The world is facing a syndemic of COVID-19 paired with the growing tide of cardiovascular diseases - and cities play an ever more essential role in determining the health outcomes of populations. The Novartis Foundation and its partners pioneered a new strategy called CARDIO for addressing cardiovascular risk factors and cardiovascular disease prevention in low-income urban settings.

Infographic showing Cardio Approach with 6 Pillars: Improve quality of CARE, Early ACCESS to health and care, REFORM policies with proven health benefit, Leverage DATA and DIGITAL technology, Create INTER-SECTORAL collaboration, Ensure local OWNERSHIP

This toolkit starts with a needs assessment to discover what policies exist, understand the population at risk, map the patient pathway, and understand what barriers prevent progress toward achieving the priorities of a city's priorities in its efforts to improve cardiovascular (CV) health.

The CARDIO approach presented in this Urban Population Health Toolkit provides insights, evidence-based strategies, tools and best practices to improve early detection and management of the main risk factor for CVD - hypertension (high blood pressure). The toolkit will constantly introduce new learnings and tools as they become available, while we expand our approach toward lowering the overall CV risk in urban populations.

See top interventions from the CARDIO Approach

Physician with a stethoscope listening to a female patient's heart

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Once you have completed the needs assessment explore the six-step CARDIO approach to plan your journey to better heart health.

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CARDIO: A six-pillar strategy for reducing heart disease 

Cardiovascular diseases (CVD) exact a growing toll on global public health, with most of the burden now falling on low- and middle-income countries (LMICs). At the same time, the trend of rapid, often unplanned urbanization spans across regions and cultures, and will only accelerate in coming years. With urbanization drawing people to cities, LMICs are registering new cases of heart disease at alarming rates and health systems are struggling to keep up. This makes cities an ideal proving ground for innovating the way we approach cardiovascular (CV) population health.

Through Better Hearts Better Cities, the Novartis Foundation and partners established and validated a comprehensive approach toward improving CV health in urban populations.

The approach consists of six pillars, called CARDIO, shorthand for quality of Care, Access, policy Reform, Data and Digital, Intersectoral collaboration, and Ownership. This proved to be a recipe for success in terms of both health and economic impact.

Physician wearing a mask, with a stethoscope listening to a female patient's heart

Quality of care

Improving hypertension management with streamlined protocols and training of healthcare professionals.
Woman wearing a mask measures blood pressure of a young man at a hair salon in Vietnam

Ensure access

Bringing health and care closer to where people live and work and engaging non-health players.
Woman reading in a flyer about blood pressure measurement

Policy reform

Governments should enforce strategies and reforms, taxation and incentive structures, to address the growing burden of cardiovascular disease.
Image showing telemedicine employees in Ghana at their workplace

Leverage data and digital technology

Beside the collection and use of real-time data, digital technology provides an array of opportunities to transform the way health and care are delivered.
Two children playing soccer on a soccer court

Intersectoral collaboration

Public- and private-sector stakeholders from across society are all playing a role in fighting hypertension.
Image of a fruit seller standing in front of a fruit stand

Ensure local ownership

Local authorities and local partners should own the design, implementation and monitoring of interventions and solutions to fight hypertension and cardiovascular disease.

Acknowledgements

Agência tellus, American Heart Association, Associação Samaritano, Atenção Primária à Saúde Santa Marcelina, G.R.C. Escola de Samba Leandro de Itaquera, intel, IntraHealth International, IQVIA, KaziBantu - Healthy Schools for Healthy Communities, Ministère de la santé et de l'Action Sociale, Ministry of Health, Mongolian Public Health Professionals' Association, Nelson Mandela University, Onom Foundation, PATH, Prefeitura de São Paulo Educação, Prefeitura de São Paulo Saúde, Province of the Eastern Cape Education, Province of the Eastern Cape Health, Responsabilidade Social Corinthians, SBH - Sociedade Brasileira de Hipertensão, SOCESP - Sociedade de Cardiologia do Estado de São Paulo, Swiss TPH - Swiss Tropical and Public Health, Institute, University of Basel