{
  "abstract": "WHO’s Global HEARTS is the largest worldwide effort to improve hypertension control through standardised care. HEARTS in the Americas is its regional adaptation. To address the rising burden of cardiovascular, kidney and metabolic conditions, the initiative launched HEARTS 2.0, aiming to promote integrated care, reduce fragmentation and improve quality, access and health outcomes. In phase I, an expert-led consensus identified 45 evidence-based interventions for inclusion in an expanded Clinical Pathway. This report presents findings from phase II on the readiness of 26 Latin American and Caribbean countries to implement these interventions. We used a cross-sectional design and a structured, self-administered questionnaire completed by national implementation teams. It systematically assessed the availability, feasibility, time required and key barriers for each proposed intervention. While many interventions, especially for risk assessment and non-pharmacological treatments, are considered feasible in many countries, their current availability is limited due to ongoing shortages of diagnostics, medicines and infrastructure. Over the next 3 years, 18 countries are projected to implement >30 of the 45 interventions, four countries aim to implement 20–30 and four expect to implement fewer than 20. While primary health systems in most HEARTS-implementing countries do not yet appear ready to deliver integrated cardiovascular, kidney and metabolic care, the scale-up of HEARTS 2.0 presents a strong opportunity to advance this integration. As health systems worldwide face the challenge of increasing multimorbidity in their patients and fragmented care delivery systems, this assessment offers a practical tool for planning and action.",
  "authors": [
    {
      "affiliations": [
        "Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization, Washington, District of Columbia, USA"
      ],
      "name": "Pedro Ordunez"
    },
    {
      "affiliations": [
        "Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization, Washington, District of Columbia, USA"
      ],
      "name": "Andres Rosende"
    },
    {
      "affiliations": [
        "Kaiser Permanente Bernard J Tyson School of Medicine, Pasadena, California, USA"
      ],
      "name": "Jeffrey Brettler"
    },
    {
      "affiliations": [
        "Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization, Washington, District of Columbia, USA"
      ],
      "name": "Esteban Londono"
    },
    {
      "affiliations": [
        "Public Health and Primary Care, Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium"
      ],
      "name": "Patrick Van der Stuyft"
    },
    {
      "affiliations": [
        "Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization, Washington, District of Columbia, USA"
      ],
      "name": "Ramon Martinez-Piedra"
    },
    {
      "affiliations": [
        "Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization, Washington, District of Columbia, USA"
      ],
      "name": "Libardo Rodriguez"
    },
    {
      "affiliations": [
        "Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization, Washington, District of Columbia, USA"
      ],
      "name": "Mariana Lisbeth Rodriguez de la Cerda"
    },
    {
      "affiliations": [
        "Ministry of Health of Grenada, Saint George, Grenada"
      ],
      "name": "Kerry-Ann Renaud-Thomas"
    },
    {
      "affiliations": [
        "Universidad San Ignacio de Loyola, Lima District, Lima Region, Peru"
      ],
      "name": "Vicente Aleixandre Benites-Zapata"
    },
    {
      "affiliations": [
        "Pan American Health Organization Venezuela, Caracas, Dto. Capital, Bolivarian Republic of Venezuela"
      ],
      "name": "Yadexy Carbay"
    },
    {
      "affiliations": [
        "Government of the Republic of Trinidad and Tobago Ministry of Health, Port of Spain, Trinidad and Tobago"
      ],
      "name": "Maria Clapperton"
    },
    {
      "affiliations": [
        "National Center for Preventive Programs and Disease Control (CENAPRECE), Ministry of Health of Mexico, Mexico City, Mexico"
      ],
      "name": "Miguel Angel Diaz Aguilera"
    },
    {
      "affiliations": [
        "Ministry of Health and Sport, La Paz, La Paz Department, Plurinational State of Bolivia"
      ],
      "name": "Roxana Salamanca Kacic"
    },
    {
      "affiliations": [
        "Turks and Caicos Islands Ministry of Health, Cockburn Town, Turks Islands, Turks and Caicos Islands"
      ],
      "name": "Leeann Sills"
    },
    {
      "affiliations": [
        "Ministry of Public Health of Cuba, Havana, Cuba"
      ],
      "name": "Salvador Tamayo Muñiz"
    },
    {
      "affiliations": [
        "Ministry of Health of Brazil, Brasilia, Brazil"
      ],
      "name": "Hannah Carolina Tavares Domingos"
    },
    {
      "affiliations": [
        "Anton de Kom University of Suriname, Paramaribo, Paramaribo District, Suriname"
      ],
      "name": "Jerry Toelsie"
    },
    {
      "affiliations": [
        "Ministry of Public Health of Cuba, Havana, Cuba"
      ],
      "name": "Yamile Valdes Gonzalez"
    },
    {
      "affiliations": [
        "Government of Argentina Ministry of Health, Buenos Aires, Argentina"
      ],
      "name": "Natalia Vensentini"
    },
    {
      "affiliations": [
        "Republic of El Salvador Ministry of Health, San Salvador, San Salvador Department, El Salvador"
      ],
      "name": "Matias Villatoro"
    },
    {
      "affiliations": [
        "Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA",
        "Department of Medicine, Columbia University Medical Center, New York, New York, USA"
      ],
      "name": "Sonia Angell"
    }
  ],
  "title": "Readiness to deliver integrated cardiovascular, kidney and metabolic care in primary healthcare: phase II of HEARTS 2.0 in 26 countries in the Americas",
  "uid": "08506043-616b-5e7f-8fde-c0d3debd2f67"
}