Heart Health: Prevention, Prevention And Prevention Again

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Heart Health: Prevention, Prevention And Prevention Again
Heart Health: Prevention, Prevention And Prevention Again

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Video: Heart Disease Prevention: The Impact of Diet and Exercise on Heart Health; By David Maron, MD 2023, January

Heart health: prevention, prevention and prevention again

On September 29, World Heart Day was celebrated to draw attention to the most common cause of death and various forms of prevention of cardiovascular disease. Relapses and complications of cardiovascular events, after which rehabilitation is practically not developed in our country, make a significant contribution to mortality from CVD.

Heart health: prevention, prevention and prevention again
Heart health: prevention, prevention and prevention again

Photo: pixabay.com /

On September 29, World Heart Day was celebrated to draw attention to the most common cause of death and various forms of prevention of cardiovascular disease. Relapses and complications of cardiovascular events, after which rehabilitation is practically not developed in our country, make a significant contribution to mortality from CVD.

Cardiovascular diseases occupy a leading position in the structure of mortality in our country and in the world. According to the Ministry of Health, today mortality from diseases of the circulatory system is 565 cases per 100 thousand people.

Primary prevention

Chief cardiac surgeon of the Ministry of Health, President of the League of Nation's Health Academician Leo Bokeria spoke about the methods of natural healing at the World Heart Day. He recalled that the best prevention is giving up bad habits and physical activity.So, hypertension does not progress if it is detected on time and a person begins to exercise, walk within the limits recommended by a doctor, and adhere to a diet. “It has long been proven that systematic physical education significantly reduces the risks of cardiovascular and other chronic diseases. Walking remains the most physiological and accessible form of physical activity; it does not require additional equipment and specially organized space. That is why the League of Nation's Health, Bakulev Center initiated such projects as "10,000 steps to life", "Walking man" and "Walk with a doctor". All these projects have one thing in common - walking, as a universal, natural, habitual and physiological type of physical activity for a person of any age and gender.", - said Bokeria.

According to him, the advantage of walking is that it does not involve any special efforts and forms a habit of daily physical activity. “You need to walk at an even pace so that a person can speak and breathe at the same time. Accordingly, more oxygen will enter his body. You need to increase the load gradually. It is desirable, of course, that he did not walk relaxed, but kept a certain pace, corresponding to the pulse rate. You need to walk so that it is comfortable for him to walk at least a kilometer. Then, as practice shows, people who have been walking for a year or a year and a half return to the kinds of sports they once practiced. They begin to feel better, get together with friends, play a little football or something else,”said Leo Bokeria.

The 10,000 Steps to Life program has existed for over 6 years and is based on the WHO recommendation to take 6 to 10 thousand steps a day to maintain a minimum of normal physical activity. “This is not a symbolic figure. It is based on numerous studies. For example, the famous Mayo Brothers Clinic has a Health Institute, where relevant research is carried out,”explained Leo Bockeria. The "Walk with a Doctor" project has a long international history, initially the project was conceived and implemented in Australia. “The essence of the project is in the name. This is a walk with a doctor, during which people can consult, talk with a doctor on topics of interest to them.The target audience of the project is most often people who already have problems with the cardiovascular system or have undergone surgery and need rehabilitation measures. But, of course, the format of the walk does not exclude healthy people from taking part in it,”Bokeria said.

Secondary prevention

Secondary prevention is aimed at people already suffering from CVD in order to prevent re-exacerbation and decompensation of the disease. According to Igor Zhirov, a leading researcher at the Department of Heart Failure and Myocardial Diseases, Professor of the Department of Cardiology of the RMANPO, according to modern concepts, secondary prevention is one of the cornerstones in reducing mortality from cardiovascular diseases.

Any exacerbation does not arise from scratch. Most cardiovascular accidents occur against the background of long-term ongoing processes in the patient's body. In a patient who has already had a myocardial infarction or cerebral stroke, the likelihood of their recurrence is very high. Current treatments for acute cardiovascular conditions are effective, but their success must be sustained. Secondary prevention is long-term and persistent therapy. At the same time, it is important not only to prescribe a therapy, but also to make the patient follow the recommendations, to strengthen his adherence to therapy,”the expert believes.

Secondary prophylaxis necessarily includes a certain set of medications with strict control of their use and selection of doses, recalls the head of the cardiac intensive care unit of the Bauman City Clinical Hospital No. 29, Alexey Erlikh. Some of these medicines are readily available, but some are quite expensive, which most patients cannot afford to pay. And outpatient drug treatment in the Russian Federation is not covered from the CHI fund.This is the first problem. The second problem is in the approaches of medicine to treatment. If, for example, primary prevention is largely without the participation of a doctor, then secondary prevention necessarily requires the participation of a doctor who understands what he is doing. “And there are not very many such doctors in general, the shortage of personnel is obvious, the shortage of good personnel is obvious 100 times more, and many doctors are not committed to conducting rational secondary prevention in their patients,” notes Alexey Erlikh.

According to Igor Zhirov, in order to increase adherence to therapy in patients after acute coronary syndrome, two issues need to be addressed. First of all, it is necessary to raise the awareness of doctors about new ways of managing such patients. It is imperative that professionals prescribe therapy with proven efficacy. In addition, the patient must be motivated to follow all recommendations. Therefore, it is of great importance to raise awareness about diseases, schools for patients, some way of reminding about the need to continue treatment and the rules of a healthy lifestyle, as well as the appointment of fixed combinations of drugs.

Just prevention

In the West, there is no such thing as secondary and primary prevention of cardiovascular diseases, says Maria Vedunova, director of the Institute of Biology and Biomedicine at Lobachevsky University, 5-100 University. “There is simply the prevention of CVD, and now they have a huge number of programs aimed at, in principle, reducing strokes and heart attacks,” the expert notes. “For example, in Belgium, many businesses pay their employees extra for cycling to work. As for working with people who have already been diagnosed, in Europe it is, firstly, social rehabilitation of people who have been diagnosed, and secondly, lifelong support by therapists and psychologists.A powerful system of social rehabilitation and psychological assistance is working for those people who have suffered heart attacks or strokes. They are trying to teach them to live differently, go to psychologists, change their diet, lifestyle. In our country, unfortunately, rehabilitation is not developed, and there are no specialists as such”.

Meanwhile, as the Health Independent Monitoring Foundation reported today, only 17 out of 85 regions of Russia have included all cardiovascular drugs from the federal VED list on the preferential lists of drugs. The experts of the Foundation obtained such data by analyzing the data of Rosstat and territorial programs of state guarantees. In total, the federal list of vital and essential drugs, approved by the government for 2019, includes 53 types of drugs for the treatment of diseases of the cardiovascular system. “There is a risk that residents of the remaining 68 regions have a limited opportunity to receive drugs for cardiovascular diseases with a 50% discount or free. And this strikes a blow on their well-being and can lead to an increase in mortality from these diseases, because it is extremely important for heart patients to comply with the doctor's prescriptions for daily medication intake,”- said the director of the Health Foundation Eduard Gavrilov.

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