Diseases of the cardiovascular system statistics. Statistics of cardiovascular diseases in Europe

• 1 Pulse rate
• 2 Causes of increased heart rate
• 3 Symptoms
• 4 First aid for a quick decrease in heart rate at home
  • 4.1 Medicines
  • 4.2 Useful products
  • 4.3 Exercise
  • 4.4 Folk remedies: herbs, fees
    • 4.4.1 Benefits of honey
• 5 How to slow down the pulse of a child at home?

Patients suffering from cardiovascular diseases, it is important to be able to quickly reduce the pulse at home. To do this correctly, you need to have knowledge about the factors that accelerate the pulse in each case, and about all kinds of methods that allow you to bring the pulse down to normal values. It is also important to know about the contraindications that exist for each method of treatment.

Pulse rates

The heart rate of a healthy adult at normal pressure ranges from 60 to 90 beats per minute.

Factors affecting heart rate in healthy people:

1. Age - in a newborn, the heart rate is 2 times more frequent than in an adult.
2. Sex - the rhythm of the heartbeat of women is on average 10 beats per minute more than that of men.
3. Physical activity - the heart muscle of athletes contracts more slowly than in people who lead a sedentary life.
4. Nutrition - taking fatty, spicy foods speeds up the heartbeat, increases the pulse.
5. Availability bad habits- Smoking and alcohol increase heart rate.
6. Pregnancy - in women in position, the volume of blood increases and the pulse accelerates.

Back to index

Causes of an increase in heart rate

For people with cardiovascular disease, coffee abuse is dangerous to health.

Factors in the development of an abnormally high pulse in humans:

• excess body weight;
• hot climate;
• increase in body temperature;
• smoking;
• intake of alcoholic beverages;
• excessive consumption of strong coffee;
• pregnancy;
• period of menstruation, menopause;
• stress;
• sleep disturbance;
• diseases:
  • hypertension;
  • ischemia;
  • atherosclerosis;
  • tachycardia;
  • anemia;
  • diseases of the endocrine system;
  • pathology of the heart valves.
• taking antidepressants.

Back to index

Symptoms

A person feels a rapid pulse throughout the day. This may be a consequence of nervous tension, fatigue, physical activity, unusual for the body. After the end of the influence of external factors, palpitations are restored to normal. If the heart rhythm does not return to normal on its own, drugs to reduce the heart rate should be used.

Signs that the patient should lower the heart rate using pills or folk remedies:

• feels a pulsation in the temporal zone and ringing in the ears;
• there is cold perspiration on the forehead;
• concerned about weakness, drowsiness, dizziness.

A condition in which the cause of an increased heart rate is external factor(excitement or physical overload), called sinus tachycardia; if palpitations are due to internal diseases cordially- vascular system This is paroxysmal tachycardia.

Back to index

First aid for a quick decrease in heart rate at home

With increased irritability and emotional experiences, sedatives can be taken.

It is important to reduce the pulse at home both at high pressure and at low pressure. It is important to understand the reason why this condition is caused. If excitement was a factor in the excessive heart rate, you can calm the nerves at home with the help of sedatives (Corvalol, Valocordin, Nitroglycerin, valerian, motherwort). If a high pulse appeared against the background of an increase or decrease in pressure, it is possible to restore heart rate at home with medicinal and folk remedies hyper- and hypotensive action.

Back to index

Medications

Synthetic drugs with a high pulse, allowing you to normalize the heart rhythm quickly at home:

• "Reserpine". The drug is effective for hypertension, neurosis, psychosis. Take a two-week course of 100-250 mg per day.
• "Etacizin". Scope of application - tachycardia, ventricular extrasystole. The tool helps to bring the heart rate back to normal if you drink it 50 mg 3 times a day. The attending physician controls the duration of treatment.
• "Pulsnorma" - a medicine in the form of dragee tablets, indications: arrhythmia, intoxication with cardiac glycosides. Drink 2 pcs. three times a day with meals. The amount of the drug consumed should be reduced to zero, gradually reducing the daily dose.
• Finoptin. Indications for use: angina pectoris, increased heart rate, nervous tension. Reception can last from 2 weeks to six months, depending on the severity of the case. Dosage - 3 r per day, 1 tablet.
• "Ritmilen" is taken for acute violations of heart rate. Once at home, you should take 300 mg of the drug. Relief occurs 3-4 hours after taking the pill.

Back to index

Healthy foods

Suitable foods have a positive effect on the body due to beneficial substances.

Some foods will help stabilize a fast heart rate without medication at home. You can reduce your heart rate by eating omega-3-containing foods: fish (mackerel, salmon, herring, tuna), fish fat, seafood (shrimp, oysters, cod), vegetable oils (coconut, olive, linseed, sesame, mustard), nuts (almonds, pistachios, walnuts), pumpkin and sunflower seeds, greens (spinach, beet leaves), green salad. Dried fruits raisins, figs, dried apricots, rich in minerals (potassium, magnesium), important for the normal functioning of the myocardium.

