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23contingents patients, a leading role in the disability of the population, a significant level of morbidity, in particular with temporary disability, especially in men of working age. These features lead to an increase in the medical and social importance of arterial hypertension and other diseases of the circulatory system in Ukraine, as they cause significant economic losses to the state: financial expenses for diagnosis, treatment, rehabilitation of patients, etc.
References
1. Brusati L, Komarov Yu, Vasko L. Calculation of the cost of health care as support for the definition of medical standards. NICARE 2006: 54 p.
2. Gavrilyuk OF. Need of rural residents in accessible inpatient care. Bulletin of Social Hygiene and
Health Care Organizations of Ukraine. 2007; 1: 81-83.
3. Navchuk IV, Customs officer, Uvarenko AP. Development and substantiation of the model of primary and secondary prevention of arterial hypertension in the rural population. Ed. Navchka IV. Chernivtsi: BDMU, 2013. - 184 p.
4. Sirenko YM. Prevention of stroke in patients with arterial hypertension. Cardiovascular and vascular diseases: current recommendations for prevention and treatment: selected lectures by the Ukrainian Cardiology School. M.D. Strazhesko - K. 2006: 180-197.
5. Uvarenko AP, Pariah VD. Primary health care in the countryside. Zhytomyr: Polissya 2009: 206 p.
6. Veselsky VL. On the development of rural health in 2006: (according to monitoring and rating). Ukraine. The health of the nation. 2007; 3: 3-4; 83-85.
RISK FACTORS FOR ARTERIAL HYPERTENSION AND OTHER CIRCULATORY SYSTEM
DISEASES AND THEIR PREVENTION
Navchuk I.,
Bukovina State Medical University, Ukraine
Navchuk G.,
Bukovina State Medical University, Ukraine
SobkoD.
Bukovina State Medical University, Ukraine
Abstract
The fight against most non-communicable diseases, including those with arterial hypertension, is most effective, and in some cases - the only possible, only in the prophylactic plane. Thus, the implementation of a number of programs to combat cardiovascular disease as the most significant nosological group of diseases has shown that control of risk factors contributes to the reduction of morbidity, disability and mortality. World experience shows that preventive measures aimed only at lifestyle changes contribute to reducing the occurrence of new cases of arterial hypertension by 50% and prolonging life expectancy.
Keywords: diseases of the circulatory system, risk factors, arterial hypertension, prophylaxis.
The fight against most non-communicable diseases, including those with arterial hypertension, is most effective, and in some cases - the only possible, only in the prophylactic plane. Thus, the implementation of a number of programs to combat cardiovascular disease as the most significant nosological group of diseases has shown that control of risk factors contributes to the reduction of morbidity, disability and mortality. World experience shows that preventive measures aimed only at lifestyle changes contribute to reducing the occurrence of new cases of arterial hypertension by 50% and prolonging life expectancy.
The onset and progression of arterial hypertension are closely related to unmanageable and manageable risk factors. Uncertain risk factors are age, gender, racial and ethnic characteristics, heredity, etc.
Age. There is a direct relationship between arterial pressure and age. Thus, the level of diastolic blood pressure increases to 55 years, then changes little, and systolic blood pressure increases with age constantly. If we talk about age groups, we have the greatest number of patients and the greatest expenses are at the age of 40 - 49 years.
Sex. The average blood pressure and the prevalence of arterial hypertension in young and middle-aged women are somewhat lower than in men. With age, this addiction varies up to the reversal. We want to
note that women are more actively treated and engaged in the prevention of hypertension.
Heredity. This is one of the most influential factors for the future development of arterial hypertension. A close correlation between arterial pressure was found the closest relatives (parents, brothers and sisters). The presence of high blood pressure in a family history, according to literature, 51.7% of patients with arterial hypertension, do not have - 18.1%, according to the results of our study, given below. Heredity is associated with syndrome of family dislipidemic hypertension.
Genetic aspects. The generally accepted concept of the genetic basis of high blood pressure. Although some monogenic hypertension disorders are described in humans, however, in the majority of them, arterial hypertension is a polygenic disease. In our time, a number of genes are studied, which may be responsible for the origin of arterial hypertension. Probably, in the future, with the help of molecular biology, it will be possible to identify the propensity to develop arterial hypertension.
Controlled risk factors for arterial hypertension are features of the neonatal period, central obesity and metabolic syndrome, body weight.
Features of the neonatal period. The adverse environment in critical periods of fetal development and
premature birth are risk factors for cardiovascular disease, in particular high blood pressure. The reciprocal connection between the level of blood pressure and body weight at birth is also proven in prospective studies among children and adults.
