HEARTS quality: a policy framework to strengthen hypertension and cardiovascular risk management in primary healthcare—insights from HEARTS in the Americas
HEARTS in the Americas is the largest-scale implementation of the WHO's global initiative, with 33 countries participating, 28 having adopted standardized clinical pathways, and about 10,000 primary healthcare facilities engaged. Despite progress, fragmented care, limited availability of validated blood pressure devices, restricted access to essential medicines, and weak quality assurance systems continue to hinder hypertension control and cardiovascular risk management. In response, PAHO and participating countries co-developed the HEARTS Quality Framework. Grounded in regional implementation, this model synthesizes global evidence and lessons from Latin America and the Caribbean. Co-designed by Ministries of Health, care providers, and international experts, it translates HEARTS strategies into actionable system-level objectives. Clearly defined outcome indicators and implementation targets promote institutionalization, quality improvement, and primary healthcare strengthening-supporting HEARTS scale-up and equitable outcomes. With appropriate contextualization, the HEARTS Quality Framework provides a practical roadmap for countries beyond the Region to advance primary healthcare-based chronic disease care.
Authors
- Grace Marie Ku (ORCID: https://orcid.org/0000-0002-4276-9104)
- Libardo Rodríguez
- Carolina Neira (ORCID: https://orcid.org/0000-0001-9133-8354)
- Vivian Pérez (ORCID: https://orcid.org/0000-0002-8382-7649)
- Andelys De la Rosa (ORCID: https://orcid.org/0009-0000-6777-6055)
- Yamilé Valdés
- Martin Heine (ORCID: https://orcid.org/0000-0003-4131-2863)
- Andrés Rosende (ORCID: https://orcid.org/0000-0001-8173-0686)
- Teresa Aumala (ORCID: https://orcid.org/0000-0001-7073-0787)
- Pedro Ordúñez (ORCID: https://orcid.org/0000-0002-9871-6845)
- Vilma Irazola (ORCID: https://orcid.org/0000-0002-6100-1862)
- Jeffrey Brettler (ORCID: https://orcid.org/0000-0002-2069-9643)
- Esteban Londoño Agudelo (ORCID: https://orcid.org/0000-0003-3254-3651)
- Michael Pereira (ORCID: https://orcid.org/0000-0003-4400-3759)
- Gloria Giraldo (ORCID: https://orcid.org/0000-0002-6880-7324)
- Reena Gupta (ORCID: https://orcid.org/0009-0004-7116-7278)
- Eric Zúñiga (ORCID: https://orcid.org/0000-0002-1136-8260)
- María Cristina Escobar (ORCID: https://orcid.org/0000-0002-7978-1449)
- Patrick Van der Stuyft (ORCID: https://orcid.org/0009-0005-0895-1200)
- Matías Humberto Villatoro
- Alied Bencomo
- Jerry Toelsie
Institutions
- Universidad de Antofagasta (CL)
- Kaiser Permanente (US)
- Anton de Kom University of Suriname (SR)
- University Medical Center Utrecht (NL)
- Ghent University (BE)
- Cal Humanities (US)
- World Health Organization Regional Office for the Americas (US)
- Ministry of Health (CL)
- Ministerio de Salud Pública (CU)
- Instituto de Efectividad Clínica y Sanitaria (AR)
- Ministerio de Salud (SV)
- Hospital Metropolitano (EC)
- Pan American Health Organization (Cuba) (CU)
- Instituut voor Tropische Geneeskunde (BE)
- Universidad Panamericana (MX)
- University of Guyana (GY)
Publication Details
- Journal
- The Lancet Regional Health - Americas
- Published
- 2025-12-01
- DOI
- https://doi.org/10.1016/j.lana.2025.101311
- Primary Topic
- Blood Pressure and Hypertension Studies
- Type
- article
- Field-Weighted Citation Impact
- 0.00