Back to index

Exercises

Regular aerobic physical exercises allow you to gradually lower your heart rate without using drugs to reduce your heart rate. You need to choose swimming, walking, cycling, dance exercises, jogging. The training regimen can be any, but it is advisable to train for at least half an hour a day.

You can lower your heart rate by breathing. Doing these exercises at home is easy. Necessary:

1. Sit straight.
2. Place one hand on your chest, the other on your stomach.
3. Take a deep breath through the nose.
4. Exhale smoothly through your mouth.
5. Repeat 10 times.

Another breathing exercise to do at home:

1. Take three quick breaths in and out (about three per second) through your nose.
2. Take a slow breath in and out through your nose.
3. Repeat for 15 seconds.

Meditation helps to calm the heart rate, relieve nervous tension. To begin with, you can meditate for 5 minutes. It is required to sit on the floor in a comfortable position (lotus position) and focus only on breathing, driving away extraneous thoughts. Such exercises are called clear mind meditation. Yogis use them in their practice to calm the soul and find physical and mental balance.

Back to index

Folk remedies: herbs, fees

Rosehip tinctures and decoctions can stabilize the heartbeat.

You can lower your heart rate at home using grandmother's recipes: berries, herbs, their decoctions, tinctures and fees:

• Rosehip (2 tablespoons of ground berries) pour 2 cups of boiling water and boil. Strain the broth and drink half a cup a day.
• Currant berries, if taken in fresh or in the form of jam, will reduce the risk of cardiovascular disease. From the dry leaves of this plant, decoctions are made (2 tablespoons of raw materials per liter of water), which have a general strengthening effect on the body.
• Pour 100 g of dried lemon balm leaves with a glass of alcohol and leave for 10 days, take 5 ml, dissolved in half a glass of water, 4 times a day.
• A mixture of calendula and motherwort 1:1 pour a liter of boiling water and leave for 2 hours. Drink a spoonful before meals. The prescription is used in patients with low blood pressure.
• 1 st. l. dip the root of the valerian officinalis into boiling water and cook for half an hour. Strained broth take 1 tbsp. l. three times after meals.
• Chop 1 onion and 1 head of garlic, add a spoonful of rowan juice and pour water. Let it boil for 10 minutes, then insist 20 minutes. Add dill and parsley to the broth and drink for two weeks before meals in a teaspoon.

You can increase your heart rate at home with the help of:

• ginseng root;
• lemongrass;
• eleutherococcus;
• coffee;
• strong sweet tea.

Back to index

Benefits of honey

Everyone knows about the usefulness of honey. This tool will help with a high pulse rate. You can take honey in its pure form, a tablespoon a day. It is also useful to brew tea with chamomile and honey, which, in addition to lowering the pulse rate, acts on the body as an immunomodulator, improves health, and lowers blood pressure.

Back to index

How to slow down the pulse of a child at home?

When self-medicating in children, one must be very careful, since any violation of the child's pulse rhythm may indicate myocardial pathologies. It is recommended to reduce the child's pulse quickly at home with the help of medicines only in emergency cases. Basically, it is enough to take the baby to fresh air, lay down and ensure peace of mind. If heart rate disturbances are observed systematically, you should consult a doctor.

Comment

Nickname

The likelihood of cardiovascular disease

• diabetes;
• atherosclerosis;
• cardiac ischemia;
• with your relatives early age cardiovascular diseases have been identified;
• you are obese and lead a sedentary lifestyle.

Normalization of pressure using arifon retard

1. Beneficial features
2. When should you take indapamide?
3. Instruction
4. Reviews

Hypertension will help to overcome only her complex treatment, consisting of a combination medicines and light physical activity. Physical education means exercising at a moderate pace. These include walking, exercising, light running, etc.

The therapeutic part includes the cyclical intake of drugs that cause a stable and long-term decrease in pressure. One of these medicines is retard.

Beneficial features

Main active ingredient drug Arifon Retard - indapamide.

Retard 100, Retard 200 and Retard 400 differ from each other in its concentration. Lipophilicity allows indapamide to act on blood vessels and renal tissue. The drug modernizes the flow of ions through cell membranes and reduces the sensitivity of blood vessels to adrenaline. The nephroprotective effect of Arifon retard 1.5 mg, the price of which is indicated on the web resources of pharmacies, is manifested in those suffering from type II diabetes mellitus. At a dosage of 1.5 mg, it reduced the release of protein into the urine by 46%.

1. The drug is metabolically neutral.
2. It does not affect the metabolism of carbohydrates, lipids and purines when taken for a year.
3. The level of glucose, uric acid, cholesterol and triglycerides remains normal in patients.
4. After a single dose, Arifon Retard controls the patient's blood pressure for 24 hours. This is ensured by the special structure of the tablets. The active substance is dissolved in the structure of the matrix. Inside the matrix, fibers of different densities release indapamide gradually.

