Better Hearts Better Cities program shares exciting progress

Hypertension (HTN), also known as high or raised blood pressure, is a condition in which the blood vessels have persistently raised pressure. The risk of death from stroke, heart disease, or other vascular disease doubles with every 20 mmHg increase in systolic blood pressure, the top number in a blood pressure reading, and 10 mmHg increase in diastolic blood pressure, the bottom number in a blood pressure reading.

In January 2018, the American Heart Association joined the Novartis Foundation’s Better Hearts Better Cities (BHBC) program to support global efforts to improve cardiovascular health in a sustainable way. The overarching goal of this multisectoral, multidisciplinary program is to improve hypertension screening, diagnosis, treatment and control in three cities in low-middle income countries (Senegal, Brazil and Mongolia) with a significant burden of hypertension. Key strategies include strengthening primary healthcare capability to manage hypertension; improving people-centeredness and coordination of care; leveraging patients as agents of change through education and empowerment; strengthening equitable access to medicines; and creating healthier living and working conditions.

Key American Heart Association activities in 2018 included:

Simplified Guidelines Project

Developed small concentrated pocket guide and infographic


Healthcare Provider Education

Developed an education curriculum package that included the full curriculum, designed as 4 modules; evaluation tool for each module; a template for certificate of attendance; CME data collection sheet, referenced in the intro section of the full curriculum; gap analysis tool, with and without answers; a draft of HTN poster and pocket guide


Quality Improvement (QI)

Customized Measure Accurately, Act Rapidly, Partner with Patients (MAP) QI program framework and materials for local delivery in each of the 3 pilot cities; translated the AMA video on blood pressure measurement in local languages


Policy Shaping/Advocacy

Developed mini-policy notes on each project city with a commentary on key characteristics including disease burden, key issues (country capacity, laws, regulations, policies, strategies, plans, programs, technical guidelines, etc.), and select recommendations; high level literature review of the current sodium landscape for each BHBC country and sodium reduction studies conducted in the past 5 years in the country or region; a checklist of the progress made in the global target goals and policy to address non-communicable diseases

In 2019, BHBC’s main focus areas are Quality Improvement (QI) and Monitoring and Evaluation (M&E). The goal of the QI activities is to reduce performance gaps, thus improving the application of guidelines-based care in practice while improving efficiencies and process within the clinics that can be replicated as BHBC expands. Through in-person visit and remote consultation, the American Heart Association provides insights on observed gaps in care among the participating clinics and helps identify strategic QI activities, for the appropriate local organizations within each city to customize and implement.

As the global M&E partner, the Association monitors program performance, and provides expert guidance and technical assistance for the analysis and presentation of program findings.

 The AHA team with Novartis in a BHBC district in Dakar, Senegal
The AHA team with Novartis in a BHBC district in Dakar, Senegal
 The AHA team visited a BHBC clinic in Sao Paulo, Brazil
The AHA team visited a BHBC clinic in Sao Paulo, Brazil