Central obesity and metabolic syndrome. Obesity positively correlates with the level of arterial pressure. The connection of obesity, insulin resistance, hyperin-sulinemia, reduced glucose tolerance, lipid metabolism disorders and arterial hypertension are the subject of close attention of researchers. Thus, the effect of elevated levels of insulin on the increase in blood pressure has been established.
Body weight. Correlation of body weight and blood pressure level is direct, significant and stable. Excess weight is associated with a 2 to 6-fold increase in the risk of arterial hypertension.
The influence of various alimentary factors on the blood pressure level is extremely important, for example:
NaCl is a kitchen salt, its use over the physiological norm is positively correlated with arterial hypertension.
Other trace elements. There is a feedback between the use of K +, Ca2 +, Mg2 + and arterial pressure.
Macroelements: proteins, fats, carbohydrates, edible fibers. Prevalence in the diet of vegetables and fruits, fish, chicken meat, restriction of the use of saturated fats, cholesterol and sweets contributes to the reduction of blood pressure.
Coffee. Restoring the pressor effect of caffeine occurs a few hours after drinking coffee. Arterial hypertension occurs three times more often among those who take 1 to 5 cups of coffee per day compared to those who do not drink coffee at all. Caffeine contained in strong coffee increases diastolic blood pressure in men with elevated blood pressure of 8 mm Hg. Art., and in people with normal arterial pressure - at 3 mm Hg. Art.
Alcohol. The consumption of alcohol directly correlates with the level of blood pressure. The frequency of arterial hypertension is the smallest in people who use alcohologlycol rarely and gradually increases depending on the daily amount of alcoholic beverages used. Excessive consumption of alcohol often causes resistance to antihypertensive therapy.
Smoking Nicotine sharply enhances blood pressure even in hard-core smokers. The effect of each cigarette lasts about 30 minutes. Already at the first minute after burning cigarettes systolic blood pressure rises by 15 mm Hg. Art., and in the fourth - by 25 mm Hg. Art. cerebral stroke and ischemic heart disease at the same levels of arterial pressure occur 2 to 3 times more often among smokers than those who do not smoke. Smoking contributes to the progression of vascular arteriosclerosis. When you burn 10 cigarettes a day, the risk of arterial hypertension increases 2-fold and 20-3 times.
Psychosocial factors are stress and socio-economic status.
Stress contributes to an increase in blood pressure. However, it is not yet known whether it leads to prolonged stress for a long-term increase in blood pressure. Psychoemotional stress, which activates the congenital physiological mechanisms (certain structures of the
central nervous system, sympathetic department of the autonomic nervous system), increases the release of catecholamines, reduces blood vessels, increases the level of sugar, cholesterol, and arterial pressure. Inclusion of these mechanisms was accompanied by a muscular "discharge", which contributed to the removal of nerve strain. Conditions of life of modern humans have changed, under stressful situations, "discharges" does not occur. Conditions are created for the development of neurosis, arterial hypertension, atherosclerosis.
Socio-economic status. In the countries of the post-transient periode, the feedback between the level of blood pressure and the level of education, income and professional status is determined. However, in countries of transitional and pre-transitional periods, a significant prevalence of arterial hypertension among well-offs of the population is determined. The experience of most countries suggests that as the economy grows in society, the steady increase in blood pressure and the prevalence of arterial hypertension among low income groups is registered.
Physical activity. In people who have a sedentary lifestyle, the risk of arterial hypertension is 20-50% higher than that of the physically active. Physical loads during hours of fulfilling professional duties contribute to an increase in blood pressure, and physical activity during leisure - on the contrary. Regular aerobic exercise is a very effective means of non-medicated treatment for arterial hypertension, including fast walking 3 to 5 times a week.
Environmental factors. Noise, pollution by water, rigidity of drinking water, food, soil, radiation level, electromagnetic fields are risk factors for arterial hypertension, their share of exposure is 20-21%.
The share of controlled risk factors for arterial hypertension in arterial pressure regulation is 51 - 52%.
Among the biochemical and physiological characteristics associated with an increased risk of cardiovascular disease, hypertension, dyslipidemia, glucose intolerance, diabetes and obesity are excreted. The class of new risk factors or prognostic factors includes left ventricular hypertrophy, hyperhomocysteinemia, excess lipoprotein, hypertriglyceridemia, elevated levels of fibrinogen and other thrombogenic factors, oxidative stress, infections, inflammation and atherosclerosis.
In the early 70's of the last century, mortality from circulatory disease was the same in most countries in the European region and the United States, where it was roughly 500 cases per 100,000 population. However, in subsequent years, a significant reduction in cardiovascular mortality was observed in most Western European and US countries, while mortality rates in Eastern Europe, including Ukraine, increased sharply.