Complete absorption of the drug occurs in the digestive tract 2-3 hours after ingestion. The gradual release of indapamide reduces the risk of hypokalemia and negative effects by 60%. Also, the positive aspects of taking the drug Arifon Retard include:

• Effectiveness in essential and isolated systolic hypertension;
• Nephroprotective and cardioprotective properties;
• Inertness to purine, carbohydrate and lipid metabolism;
• Ease of use (1 time per day);
• Suitable for patients aged 80 and suffering from diabetes;
• Safety and rapid elimination of the consequences of an overdose;
• Decreased overall mortality of patients after undergoing a year of therapy.

The drug is completely absorbed by the body from the digestive tract. If you use Arifon Retard with food, the absorption rate of the drug will decrease, and the composition active substance Will not change.

The structure of the cortical layer of the renal tissue changes somewhat. He begins to reabsorb sodium worse, which is why potassium, chloride and magnesium are excreted in the urine. The volume of released fluid increases by 20-30%.

You won't be able to buy a retard without a referral from a therapist. Detailed instructions are supplied with the drug indapamide retard. It describes the features of the reception, side effects and drug interactions with other drugs.

When should you take indapamide?

The drug Arifon Retard and its analogues are therapeutic drugs, i.e. You will notice a positive effect from their use after a certain time.

These pills are not suitable for emergency pressure reduction, but they can stabilize it with prolonged use. The main active ingredient of the drug is a diuretic, so the doctor should prescribe Arifon Retard based on the results of the tests.

Instruction

The drug indapamide retard should be started as prescribed by a doctor. The tablet does not need to be chewed. For quick assimilation, it is washed down with plenty of water. Regardless of the age group, patients are prescribed 1 tablet per day to be taken in the morning.

The maximum dose of Arifon retard is 1.5 mg. When the dose is increased, patients are not diagnosed with a rapid decrease in blood pressure, but the risk of side effects increases.

Before starting to take Arifon retard 1.5 and similar in action angiosyl retard, metindol retard and other drugs, patients determine the level of sodium, potassium, calcium and glucose in the blood. Repeated testing is carried out after 1.5 - 2 months.

indapamide and children

The drug arifon retard, the price of which is indicated in pharmacies, is not prescribed for children and adolescents. There is no experience with the drug in this age group.

Overdose

Indapamide in a concentration of up to 40 mg does not have a toxic effect on the body. At acute poisoning drug observed hypokalemia and hyponatremia. In parallel, the patient with an overdose manifests nausea, vomiting, lowering blood pressure, drowsiness, dizziness, decreased blood circulation, polyuria / oliguria and cessation of urine flow into the bladder.

To eliminate the consequences of an overdose, the drug is removed from the body by gastric lavage or by taking sorbents, and drugs are taken to restore the water-electric balance.

Interaction with other drugs

You should not take arifon retard 1.5, the price of which is affordable for a wide range of consumers, and normotimics at the same time. In 70% of cases, this leads to a sharp increase in the concentration of lithium in the blood due to a decrease in its absorption, which contributes to the appearance of overdose symptoms.

Ventricular tachycardia can be caused by taking Arifon Retard together with:

• quinidine, disopyramide and other sodium channel blockers belonging to class IA antiarrhythmic drugs;
• dofetilide, sotalol and other sodium channel blockers classified as class III antiarrhythmic drugs;
• a number of antipsychotics that reduce the absorption of sodium and potassium by the body (tapride, cyamemazine, etc.);
• other drugs that inhibit the work of sodium channels (pentamidine, moxifloxacin, etc.).

Hypokalemia is one of the causes of ventricular arrhythmias. Therefore, before taking mebsin retard and other drugs containing indapamide, the percentage of potassium in the blood is diagnosed before the start of therapy against hypertension and taking drugs above. If the patient is diagnosed with hypokalemia, then taking drugs that block sodium channels is prohibited. If everything is normal with the potassium level, then the combination of drugs is possible, however, the patient will have to take tests for the content of potassium in the blood plasma every 2 weeks.

indapamide and antidepressants

With the simultaneous administration of the drug Retard and antipsychotic drugs, a sharp decrease in pressure is diagnosed (by 20% or more).

Pregnancy and lactation

Diuretic drugs are not prescribed for pregnant women. The patient should not arbitrarily take them to reduce swelling, because. they can provoke fetal developmental disorders and suspend the exchange of nutrients. Indapamide is released along with breast milk, so while the child is on breastfeeding he is also not nominated.

Special Instructions

In less than 20% of patients, the development of photosensitivity is diagnosed while taking the drug. If it manifests itself, then it is recommended to stop taking the diuretic.

