Donald J.. No especifíca;Fil: Brettler, Jeffrey. Kaiser Permanente; Estados UnidosFil: Van der Stuyft, Patrick. Ghent University; BélgicaFil: Satheesh, Gautam. The George Institute For Global Health; AustraliaFil: Perel, Pablo. No especifíca;Fil: Chapman, Niamh. University Of Sydney; AustraliaFil: Moran, Andrew E.. Columbia University; Estados UnidosFil: Schutte, Aletta E.. The George Institute For Global Health; AustraliaFil: Sharman, James E.. Menzies Institute For Medical Research; AustraliaFil: Irazola, Vilma. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: Huffman, Mark D.. No especifíca;Fil: Campbell, Norm R. C.. No especifíca;Fil: Salam, Abdul. No especifíca;Fil: Lanas, Fernando. No especifíca;Fil: Coca, Antonio. No especifíca;Fil: Garcia Zamora, Sebastian. No especifíca;Fil: Ferreiro, Alejandro. No especifíca;Fil: Lopez Jaramillo, Patricio. No especifíca;Fil: Rico Fontalvo, Jorge. No especifíca;Fil: Ridley, Emily. No especifíca;Fil: Picone, Dean. No especifíca;Fil: Flood, David. No especifíca;Fil: Piñeiro, Daniel José. No especifíca;Fil: Ojeda, Carolina Neira. No especifíca;Fil: Rodriguez, Gonzalo. No especifíca;Fil: Wellmann, Irmgardt A.. No especifíca;Fil: Orias, Marcelo. No especifíca;Fil: Rivera, Marcela. No especifíca;Fil: Reyes, Matías Villatoro. No especifíca;Fil: Onuma, Oyere. No especifíca;Fil: Ramroop, Shaun. No especifíca;Fil: Khan, Taskeen. No especifíca;Fil: Gonzalez, Yamile Valdes. No especifíca;Fil: Barroso, Weimar Kunz Sebba. No especifíca;Fil: Plavnik, Frida L.. No especifíca;Fil: Zuniga, Eric. No especifíca;Fil: Grassani, Ana María. No especifíca;Fil: Tajer, Carlos. No especifíca;Fil: Zaidel, Ezequiel. No especifíca;Fil: Marin, Marcos J.. No especifíca;Fil: Cyr Philbert, Shana. No especifíca;Fil: Amorin, Ignacio. No especifíca;Fil: Diaz Aguilera, Miguel Angel. No especifíca;Fil: Bortolotto, Luiz. No especifíca;Fil: Avezum, Alvaro. No especifíca;Fil: Ribeiro, Antonio Luiz P.. No especifíca;Fil: Tobe, Sheldon. No especifíca;Fil: Aumala, Teresa. No especifíca;Fil: Angell, Sonia. No especifíca;Fil: Lavados, Pablo. No especifíca;Fil: Martins, Sheila Ouriques. No especifíca;Fil: Echeverri, Ana Munera. No especifíca;Fil: Jaffe, Marc G.. No especifíca;Fil: Prabhakaran, Dorairaj. No especifíca;Fil: Parati, Gianfranco. No especifíca;Fil: Zhang, Xin Hua. No especifíca;Fil: Rodgers, Anthony. No especifíca;Fil: Yusuf, Salim. No especifíca;Fil: Whelton, Paul K.. No especifíca;Fil: Ordunez, Pedro. No especifíca;Ubiquity Press2025-05info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/291158Rosende, Andres; Romero, Cesar; DiPette, Donald J.; Brettler, Jeffrey; Van der Stuyft, Patrick; et al.; Candidate Interventions for Integrating Hypertension and Cardiovascular-Kidney-Metabolic Care in Primary Health Settings: HEARTS 2.0 Phase 1; Ubiquity Press; Global Heart; 20; 1; 5-2025; 1-172211-81602211-8179CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://account.globalheartjournal.com/index.php/up-j-gh/article/view/1428info:eu-repo/semantics/altIdentifier/doi/10.5334/gh.1428info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2026-08-25T14:49:49Zoai:ri.conicet.gov.ar:11336/291158instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982026-08-25 14:49:50.186CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Candidate Interventions for Integrating Hypertension and Cardiovascular-Kidney-Metabolic Care in Primary Health Settings: HEARTS 2.0 Phase 1
