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EVALUATION OF CARDIOVASCULAR EVENTS FOR THE PREVENTION OF CARDIOVASCULAR DISEASES
Turdiev Muhammad Rustamovich, External doctorate student of the State Institution "Republican Specialized Scientific and Practical Medical Center of Therapy and Medical Rehabilitation", Tashkent, Uzbekistan
Ismailov Saidmurod Ibrahimovich, Doctor of Science Kamilova Umida Kabirovna, Doctor of Science, professor, Deputy Director for Research of the State Institution "Republican Specialized Scientific and Practical Medical Center of Therapy and Medical Rehabilitation", Tashkent, Uzbekistan E-mail: umida_kamilova@mail.ru
EVALUATION OF CARDIOVASCULAR EVENTS FOR THE PREVENTION OF CARDIOVASCULAR DISEASES
Abstract. It is recommended to determine the total cardiovascular risk for primary and secondary prevention of CVD. The implementation of the SCORE risk chart in primary health care will contribute to the evaluation of cardiovascular risk and the development of preventive measures to the main risk factors. Keywords: prevention, prognosis, cardiovascular diseases.
At the present time, the following prevention strategies are distinguished: population strategy; high risk strategy; secondary prevention strategy. The population prevention strategy primary aim is to promote healthy lifestyles among members of society, to promote health protection knowledge, and to perform widespread informational work with the population, regardless of whether they have risk factors or chronic noncommunicable diseases. The role of the family doctor in the implementation of the population prevention strategy is to actively inform and promote healthy lifestyle among the population to a healthy life style and seek to medical advice if there are risk factors [1; 2]. It is important to engage in primary prevention of chronic diseases from childhood, as numerous studies have confirmed that the so-called risk factors are formed in childhood and adolescence, are sustainable and subsequently pass into the lifestyle of an adult. The concept of risk factors is based on the results of prospective epide-miological studies and is currently the methodological basis for planning and organizing primary prevention of cardiovascular pathology [3; 4]. The concept differentiates between modifiable and non-modifiable risk factors. Non-modifiable risk factors are: age, gender, genetic predisposition. They are used to develop a system for stratifying the risk of developing diseases. Those risk factors cannot be adjusted, but can only be taken into account when determining the degree of risk of developing diseases. Modified risk factors are subject to correction. They are divided into behavioral and biological risk factors. The behavioral risk factors include: smoking, unhealthy diet, low physical activity, excessive alcohol consump-
tion, chronic psycho-emotional stress. These are the most common behavioral risk factors in the lifestyle of a modern person that contribute to the development of diseases. With prolonged exposure to behavioral risk factors on the human body, the following biological risk factors can form: arterial hypertension (AH), dyslipidemia, excessive weight, obesity and diabetes mellitus, which are important for the development of cardiovascular diseases. In addition to identifying risk factors for developing diseases, effective prevention strategies are being developed [5; 6].
Due to the fact that CVDs are considered as diseases with a multifactorial etiology, and the potentiating effect of risk factors on their development has been established, a total cardiovascular risk estimation system has been developed, which is based on taking into account the combination of certain risk factors. The determination of total cardiovascular risk is recommended for primary and secondary prevention of CVD, including during clinical examination of certain age groups of the population and preventive medical examinations. It was proposed to determine the total cardiovascular risk using the European SCORE risk chart, which estimates the 10-year risk of fatal cardiovascular complications [7]. Fatal cardiovascular complications include death from myocardial infarction and other forms of ischemic disease heart (IHD) and stroke. It is important that during any visit of patients that seek medical attention, an opportunistic screening is conducted to identify risk factors for the development of cardiovascular diseases and the total cardiovascular risk of developing fatal complications is determined in the next 10 years [3]. The purpose of our
Section 2. Medical science
study was to evaluate the role of determining the total cardiovascular risk on the SCORE risk chart in primary care in the prevention of cardiovascular diseases (CVD).
Research methods
400 individuals aged 40 to 55 years were surveyed. Risk factors were determined using a questionnaire and the risk of cardiovascular events was evaluated according to the SCORE risk chart.
Results
To study the total cardiovascular risk using the SCORE chart, different risk factors (such as smoking) were observed, which occurred in 226 individuals (56.5%), hypercholesterolemia to determine the level of total cholesterol was found in 134 individuals (33.5%) and hypertension was detected in 174 individuals (43.5%). The results of the study of the total cardiovascular risk by the SCORE chart revealed: low cardiovascular risk was detected in 82% individuals; mean is 9.0%, moderate
risk in 4%, high in 4% and very high risk in 1% of patients. We also analyzed other risk factors of CVD: 274 (68.5%) of the patients had family history tainted with CVD. Other factors, such as excessive weight > 24.9 kg/m2 had 314 (77.5%) patients, of which 151 (48%) were overweight, 84 (26.7%) had 1 degree obesity, 38 (12.1%) had 2 degree obesity, 165 has a visceral type of obesity with WHR1.3 ± 0.3. During survey and active questioning, low physical activity was detected in 294 (74.0%) people (lifestyle, habits, restriction due to pain or discomfort in the heart area, inspiratory dyspnea during exercise). All participants have participated in a discussion about the cardiovascular diseases risk factors and their prevention.
Conclusion
The implementation of the SCORE risk chart in primary health care will contribute to the evaluation of cardiovascular risk and the development of preventive measures to the main risk factors.
References:
1. Gersh B. J., Sliwa K., Mayosi B. M., Yusuf S. The epidemic of cardiovascular disease in the developing world // Eur. Heart J. 2010.- Vol. 31.- P. 642-648.
2. Piepoli M. F., Hoes A. W., Agewall S., et al. European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J 2016; 37(29): 2315-81.
3. Perk J., De Backer G., Gohlke H., et al. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012) // European Heart Journal.2012.- Vol. 33.- P. 1635-1701.
4. Global health risks: mortality and burden of disease attributable to selected major risks. Geneva, World Health Organization, 2009. URL: http://www.who.int/healthinfo/global_burden_disease/GlobalHealthRisks_report_Front.pdf -Профилактика хронических неинфекционных заболеваний. Рекомендации.- М., 2013.- 136
5. Townsend N., Wilson L., Bhatnagar P., et al. Cardiovascular disease in Europe: epidemiological update 2016. Eur Heart J 2016; 37(42): 3232-3245.
6. Janssen V., De Gucht V., Dusseldorp E., Maes S. Lifestyle modification programmes for patients with coronary heart disease: a systematic review and meta-analysis of randomized controlled trials. Eur J Prev Cardiol 2013; 20: 620-640.
7. European recommendations for the prevention of cardiovascular diseases in clinical practice (2016 revision) // Russian Journal of Cardiology.2017.- No. 6.- P. 34-35.
