P040 STRENGTHENING PRIMARY HEALTH SYSTEMS FOR HYPERTENSION: THE CASE OF HEARTS IMPLEMENTATION IN GUATEMALA

Hypertension is considered the leading cause of death and disability worldwide due to the multiple complications it entails. Hypertension contributes to 40% of the total cardiovascular diseases worldwide. In Guatemala, the burden of hypertension is increasing, with a prevalence of 32.2%. Hypertension alone is responsible for 12% of deaths in the country. The World Health Organization's (WHO) HEARTS is global to local initiative that consists in a technical package represents a public health approach to hypertension control, with a strong foundation in the effective and sustainable delivery of care for chronic diseases in primary care centers and their communities. Since 2017, Resolve to Save Lives, WHO, and other partners have supported the implementation of the HEARTS hypertension control program in public health care centers in LMICs (Low- and Middle-Income Countries). The goal was to establish a model for hypertension control suitable for broader expansion. By December 2022, 12.2 million hypertensive patients had been treated in the program across 33 participating LMICs. A pilot study integrating the diabetes module (HEARTS-D) into the implementation of the hypertension care model has been conducted in two health areas (Sololá and Chiquimula) since 2023. Starting in 2024, the execution of a project funded by the World Diabetes Foundation (WDF) will be carried out to expand these strategies by implementing a national comprehensive care model for diabetes and hypertension in the country. In 2021, a pilot study focused on the implementation of the model was conducted, resulting in a fourfold increase in the treatment rate of patients and a 14% increase in the proportion achieving blood pressure control. These results support the feasibility of implementing the HEARTS model for blood pressure control in the healthcare system of LMICs. The integration of the model in Guatemala since November 2022 enhances previous efforts and solidifies the country's commitment to integrating timely responses in the management of these conditions and the implementation of standardized treatment.