Prevention of cardiovascular diseases

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Prevention of cardiovascular diseases

Cardiovascular diseases (CVD) of atherosclerotic origin, especially coronary heart disease (CHD), remain the leading cause of premature death worldwide.

The increase in morbidity and mortality from circulatory system diseases (CVDs) in the Republic of Belarus is due to objective and subjective factors:

aging population,
financial and economic situation,
increase in psycho-emotional stress,
urbanization of the population,
changing the nature of nutrition,
living conditions, working conditions,
the presence of many risk factors for the development of CSD in a significant proportion of residents,
primarily the widespread prevalence of smoking,
alcohol consumption, sedentary lifestyle,
overweight,
lack of motivation among the population to take care of their own health and maintain a healthy lifestyle.

According to epidemiological studies, the prevention of CVD is highly effective. A 50% reduction in mortality from coronary artery disease is associated with interventions on risk factors and only 40% with improved treatment.

Prevention of CVD is a coordinated effort at the community and individual levels aimed at eliminating or minimizing the impact of CVD and associated disability. Preventive measures should be carried out throughout life, from birth to old age.

Reducing morbidity and mortality from CVD among the entire population can be achieved through a population-based (mass) and individual prevention strategy , which consists of changing lifestyle and environmental factors associated with diseases, as well as their social and economic consequences.

Prevention of CVD can be divided into two groups:

Primary prevention includes a rational regime of work and rest, increasing physical activity, limiting table salt, giving up alcohol and smoking, reducing caloric intake and body weight. In fact, it is primary prevention that allows one to maintain rational conditions for human life.

Secondary (drug and non-drug) prevention is carried out differentiatedly with groups of patients with verified CVD in order to prevent relapses of diseases, the development of complications in people with realized risk factors, reduce morbidity and mortality from these diseases, and improve the quality of life of patients.

According to WHO, three main risk factors make the greatest contribution to the risk of sudden death: hypertension, hypercholesterolemia (dyslipidemia) and smoking.

Classification of CVD risk factors:

Biological (non-modifiable) factors:

Age, gender, heredity (early development of CVD in relatives), genetic factors contributing to the occurrence of dyslipidemia, hypertension, glucose tolerance, diabetes mellitus and obesity
Anatomical, physiological and metabolic (biochemical) features: dyslipidemia, obesity and the nature of the distribution of fat in the body, diabetes mellitus.

Behavioral (modifiable) factors:

Eating habits, smoking, physical activity, alcohol consumption, exposure to stress.

The presence of even one of the risk factors increases the mortality rate of men aged 50-69 years by 3.5 times, and the combined effect of several factors - by 5-7 times. Thus, in order to influence CVD risk factors, it is necessary to motivate each individual to form a healthy lifestyle.

Activities that promote a healthy lifestyle and reduce risk factors:

1. Quitting smoking (for non-smokers staying in smoking rooms (passive smoking). If a person smokes 5 cigarettes a day, the risk of death increases by 40%, if one pack a day - by 400%, that is, the chances of dying are 10 times greater ! In the Republic of Belarus, tobacco smoking is an indirect cause of death in every fifth death of persons over 35 years of age.

2. Following a low-cholesterol diet : reducing saturated fats (reducing the consumption of fatty pork, introducing turkey and rabbit meat with low cholesterol into the diet), focusing on whole grains, vegetables (recommended up to 5 servings per day), fruits and fish. Vegetable oils should be used: sunflower, corn, rapeseed or olive. The total fat content should not exceed 30% of the total energy composition, and the saturated fat content should not exceed 1/3 of all fat consumed.

3. Reduce table salt consumption to 5 g/day. Reduce the consumption of foods containing “hidden” salt: smoked and boiled sausages, bread. Research by scientists has shown that if you limit your salt intake, the risk of myocardial infarction and other heart events can be reduced by 25%. It is very useful to increase the consumption of foods containing potassium and magnesium (seaweed, raisins, beets, apricots, zucchini, pumpkin, buckwheat).

