Unmet needs in cardiovascular disease care: an umbrella review of challenges, innovations, and systemic barriers

INTRODUCTION: Cardiovascular disease (CVD) remains a leading global health challenge, accounting for 32% of global deaths, with significant disparities in access to care and outcomes, particularly in low- and middle-income countries (LMICs). Despite advancements in prevention, diagnosis, and treatment, unmet needs persist across clinical management, technological integration, and health system barriers. This umbrella review synthesizes evidence on these unmet needs to provide a comprehensive framework for future research and policy interventions. EVIDENCE ACQUISITION: A systematic search was conducted across PubMed, Scopus, Google Scholar, and the Cochrane Library from 2010 to 2023, using keywords such as "unmet needs," "cardiovascular disease," and "health system barriers." Fifty systematic reviews, encompassing 580 studies, were included. Data extraction and quality assessment were performed using the Joanna Briggs Institute checklist, with findings categorized into clinical, technological, socioeconomic, and population-specific domains. EVIDENCE SYNTHESIS: The review identified critical gaps in cardiovascular care, including limited access to specialized services, suboptimal adherence to clinical guidelines, and disparities in technological integration, particularly in LMICs. Socioeconomic factors, such as income inequality and gender disparities, significantly impact access to care and outcomes. Technological advancements, including telemedicine, wearable devices, and AI, show promise but face barriers to widespread adoption. Patient education and mental health integration emerged as essential components of comprehensive care models. Precision public policy was highlighted as a key strategy to address these disparities through targeted, data-driven interventions. CONCLUSIONS: This review highlights the urgent need for multifaceted strategies to address unmet needs in cardiovascular care. Enhancing access to care, improving guideline adherence, integrating technology, and addressing socioeconomic disparities are critical to reducing the global burden of CVD. Collaborative efforts among policymakers, healthcare providers, and researchers are essential to develop equitable, patient-centered solutions. Precision public policy, tailored to the unique needs of diverse populations, offers a promising pathway to achieving these goals and improving cardiovascular health outcomes worldwide.