Cardiovascular Disease in Haiti: Establishing Hypertension Primary Care Guidelines and Initiating a Longitudinal Cohort Study

Cardiovascular disease (CVD) is now the leading cause of adult mortality in Haiti, having surpassed HIV in the last decade. Responding to this urgent need to understand this emerging epidemic in Haiti, Dr. Margaret McNairy, Associate Professor of Medicine at Weill Cornell, has led several research initiatives related to CVD in collaboration with partners at Weill Cornell Medicine and the GHESKIO Clinics in Haiti.

In May 2019, Cornell and GHESKIO collaborated with the Haitian Ministry of Health to host the Inaugural Clinical Conference of GHESKIO Centers on Cardiovascular Disease. This conference convened CVD experts and physicians from around the world as well as national stakeholders in Haiti to establish Primary-Care Hypertension Guidelines. These guidelines are being implemented across all GHESKIO clinics to improve the prevention and treatment of CVD across Haiti.

That same spring, enrollment commenced for the first longitudinal, population-based cohort to study the natural history of CVD in Haiti. To date, more than 700 participants have been enrolled towards the goal of establishing a cohort of 3,000 adults from Port-au-Prince. The cohort will be followed for three years during which data will be collected on blood pressure, clinical characteristics, health behaviors, living environments and cardiovascular disease outcomes. 

Preliminary results demonstrate high rates of hypertension and cases of cardiovascular diseases like heart failure and myocardial infarction. The team hypothesizes that these results may be explained by social and environmental determinants like stress, social isolation, depression, food insecurity and lead exposure.

Data from this study will be used to estimate the prevalence and incidence of CVD in Haiti as well as to understand the determinants of the CVD epidemic. This new knowledge can be translated into policy and practice that will directly improve health outcomes of Haitians in both Haiti and the US.