ACC-New York, Dec. 11, 2015 No Disclosures

PROMOTING HEALTH

CHILDREN, FAMILY & COMMUNITY

Leadership & Motivation

Documents on Global CV Health – Follow-up ?

Promoting Cardiovascular Health in the Developing World; A Critical Challenge to Achieve Global Health.

Ed. V Fuster and B Kelly. IOM of the Natl. Academies. Natl . Academies Press. Washington DC.2010.

Institute of Medicine Experience

“A Critical Challenge to Achieve Global Health”

2011 June 27 2014

Circ. 2011;123:1671 12 RECOMMEDATIONS

“FUNDING THE FIGHT AGAINST CHRONIC NCD”

Sense of Need - Local, National and International

Government, Non-Profit Private, For-Profit Private, Partnerships

“EDUCATION & LOCAL DATA”

Census-Based, Survey-Based, Study-Based - Great Impact

ACC-New York, Dec. 11, 2015 No Disclosures

PROMOTING HEALTH

CHILDREN, FAMILY & COMMUNITY

Leadership & Motivation

Health & Quality of Life (QoL) – Aging (A) to Birth (B)

B

B

B

Prom.

Health

Subcl.

Disease

Stable-Unst.

Disease

Window

Young

Future

Behav.

Change

Adherence

Simplicity

25 50 75 100

25 50 75 100

A

Present

Late

Expensive

Early

Economic

Health (QoL)

A

A 0

Science

Education

V Fuster, JACC 2015 (October)

Environment

Policy Mandatory (?)

Air Pollution & Noise

Education

0

JN Giedd. Scientific American 2015;312:32

Child’s Brain Development

Less Networking Brings Atention

1B

GENERAL

PUBLIC

3-5 CHILDREN 6-8 9-14

EDUCATIVE GOAL: HEALTHY HABITS FOR CHILDREN BETWEEN 3 & 5 YRS

COLOMBIA – CHILDREN’S PROGRAM

1. In Children’s KAH Mean Scores*

40.0

50.0

60.0

70.0

80.0

90.0

100.0

0 18 36

Sco

re (

me

an)

Knowledge Attitudes Habits (physical activity)

p< 0.001

p< 0.001

p< 0.001

p< 0.001

p< 0.001

The Amer J of Med 2012; 126, 27 The Amer J of Med 2013;126:1122 Bogota – 25,000

JL Peñalvo, V Fuster et. al. JACC 2015 (In Press). - 75,000,

2. Changes In Anthropometric Variables

At Each FU In Overweight Children

Body Mass Index (BMI)

Waist Circumference (WC)

ACC-New York, Dec. 11, 2015 No Disclosures

PROMOTING HEALTH

CHILDREN, FAMILY & COMMUNITY

Leadership & Motivation

Health & Quality of Life (QoL) – Aging (A) to Birth (B)

B

B

B

Prom.

Health

Subcl.

Disease

Stable-Unst.

Disease

Window

Young

Future

Behav.

Change

Adherence

Simplicity

25 50 75 100

25 50 75 100

A

Present

Late

Expensive

Early

Economic

Health (QoL)

A

A 0

Science

Education

V Fuster, JACC 2015 (October)

Environment

Policy Mandatory (?)

Air Pollution & Noise

Education

0

Subclinical Disease (N=10,000)

Carotid 3D-US, Coronary Calcification

U Baber, R Mehran, V Fuster, et al. J. Am. Coll. Card. 2015; 65: 1065 L Fernandez-Friera, A Fernandez-Ortiz, V Fuster et.al Circ 2015, 4/20

c

?

A Health Center

In The Adult Brain (?)

To Stimulate / Motivate

2B

1. AMPATH Centers In Kenya

BP Control / Non MD / High Technology

R Vedanthan, V Fuster, NHLBI / Kenya Model (2012-2016)

2a. CARDONA INTEGRAL – “FIFTY-FIFTY”

SMOKING 0 11 2 -- -- 2

OVERWEIGHT 0 12 2 -- -- 2

SEDENTARISM 0 13 2 -- -- 2

HYPERTENSION 0 14 2† -- -- 2

TOTAL HABIT SCORE 8

95% of the people have improved in one or more of the habits or RF.

SIX MONTHS

86

69

96

104

127

70

86

N=552

2b.The Seven Community Study

E. Gomez, V Fuster et al 2015 (Subm)

Approach 3: PESA Program, Madrid – AHA 2015, Orlando

2c. Global Demonstration Project - GHP

1975

2000

2000

High Risk Factor Profile

2c. GHP-CHANGE

Grenada Heart Project –Community Health ActioN to

EncouraGe Healthy BEhaviors.

Planning

• August/Sept

2014

Baseline

Assessment

• Completed

March

2015

Group

Meetings

• Ongoing

currently

Midpoint

Assessment

• August/Sept

2015

Post-Interv.

