CARDIOVASCULAR disease has been and will continue to be a major public health concern for the foreseeable future. The impact of this disease on public health and national economies cannot be overestimated, more so for developing societies like Jamaica.

According to the World Health Organisation, 17 million deaths are recorded annually from cardiovascular diseases and 32 million individuals suffer from heart attacks or strokes each year. Unfortunately, while 85 per cent of the resources for the treatment of cardiovascular diseases are available in developed countries of the world, more than 85 per cent of the global burden of cardiovascular diseases, including heart attacks and strokes, occur in developing countries like Jamaica. Ironically, these are countries with limited resources and limited access to advanced technologies and treatment methods to mitigate the complications resulting from cardiovascular diseases.

Economic transition, urbanisation, industrialisation, and globalisation encourage lifestyle changes that promote diabetes, hypertension and heart disease. The rising prevalence of cardiovascular disease in Jamaica is fuelled in part by a rise in the prevalence of cardiovascular risk factors and its promoters like diabetes, hypertension, high cholesterol, inactivity, tobacco use, and obesity.

About 20-30 per cent of the Jamaican adult population is hypertensive, about 30 per cent of men and 60 per cent of women are overweight or obese and as many as 1 in 6 adults are thought to be afflicted by diabetes. More worrisome data is emerging in the young as well, fuelled in part by obesity and physical inactivity. More adolescents are becoming obese at an early age and are therefore at an increased risk for developing type 2 diabetes and a subsequent increased risk of developing coronary artery disease later in life. The emerging trend in Jamaica is consistent with the global phenomenon showing that we in the Caribbean region are not insulated from the negative health consequences that result from westernisation. It further indicates how poor nutritional choices, physical inactivity and obesity fuel the global epidemic of diabetes, hypertension and cardiovascular disease.

Cardiovascular disease and its associated promoting illnesses will account for about one million deaths annually in Latin America, representing over 25 per cent of all deaths, affecting an equal number of men and women. In the Caribbean and South America, cardiovascular diseases and its associated risk factors will be responsible for three times more deaths and disability by 2025, affecting mainly individuals in their mid-life years, disrupting the future of families, undermining social structures, and depriving nations of workers in their most productive years, thus precipitating economic decline and underdevelopment.

In recognition of the potential health threats to the region in a time of epidemiologic transition, the Caribbean Community Heads of Government asserted in their Nassau Declaration of 2001 that “the health of the region is the wealth of the region”, fully cognisant of the critical relationship between the population’s health status and economic growth as elegantly demonstrated in multiple studies by Hans Rosling. An analysis for Jamaica alone has shown that the cost of hypertension and diabetes for the year 2002 was estimated to be about $US58.5 million, excluding the economic value of premature deaths that these diseases caused.

Following a mandate from the Heads of Government, a task force, the Caribbean Commission on Health and Development was established in 2003 to formulate a framework and a set of strategies to actualise this declaration. The task force report recognised chronic non-communicable diseases (NCDs) as the key contributors to overall mortality and morbidity in the Caribbean. According to the report, cardiovascular diseases — high blood pressure, coronary heart diseases and stroke — diabetes and cancer accounted for 51 per cent of the deaths in the region in the latter part of the 1990s. The report emphasised the critical need for effective and appropriate treatment and management of these diseases and to establish surveillance systems to effectively monitor lifestyle or behavioural risks to inform policymaking as well as public education and prevention campaigns.

Professor Ernest Madu, founder of the Heart Institute of the Caribbean, is an internationally acclaimed cardiologist and expert on innovative health solutions. HIC is a centre of excellence for cardiovascular care in the English-speaking Caribbean.