Nursing Strategies to Decrease the Global Burden of Cardiovascular Disease

Cardiovascular disease (CVD) is the leading cause of death throughout the world.  Rates of CVD have been increasing globally as a result of population aging, urbanization and globalization.  The importance of CVD and other chronic diseases will be discussed, along with global trends. Risk factors for CVD are known and similar throughout the world – unhealthy diet, physical inactivity, and tobacco use -which contribute to elevated blood pressure and blood glucose, abnormal blood lipids, and overweight/obesity.  The importance of these risk factors will be highlighted. These same risk factors are also important in terms of stroke, cancer, chronic respiratory diseases and diabetes. Importantly most risk factors can be prevented or modified. Myths (where and among whom chronic diseases are concentrated, focus on infectious diseases, age- and gender-related effects, causes, effects of prevention, expense, and inevitability) regarding chronic disease will be presented, along with the evidence showing the effectiveness of risk factor modification. Interventions to decrease both CVD and its complications have been developed and have shown to be successful.  The concept of prevention (primordial, primary, and secondary), ideal cardiovascular health, and behavior will be discussed in order to provide a basis for specific interventions. The research evidence will be presented (according to population studied, conceptual framework, design, intervention components, measures and outcomes) and synthesized, highlighting areas of strength (use of cognitive behavioral therapy, treatment, disease management, coaching and use of e-Health) and those areas in need of further development (measures of self-care/self-management, duration of interventions, content, and outcomes addressed). These findings will serve as a basis for nursing interventions aimed at reducing the risk of CVD and its complications in Africa. Potential barriers to implementation of evidence-based care aimed at CVD risk reduction will be discussed. Areas for future nursing research, nursing education, clinical practice and for public policy aimed at decreasing the burden of CVD will be highlighted.