A balanced diet is a balanced, regular (at least 4 times a day) diet with limited salt intake.

4. Reducing excess weight. Excess weight increases the risk of developing coronary artery disease and other diseases associated with atherosclerosis. Noteworthy is the fact that more than 12% of the population does not know their weight at all. The prevalence of overweight increases with age. To estimate your weight, use a simple formula for determining body mass index (BMI) = weight (kg) / height (m 2 ).

BMI

up to 24.9 is normal body weight;
25-29.9 – overweight;
30-34.9 – I degree obesity;
35-39.9 – II degree obesity;
40 or more – III degree obesity.

Moreover, the so-called central obesity (male type), when fat is deposited on the abdomen, is more dangerous. The presence of central obesity can be judged by waist circumference (WC) and the ratio of waist circumference to hip circumference. The risk of CVD increases in men with a WC greater than 94 cm and, especially, with a circumference greater than 102 cm, in women - more than 80 cm and 88 cm, respectively. The ratio of waist circumference to hip circumference in men is more than 1.0 and in women more than 0.85 is a more accurate indicator of the central type of obesity.

For men with WC < 102 cm and women with WC < 88 cm and/or BMI < 30 kg/m2, it is recommended not to gain weight.

For men with WC ≥ 102 cm and women with WC ≥ 88 cm and/or BMI ≥ 30 kg/m2, it is recommended to reduce body weight.

5. Blood pressure control. Maintain blood pressure level no higher than 140/90 mm Hg. Art.

6. Increase physical activity. Playing sports is not only useful, but also enjoyable. The body will always be in good shape, weight will be normal. We are now talking about aerobic activity, that is, movement in the fresh air. This could be running, brisk walking, or a good warm-up. At least 150 minutes per week (30 minutes per day, 5 times per week) of moderate aerobic physical activity (walking, swimming, cycling) or 75 minutes per week of vigorous physical activity, or a combination of both. Choose the type of fitness activity yourself, according to your taste and age.

7. Monitoring lipid metabolism indicators. In patients with very high CV risk, it is recommended to achieve a target low-density lipoprotein cholesterol (LDL-C) level of <1.8 mmol/L or reduce it by at least 50% if the baseline value was 1.8-3.5 mmol/L.

In patients with high cardiovascular risk, it is recommended to achieve a target LDL-C level of <2.6 mmol/l or reduce it by at least 50% if the initial value was 2.6-5.1 mmol/l. In the remaining patients, the target LDL-C level is <3.0 mmol/l.

8. Avoid drinking alcohol. If it is very difficult to completely give up alcohol, leave dry red wine in your diet. Limit alcohol intake to less than 2 standard drinks (1 drink - 12 g/18 ml ethanol) per day for men and less than 1 standard drink per day for women, which approximately corresponds to 330 ml of beer, or 150 ml of wine, or 45 ml of strong drink .

9. Glycemic control. Glycated hemoglobin level < 6-6.5%.

10. Avoid prolonged stressful situations. The fight against stress can and should be effective. Do you feel emotional stress? Walking will help. The mind will be distracted from negative emotions, and the body will receive the necessary physical activity. Learn other relaxation methods: breathing exercises, yoga, psychological stress management techniques.

Adequate healthy sleep is a very important component of health. A rested person looks at all difficulties differently and is much less likely to suffer from depression. The heart also needs rest - allow it this “luxury”.

In conclusion, it should be noted that even small changes made to lifestyle can slow down the premature aging of the heart and blood vessels. It's never too late to start living a healthy lifestyle. After a person develops signs of coronary artery disease, risk factors continue to act, contributing to the progression of the disease and worsening the prognosis, so their correction should be an integral part of treatment tactics.

Information material prepared by: valeologist of the 1st City Clinical Hospital Zhuravel L.V.