Further resumption of reception is possible, but the patient will have to additionally protect the skin from ultraviolet and sunlight. If hypercalcemia appears during the administration of the drug, then the patient has not diagnosed hyperfunction thyroid gland. The drug is stopped.

Patients suffering from diabetes mellitus, while taking the drug Corinfar retard and other drugs with indapamide, need to constantly. Before starting therapy, everyone, without exception, needs to determine the content of sodium and potassium ions in the blood. With their normal concentration while taking the drug, you should be re-examined every 1-1.5 months. If mild hypokalemia and hyponatremia are diagnosed, tests are taken every 2 weeks.

Important! In the initial stages, the reduced concentration of sodium and potassium in the body does not manifest itself at all. Therefore, before starting any therapy with diuretics, they donate blood for chemical analysis.

Professional athletes should not take indapamide, because. during doping tests, he gives positive results. Patients over 55 years of age, in addition to sodium and potassium, should control plasma creatine levels based on body weight, sex and age. Arifon retard is prescribed to patients over 55 years of age with normally functioning kidneys. In those suffering from gout, the course of the disease may worsen or the frequency of seizures may increase.

Before taking the drug, they take tests for the content of calcium in the blood. If significant violations are noticeable, then the patient is referred for the diagnosis of the parathyroid gland. The drug does not affect the speed of the psychomotor reaction, but lowers the pressure. Because of this, 10% of patients experience individual reactions in the form of nausea and dizziness. Therefore, patients at the beginning of therapy manage transport and construction / engineering mechanisms with caution.

Active prevention of cardiovascular diseases involves the use of different approaches - prevention strategies:

Prevention Strategies for Cardiovascular Diseases

Population (mass) strategy - monitoring of cardiovascular diseases and their risk factors, education of the population, the formation of a healthy lifestyle at the social level (society as a whole)

Strategy for influencing high-risk groups (primary prevention) - identifying individuals at high risk of cardiovascular disease, correcting individual risk factors

Secondary prevention - prevention of the progression of cardiovascular diseases in patients at different stages of the cardiovascular continuum

A decrease in morbidity and mortality from cardiovascular diseases can be achieved by improving the cardiological service in all its areas and by strengthening preventive measures using all three strategies.

A population strategy is key to reducing cardiovascular morbidity, as involves reducing the impact of risk factors at the level of the entire population through lifestyle changes and does not require medical examination. However, it is designed for the long term and its results can only be manifested over the course of generations. One example of such a strategy at the state level is the adoption of an “anti-tobacco law”. But in order for it to function effectively, it must be adequately perceived by society, which requires active sanitary and educational work.

Two other strategies aim to reduce cardiovascular risk in high-risk individuals (primary prevention) and in patients with cardiovascular disease (secondary prevention). To prevent one adverse outcome, primary prevention should be carried out in a large number people for whom it does not directly benefit (prevention paradox!). First of all, it is necessary to assess risk factors and, on this basis, identify high-risk groups - impact groups that can be formed on the basis of medical examinations of the population.

results primary prevention are identified using statistical population studies, more often retrospectively. But secondary prevention can give a clear result in a fairly short time and, most importantly, in a particular person based on an assessment of his clinical and social status.

Most of the recommendations for the prevention of cardiovascular disease look very simple, which makes them at first glance frivolous and incomparable with the action of drugs. But it is these banal recommendations - healthy food, sufficient physical activity and giving up bad habits (smoking) that can most naturally prevent the development of atherosclerosis, arterial hypertension, diabetes mellitus and stop the further progression of coronary pathology. Without the implementation of preventive measures, the treatment of coronary artery disease may become unpromising.

Rehabilitation programs take into account the nosological and pathophysiological characteristics of the pathology and the degree of dysfunction. Building a rehabilitation program for each patient implements the principles of complexity rehabilitation measures with their mandatory individualization.

The American Heart Association in 1994 formulated a position according to which the program of cardiac rehabilitation should contain multidisciplinary and multifactorial approaches. Programs consisting only of physical training cannot be considered cardiac rehabilitation.

Drawing up an individual rehabilitation program includes:

evaluation clinical condition patient upon admission to rehabilitation center and verification of the diagnosis formulated upon discharge from the hospital

identification of risk factors for cardiovascular complications, reduction of the impact

modifiable risk factors

determination of the functional capacity of the patient (functional class of angina pectoris and heart failure) and his rehabilitation potential

assessment of the level of motor activity achieved in the hospital and determination of the level of exercise therapy for the adaptation period

carrying out functional studies and stress tests (ECG at rest, Holter monitoring, EchoCG, StressEchoCG, bicycle ergometry, treadmill, 6-minute walk test) according to individual indications in order, in particular, to determine indications for cardiac surgery, to reasonably determine the level of exercise therapy at the training stage of rehabilitation , etc.

drawing up a program of kinesitherapy (exercise therapy)

achievement of target levels of hemodynamic and biochemical parameters

Formation of a healthy lifestyle and correction of risk factors

The development of cardiovascular disease is highly dependent on lifestyle and a large number of risk factors, many of which are modifiable. The widely used concept healthy lifestyle life" is considered as a category general concept lifestyle, including favorable conditions human life, the level of culture and hygienic skills, allowing to maintain and strengthen health, maintain an optimal quality of life.

