Implementation of Global Hearts Hypertension Control Programs in 32 Low- and Middle-Income Countries: JACC International

In 2017, the World Health Organization (WHO) and Resolve to Save Lives partnered with country governments and other stakeholders to design, test, and scale up the WHO HEARTS hypertension services package in 32 low- and middle-income countries. Facility-based HEARTS performance indicators included number of patients enrolled, number treated and with blood pressure controlled, number who missed a scheduled follow-up visit, and number lost to follow-up. By 2022, HEARTS hypertension control programs treated 12.2 million patients in 165,000 primary care facilities. Hypertension control was 38% (median 48%; range 5%-86%). In 4 HEARTS countries using the same digital health information system, facility-based control improved from 18% at baseline to 46% in 48 months. At the population level, median estimated population-based hypertension control was 11.0% of all hypertension patients (range 2.0%-34.7%). The Global Hearts experience of implementing WHO HEARTS demonstrates the feasibility of controlling hypertension in low- and middle-income country primary care settings.