Hong Kong ranked number one among 50 cities around the world for their efforts at combating cardiovascular disease (CVD), while Kathmandu lagged far behind and came at the bottom, according to a report released by World Health Federation (WHF) on Wednesday.

London and Madrid were ranked second and third respectively in the City Heartbeat Index, a latest project of the Geneva based NGO,launched to find outthe most important factors influencing cardiovascular health in citiesacross the world and to improve its care and treatment.

Cardiovascular diseases include a group of disorders related to heart and blood vessels like coronary heart disease, cerebrovascular disease and rheumatic heart disease.

The City Heartbeat Index analyzed presence of 44 indicators across five domains in the 50 cities, mainly social determinants like poverty, physical environmental factors including quality of air, health risk factors like presence of hypertension, accessibility tohealth services and governance or implementation of policies related to health, Health Policy Watch reported.

Cities were selected according to the size of their population and prevalence of cardiovascular diseases. 

Data for the report came from experts, health departments, government websites and available literature on the topic, according to Health Policy Watch.

Most of the cities in the Asia- Pacicific region were found highly efficient when it came to protecting heart health and some policies like the expansion of low- emission zones in Seoul, smog-free tower in Beijing and implementation of compulsory diabetes and hypertension screening for everyone above age 21 in Bangkok were found highly successful in preventing the deadly condition. 

London ranked high for its decision to expand the Ultra Low Emission Zone (ULEZ) to the entire urban area, making separate lanes for bikes and by prohibiting advertising related to junk food. 

Sadiq Khan, Mayor of London proudly listed their achievements. "I am extremely proud of the work we have done to make London a healthier place to live. We have made real progress improving health outcomes by taking old polluting cars off our roads and bringing cleaner air to millions more Londoners, enabling more walking and cycling and promoting healthier food advertising on our transport network," he said.

Despite being located in countries with high rates of CVD cases, Berlin and New York City were found highly efficient in their efforts to protect heart health.  On the other hand, cities like Singapore and Toronto succeeded to address the issue by running an excellent system of data collection.

While European cities like Paris and Rome performed bad at addressing the issue, cities like Jakarta managed to do well even with their low financial resources. Meanwhile, cities in Middle East and Africa were found struggling with funding and policy support.

The report found that income of a country influenced their performance and that life expectancy went up with higher index scores. Giving more attention to certain health risk factors like diabetes and hypertension and ignoringsome others like low vegetable consumption, high cholesterol and trans-fat intake affected policy implementation. Most of the cities also lacked data on certain health issues like cholesterol and trans-fat consumption, affecting how policies were successfully implemented.

The findings are expected to help highlight importance of focusing more on tackling CVD at city-level.

"This is the first attempt of this kind, and more importantly that it is going to enthuse the governments or the non-governmental organizations or the local bodies to be trying to do better," Dr Jagat Narula, president-elect of the WHF, told Health Policy Watch. "We are talking about the heartbeat index here, but it is actually going to give you a much broader vision and much better chances of working towards policies."

The report was conducted by Economist Impact. "The City Heartbeat Index shows that the many efforts by cities - where over half of the world's population resides - on heart health is visible and increasingly important," Dr Vasilisa Sazonov, Therapeutic Area Head, Novartis, said in a statement.

The report comes at a time when CVD kills more than 17.9 million people every year, making it one of the leading causes of death worldwide.