WHO experts have identified 6 main components that adversely affect human health, which are classified as lifestyle:

psychosocial stress

unhealthy food

Alcohol abuse

• Low physical activity

  drug use

Improvement of lifestyle and correction of modifiable risk factors should be attributed to mandatory general rehabilitation measures.

CV risk factors

The term "risk factor" was first used by W.B. Kannel in 1961 in an article on the Framingham Study. The concept of risk factors is the theoretical basis for the secondary prevention of cardiovascular events, including within the framework of rehabilitation. Knowing the specific risk factors for each patient allows you to develop methods for their correction and prevention, and thereby affect the prognosis.

Cardiovascular morbidity and mortality vary significantly depending on the socioeconomic status of people, which is explained by the distribution of standard risk factors in the population: smoking, increased blood pressure, cholesterol and blood glucose levels.

Of fundamental importance is the division of risk factors into modifiable (correctable), which can be changed by willpower and actions of the doctor and patient, and non-modifiable, independent of our will and consciousness.

In a large epidemiological study INTERHEART (2004), the main risk factors for the development of acute myocardial infarction were studied. It was found that more than 90% of the risk of acute myocardial infarction in different geographical areas, different ethnic groups, in men and women, in young and old, is determined by 9 factors, and really changeable (table below). The association of these factors with myocardial infarction was assessed using odds ratios and their 99% confidence intervals.

Modifiable risk factors for acute myocardial infarction.
(INTERHEART study, 2004)

Multivariate analysis showed that current smoking and an increased ratio of apoB/apoA1 apolipoproteins are the most significant risk factors. They are followed by psychosocial factors, diabetes mellitus, arterial hypertension. The association of myocardial infarction with elevated body mass index was significantly weaker than with abdominal obesity, defined by the ratio of waist and hip circumferences. In addition, overweight and abdominal obesity, which are present in 70-80% of patients with chronic coronary artery disease, as a rule, are accompanied by arterial hypertension.

The relationship with myocardial infarction of daily consumption of fruits and vegetables, sufficient physical activity was inverse, which allowed us to consider these factors as protective.

In 2017, cardiovascular diseases claimed the lives of 858 thousand people, which is 5% less than a year earlier. The death rate has reached its lowest level since the beginning of the decade. The Ministry of Health believes that mass medical examinations and the creation of vascular centers throughout the country played a role in this. According to experts, reducing mortality from circulatory disorders is now being increased attention, as it leads to an increase in life expectancy of the population and the strengthening of the economy.

In 2017, the death rate from cardiovascular disease dropped below 600 per 100,000 for the first time since the beginning of the decade. This is evidenced by the data of Rosstat, which Izvestia got acquainted with. Last year, 858 thousand people died from diseases of the circulatory system - 5% less than in 2016. This is 584.7 cases per 100,000 people.

A steady decline has been observed since 2010. But cardiovascular disease still remains main reason deaths of Russians - almost half (47%) of deaths.

RELATED MORE

The main weapon in the fight against circulatory disorders is prevention, the Ministry of Health notes. Mortality continues to decline due to the mass medical examination, which has been carried out in the country since 2013. This made it possible to increase the coverage of the population by 18% - up to almost 59 million people, which makes it possible to more often detect diseases in the early stages.

In addition, there are more than 593 vascular centers operating in the country, where modern technologies management of patients with complex conditions.

As a result, mortality from strokes decreased by 25%, from myocardial infarction - by 14%, the Ministry of Health said.

Cardiovascular diseases are in first place in the overall mortality statistics in many countries of the world, said the deputy director of the Institute of Cardiac Surgery named after V.I. IN AND. Burakovsky Yuri Buziashvili. According to him, in last years doctors began to actively use invasive examination methods (with penetration into the organ itself, for example, cardiac probing or vascular catheterization).

Decrease in mortality from cardiovascular diseases leads to an increase medium duration the lives of Russians. This is a direct contribution to the Russian economy, which is why diseases of cardio-vascular system pay increased attention, said Yury Krestinsky, director of the Institute for the Development of Public Health.

In recent years, many clinics with high-tech equipment have indeed been opened, and a network of vascular centers has been developed. These measures help to respond quickly and save patients,” he explained.

Earlier, Izvestia announced that it was planned to allow the use of defibrillators for first aid. So far, this is prohibited, because this method of cardiopulmonary resuscitation is not on the list approved by the order of the Ministry of Health. The department plans to correct this situation. After that, defibrillators may appear in crowded places - at train stations, airports, subways, stadiums.

