Global cardiovascular disease prevention and management: A collaboration of key organizations, groups, and investigators in low‐ and middle‐income countries

The US Centers for Disease Control and Prevention (CDC), the Lancet Commission on Hypertension Group, Resolve to Save Lives (RTSL), and the World Hypertension League (WHL) share a collective goal of expanding the evidence base on hypertension, sodium, and trans fatty acid reduction strategies as a critical pathway to preventing and managing cardiovascular diseases. An important strategy for achieving this goal is to increase opportunities for investigators in low- and middle-income countries to contribute their studies in these areas to the scientific literature. CDC collaborates with partners to enhance health and economic security and reduce premature disability and death by facilitating prevention, detection, and response to global public health threats. CDC tackles the global non-communicable disease burden by working with countries to improve public health systems, strengthen workforce, and generate scientific evidence. In 2019, CDC began a mentorship collaboration with the Lancet Commission on Hypertension Group, RTSL, and WHL. CDC and RTSL invited 35 public health trainees and practitioners working on RTSL-supported hypertension, sodium, and artificial trans-fat initiatives in low- and middle-income countries to propose manuscripts that could enhance the evidence base and inform future work. Potential authors were paired with mentors from the Lancet Commission on Hypertension Group to define a clear study aim, describe methods, and present and discuss the results. Mentors helped authors strengthen their scientific communication and dissemination skills and share project results with the larger scientific community, thus increasing the global impact of their work. RTSL aims to reduce disability and deaths from cardiovascular disease worldwide through its Cardiovascular Health Initiative, which focuses on three main interventions: population salt reduction, trans fatty acid elimination, and hypertension control. RTSL is based at non-governmental global health organization Vital Strategies, and partners closely with CDC Foundation, the World Health Organization (WHO), Johns Hopkins University and, the Global Health Advocacy Incubator. RTSL collaborated with WHO to develop and promote the REPLACE Action Package, a set of tools to eliminate trans fatty acids from national food supplies, with the goal of global elimination by 2023. Since then, RTSL and its partners have supported trans fatty acid elimination efforts in 24 countries. RTSL and its partners also support the implementation and scale-up of national hypertension programs including efficient opportunistic screening in health care facilities and community-based chronic care convenient to patients.1 While RTSL primarily funds activities in nine focus countries, the Cardiovascular Health Initiative aims to foster a global learning community around cardiovascular health promotion. The dissemination of best practices and lessons learned across all three interventions by public health trainees and practitioners in the countries participating in the initiative, whether from RTSL-funded projects or other groups, is a crucial part of this effort. Through the current initiative, the Lancet Commission has mentored investigators working in low-and middle-income countries to facilitate greater representation in the literature and expand the evidence base on hypertension awareness, use of standardized treatment, and improved patient follow-up, which are all championed by the Lancet Commission on Hypertension Group. WHL is dedicated to the prevention and control of hypertension at the population level and is delighted to use WHL's official journal, the Journal of Clinical Hypertension, to publish a special issue showcasing articles written by investigators in low- and middle-income countries. WHL was especially enthusiastic about this collaboration as it is designed to build and enhance the scientific experiences of public health trainees and practitioners through close mentoring by international leaders. WHL is comprised of multiple national, regional, and international specialty organizations in the fields of hypertension and the prevention of cardiovascular disease, stroke, and kidney disease. WHL is committed to enhance the clinical care of hypertension and related conditions across all parts of the world; support public advocacy for confronting adverse dietary practices such as use of excess salt and artificial trans-fats; educate workers at all levels of health care systems; and—as exemplified by this special publication—help build careers of trainees and practitioners who WHL hopes will continue to contribute to the missions of WHL and its partner organizations. The above articles expand the evidence base on preventing and managing cardiovascular diseases and contribute to building the scientific dissemination capacity of investigators in low- and middle-income countries. All supporting partners are pleased to highlight this important work. A future special section will spotlight additional studies from investigators participating in the mentorship collaboration. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.