The Global Cardiovascular Nursing Leadership Forum: Enhancing Cardiovascular Health Worldwide

The Global Cardiovascular Nursing Leadership Forum (GCNLF), a project of the Preventive Cardiovascular Nurses Association (PCNA), was initiated in collaboration with colleagues from the American Heart Association's Council on Cardiovascular and Stroke Nursing and the European Society of Cardiology's Association of Cardiovascular Nurses and Allied Professions. Recognizing the global burden of cardiovascular disease (CVD) and the important role of nurses and nursing in cardiovascular care, the mission of the GCNLF has been to engage and mobilize an international community of nurses to promote prevention of CVD and stroke worldwide through research, education, policy, leadership, and advocacy. Several PCNA-championed activities provided the background and foundation for the GCNLF, including the first meeting held in 2014 in New York City.1–3 Subsequent in-person meetings were held in Barcelona, Spain (2016); Lisbon, Portugal (2018)4,5; Copenhagen, Denmark (2022); and most recently Budapest, Hungary (2024). Of note, virtual meetings of the GCNLF were held in 2020, 2021, and 2023. Attendees, active participants at each of these meetings, are recognized leaders in cardiovascular and stroke nursing and herald from the 6 World Health Organization (WHO) regions. Although the activities of the GCNLF have changed over time, the major mission-related goals continue to be emphasized: (1) champion a global nursing movement for CVD and stroke prevention across the life course of all individuals and families; (2) empower nurses worldwide on the science and practice of health promotion and CVD and stroke prevention, and (3) empower nurses as leaders in CVD and stroke prevention.3–5 The 2024 meeting of the GCNLF (held in Budapest) provided an opportunity to highlight the goal-related contributions and accomplishments of the GCNLF and our nurse leaders who have been actively engaged in global CVD prevention through research, patient and provider education, policy, and advocacy initiatives. The Chair of PCNA's International Committee presented the origins and developmental trajectory of the GCNLF, an overview of major themes that emerged from prior GCNLF meetings, reaffirmed the mission and goals, and noted several recent accomplishments as well as ongoing initiatives. Accomplishments noted included dissemination and global uptake of the Cardiovascular Nursing Certificate Program, designed to enhance both knowledge and skills in cardiovascular care as well as support career advancement. The Guidance Document focused on promoting cardiovascular nursing globally, an information flyer about coalition members and sponsors (available in several languages) and the 20 liaison organizations that endorse the mission and goals of the GCNLF. Of note, the GCNLF website (http://pcna.net/gcnlf/news-events) houses patient education materials, the Guidance document, information flyer, individual and collective success stories, and current and future events including webinars as well as information on our partners. The 2024 GCNLF featured keynote speaker, Dr Salim S. Virani, Professor of Medicine and Vice Provost for Research, Aga Khan University, who presented “The Big Picture of Cardiovascular Prevention and Management: Past and Future Changes and Challenges.” He emphasized the global trends in CVD, including the differences observed between and across countries, and noted the excess burden in low-income countries. Dr Virani also provided global data on potentially modifiable risk factors for CVD and emphasized hypertension as a major contributor to morbidity and mortality across the 6 WHO regions. Although progress has been made in management of CVD, Dr Virani underscored the importance of prevention—beginning early in life and extending across the life course of individuals and populations. He presented data supporting a novel term, preprimordial prevention, focused on promoting optimal health of mothers before conception and throughout pregnancy. Dr Virani also highlighted the importance of considering environmental pollution as a risk factor for CVD as well as all-cause mortality. Indeed, global estimates of attributable deaths indicate that environmental risk factors (especially air and water pollution) as well as climate change contribute significantly to global mortality.6 Dr Virani suggested that multilevel, multisectoral efforts are needed to improve cardiovascular health across socioecological contexts, including policies, public health programs, institutions, neighborhood, and community as well as individuals and families.7 In closing, Dr Virani offered several “take home” messages: progress has been made in CVD prevention; diabetes, obesity, and environmental pollution remain threats; the need to move across the scope of prevention (from secondary to primordial and preprimordial); the need to start early and take a life course approach to prevention; and focus on social determinants of health and multisectoral, multisector approaches to CVD prevention across the life span. Finally, Dr Virani encouraged nurses and nursing to use our unique skill sets in healthcare and community settings to engage in promoting optimal cardiovascular health across the life course of individuals and populations. A panel discussion facilitated by Dr Erin Ferranti, PCNA board member, featuring global leaders in CVD prevention included a presentation on hypertension management in Ghana (Thomas Hinneh); CVD risk stratification in Santiago, Chile, and nurse counseling within the context of risk estimations (Dr Maria Teresa Lira); and innovative digital interventions: closing the gap at hospital discharge after a cardiovascular event (Dr Lis Neubeck). Panelists offered recommendations including challenges and opportunities for nurses and nursing designed to promote prevention of CVD and optimize cardiovascular health globally. Reflecting on both Dr Virani's keynote and the panelists' presentations, breakout groups discussed opportunities for GCNLF going forward as well as potential challenges. Major points that emerged include need for data linking nursing interventions and patient outcomes; evidence supporting benefits of nurses functioning at full scope of practice; optimizing implementation of evidence-based clinical guidelines; increased inclusion of nurses and allied health professionals in development and implementation of clinical guidelines; integration of technology in providing opportunities to decrease exposure to environmental toxins; and multilevel, multisectoral efforts to increase preprimordial and primordial prevention globally including in schools. Dr Monica Parry, Professor, Lawrence Bloomberg Faculty of Nursing, University of Toronto, Canada, provided the second keynote address titled, “The Importance of Cross-Disciplinary Partnerships.” She addressed the potential barriers to interdisciplinarity and emphasized practical solutions for fostering cross-disciplinary research and programmatic initiatives. Of note, Dr Parry provided simple rules for successful cross-disciplinary collaboration, including (but not limited to) enjoying a new field of research, learning the language, staying patient, knowing what one can expect, addressing advantages and disadvantages, creating and managing structural bonds, and being synergistic8 Dr Parry also provided a brief overview of her program of research focused on community- and patient -partner engagement in women's CVD research.9 The information and ideas shared by both keynoters (Drs Virani and Parry) informed and guided the subsequent discussions of breakout groups that focused on specific strategies to optimize the mission and goals of the GCNLF on a global level. The commitment of PCNA and GCNLF in promoting optimal cardiovascular health for all individuals from diverse global populations was reaffirmed. The global cardiovascular nursing community will be kept abreast of progress toward achieving the GCNLF mission and goals that are closely aligned with those of WHO, the World Heart Federation, the American Heart Association, and other like-minded organizations focused on reducing the global risk and burden of CVD while promoting optimal cardiovascular health worldwide.