Cardiovascular diseases are the leading cause of death and disability globally. Out of 54 million deaths each year, one-third (18 million) are caused by some form of cardiovascular disease. As of 2015, there are an estimated 422 million individuals living with prevalent cardiovascular diseases, with 7 million fatal heart attacks and 9 million fatal strokes each year. Most (80 percent) events occur in low- or middle-income country settings where they are also more likely to occur prematurely (younger than 70 years).
The Center for Global Cardiovascular Health aims to bridge the gap between the world we live in and the world we aim to get to. Imagine a world where every person who has an acute cardiovascular event receives timely, high-quality care no matter where they live, where individuals with cardiovascular disease are supported to optimize their health behaviors and adherence to simpler, lower-cost medications that are tailored to their needs, where the food supply supports cardiovascular health and almost no one uses tobacco. This picture is very different than the world in which we live where individuals who have acute cardiovascular diseases receive highly heterogeneous care, where most individuals with cardiovascular disease take zero medications to prevent a recurrent event, where the food supply is rife with junk food and where 20 percent of the world uses tobacco.
At the Center for Global Cardiovascular Health, we seek to improve cardiovascular health and health equity for individuals and populations worldwide by investing in innovative research, interdisciplinary education, and collaborative partnerships."
– Lisa Hirschhorn, MD, MPH, Interim Director, Center for Cardiovascular Health
"Cardiovascular Research Training in Nigeria (CeTRIN) - NHBLI – D43"
Northwestern Faculty: Mark D Huffman, MD, MPH, Lisa Hirschhorn, MD MPH, Leah C Neubauer, EdD, MA
The program will leverage existing investments by the NIH at both institutions to foster timely and relevant research using a contemporary, adult-learning theory-based approach to strengthen Cardiovascular research at Univeristy of Abuja, Nigeria.
Northwestern Faculty and Staff: Mark Huffman, MD, MPH; Lisa Hirschhorn, MD, MPH; Abigail Baldridge, MS; Namratha R Kandula, MD, MPH; C. Hendricks Brown,
This project will contextualize, implement and evaluate the effect of a large-scale, multi-level hypertension control program intervention in 50 primary health centers in Nigeria in partnership with the University of Abuja and Resolve to Save Lives.
"Designing an implementation science clinical trial to Integrate hypertension and cardiovascular diseases care into existing HIV services package in Botswana (InterCARE)"
Northwestern PIs: Lisa Hirschhorn, MD, MPH; Amelia E. Van Pelt, PhD, MPH
Hypertension is one of the leading contributors of excess risk of heart attacks and strokes among the 36 million people living with HIV (PLWHIV) globally. The hypertension care cascade among PLWHIV has major deficits when compared to the HIV care cascade of 90:90:90. InterCARE is being conducted in Botswana, to leverage a successful national ART program and infrastructure of a recently completed CDC/NIH funded HIV prevention trial to develop an implementation strategy, and then use the new implementation strategy to conduct a type 2 hybrid multi-component cluster randomized trial to optimize evidence based implementation (EBI) uptake and improvement in the hypertension cascade among adults with dual diagnosis of HIV and Hypertension.
Northwestern Key Personnel: Mark Huffman, MD, MPH, Lisa Hirschhorn, MD, MPH, Linda Van Horn, PhD, RD,
Partner Institutions: The University of Abuja and Washington University in St.Louis.
Nearly half of Nigerian adults have hypertension, and Nigeria has announced a national sodium reduction program for population-level hypertension prevention and control based on the WHO’s best buy SHAKE package. Using a type 3 hybrid study design and the EPIS, CFIR, and RE-AIM frameworks, we will perform a baseline health needs assessment (UG3 phase) and follow-up assessments (UH3 phase) using stakeholder interviews, population surveys, and retail surveys. This embedded study will optimize local, regional, and national implementation and will provide generalizable knowledge about implementation strategies to lower dietary sodium intake at scale. This grant is part of the Global Alliance for Chronic Diseases.