Among premature deaths in our country, cardiovascular diseases have long and firmly held the first place. And in terms of mortality from acute myocardial infarction, Russia occupies one of the leading places in the world. Why?

For an answer, we turned to leading cardiologists.

Bitter realities

Until the thunder breaks out, the peasant will not cross himself - such an attitude towards their own health is professed by the vast majority of our fellow citizens. Experts have been sounding the alarm for a long time: despite the efforts that are being made in our country to prevent and treat cardiovascular diseases, there is no significant reduction in them. According to the data provided by the Russian Society of Cardiology and the Society for arterial hypertension, 40-42% of the adult population has high blood pressure.

The situation is no better with the control of other risk factors that lead to coronary disease heart, and eventually to acute myocardial infarction. We are talking about lipid and carbohydrate metabolism disorders. The recent NATION All-Russian epidemiological study on the prevalence of type 2 diabetes mellitus, which involved more than 26 thousand people aged 20 to 79 years from 63 regions of Russia, leads to sad thoughts: 54% of people with diabetes identified during the study did not knew about their illness.

For doctors, this state of affairs does not cause anything but chagrin.

Maria Glezer, Chief Freelance Cardiologist of the Ministry of Health of the Moscow Region, Professor of the Department of Preventive and Emergency Cardiology at I.M. Sechenov First Moscow State Medical University, Doctor of Medical Sciences:

We currently have 26 health centers for adults and 8 for children, 8 prevention centers (including those at the regional level) in the Moscow Region. There are prevention rooms in every polyclinic.

Specially trained doctors work there, and if desired, every resident of the Moscow Region who has compulsory medical insurance policy, it is possible to quickly, within one day, undergo basic screening examinations, and if necessary, get a referral for a more in-depth examination and consultation with specialist doctors. But, unfortunately, not everyone takes advantage of this opportunity.

Dangerous Scenario

Our fellow citizens underestimate the risk that arises as a result of acute violation coronary circulation. After analyzing the data on how much time passes from the moment the attack begins to the appeal to the “ ambulance» Regarding the compressive, pressing or burning pain behind the sternum, which is not stopped by taking nitroglycerin, the experts were puzzled: this period sometimes reaches ... 5-6 hours, or even 2-3 days! And this despite the fact that recently in our country the situation with the provision of emergency medical care improved in patients with myocardial infarction.

Dmitry Napalkov, Professor of the Department of Faculty Therapy No. 1 of the First Moscow State Medical University named after I. M. Sechenov, Doctor of Medical Sciences:

Implementation of an algorithm for helping patients with acute myocardial infarction and coronary syndrome, re-equipment vascular departments hospitals and the emergence of new vascular centers has led to the fact that the death rate from a heart attack in our country has decreased significantly.

It could have decreased even more if it were not for the arrogance of our citizens. People often endure to the last, not suspecting that since the onset of heart pain, only 90 minutes have been allotted to save heart cells, and sometimes even their lives. These are the canons of emergency medical care for myocardial infarction, one of the cornerstone principles of which is the maximum possible reduction in the time of delivery of the patient to the hospital. This period is called the “therapeutic window”, during which it is necessary to restore the patency of the vessels that feed the heart: either by introducing special preparations or by using stenting, in which a thin metal spacer is inserted into the damaged vessel under the control of special equipment.

Area of ​​responsibility

Doctors have many questions and how patients, even those who have already had a heart attack, follow medical recommendations.

Maria Glazer:

Today, in our country, absolutely the entire arsenal of medicines that are available in the world for the treatment and prevention of cardiovascular diseases is used. The problem is that people do not always use even well-chosen drugs correctly: they skip taking them, change doses themselves, do not take part of the prescribed drugs, which leads to a decrease in the effectiveness of treatment.

However, there is another problem that doctors talk about with anxiety and pain: interruptions in the holding of auctions for the purchase subsidized medicines, in the list of which, according to experts, there is a lot of superfluous, and of those that are, far from all are the most effective. But even from this situation it would be possible to find a way out.

Dmitry Napalkov:

I have been talking about the need to monetize benefits for a long time, providing some kind of social and financial support to our citizens, who, having paid a little extra, could go to the pharmacy for more expensive, but, most importantly, better drugs. Given the crisis situation, no one, even the most advanced state, can afford to provide them all in full. But are our citizens ready for such a step, many of whom are used to being treated “for free”?

Experts agree in conclusions: in order to turn the tide, the efforts of the medical community alone are not enough. It is necessary to change the attitude of the citizens themselves to their own health, for whom it is time to understand: first of all, this is the zone of our personal responsibility. And already in the second - the doctor.