title Candidate Interventions for Integrating Hypertension and Cardiovascular-Kidney-Metabolic Care in Primary Health Settings: HEARTS 2.0 Phase 1
spellingShingle Candidate Interventions for Integrating Hypertension and Cardiovascular-Kidney-Metabolic Care in Primary Health Settings: HEARTS 2.0 Phase 1
Rosende, Andres
Cardiovascular Diseases
Chronic
Primary Health Care
Renal Insufficiency
Stroke
diabetes mellitus
hypertension
title_short Candidate Interventions for Integrating Hypertension and Cardiovascular-Kidney-Metabolic Care in Primary Health Settings: HEARTS 2.0 Phase 1
title_full Candidate Interventions for Integrating Hypertension and Cardiovascular-Kidney-Metabolic Care in Primary Health Settings: HEARTS 2.0 Phase 1
title_fullStr Candidate Interventions for Integrating Hypertension and Cardiovascular-Kidney-Metabolic Care in Primary Health Settings: HEARTS 2.0 Phase 1
title_full_unstemmed Candidate Interventions for Integrating Hypertension and Cardiovascular-Kidney-Metabolic Care in Primary Health Settings: HEARTS 2.0 Phase 1
title_sort Candidate Interventions for Integrating Hypertension and Cardiovascular-Kidney-Metabolic Care in Primary Health Settings: HEARTS 2.0 Phase 1
dc.creator.none.fl_str_mv Rosende, Andres
Romero, Cesar
DiPette, Donald J.
Brettler, Jeffrey
Van der Stuyft, Patrick
Satheesh, Gautam
Perel, Pablo
Chapman, Niamh
Moran, Andrew E.
Schutte, Aletta E.
Sharman, James E.
Irazola, Vilma
Huffman, Mark D.
Campbell, Norm R. C.
Salam, Abdul
Lanas, Fernando
Coca, Antonio
Garcia Zamora, Sebastian
Ferreiro, Alejandro
Lopez Jaramillo, Patricio
Rico Fontalvo, Jorge
Ridley, Emily
Picone, Dean
Flood, David
Piñeiro, Daniel José
Ojeda, Carolina Neira
Rodriguez, Gonzalo
Wellmann, Irmgardt A.
Orias, Marcelo
Rivera, Marcela
Reyes, Matías Villatoro
Onuma, Oyere
Ramroop, Shaun
Khan, Taskeen
Gonzalez, Yamile Valdes
Barroso, Weimar Kunz Sebba
Plavnik, Frida L.
Zuniga, Eric
Grassani, Ana María
Tajer, Carlos
Zaidel, Ezequiel
Marin, Marcos J.
Cyr Philbert, Shana
Amorin, Ignacio
Diaz Aguilera, Miguel Angel
Bortolotto, Luiz
Avezum, Alvaro
Ribeiro, Antonio Luiz P.
Tobe, Sheldon
Aumala, Teresa
Angell, Sonia
Lavados, Pablo
Martins, Sheila Ouriques
Echeverri, Ana Munera
Jaffe, Marc G.
Prabhakaran, Dorairaj
Parati, Gianfranco
Zhang, Xin Hua
Rodgers, Anthony
Yusuf, Salim
Whelton, Paul K.
Ordunez, Pedro
author Rosende, Andres
author_facet Rosende, Andres
Romero, Cesar
DiPette, Donald J.
Brettler, Jeffrey
Van der Stuyft, Patrick
Satheesh, Gautam
Perel, Pablo
Chapman, Niamh
Moran, Andrew E.
Schutte, Aletta E.
Sharman, James E.
Irazola, Vilma
Huffman, Mark D.
Campbell, Norm R. C.
Salam, Abdul
Lanas, Fernando
Coca, Antonio
Garcia Zamora, Sebastian
Ferreiro, Alejandro
Lopez Jaramillo, Patricio
Rico Fontalvo, Jorge
Ridley, Emily
Picone, Dean
Flood, David
Piñeiro, Daniel José
Ojeda, Carolina Neira
Rodriguez, Gonzalo
Wellmann, Irmgardt A.