Assessment

• March/April

2016

>1 CV Risk Frs

N=402

Monthly Group

Meetings

12 month GHP

Outcomes Score

Self-

Management

12 month GHP

Outcomes Score

R

Health & Quality of Life (QoL) – Aging (A) to Birth (B)

B

B

B

Prom.

Health

Subcl.

Disease

Stable-Unst.

Disease

Window

Young

Future

Behav.

Change

Adherence

Simplicity

25 50 75 100

25 50 75 100

A

Present

Late

Expensive

Early

Economic

Health (QoL)

A

A 0

Science

Education

V Fuster, JACC 2015 (October)

Environment

Policy Mandatory (7)

Air Pollution & Noise

Education

0

1. DBD/AD - CVRFs, Lacunar Les., < Cognitive

MRI – Perfusion

Ischemia affects 60 to 90% of patients with Alzheimer’s

1.V Novak, I Hajjar. Nat. Rev. Cardiol. 2010; 7:686(HMS)

2. HW Querfurth, FM LaFerla. NEJM 2010; 362:329

Autopsy (n=6000)

3. JB Toledo et al. Brain July 10, 2013

CV Risk Factors, Cognitive Function, Imaging

4. CARDIA (K Yaffe et al) Circ. 2015 (In Press)

5.JI Friedman, V Fuster et. al– JACC CV Imag. 2015 (In Press)

Intervention

6. FINGER (T Ngandu et al)., The Lancet 2015; 385:2255

3B

2. Aging / Frailty

Oxidative Stress on Telomere

B Niemann et. al. JACC 2011; 57: 577.

R Madonna, R De Caterina et. al EHJ 2011;32:1190 (Houston &Chieti, Italy)

JC Kovacic, EG Nabel, V Fuster – Circ. 2011;123:1650

1

2

4

3

3. CV Drugs Underuse - Polypill, 2ary Prevention.

Am. H J 2011;162:811 Semin.Thor.Cardiov.Surg 2011;23:24 JACC, 2014; 64:2071 Approved in 26 Countries

* Valentín Fuster (inventor)

FOOD INTERACTION

PHARMACOKINETIC INTERACTION WITH ASPIRIN

PHARMACOKINETIC INTERACTION WITH

SYMVASTATIN

PHARMACOKINETIC INTERACTION WITH RAMIPRIL

PHARMACODYNAMIC INTERACTION WITH ASPIRIN

PHARMACODYNAMIC INTERACTION WITH

SYMVASTATIN

PHARMACODINAMIC INTERACTION WITH RAMIPRIL

BIO-EQUIVALENCE

ASA, Statin, ACE-Inhibitor

Argentina Brazil Paraguay Italy Spain

FOCUS 1 & 2

FREEDOM

AETNA-DIABETES

SECURE-EC 2015

Colombia / Spain

Behavior

Science, Health, Education(SHE)

2 . Five Countries

Kenya/Spain/Grenada

IIIP / PPPI

“Extended healthy lives” in part due to medical research

generates dramatic returns - Albert & Mary Lasker Found.- 2002

Polypill

American Heart Association,

Focused Prevention Research Center

Family-Based Approach

Prevention of CVD in a Minority Community

Integrating Systems-Biology

Icahn School of Medicine at Mount Sinai

Head Start Organization

O

Start

Start

Children

3 Groups

Caregivers

3 Groups

P

P

P

P

P

P

Teachers

O

I

I

I

O

O

O

O O

O

O

O

O

O

KAH-BEA

Mol. Genomics KAH-BEA S-KAH-BEA

BEWAT

Point of Care.

3D-US

Mol. Genomics

O

IP

II II

O

IP

Contr./Interv.

S-BEWAT

Point of Care

BEWAT

Point of Care

3D-US

Mol. Genomics

1st

Yr 2nd

Yr 3rd

Yr 4th

Yr

Intervention.

Intervention

Control

IIIP

PPPI

KAH-BEA = Knowledge, Attitude, Habit -BMI, Exercise, Alimentation

PPPI = Peer-to-Peer Program Interv;

IIIP = Intensive Individual Intervention Program

BEWAT = BP, Exercise, Weight, Alimentation, Tobacco

(1)

(2)

(3)

(3)

(1)

(2)

Wearable Tech

Lanzamiento de la versión internacional THE CIRCLE OF HEALTH

Actividades previstas

Interactive “Circle of Health” - App

FC Barcelona

Evolving Partners

Engaging Partners

Mount Sinaí

Heart

ACC-New York, Dec. 11, 2015 No Disclosures

PROMOTING HEALTH

CHILDREN, FAMILY & COMMUNITY

Leadership & Motivation

HEALTH

ENVIRONMENT

SCIENCE

EDUCATION

EDUCATION

CARDONA

HARLEM

GRENADA

KENYA

MADRID

BOGOTA

Co

ntin

uity

Community

Family

Adults

Children

ACC-New York, Dec. 11, 2015 No Disclosures

PROMOTING HEALTH

A CHALLENGE FOR SCIENCE & EDUCATION

Leadership & Motivation