How to recognize a heart attack:

It is urgent to dial "103" if pain in the heart area:

• is not similar to the previous ones and is not stopped by a standard dose of nitropreparations;
• lasts more than 15 minutes;
• gives to the shoulder, epigastric region, jaw, neck;
• first appeared in a man over 30-35 years old or in a woman over 40-45 years old;
• accompanied by cold sweat, shortness of breath, general weakness, rise in blood pressure.

Before the ambulance arrives, it is not forbidden to take nitrospray once or twice (preferably in a sitting or lying position, this prevents a sharp decrease in blood pressure and the appearance of fainting).

What leads to disaster:

High blood pressure

The risk of dying from a heart attack is much higher if high blood pressure is added to the increase in cholesterol levels.

What to aim for: normal blood pressure should not be higher than 140/90 mm Hg.

Lipid metabolism disorder

An increase in the level of cholesterol in the blood by only 10% increases the death rate from a heart attack by 15%.

What to aim for: optimally, the level of low-density lipoprotein (LDL) "bad" cholesterol should be less than 3.0 mmol/l, and total cholesterol - less than 5.0 mmol/l.

Smoking

Smokers have a 8-10 times higher risk of developing cardiovascular diseases. Smoking is especially dangerous for women. They even one cigarette a day becomes a risk factor for the heart.

What to aim for: to a gradual reduction in the number of cigarettes smoked and to the complete rejection of tobacco.

Obesity

In overweight people, the risk of developing a heart attack is 3-4 times higher (especially if obesity is combined with high blood pressure high levels of cholesterol and blood glucose).

What to aim for: to the normal waist, which in women should be less than 80 cm, in men - less than 94 cm.

High blood glucose

A coil of elevated blood glucose pulls a whole trail of hormonal and metabolic disorders, which primarily lead to damage to the cardiovascular system. In 80% of cases, patients with diabetes die from heart attacks and strokes.

What to aim for: according to the recommendations of the World Health Organization, the normal level of plasma glucose (blood from a vein) on an empty stomach is less than 6.1 mmol / l, and 2 hours after the exercise test - less than 7.8 mmol / l.

When to be examined

Starting from the age of 40 (for men) and 45 years (for women), it is necessary to undergo an annual cardiological examination, which includes:

• blood test for cholesterol levels and various
• its fractions (lipid profile)
• blood glucose test
• uric acid test
• ECG, echocardiogram (according to indications)
• ultrasound carotid arteries(if there are risk factors)

Reminder for patients after a heart attack

Is it possible to live a full life after a heart attack and avoid its recurrence?

Doctors say it's possible. The main thing is to follow a number of important rules.

Take necessary medications.

Namely: ACE inhibitors, beta-blockers, antiplatelet agents and statins. Patients who have had a heart attack should take these drugs for the rest of their lives.

Visit a cardiologist regularly.

Preferably the same one who knows your medical history well and can adjust the dose of medication.

Observe the optimal level of blood pressure and pulse.

In a person who has had a heart attack, blood pressure targets should be higher than is customary for hypertension: systolic (upper) - not lower than 120 and not higher than 150, and diastolic (lower) - not higher than 90. At the same time, the recommended pulse rate should be 56-60 beats per minute.

Don't lie!

The sooner the patient begins physical rehabilitation after an uncomplicated heart attack, the better. First, with the help of massage, walking on a cardio machine. The part of the heart muscle that remains healthy after a heart attack needs training.

Five steps to a healthy heart

Control blood pressure levels

The world experience of the last decades shows that thanks to the control over blood pressure, which should be regularly measured starting at age 40, has been able to reduce the incidence of myocardial infarction by 30%, and stroke by 50%.

Quit smoking and do not abuse alcohol

According to the Ministry of Health of the Russian Federation, only in the first year after the start of the anti-tobacco campaign in our country, as a result of smoking cessation, mortality from cardiovascular diseases decreased by 15.7%.

Establish nutrition

Reduce salt intake to 5 g per day.

Limit the consumption of sweets (sugar, honey, pastries).

Limit the consumption of animal products rich in cholesterol (fatty meats, sausages, fatty cheeses and dairy products, canned food).

There are more products plant origin(raw vegetables and fruits). The average rate is 600 g per day.

Move more

The best option is walking at a fast pace (preferably in the fresh air), the average rate is 10 thousand steps per day (3-5 km). Swimming and cycling are also beneficial for vascular health.

Build resistance to stress

To get started, adjust your sleep, which should average at least 8 hours a day. Observe the alternation of the regime of work and rest.

20704 0

In the XX century. For most countries of the world, a turning point has come: life expectancy has increased significantly.

By 1998, it averaged 60 years.

The health of the population depends on the socio-economic development of society. Industrialization in developed countries was accompanied by a change in the structure of mortality: malnutrition and infectious diseases ceased to play a decisive role, and their place, starting from the 60s, was taken by the CVD.