Orias, Marcelo
Rivera, Marcela
Reyes, Matías Villatoro
Onuma, Oyere
Ramroop, Shaun
Khan, Taskeen
Gonzalez, Yamile Valdes
Barroso, Weimar Kunz Sebba
Plavnik, Frida L.
Zuniga, Eric
Grassani, Ana María
Tajer, Carlos
Zaidel, Ezequiel
Marin, Marcos J.
Cyr Philbert, Shana
Amorin, Ignacio
Diaz Aguilera, Miguel Angel
Bortolotto, Luiz
Avezum, Alvaro
Ribeiro, Antonio Luiz P.
Tobe, Sheldon
Aumala, Teresa
Angell, Sonia
Lavados, Pablo
Martins, Sheila Ouriques
Echeverri, Ana Munera
Jaffe, Marc G.
Prabhakaran, Dorairaj
Parati, Gianfranco
Zhang, Xin Hua
Rodgers, Anthony
Yusuf, Salim
Whelton, Paul K.
Ordunez, Pedro
author_role author
author2 Romero, Cesar
DiPette, Donald J.
Brettler, Jeffrey
Van der Stuyft, Patrick
Satheesh, Gautam
Perel, Pablo
Chapman, Niamh
Moran, Andrew E.
Schutte, Aletta E.
Sharman, James E.
Irazola, Vilma
Huffman, Mark D.
Campbell, Norm R. C.
Salam, Abdul
Lanas, Fernando
Coca, Antonio
Garcia Zamora, Sebastian
Ferreiro, Alejandro
Lopez Jaramillo, Patricio
Rico Fontalvo, Jorge
Ridley, Emily
Picone, Dean
Flood, David
Piñeiro, Daniel José
Ojeda, Carolina Neira
Rodriguez, Gonzalo
Wellmann, Irmgardt A.
Orias, Marcelo
Rivera, Marcela
Reyes, Matías Villatoro
Onuma, Oyere
Ramroop, Shaun
Khan, Taskeen
Gonzalez, Yamile Valdes
Barroso, Weimar Kunz Sebba
Plavnik, Frida L.
Zuniga, Eric
Grassani, Ana María
Tajer, Carlos
Zaidel, Ezequiel
Marin, Marcos J.
Cyr Philbert, Shana
Amorin, Ignacio
Diaz Aguilera, Miguel Angel
Bortolotto, Luiz
Avezum, Alvaro
Ribeiro, Antonio Luiz P.
Tobe, Sheldon
Aumala, Teresa
Angell, Sonia
Lavados, Pablo
Martins, Sheila Ouriques
Echeverri, Ana Munera
Jaffe, Marc G.
Prabhakaran, Dorairaj
Parati, Gianfranco
Zhang, Xin Hua
Rodgers, Anthony
Yusuf, Salim
Whelton, Paul K.
Ordunez, Pedro
author2_role author
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author
author
author
author
author
author
author
author
author
author
author
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author
author
author
author
author
author
author
author
author
author
author
author
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author
author
author
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dc.subject.none.fl_str_mv Cardiovascular Diseases
Chronic
Primary Health Care
Renal Insufficiency
Stroke
diabetes mellitus
hypertension
topic Cardiovascular Diseases
Chronic
Primary Health Care
Renal Insufficiency
Stroke
diabetes mellitus
hypertension
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.3
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Background: HEARTS in the Americas is the regional adaptation of the WHO Global HEARTS Initiative, aimed at helping countries enhance hypertension and cardiovascular disease (CVD) risk management in primary care settings. Its core implementation tool, the HEARTS Clinical Pathway, has been adopted by 28 countries. To improve the care of hypertension, diabetes, and chronic kidney disease (CKD), HEARTS 2.0 was developed as a three-phase process to integrate evidence-based interventions into a unified care pathway, ensuring consistency across fragmented guidelines. This paper focuses on Phase 1, highlighting targeted interventions to improve and update the HEARTS Clinical Pathway.Methods: First, the coordinating group defined the project´s scope, objectives, principles, methodological framework, and tools. Second, international experts from different disciplines proposed interventions to enhance the HEARTS Clinical Pathway. Third, the coordinating group harmonized these proposals into unique interventions. Fourth, experts appraised the appropriateness of the proposed interventions on a 1-to-9 scale using the adapted RAND/UCLA Appropriateness Method. Finally, interventions with a median score above 6 were deemed appropriate