Table 1.1Essential Package of Interventions: Interventions Targeted Toward the Prevention or Management of Shared Risk Factors for Cardiovascular and Respiratory Disease

ConditionFiscal interventionsIntersectoral interventionsPublic health interventionsPersonal health services, by delivery platform
Community basedPrimary health centerFirst-level hospitalReferral and specialized hospitals
All conditions1. Large excise taxes on tobacco productsa
2. Product taxes on sugar-sweetened beverages		3. Improvements to the built environment to encourage physical activityb
4. School-based programs to improve nutrition and encourage physical activity
5. Regulations on advertising and labeling tobacco products
6. Actions to reduce salt content in manufactured food products
7. Ban on trans fatty acids		8. Nutritional supplementation for women of reproductive agec
9. Use of mass media concerning harms of specific unhealthy foods and tobacco products		10. Use of community health workers to screen for CVRD using non-lab-based tools for overall CVD risk, improving adherence, and referral to primary health centers for continued medical management11. Opportunistic screening for hypertension for all adultsd
12. Screening for diabetes in all high-risk adults,e including pregnant women
13. Combination therapyf for persons with multiple risk factors to reduce risk of CVD		14. Tobacco cessation counseling and use of nicotine replacement therapy in certain circumstances—

Note: Red type denotes urgent care; blue type denotes continuing care; black type denotes routine care. — = none; CVRD = cardiovascular and respiratory disease; CVD = cardiovascular disease; ACEi = angiotensin-converting-enzyme inhibitors.

a

For fiscal and intersectoral policies that address CVRD attributable to indoor and outdoor sources of air pollution, see chapter 1 of DCP3 volume 7.

b

Data are from high-income countries only.

c

Aimed at preventing gestational diabetes and low birthweight.

d

Treatment with generic drugs is recommended, guided by the severity of hypertension or the presence of additional risk factors.

e

High risk is typically defined as individuals who are older, have high blood pressure, or are overweight or obese (as measured for example by waist circumference).

f

Where available, fixed dose combination therapy is preferred.

From: Chapter 1, Cardiovascular, Respiratory, and Related Disorders: Key Messages and Essential Interventions to Address Their Burden in Low- and Middle-Income Countries

Cover of Cardiovascular, Respiratory, and Related Disorders
Cardiovascular, Respiratory, and Related Disorders. 3rd edition.
Prabhakaran D, Anand S, Gaziano TA, et al., editors.
© 2017 International Bank for Reconstruction and Development / The World Bank.

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