The impact of a community-based cardiovascular disease prevention – COIMBRA UNITED BY THE HEART

Cardiovascular disease is the main cause of death in Portugal and one of the most important causes of morbidity and incapacity in Portugal. Since 2016, through the project "Coimbra United by the Heart" (CUH) municipalities scaled-up efforts on cardiovascular disease prevention, creating a community health network that: 1) early identifies citizens with cardiovascular risk; 2) provide awareness-raising strategies for a healthy lifestyle; 3) improve the health surveillance of people with cardiovascular risk; 4) qualify demand for primary health care for health surveillance. In Coimbra, Hospital (Heart and vesel CHUC department), Community Care Units, Nursing and Health School and Coimbra City Hall mobilize various thematic posts throughout the city (healthy lifestyles, healthy eating, smoking cessation, alcohol consumption, sleep disorder, stress management and physical activity), where citizens can know his cardiovascular risk and raise awareness about CVD prevention. Three months after, impact evaluation and citizens’ PHC surveillance is evaluated. Until 2023, the SCORE (risk of death from cardiovascular disease in the next 10 years) was evaluated in 2745 citizens with an average age of 53.4 ± 17.8 years, of which 55% had low CVR, 19% moderate RCV, 18% high RCV and 8% very high RCV. 1 in 2 citizens of Coimbra has high cholesterol, has Blood Pressure values higher than recommended, and has at least a high risk of developing metabolic diseases. The data obtained was sent to the respective general practitioners and all citizens who did not have health monitoring within a period of time defined by their cardiovascular risk were summoned by their family health team. Through telephone interviews 3 months after each intervention, between 1 (not useful) and 10 (very useful), the project was classified with 8.8 ± 1.3 points regarding its usefulness and that it should continue. The “Coimbra united by the heart” project proved to be effective in identifying and referring citizens who needed health surveillance and capable of stimulating the demand for Primary Health Care as a way of promoting health. Based on the experience gained, it is perceived by all those involved that it must be continued and improved in the coming years. Through partnerships with numerous leading institutions in the Coimbra community, “Coimbra united by the Heart” becomes an efficient network of community partnerships for the well-being of citizens. Through the constant project monitoring, it was possible to underlie and plan new areas of intervention such as better articulation between differentiated health care and PHC, improvement of established indicators for cardiovascular disease prevention and specialized training in primary health care.