and selected as candidates to enhance the HEARTS Clinical Pathway.Results: Building on the existing HEARTS Clinical Pathway, 45 unique interventions were selected, including community-based screening, early detection and management of risk factors, lower blood pressure thresholds for diagnosing hypertension in high-CVD-risk patients, reinforcement of single-pill combination therapy, inclusion of sodium-glucose cotransporter-2 inhibitors for patients with diabetes, CKD, or heart failure, expanded roles for non-physician health workers in team-based care, and strengthened clinical documentation, monitoring, and evaluation.Conclusion: HEARTS 2.0 Phase 1 identifies key interventions to integrate and improve hypertension and cardiovascular-kidney-metabolic care within primary care, enabling their seamless incorporation into a unified and effective clinical pathway. This process will inform an update to the HEARTS Clinical Pathway, optimizing resources, reducing care fragmentation, improving care delivery, and advancing health equity, thereby supporting global efforts to combat the leading causes of death and disability.
Fil: Rosende, Andres. Pan American Health Organization; Estados Unidos
Fil: Romero, Cesar. University of Emory; Estados Unidos
Fil: DiPette, Donald J.. No especifíca;
Fil: Brettler, Jeffrey. Kaiser Permanente; Estados Unidos
Fil: Van der Stuyft, Patrick. Ghent University; Bélgica
Fil: Satheesh, Gautam. The George Institute For Global Health; Australia
Fil: Perel, Pablo. No especifíca;
Fil: Chapman, Niamh. University Of Sydney; Australia
Fil: Moran, Andrew E.. Columbia University; Estados Unidos
Fil: Schutte, Aletta E.. The George Institute For Global Health; Australia
Fil: Sharman, James E.. Menzies Institute For Medical Research; Australia
Fil: Irazola, Vilma. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
Fil: Huffman, Mark D.. No especifíca;
Fil: Campbell, Norm R. C.. No especifíca;
Fil: Salam, Abdul. No especifíca;
Fil: Lanas, Fernando. No especifíca;
Fil: Coca, Antonio. No especifíca;
Fil: Garcia Zamora, Sebastian. No especifíca;
Fil: Ferreiro, Alejandro. No especifíca;
Fil: Lopez Jaramillo, Patricio. No especifíca;
Fil: Rico Fontalvo, Jorge. No especifíca;
Fil: Ridley, Emily. No especifíca;
Fil: Picone, Dean. No especifíca;
Fil: Flood, David. No especifíca;
Fil: Piñeiro, Daniel José. No especifíca;
Fil: Ojeda, Carolina Neira. No especifíca;
Fil: Rodriguez, Gonzalo. No especifíca;
Fil: Wellmann, Irmgardt A.. No especifíca;
Fil: Orias, Marcelo. No especifíca;
Fil: Rivera, Marcela. No especifíca;
Fil: Reyes, Matías Villatoro. No especifíca;
Fil: Onuma, Oyere. No especifíca;
Fil: Ramroop, Shaun. No especifíca;
Fil: Khan, Taskeen. No especifíca;
Fil: Gonzalez, Yamile Valdes. No especifíca;
Fil: Barroso, Weimar Kunz Sebba. No especifíca;
Fil: Plavnik, Frida L.. No especifíca;
Fil: Zuniga, Eric. No especifíca;
Fil: Grassani, Ana María. No especifíca;
Fil: Tajer, Carlos. No especifíca;
Fil: Zaidel, Ezequiel. No especifíca;
Fil: Marin, Marcos J.. No especifíca;
Fil: Cyr Philbert, Shana. No especifíca;
Fil: Amorin, Ignacio. No especifíca;
Fil: Diaz Aguilera, Miguel Angel. No especifíca;
Fil: Bortolotto, Luiz. No especifíca;
Fil: Avezum, Alvaro. No especifíca;
Fil: Ribeiro, Antonio Luiz P.. No especifíca;
Fil: Tobe, Sheldon. No especifíca;
Fil: Aumala, Teresa. No especifíca;
Fil: Angell, Sonia. No especifíca;
Fil: Lavados, Pablo. No especifíca;
Fil: Martins, Sheila Ouriques. No especifíca;
Fil: Echeverri, Ana Munera. No especifíca;
Fil: Jaffe, Marc G.. No especifíca;
Fil: Prabhakaran, Dorairaj. No especifíca;
Fil: Parati, Gianfranco. No especifíca;
Fil: Zhang, Xin Hua. No especifíca;
Fil: Rodgers, Anthony. No especifíca;
Fil: Yusuf, Salim. No especifíca;