Faculty and Staff: Mark Huffman, MD, MPH; Abigail Baldridge, MS; Linda Van Horn, PhD, RD
FoodSwitch is a mobile phone application developed by The George Institute for Global Health for download for iOS and Android devices in nine countries to help consumers make healthier choices at the point of purchase. Data within the FoodSwitch system are also used for surveillance of the packaged food supply to help enable healthier food environments.
"Acute Coronary Syndrome Quality Improvement in Kerala"
Northwestern Faculty and Staff: PI Mark Huffman, MD, MPH; Abigail Baldridge, MS; Donald M. Lloyd-Jones, MD, ScM; Lihui Zhao, PhD
This stepped wedge, cluster randomized trial was the largest cardiovascular randomized trial in India and demonstrated improvements in process measures among 21,374 patients with heart attacks who were recruited from 63 hospitals in Kerala, India, from 2014 to 2016. The trial also reported health-related quality of life and individual- and household-level costs among heart attack survivors and served as a training hub/model for seven Fogarty-funded Northwestern global health fellows.
"World Heart Federation Salim Yusuf Emerging Leaders Programme"
Northwestern Faculty and Staff: Mark Huffman, MD, MPH; Darwin Labarthe, MD, PhD, MPH; Abigail Baldridge, MS; Namratha R. Kandula, MD, MPH
This first-of-its-kind training program in implementation science, health systems and health policy was co-created by Huffman, Labarthe and Salim Yusuf in 2014. The program has trained 125 Emerging Leaders from 49 countries over its first five years and features a rotating theme each year.
Northwestern Faculty: Mark Huffman, MD, MPH
The Center for Global Cardiovascular Health aims to improve access to essential cardiovascular medicines by working through the World Health Organization and national model lists of essential medicines and has contributed to the addition of clopidogrel and direct oral anticoagulants to the World Health Organization list, among other changes. An independent study course is offered through the Program in Public Health for students to develop and submit applications to the World Health Organization’s list on a biennial basis.
Northwestern faculty: Juned Siddique, DrPH
The goal of this project is to develop collaborations with scientists at the CRONICAS Center of Excellence in Chronic Diseases at the Universidad Peruana Cayetano Heredia on the design, implementation and analysis of large-scale pragmatic clinical trials for the prevention and treatment of chronic diseases in vulnerable populations. Siddique will accomplish this through statistical consulting, teaching, analysis of existing CRONICAS data and statistical methods development. The long-term goal of this exchange is to start a relationship between Northwestern University and UPCH and encourage the exchange of fellows, students and faculty between the two institutions.
Funding: Fulbright U.S. Scholar Award, 2019-2020
Partners: CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia
Northwestern Faculty and Staff: PI Mark Huffman, MD, MPH, and Jody D Ciolino, PhD; Abigail Baldridge, MS; Namratha R. Kandula, MD, MPH; Donald M. Lloyd-Jones, MD, ScM; Stephen D. Persell, MD, MPH; James Paparello, MD; Swapna Dave, MPH, PMP, MBBS; Sadiya Khan, MD, MS; Mianzhao Guo.
QUARTET USA is a phase II randomized trial testing the effect of a four-drug, quarter-dose blood pressure lowering combination among individuals with hypertension in federally qualified health centers in Chicago as part of the global QUARTET program (trial ongoing in Australia and in development in The Netherlands and Japan). This trial represents a reverse innovation of using fixed-dose combination, or polypill, therapy for cardiovascular disease prevention within a U.S. population that bears one of the highest burdens of hypertension-related illness in the world.
Cardiovascular diseases and stroke are the leading cause of death and disability in most countries in the world, as they have been over many decades. To address this global health challenge, the seminars were founded in 1968 by Professors Jeremiah and Rose Stamler and Richard Remington from the USA, and Professor Geoffrey Rose from the UK. Initial support was provided by the International Society and Federation of Cardiology (since 1998, World Heart Federation) Council on Epidemiology and Prevention and the Cardiovascular Disease Unit of the World Health Organization in Geneva. From 2008, the sponsor has been the International Society of Cardiovascular Disease Epidemiology and Prevention (ISCEP). The 50th International Seminar was convened in Goa, India, in 2018, and plans are being made for the 51st and beyond.
