Emory University cardiologist Laurence Sperling, MD, introduced the World Heart Federation's (WHF) new roadmap aimed at reducing the global burden of cardiovascular disease (CVD) in people living with diabetes at the joint European Society of Cardiology (ESC) Congress 2019 and World Congress of Cardiology in Paris on Monday, Sept. 2.
The Roadmap is a key reference document for anyone involved in the planning, organization, implementation, monitoring and evaluation of approaches related to CVD prevention in people living with diabetes. It outlines a vision of an ideal pathway of care, potential roadblocks along this pathway and proposed solutions, with examples from practice.
Rapid urbanization, unhealthy diets and increasingly sedentary lifestyles have resulted in fast-growing rates of obesity and diabetes, with an estimated 425 million people currently living with type 2 diabetes worldwide. Alarmingly, the situation is set to deteriorate further in the coming decades, with the total number of people with diabetes predicted to increase to over 600 million by 2045. It has been estimated that globally, up to 50 percent of people with diabetes are unaware of their disease.
While diabetes is treatable, even when glucose levels are under control it greatly increases the risk of CVD - people with diabetes are two to three times more likely to have increased risk of coronary artery disease, stroke, myocardial infarction and angina pectoris compared to those without diabetes. Prevention of CVD in people with diabetes is a necessity, and preventive strategies predominantly focus on lifestyle management and risk factor interventions.
Developed in partnership with the International Diabetes Federation (IDF), the Roadmap draws on the expertise of diabetes expert clinicians, researchers, implementation science experts and patients from around the world, and presents an integrated approach to patient care, involving the patient perspective, healthcare system perspective and health policy perspective.
Sperling, who is chair of the CVD and Diabetes Roadmap Writing Group and director of the Emory Heart Disease Prevention Center explains, "We have identified important gaps in the care of people living with diabetes who are at high cardiovascular risk, and focused on priorities and key action areas to close these gaps. We also provide an implementation toolkit for successful translation of the Roadmap to national and local initiatives, aiming to ensure that as many people living with diabetes as possible receive optimal preventive care and treatment."
In 2014, the WHF launched an initiative to develop a series of Global Roadmaps, with the aim to identify potential roadblocks on the pathway to effective prevention, detection and management of CVD, along with evidence-based solutions to overcome them. The WHF Global Roadmap on the prevention of CVD among people living with diabetes will be published as open-access in the WHF journal, Global Heart and can also be found at http://www.cvdroadmaps.org.
"Diabetes and its related CVD complications are a huge global issue, says Professor Karen Sliwa, president of the WHF. "All over the world, due to limited resources, countries are struggling to provide the necessary preventive or medical care, with a disproportionate burden falling on low-and middle-income countries. Given the worldwide impact of the epidemic of CVD and diabetes, we decided to take action to address it globally through this new roadmap on the prevention of CVD among people living with diabetes."
The Roadmap publications have become the cornerstone of WHF activities as resources for implementation to guide initiatives to support heart health globally, translating science into policy and influencing agencies, governments and policymakers alike. With this framework, countries can develop or update national non-communicable disease (NCD) programs. The overall aim is to drive efforts within national agendas to meet the ambitious target set out in the UN Sustainable Development Goals: a 30 percent reduction in premature mortality caused by NCDs, including CVD, by 2030.
"In order to be implemented successfully, the CVD and diabetes roadmap requires committed global action," says Sperling. "Launching the Roadmap at the largest cardiovascular congress in the world is the perfect forum to raise awareness of this impactful global epidemic. Our goal is to demonstrate how utilization of this roadmap can help a broad base of stakeholders begin to tackle the problem and make a longstanding difference."