Fil: Whelton, Paul K.. No especifíca;
Fil: Ordunez, Pedro. No especifíca;
description Background: HEARTS in the Americas is the regional adaptation of the WHO Global HEARTS Initiative, aimed at helping countries enhance hypertension and cardiovascular disease (CVD) risk management in primary care settings. Its core implementation tool, the HEARTS Clinical Pathway, has been adopted by 28 countries. To improve the care of hypertension, diabetes, and chronic kidney disease (CKD), HEARTS 2.0 was developed as a three-phase process to integrate evidence-based interventions into a unified care pathway, ensuring consistency across fragmented guidelines. This paper focuses on Phase 1, highlighting targeted interventions to improve and update the HEARTS Clinical Pathway.Methods: First, the coordinating group defined the project´s scope, objectives, principles, methodological framework, and tools. Second, international experts from different disciplines proposed interventions to enhance the HEARTS Clinical Pathway. Third, the coordinating group harmonized these proposals into unique interventions. Fourth, experts appraised the appropriateness of the proposed interventions on a 1-to-9 scale using the adapted RAND/UCLA Appropriateness Method. Finally, interventions with a median score above 6 were deemed appropriate and selected as candidates to enhance the HEARTS Clinical Pathway.Results: Building on the existing HEARTS Clinical Pathway, 45 unique interventions were selected, including community-based screening, early detection and management of risk factors, lower blood pressure thresholds for diagnosing hypertension in high-CVD-risk patients, reinforcement of single-pill combination therapy, inclusion of sodium-glucose cotransporter-2 inhibitors for patients with diabetes, CKD, or heart failure, expanded roles for non-physician health workers in team-based care, and strengthened clinical documentation, monitoring, and evaluation.Conclusion: HEARTS 2.0 Phase 1 identifies key interventions to integrate and improve hypertension and cardiovascular-kidney-metabolic care within primary care, enabling their seamless incorporation into a unified and effective clinical pathway. This process will inform an update to the HEARTS Clinical Pathway, optimizing resources, reducing care fragmentation, improving care delivery, and advancing health equity, thereby supporting global efforts to combat the leading causes of death and disability.
publishDate 2025
dc.date.none.fl_str_mv 2025-05
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/291158
Rosende, Andres; Romero, Cesar; DiPette, Donald J.; Brettler, Jeffrey; Van der Stuyft, Patrick; et al.; Candidate Interventions for Integrating Hypertension and Cardiovascular-Kidney-Metabolic Care in Primary Health Settings: HEARTS 2.0 Phase 1; Ubiquity Press; Global Heart; 20; 1; 5-2025; 1-17
2211-8160
2211-8179
CONICET Digital
CONICET
url http://hdl.handle.net/11336/291158
identifier_str_mv Rosende, Andres; Romero, Cesar; DiPette, Donald J.; Brettler, Jeffrey; Van der Stuyft, Patrick; et al.; Candidate Interventions for Integrating Hypertension and Cardiovascular-Kidney-Metabolic Care in Primary Health Settings: HEARTS 2.0 Phase 1; Ubiquity Press; Global Heart; 20; 1; 5-2025; 1-17
2211-8160
2211-8179
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/https://account.globalheartjournal.com/index.php/up-j-gh/article/view/1428
info:eu-repo/semantics/altIdentifier/doi/10.5334/gh.1428
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Ubiquity Press
publisher.none.fl_str_mv Ubiquity Press
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
_version_ 1874774738882002944
score 13.24418

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