PAHO Unveils Roadmap to Enhance High Blood Pressure Control and Save Lives
The HEARTSQuality Framework in The Lancet Offers Strategies to Strengthen Cardiovascular Care in the Americas, Potentially Preventing 400,000 Deaths by 2030
Washington, D.C., December 10, 2025 (PAHO) -- The Pan American Health Organization (PAHO) has introduced the groundbreaking HEARTS Quality Framework, a practical guide published in The Lancet Regional Health – Americas. This framework empowers countries to take immediate action in improving hypertension and cardiovascular risk management, thereby preventing heart attacks and strokes and delivering superior care through primary healthcare services closer to people's homes.
Heart disease and strokes claim over 2.2 million lives annually in the Americas, often affecting individuals in their most productive years. High blood pressure, the leading risk factor, affects nearly four in ten adults across the region. Despite the availability of affordable and effective treatments, only one in three people with hypertension currently has it under control.
"Hypertension remains the world's deadliest health threat, but it is also one of the most manageable," said Dr. Jarbas Barbosa, PAHO Director. "This Framework is not just a policy document; it's a practical guide already saving lives in thousands of neighborhood clinics. If countries adopt and scale it up, we can prevent millions of heart attacks and strokes over the next decade."
The HEARTS Quality Framework translates real-world experiences into a tested blueprint for overcoming barriers that prevent millions from receiving the care they need. These barriers include inaccurate blood pressure measurements due to outdated equipment, limited availability of essential medicines, inconsistent treatment across providers, and unnecessary monthly visits to renew prescriptions.
HEARTS in the Americas is the world's largest adaptation of the World Health Organization's (WHO) global HEARTS initiative and is now active in 33 countries, reaching nearly 10,000 primary healthcare facilities and treating over six million people. When fully implemented, six in ten patients achieve blood pressure control, almost double the regional average.
The framework transforms these proven successes into a structured model that any country can adopt and tailor to its needs. It outlines concrete strategies, such as mandating the use of reliable, automatic blood pressure monitors, ensuring a steady supply of quality medicines at affordable prices through bulk regional purchasing, enabling multi-month prescriptions, and empowering trained nurses to adjust medication doses. It also proposes simple monthly monitoring tools to track performance and facilitate rapid improvements.
These strategies collectively support the "80-80-80 target" for blood pressure control: 80% of people with hypertension diagnosed, 80% of those diagnosed treated, and 80% of those treated achieving blood pressure control. "Reaching this goal could prevent more than 400,000 deaths and 2.4 million hospitalizations by 2030 in the Americas," explained Dr. Pedro Orduñez, the corresponding author and PAHO Senior Advisor for Cardiovascular Disease.
"We urge ministries of health, policymakers, and healthcare providers to adopt the HEARTS Quality Framework," said Dr. Anselm Hennis, Director of the Department of Noncommunicable Diseases and Mental Health at PAHO. "By committing to this model, we can deliver better care for NCDs, save millions of lives, and strengthen primary healthcare across the Americas."
Proven Results Across the Region
The HEARTS approach is already transforming hypertension and cardiovascular risk care. In Matanzas, Cuba, control rates rose from 36% to 58% in one year; in Chile, from 37% to 65%, with analyses showing the program pays for itself in under two years by preventing expensive cardiac events. Communities in Colombia, Mexico, Trinidad and Tobago, and others have similarly increased control rates after adopting HEARTS standards.
In the Dominican Republic, HEARTS is a government priority, providing free treatment to millions. El Salvador expanded HEARTS across its primary healthcare network, achieving control rates of nearly 70%, and Mexico has also initiated large-scale implementation nationwide.
"These results show that hypertension control and cardiovascular risk management at scale is possible," said Dr. Esteban Londoño, lead author and PAHO international consultant in noncommunicable diseases. "Primary healthcare equipped with standardized clinical pathways, reliable medicines, team-based care, and quality-improvement tools can generate life-saving impact for millions."
HEARTS Quality: A Policy Framework to Strengthen Hypertension and Cardiovascular Risk Management in Primary Healthcare—Insights from HEARTS in the Americas, is available in The Lancet Regional Health – Americas (https://doi.org/10.1016/j.lana.2025.101311).