These include oncopathology, diabetes mellitus, chronic diseases lungs, united by such lifestyle features as diet, smoking, physical activity.

The widespread occurrence of CVD throughout the world forced in the second half of the 20th century to talk about the epidemic of CVD, in the 21st century. the situation has not changed significantly. CVD, more than 2/3 of which are coronary artery disease, stroke and peripheral arterial disease caused by atherosclerosis, remain the main cause of death worldwide. According to the World Health Organization (WHO), more than 16 million people die each year from CVD.

Population aging and changing lifestyles are driving CVD into developing countries. Globally, CVD deaths are expected to reach approximately 25 million annually by 2020, almost half of which will be from coronary artery disease.

In our country, since the middle of the last century, mortality from CVD has been growing, and now, according to this indicator, among developed countries, Russia, unfortunately, occupies one of the first places. In Western Europe, on the contrary, there is a constant downward trend in CVD mortality. All this has led to a significant gap in mortality rates (Fig. 1).

Thus, in 2002, the mortality rate from CVD in Russia per 100,000 population was 2 times higher than in the countries of the former socialist bloc and 3 times higher than in Western European countries and the United States. An analysis of the dynamics of mortality from CVD in Russia revealed the instability of this indicator, which reflects both the general socio-economic situation and ineffective treatment and prevention of CVD in our country.

If in 1990 the standardized mortality rate from CVD among men was 836.8 per 100,000 of the population, then in 1994 it was already 1156. Then by 1998 it decreased to 933.9, and in 2003 it rose up to 1180.4. Some decrease in CVD mortality was recorded in 2004, when the mortality rate was 1139.6.

However, time will tell how stable this decline will be. Similar trends are observed among the female population, although the mortality rate here is almost 2 times lower (Fig. 2). These facts indicate that Russia, unlike Western countries, has not yet embarked on the path of effective fight with CVD. In the structure of mortality in Russia, these diseases account for 56.4%. which is significantly higher than in developed countries. Moreover, CVD mortality among the working-age population reaches 38% (among men - 37.7%, among women - 40.1%).

Figure 1. Mortality from CVD in different countries(both sexes, 2002)

Figure 2. Dynamics of CVD mortality rates in Russia

More than half of deaths in Russia are due to IVS, cerebrovascular diseases are the cause of more than 1/4 of deaths. At the same time, in our country, the structure of mortality from CVD in men and women is almost the same, and its coefficient tends to increase, unlike in other countries. In Finland, for example, the mortality rate in the mid-1970s was significantly higher than in Russia.

However, by the end of the 1990s, this indicator decreased, especially among the female population, where the proportion of deaths from CVD is 1.8 times lower than among Russian women (Fig. 3).

Figure 3. Chronological trend in the share of CVD mortality in Europe and Russia (men and women of working age)

Between 1990 and 2003, the mortality rate from CHD increased by 49%, from CVD - by 46.8%, and the proportion of deaths from CVD was significantly higher than from CHD. And only in 2004 did the growth slow down (Fig. 4).

Figure 4. Dynamics of mortality from coronary artery disease and CVD in relation to 90 years, %

In Russia, life expectancy is declining. In 2000, for example, it was 59.4 years, for women it was 72 years. This is 10-15 years less than in the developed countries of Europe.

Excluding premature CVD deaths among men and women of working age, life expectancy at birth would increase by 3.5 and 1.9 years, respectively. High mortality among a significant part of the working-age population, insufficient birth rate and the growth of the population over 65 years of age are factors in the aging of the population and the decline in the number of age groups that ensure the welfare of the country.

According to epidemiological studies conducted in different years at the State Research Center for Preventive Medicine of the Ministry of Health of the Russian Federation (GNITs PM), the prevalence of coronary artery disease among people over 35 years of age covers about 10 million people, i.e. about 9-12%. For the first time, coronary artery disease can manifest itself in the form of MI or even sudden death, but often it immediately takes chronic form. According to the Framingham study, angina pectoris can be the first manifestation of coronary artery disease in 40.7% of cases among men, among women - in 56.5% of cases.

Approximately 1/3 of those suffering from coronary artery disease are patients with angina pectoris. However, according to an international study ATP-Survey (Angina Treatment Pattarns), conducted in 2002 in 9 European countries, including 18 centers in Russia, patients with angina pectoris II and III FC predominate among our patients, and the latter are almost 2 times more than in other countries.

Mortality among patients with stable angina is about 2% per year, in addition, non-fatal MI is diagnosed in 2-3% annually. The data of the SSRC PM show that men diagnosed with coronary artery disease live 15.7 years less than their peers who do not suffer from this disease (Fig. 5). Indirectly, this indicator reflects our mistakes in the treatment of such patients.

Figure 5. Survival of men aged 40-59 depending on the presence of coronary artery disease

S.A. Shalnova

Epidemiology of cardiovascular diseases and risk factors in Russia