Improving CVD risk factors control among the people in areas with the highest burden of cardiovascular diseases in Indonesia

According to Indonesia Basic Health Research, from 2007 to 2013 there was a significant increase in cardiovascular deaths and cardiovascular risk factors in Indonesia. Prevention should not only target the cardiac patients but also focus on behavior at the population level and health providers, which can be the most effective and cheapest approach. The main goal of the project is improve cardiovascular risk factors control at the population level in the areas with the highest cardiovascular burden in Indonesia. An estimated 2500 subjects will be recruited from provinces of South Celebes and Bangka Belitung, which are two of the top four provinces with the highest cardiovascular burden. Primary Health Care Centers/Community Health Care Centers (Pusat Kesehatan Masyarakat/Puskesmas) will be the center or a community-based intervention program to achieve study goals and objectives. Primary Care Physicians and members of Puskesmas staff will receive trainings for screening and managing subjects with moderate-high cardiovascular risk factors. At-risk individuals assessed by the SCORE and INTERHEART risk score will be identified from Puskesmas visit and recruited into the study. Intervention will be delivered in the form of individualized education and exercise program. The local Healthy Heart Clubs, a society-funded club under the Indonesian Heart Foundation will plan and execute the physical activity program for the study subjects. Special efforts will be made to identify local barriers and opportunities unique to the area regarding the implementation of healthy lifestyle. The expected outcomes are positive net change in the cardiovascular risk scores, including positive changes in term of smoking cessation, increasing physical activity, achieving target blood pressure and recommended LDL level among study participants.