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Focus on National Prevention Strategies: Montenegro

Professor Ljilja Music, National CVD Prevention Coordinator in Montenegro

Cardiovascular Disease Prevention - Risk Assessment and Management in Montenegro

The healthcare system in Montenegro (650,000 inhabitants) is organised through the House of Health. The seven most frequent chronic diseases in 2009 were: hypertension, hyperlipidaemia, chronic heart diseases, allergy (except asthma), renal diseases and diabetes. There are different lifestyle aspects, which are adapted to the regional-climate properties of the northern region (mountain region) and south (Adriatic coast). Montenegro belongs to the high risk regions of Europe for cardiovascular disease (CVD). According to statistics from the National Institute of Public Health, total CVD mortality in Montenegro is over 54%.


In 1880, the King Nikola nominated Dr. Milan Jovanovic Batuta to look at the health of the population of Montenegrins and to give recommendations. A famous report on the state of the health of the population was published on 16 July 1881, which can be considered as the forerunner of today's statistical yearbook of population health and health care in Montenegro, which is published every year by the Institute of Public Health.

Some very important results were obtained in the latest enquiry from the Living Standards Measurement Survey (LSMS), Montenegro’s national health survey. The study was conducted in 2008 by the Republic of Montenegro’s Ministry of Health. This study provides the largest single source of health information for reporting on the progress in achieving the goals and objectives outlined in the latest national and international strategies and agreements that will provide a rich background in the form of comparative data for extensive reporting on progress.

Survey results should contribute harmonising the actual needs of the population and available resources in order to provide better quality and more efficient health care to accomplish the most important development goal - a longer and better life.

This National enquiry was completed in 2008, covering 7,526 adults over 20 years. The query was conducted by the Ministry of Health with support of the Institute of Public Health. The incidence of hypertension was found to be 32,7%. This is appreciably lower than the incidence of hypertension in 2000 when the it was 43,4%. The prevalence of hypertension in the south part of Montenegro was certainly under the average (27, 1%). Hypertension was frequently distributed in rural population (37% vs. 30%).
Also, this research showed the following facts: 

  • 42, 8% had optimal BMI
  • 25, 1% consumed alcohol every day
  • 10, 8% had level of glycaemia more than 6,1mmol/l
  • The average level of cholesterol was 4,78 mmol/l and 59,8 % of the population had the optimal level of cholesterol
  • The average level of triglycerides was 2,02mmol/l and 47,3% of adults in Montenegro had optimal level of triglycerides lower than 1,7 mmol/L
  • The prevalence of smoking was 32,7%. It was considerably lower than in 2000 when it was 43,8%

Since 2010, we introduced the subject “Healthy lifestyle” in elementary schools and secondary schools. These actions were initiated under the leadership of the Ministry of Education, doctors specialised in different preventive fields and the National CVD Prevention Coordinator.

As of 2011, we have a very restrictive smoking ban in public places and in 2004 we also introduced a law restricting tobacco products. The Cardiological Society of Montenegro has been focused, in collaboration with Ministry of Health and primary health care system, on the creation of two kinds of brochures for patients and doctors.

The role of the National CVD Prevention Coordinator becomes increasingly important for closing the loop between guidelines, clinical practice and political action, especially with the launch of the 5th Joint Task Force European Guidelines on CVD Prevention in Clinical Practice at EuroPRevent 2012 in Dublin.

The National CVD Prevention Coordinator with the support of the Ministry of Health and the House of Health issued a booklet for non professionals, titled: "Take heart in your hands!" The most important event in 2012 was the translation of the three ESC guidelines: CVD Prevention, Treatment of Hypertension and Treatment of STEMI.

Using these, we reinforced the implementation of the national strategy for CVD Prevention which is conducted by the WHO and was adopted by the Montenegrin government in 2008. At this stage, implementation strategies at national level include adaptation of the European guidelines to suit the local culture in collaboration with a multi-disciplinary implementation group.

The Ministry of Health together with the local WHO office and the National CVD Coordinator launched an initiative to reduce the consumption of salt. We started this action in December 2012. We still need to develop better cooperation with the food industry and improve implementation of healthy diets in everyday life – such as reduction of salt and saturated fats intake.

Other national societies and organisations active in the field of CVD prevention are the family medicine of hypertension and the counselling service for diabetes.

A specific study on a national level has been developed and reviewed, including:
1. Screening and modification of CVD risk factors
2. Treatment of hypertension and detection of an occult coronary artery disease.

There is a centre within the Institute for Public Health, whose duties are to promote health and to control chronic non-communicable diseases (NCD) within the network of the WHO for South-East Europe. The centre will become the control centre for South East Europe for a period of 6 months starting in July 2013.

For more information, please contact:

Professor Ljilja Music (email)
National CVD Prevention Coordinator in Montenegro