Exploring solutions for multimorbidities prevention and control

The Global Coalition for Circulatory Health gathered for a side event around the UN General Assembly this week. WSO Global Policy Chair Prof Bo Norrving contributed to the event - 'Exploring solutions for multi-morbidities prevention and control: the case for circulatory health". Other participants in the panel included David Wood (past WHF President) and Vivekanand Jha (President of the International Society of Nephrology). 

Multi-morbidity, the concept under discussion is core to stroke, heart disease, kidney disease, and vascular diseases, which together form a strong cluster along with hypertension driving premature morbidity and disability globally. Multi morbidity, where patients experience several conditions needs to be recognized as a major prognostic factor on its own right and clinicians and health systems need to be able to respond to multiple needs of patients to reduce mortality, disability and improve quality of life.

While multi-morbidities are expected to increase largely as a result of demographic change, circulatory diseases share many risk factors and show incredible potential for prevention. This potential provides a strong "glue" that binds partner members of the Global Coalition for Circulatory Health in their work towards global health goals. 

Prof Norrving presented recent epidemiological data from Sweden, which demonstrates that incidence of first and recurrent strokes can be substantially decreased with effective intervention on risk factors, providing proof of principle that prevention works. The priority now is to ensure that inequalities in access to preventive and acute care are reduced, so that those countries currently experiencing the greatest increase in stroke and circulatory disease - typically LMICs - can get ahead of the curve on prevention.

Multimorbidity and strengthening of the workforces will be themes for future discussions within the Global Coalition for Circulatory Health, which will have a next next summit in June 2020.

For more on the shared agenda between stroke and circulatory disease download Sustainable Action for Circulatory Health White Paper

World Stroke Organization welcomes WHO stroke classification and definition in ICD 11

The World Stroke Organization has welcomed the recent release by the World Health Organization (WHO) of the ICD 11. The ICD is the global system for clinicians, administrators, and governments to report health statistics at all levels. 

In the newly released ICD 11, cerebrovascular diseases form a single block under diseases of the nervous system. This is a major change compared to the previous classification, in which stroke was placed under diseases of the circulatory system. Furthermore, the new ICD 11 provides precise definitions of stroke and other cerebrovascular diseases for global use. 

WSO works to improve stroke prevention, treatment and support globally. It represents over 50,000 stroke experts worldwide and hasadvocated for the change.  In welcoming the classification, Prof Werner Hacke, President of WSO said ‘By categorizing stroke correctly under diseases of the Nervous System, WHO is supporting global efforts by stroke professionals, survivors and carers to increase public recognition of stroke and to improve access to stroke treatment and care. Stroke is a leading cause of death and disability worldwide, accountable for 14m deaths and 116 DALYs in 2016.  We firmly believe that correct classification will help to save millions of lives and reduce the massive individual and global impact of stroke-related disabilities in years to come. With the world now focused on reducing the burden of Non-Communicable Diseases, this is a timely and important step.’

In recent years, opportunities to improve stroke outcomes have improved due to the development of effective acute stroke treatments such as thrombolytic therapy and thrombectomy. Access to effective acute therapies such as these are contingent upon the early recognition of symptoms from the brain and fast access to appropriately designed stroke treatment facilities with the appropriate neurovascular expertise. ‘Classifying stroke as a disease of the brain is important to facilitate awareness and early recognition, and reporting stroke accurately is instrumental to recognize the true burden of stroke among the spectrum of diseases.’ Said Prof Bo Norrving, Chair of the WSO Global Policy Committee, member of the ICD 11 neurology advisory group and Chair of the working group on cerebrovascular diseases.

Stroke and heart disease share most risk factors and several heart and circulatory conditions increase individual risk of stroke. Strokes and TIAs (mini-stroke) are also leading contributors to cognitive decline and dementia.

WSO will continue to prioritize clinical and public education on the linkages between stroke and heart disease, dementias and other Non-Communicable Diseases. The Organization already works in close partnership with the World Heart Federation and the World Hypertension League and partners in the wider non-communicable disease space as a member of the NCD Alliance and in the Coalition for Vascular Health. It will continue to advocate strongly for improved primary prevention policy to address common NCD risk factors, as well as for increased and more equitable access to screening and treatment for conditions including hypertension (high blood pressure), atrial fibrillation (irregular heartbeat) and hyperlipidemia (high cholesterol) all of which are specifically associated with higher stroke risk.

Progress on preventing NCDs falls far short of target

 

On March 1, the UN Secretary General released a report on the progress of the prevention and control of Non- Communicable Diseases. It’s a vital document and a sobering read for those working to prevent stroke and other NCDs. You don’t need to read too hard between the lines to perceive the frustration and mounting impatience over lack of substantive progress in the seven years that have passed since governments first committed to address one of the ‘major challenges for development in the twenty-first century’.

World Stroke Day

Download these articles on World Stroke Day (WSD), 2011.
What will you be doing this WSD?

World Stroke Day special edition: where are we six-years on? (page 375)
http://onlinelibrary.wiley.com/doi/10.1111/j.1747-4949.2011.00663.x/full

IJS announces journal series on stroke, cognition and vascular dementia (page 375)
http://onlinelibrary.wiley.com/doi/10.1111/j.1747-4949.2011.00662.x/full

World Stroke Day (page 376)
http://onlinelibrary.wiley.com/doi/10.1111/j.1747-4949.2011.00655.x/full

World Stroke Day Editorial (page 377)
http://onlinelibrary.wiley.com/doi/10.1111/j.1747-4949.2011.00656.x/full

The International Journal of Stroke welcomes Professor Patrick Lyden as Associate Editor (page 378)
http://onlinelibrary.wiley.com/doi/10.1111/j.1747-4949.2011.00664.x/full