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

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dc.contributor.authorRosende, Andres
dc.contributor.authorRomero, Cesar
dc.contributor.authorDiPette, Donald
dc.contributor.authorBrettler, Jeffrey
dc.contributor.authorVan der Stuyft, Patrick
dc.contributor.authorSatheesh, Gautam
dc.contributor.authorPerel, Pablo
dc.contributor.authorChapman, Niamh
dc.contributor.authorMoran, Andrew
dc.contributor.authorSchutte, Aletta
dc.contributor.authorSharman, James
dc.contributor.authorIrazola, Vilma
dc.contributor.authorHuffman, Mark
dc.contributor.authorCampbell, Norm
dc.contributor.authorSalam, Abdul
dc.contributor.authorLanas, Fernando
dc.contributor.authorCoca, Antonio
dc.contributor.authorGarcia, Sebastian
dc.contributor.authorFerreiro, Alejandro
dc.contributor.authorLopez, Patricio
dc.contributor.authorRico, Jorge
dc.contributor.authorRidley, Emily
dc.contributor.authorPicone, Dean
dc.contributor.authorFlood, David
dc.contributor.authorPiñeiro, Daniel
dc.contributor.authorNeira, Carolina
dc.contributor.authorRodriguez, Gonzalo
dc.contributor.authorWellmann, Irmgardt
dc.contributor.authorOrias, Marcelo
dc.contributor.authorRivera, Marcela
dc.contributor.authorVillatoro, Matías
dc.contributor.authorOnuma, Oyere
dc.contributor.authorRamroop, Shaun
dc.contributor.authorKhan, Taskeen
dc.contributor.authorValdes, Yamile
dc.contributor.authorKunz, Weimar
dc.contributor.authorPlavnik, Frida
dc.contributor.authorZuniga, Eric
dc.contributor.authorGrassani, Ana
dc.contributor.authorTajer, Carlos
dc.contributor.authorZaidel, Ezequiel
dc.contributor.authorMarin, Marcos
dc.contributor.authorCyr-Philbert, Shana
dc.contributor.authorAmorin, Ignacio
dc.contributor.authorDiaz, Miguel
dc.contributor.authorBortolotto, Luiz
dc.contributor.authorAvezum, Alvaro
dc.contributor.authorRibeiro, Antonio
dc.contributor.authorTobe, Sheldon
dc.contributor.authorAumala, Teresa
dc.contributor.authorAngell, Sonia
dc.contributor.authorLavados, Pablo
dc.contributor.authorOuriques, Sheila
dc.contributor.authorMunera, Ana
dc.contributor.authorJaffe, Marc
dc.contributor.authorPrabhakaran, Dorairaj
dc.contributor.authorParati, Gianfranco
dc.contributor.authorZhang, Xin Hua
dc.contributor.authorRodgers, Anthony
dc.contributor.authorYusuf, Salim
dc.contributor.authorWhelton, Paul
dc.contributor.authorOrdunez, Pedro
dc.date.accessioned2026-08-27T17:37:32Z
dc.date.available2026-08-27T17:37:32Z
dc.date.issued2025
dc.description.abstractBackground: 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.
dc.description.versionVersión Publicada
dc.identifier.citationRosende A, Romero C, DiPette DJ, Brettler J, Van der Stuyft P, Satheesh G, Perel P, Chapman N, Moran AE, Schutte AE, Sharman JE, Irazola V, Huffman MD, Campbell NRC, Salam A, Lanas F, Coca A, Garcia-Zamora S, Ferreiro A, Lopez-Jaramillo P, Rico-Fontalvo J, Ridley E, Picone D, Flood D, Piñeiro DJ, Ojeda CN, Rodriguez G, Wellmann IA, Orias M, Rivera M, Reyes MV, Onuma O, Ramroop S, Khan T, Gonzalez YV, Barroso WKS, Plavnik FL, Zuniga E, Grassani AM, Tajer C, Zaidel E, Marin MJ, Cyr-Philbert S, Amorin I, Diaz Aguilera MA, Bortolotto L, Avezum A, Ribeiro ALP, Tobe S, Aumala T, Angell S, Lavados P, Martins SO, Echeverri AM, Jaffe MG, Prabhakaran D, Parati G, Zhang XH, Rodgers A, Yusuf S, Whelton PK, Ordunez P. Candidate Interventions for Integrating Hypertension and Cardiovascular-Kidney-Metabolic Care in Primary Health Settings: HEARTS 2.0 Phase 1. Glob Heart. 2025 May 27;20(1):45. doi: 10.5334/gh.1428
dc.identifier.doihttps://doi.org/10.5334/gh.1428
dc.identifier.urihttps://hdl.handle.net/11447/11044
dc.language.isoen
dc.subjectCardiovascular Diseases
dc.subjectChronic
dc.subjectPrimary Health Care
dc.subjectRenal Insufficiency
dc.subjectStroke
dc.subjectdiabetes mellitus
dc.subjecthypertension.
dc.titleCandidate Interventions for Integrating Hypertension and Cardiovascular-Kidney-Metabolic Care in Primary Health Settings: HEARTS 2.0 Phase 1
dc.typeArticle
dcterms.accessRightsAcceso Abierto
dcterms.sourceGlobal heart
dspace.entity.typePublication
relation.isAuthorOfPublicationce883977-0c50-41ce-a8ce-8adb22c2d09b
relation.isAuthorOfPublication.latestForDiscoveryce883977-0c50-41ce-a8ce-8adb22c2d09b

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