Screening for non-communicable diseases such as cancer, diabetes, and heart disease is a major focus around the world. But a revealing new study from Denmark found screening for heart disease has little value on its own—it must be tied to effective management. 1/thread
The study, published in @NEJM, was designed to maximize the likelihood that screening for heart disease would improve health outcomes. bit.ly/3VOnQjw 2/
A very high-risk population was selected—men ages 65-74—and they received intensive screening and more than five years of follow up in a well-functioning health care system. The result? No benefit of screening. 3/ 
Why? Because screening doesn't provide much benefit unless there is a strong, accountable system to track patient progress and outcomes. What gets measured can be managed. Health systems must measure AND manage risk factors for heart disease. 4/
Uncontrolled hypertension is far and away the world’s leading preventable cause of death. High blood pressure kills more people every year than Covid at its worst, and three times as many as AIDS, TB, and malaria combined. 5/
Hypertension control rates globally are less than 15-20% today, leaving approximately 1 billion people at great risk of lethal or disabling heart attacks and strokes. 6/
Programs to address heart disease will save the most lives—and prevent the most health care costs, disability, and loss of productivity—by focusing on hypertension control as the most important indicator. 7/
The @WHO HEARTS package outlines a practical, cost-effective way of doing this with state-of-the-art care. Cost of medications may be $5 or less per patient per year. bit.ly/3SbJk6I 8/
Patients must come first, and interventions that save the most lives and prevent the most disability should be the highest priority, including hypertension control, statin use for those at high risk, cancer screening and treatment, treatment of tobacco addiction, and more. 9/
Only 1 of every 7 people with hypertension have it under control.
18 million people die every year from heart disease.
Tackling heart disease can help reverse alarming trends in life expectancy driven by the Covid pandemic. 10/
18 million people die every year from heart disease.
Tackling heart disease can help reverse alarming trends in life expectancy driven by the Covid pandemic. 10/
https://twitter.com/EricTopol/status/1582026524080775168
Scaling up proven interventions including tobacco control and prevention and treatment of hypertension is the only way we'll achieve the SDG target for reducing non-communicable disease deaths at a young age. #GlobalGoals 11/end
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