Successes in reducing mortality from circulatory system diseases can be illustrated in the United States, where the trend has started to decline since 1950, and by the end of the century it was 60%, with a 73% decrease in mortality from all causes over this period of time. In other words, the success in combating the risk factors that were the cause of diseases of the blood circulation system, played a crucial role in reducing mortality.
The main factors in reducing mortality due to circulatory system diseases in the United States are: reduced smoking among people over the age of 18 from 42% (1965) to 25% (1995); lowering of average blood pressure levels among the population; an increase in the number of hypertensive patients who are being adequately monitored and treated; reduction of average blood cholesterol levels among the population; changes in the diet of Americans (a gradual decrease in consumption of foods with saturated fats and cholesterol since 1999); improvement of medical care (achievements in diagnosis and treatment, development of effective means of treating hypertension and hypercho-lesterolemia, increasing the number of specialists in cardiovascular diseases and improving their skills, etc.).
In 1999, the financial costs associated with morbidity and mortality from cardiovascular disease, including medical expenses and disability, amounted to $ 286.5 million in the United States.
Researchers explain the negative trends in mortality from cardiovascular diseases in Ukraine and Eastern European countries by the following reasons: lifestyle, socio-economic conditions, level of social protection, psychological factors, state of medical care of the population. The economic crisis in these countries and in Ukraine, in particular, declining living standards, unemployment, and political instability negatively affected the health of the population. The unhealthy way of life, including tobacco and alcohol abuse, poor nutrition, and lack of physical activity, has spread significantly. This is accompanied by an untimely request for medical assistance, lack of effective medical treatment,
a lack of knowledge of many doctors of modern treatment regimens of patients, and ineffective rehabilitation measures. In addition, less than a third of patients agree on modern treatment, because it is expensive.
Consequently, world experience shows that fighting most non-communicable diseases, including those with arterial hypertension, is most effective, and in some cases - the only possible, only in the prophylactic plane.
References
1. Golyachenko OM, Shulgay AG, Punchyshyn NJ. 3. Health of the rural population and factors that determine it: (review of literature). Bulletin of Social Hygiene and Health Care Organizations of Ukraine. 2007; 2: 7-11.
2. Moskalenko VF. Principles of building an optimal health care system: the Ukrainian context. Eastern European Journal of Public Health. 2008; 3: 55-67.
3. Klymenyuk VP. Assessment of the factors of the formation of the severity of the course and consequences of the diseases of the villagers (according to a sample survey in the Zhytomyr region). Ukraine. The health of the nation. 2007; 3-4: 52-60.
4. Klymenyuk VP. Amounts and quality of provision of medical and health care to the villagers of Zhy-tomyr region. Bulletin of Social Hygiene and Health Care Organizations of Ukraine. 2007; 3: 50-54.
5. Knight IV. Epidemiological features of circulatory system diseases, their dynamics in Ukraine and Chernivtsi region. Clinical and Experimental Pathology. Chernivtsi 2009; 8 (1): 41-46.
TECHNOLOGIES OF PRIMARY PREVENTION OF ARTERIAL HYPERTENSION IN THE RURAL
POPULATION
Navchuk I.,
Bukovina State Medical University, Ukraine
Navchuk G.,
Bukovina State Medical University, Ukraine
Sobko D.
Bukovina State Medical University, Ukraine
Abstract
It is common knowledge that arterial hypertension is ranked first in the distribution of circulatory system diseases and an important place among the causes that lead to disability in the population. In addition, arterial hypertension and its complications cause the society not only severe medical consequences, but also significant material damage. Therefore, today it is recognized that the most promising direction of reducing the incidence of arterial hypertension and other diseases of the circulatory system, disability and mortality from them is, first of all, primary prevention, based on the elimination of risk factors or reduction of their impact on a person, the formation of a healthy lifestyle as the most important means primary prevention of arterial hypertension and its consequences - diseases of the circulatory system.
Keywords: arterial hypertension, prophylaxis, rural population, circulatory system diseases, healthy lifestyle.
Given that primary prophylaxis should prevent the onset of diseases and is aimed at a conditionally healthy organism, its technologies include measures of influence on factors that are significant for the human body. Important are measures aimed at the formation of a healthy lifestyle, that is, the awareness of the need for active activity of the individual (society) in order to preserve and improve their own health.
The main purpose of promoting healthy lifestyles among the population is the correction of behavior in the direction that ensures the preservation and strengthening of the population and individual potential of physical health and reduction of psychoemotional stress on the basis of their determination in connection with the conditions of material and social well-being,
