Jan 05, 2023
  • Programs on three continents – in São Paulo, Dakar and Ulaanbataar – at least tripled blood pressure control rates, the prime risk factor for heart disease, within two years.
  • ‘CARDIO4Cities’ population health approach creates innovative citywide interventions to improve access to, and quality of, cardiovascular care, ranging from partnerships with football and samba clubs to increase early detection of cardiovascular disease, to new clinical guidelines and data systems to improve its management.
  • Experts say efficient roll out of public private partnerships such as this are urgent to address cardiovascular disease, the world’s leading cause of death, claiming almost 18 million lives every year.

Basel, January 5, 2023 - A new urban population health approach to tackle cardiovascular disease has led to significant improvements in blood pressure control rates in the cities where it was rolled out, according to a study published in the journal BMC Public Health.

The paper describes the results of implementing CARDIO4Cities, an urban population health approach developed by the Novartis Foundation and rolled out with local city authorities, illustrating how control rates for high blood pressure – the prime risk factor for heart disease –tripled or more within one to two years of implementation.

In São Paulo, Brazil, blood pressure control increased from 12.3% to 31.2%, in Dakar, Senegal, from 6.7% to 19.4% and in Ulaanbaatar, Mongolia, from 3.1% to 19.8%.

The CARDIO4Cities approach creates a series of citywide interventions to tackle hypertension and its underlying determinants through improved access to, and quality of care. These interventions in partnership with public authorities strengthened the health system through standardized evidence-based management of cardiovascular risk, a dedicated focus on data collection and use, and policy reform. Early detection of high blood pressure was optimized both within and outside the health facilities in partnership with non-traditional health players such as football and samba clubs.

Cardiovascular disease is the leading cause of death worldwide, claiming almost 18 million lives per year, of which three-quarters occur in low- and middle-income countries.

Dr Ann Aerts, Head of the Novartis Foundation and a study author, said it is urgent to replicate successful public private partnerships that improve cardiovascular population health: “Cardiovascular disease and health inequity are two of the burning issues of our time. The CARDIO4Cities approach has demonstrated we can improve heart health rapidly and affordably, and help governments narrow health inequities in the populations they serve.”

The approach has now expanded in São Paulo and Dakar to reduce overall cardiovascular risk factors, including obesity, diabetes and high cholesterol, in addition to hypertension, and is also being rolled out in Ho Chi Minh City, Vietnam.

CARDIO4Cities has also informed a three-year collaboration between Novartis Pharmaceuticals Corporation, and Thomas Jefferson University and Jefferson Health in Philadelphia, USA, to address inequities contributing to poor cardiovascular outcomes; and AI4HealthyCities, a network of major cities using data and artificial intelligence to improve urban heart equity, which launched in New York last September and is coordinated by the Novartis Foundation.

“During the implementation of CARDIO4Cities we were able to see the importance of data in driving the decision-making process. It enabled health authorities to fine-tune the population health interventions, and ensured the initiative targeted the greatest number of people at risk,” Aerts added.

“At the Novartis Foundation, we are now going one step further, working with other cities around the world, and using data, advanced analytics and artificial intelligence to decipher the underlying drivers of health and inequity. This, in turn, will deliver data driven insights that can help decision makers address health inequities more effectively.”

About the CARDIO4cities approach

CARDIO4Cities applied a simple comprehensive strategy based on six CARDIO pillars – shorthand for quality of Care, early Access, policy Reform, Data and digital technology, Intersectoral collaboration, and local Ownership. CARDIO4Cities are programs developed in conjunction with local authorities, the health sector and private sector partners. These stakeholders work together to explore unmet needs in response to hypertension and other cardiovascular risks. The intervention design was informed by a combination of best practices for hypertension and heart disease management, such as the WHO HEARTS package, the Measure Accurately, Act Rapidly, and Partner With Patients Protocol (M.A.P.) and the World Heart Federation roadmap to reduce high blood pressure, as well as local policies, guidelines and data. A key intervention was standardizing hypertension diagnosis and management for primary health providers. This was rolled out, through clinical decision support systems and online continuous medical education. The program engaged non-traditional health players such as sports clubs, dance clubs, schools and workplaces. This maximized opportunities for hypertension detection and increased opportunities for understanding of cardiovascular risk. In some instances, it even included increasing opportunities for physical exercise or healthy food options in the city.

About the Novartis Foundation

The Novartis Foundation is a non-profit organization based in Switzerland. For over 40 years, we have helped improve the health of low-income populations, initially supporting disease elimination in areas such as leprosy and malaria. Today, we tackle the burning issues of our time, cardiovascular diseases and health inequity. We take a population health approach, which means bringing together existing but disconnected data to help authorities understand the root causes of unequal health outcomes, and define the best ways and best partners to remediate those. This empowers governments to transform their health systems from being reactive to proactive, predictive and preventative, and achieve health equity among the populations they serve.


The Novartis Foundation is on Twitter at @NovartisFDN

Novartis Foundation Media Relations

Contact: Carolyn Canham

Tel: +41 79 334 4325

Email: [email protected]