Cardiovascular diseases continue to be the leading cause of death in the Region of the Americas, accounting for more than 2.2 million deaths annually, and pose a critical challenge to health systems, economic development, and social equity. The absolute number of cases has continued to rise, while the decline in mortality has slowed since the mid-2010s, jeopardizing progress toward the goal of reducing premature mortality from noncommunicable diseases by 30% by 2030. Hypertension, the leading modifiable risk factor, continues to show significant gaps in diagnosis, treatment, and control, limiting this progress and underscoring the need to persist in transforming care models through a strategic and operational approach based on primary health care.
HEARTS in the Americas has become the largest global implementation of the World Health Organization’s HEARTS initiative, led by the Ministries of Health of the Region with technical cooperation from the Pan American Health Organization. Currently implemented in 30 countries and more than 10 000 primary health care facilities, the program promotes an innovative model that uses population-based hypertension control as an entry point for the integrated management of cardiovascular, renal, and metabolic risk. Through the standardization of clinical pathways and the implementation of continuous quality improvement strategies, HEARTS is progressively transforming the organization and performance of health services.
The Special Issue of the Pan American Journal of Public Health dedicated to HEARTS in the Americas aims to document and disseminate evidence on the impact of this initiative on health outcomes and on the transformation of health systems in the Region. Through studies, implementation experiences, and quality improvement analyses, this special issue reflects the work of the HEARTS community of practice and seeks to help accelerate hypertension control and reduce the burden of cardiovascular, renal, and metabolic disease in the Americas.