BIREME Bulletin n° 68

HEARTS Initiative seeks to reduce cardiovascular disease in the Americas

Cardiovascular Diseases are the leading cause of death in the Americas, and arterial hypertension is responsible for more than 50% of these. Unfortunately, more than a quarter of adult women and four out of ten adult men are hypertensive on the American continent, and both diagnosis and treatment and control have been ineffective. Only a few countries have a population hypertension control rate greater than 50%.

To draw attention to this serious health problem, World Hypertension Day was established on May 17th. The World Health Organization (WHO) launched the Global HEARTS Initiative in 2016. Its aim is to improve clinical prevention services in primary health care using highly effective, scalable, sustainable, and proven interventions. As the WHO Regional Office for the Americas, the Pan American Health Organization (PAHO) develops and coordinates the HEARTS Initiative in the Americas with one goal: by 2025, HEARTS will be the institutionalized model for risk management of cardiovascular diseases, including hypertension, diabetes, and dyslipidemia in primary health care in the Americas. The HEARTS Americas Initiative is entering its sixth year of implementation, having expanded from the initial 4-country project to 22 countries that are currently implementing the HEARTS model. [1]

To mark the date this year, PAHO/WHO, through the HEARTS in the Americas initiative and in collaboration with The Lancet Regional Health – Americas, held a webinar that highlighted the problem of low awareness of hypertension in the world. The event also promoted the use of accurate blood pressure measurement methods and addressed the importance of controlling hypertension to live better and healthier lives. [2]

Arterial hypertension, or high blood pressure, is a disease that affects the blood vessels, heart, brain, and eyes, and can damage the kidneys. It occurs when blood pressure frequently remains above 140 over 90 mmHg. The disease is inherited from parents in 90% of cases, but there are several factors that influence blood pressure levels, including smoking, alcohol consumption, obesity, stress, excess salt consumption, high cholesterol levels, and lack of physical activity. [3]

High blood pressure has no cure, but it is treatable and can be controlled. Only healthcare professionals can determine the best treatment method for each patient. However, in addition to the medicines currently available, it is essential to adopt a healthy lifestyle, maintain an appropriate body weight, if necessary, change eating habits, not abuse salt consumption, use other seasonings that enhance the taste of food, practice regular physical activity, enjoy leisure time; quit smoking, moderate alcohol consumption, avoid fatty foods, and control diabetes. [4]


The HEARTS Initiative in the Americas aims to reduce the rate of cardiovascular diseases

With the goal of reducing the rate of cardiovascular disease, WHO launched the HEARTS Initiative in the Americas in 2016. PAHO/WHO coordinates the HEARTS initiative in the Americas, through 1,400 health facilities in 22 countries throughout the Region of the Americas. The journal Lancet Regional Health – Americas published two articles related to the initiative in its May issue of this year. One of the articles [5] provides specific recommendations to highlight the facilitating role of the HEARTS Initiative in the Americas, with the intention of catalyzing the implementation of the new WHO guideline on the pharmacological treatment of hypertension. The second deals with the implementation of eight key drivers for hypertension control, a set of clinical and management recommendations to guide program implementation and improve hypertension control. [6]

To provide scientific and technical information to health professionals, researchers, and the general public on hypertension, BIREME/PAHO/WHO developed the Window of Knowledge Hypertension, available in Portuguese, Spanish and English.



[1] Pan American Health Organization. HEARTS in the Americas: Guide and Essentials for Implementation. 2022. Available at: (only in English).

[2] Webinar – World Hypertension Day: Measure your blood pressure accurately, control it, and live longer! – Watch the recording on the PAHO/WHO YouTube Channel (in Portuguese)

[3] Pan American Health Organization – Health Topics – Hypertension. Available at: (in Spanish and English).

[4] World Hypertension Day 2022 –

[5] Campbell NRC et al. 2021 World Health Organization guideline on pharmacological treatment of hypertension: Policy implications for the region of the Americas. The Lancet Regional Health – Americas. 2022; 9:100219. 

[6] Brettler JW et al. Drivers and scorecards to improve hypertension control in primary care practice: Recommendations from the HEARTS in the Americas Innovation Group. The Lancet Regional Health – Americas. 2022; 9: 100223.


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