Cardiovascular disease

WHO CVD-risk management package for low- and medium-resource settings

Overview

The package has been designed primarily for the management of cardiovascular risk in individuals detected to have hypertension through opportunistic screening. However, it could be adapted for use with diabetes or smoking as entry points. The package is meant to be implemented in a range of health-care facilities in low- and medium-resource settings, in both developed and developing countries, and for this reason it has been designed for three scenarios that reflect the commonly encountered resource availability strata in such settings. The minimum conditions that characterize the three scenarios, in terms of the skill-level of the health worker and the diagnostic and therapeutic facilities and health services available, are described in Table 1. Before implementing the package, the health-care centres in primary, secondary and tertiary health-care levels should be categorized into one of the three scenarios, depending on the level of available facilities (see Table 1). Thereafter, the respective protocols and referral pathways should be used for CVD risk assessment and management. While the basic elements of the package remain the same across the three scenarios, the specific thresholds for clinical intervention differ across the three resource settings according to the level of personnel and facilities available. Furthermore, given the variability of conditions across countries and/or geographical areas, the tools of the package may need to be adapted to local needs.

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