Prevention of cardiovascular diseases

CVD prevention is a coordinated complex at the social and individual levels aimed at eliminating or minimizing the impact of CVD and related disabilities. Preventive measures should be carried out throughout life, from birth to old age.

Basic prevention strategies:

Population-based: lifestyle changes, environmental conditions, promotion of a healthy lifestyle;

High-risk strategy: preventive measures aimed at reducing the level of CVD risk factors. These areas of prevention should complement each other.

Prevention of CVD can be roughly divided into two groups:

Primary prevention includes a rational work and rest regime, increased physical activity, salt restriction, abstinence from alcohol and smoking, reduction of caloric intake and body weight. In fact, it is primary prevention that makes it possible to maintain rational human living conditions. In fact, the primary prevention of CVD includes a population-based strategy and a high-risk strategy.
Secondary (medicinal and non-medicinal)  Prevention is carried out differentially 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 contribute the most to the risk of sudden death: hypertension, hypercholesterolemia (dyslipidemia) and smoking.

Classification of CVD risk factors:

Biological (unmodifiable) factors:

– Age, gender, heredity (early development of CVD in relatives), genetic factors contributing to dyslipidemia, hypertension, glucose tolerance, diabetes mellitus and obesity

– Anatomical, physiological and metabolic (biochemical) features:
dyslipidemia, obesity and the nature of fat distribution in the body, diabetes mellitus.

Behavioral (modifiable) factors:

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

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

Activities that form a healthy lifestyle and reduce the level of FR:

1. Stop smoking (non-smokers from staying in smoking areas (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 more!
In the Republic of Belarus, tobacco smoking is the indirect cause of death in every fifth case of death of persons over 35 years of age.

2. Follow a hypocholesterol diet: reduction of saturated fats (reduction of consumption of fatty pork, introduction of turkey, rabbit, low-cholesterol meat into the diet), emphasis on whole grain products, vegetables (recommended up to 5 servings per day), fruits and fish. Soft margarine, sunflower, corn, rapeseed or olive oil should be used. The total fat content should not exceed 30% of the total energy content, and the saturated fat content should not exceed 1/3 of all consumed fats.

3. Reduce the consumption of table salt to 5 g / day. Reduce the consumption of products containing “hidden” salt: smoked and boiled sausages, bread. Research by scientists has shown that if you limit salt intake, the risk of myocardial infarction and other cardiac disasters can decrease by 25%. It is very useful to increase the consumption of foods containing potassium and magnesium (sea cabbage, raisins, beets, apricots, zucchini, pumpkin, buckwheat).
Rational nutrition is a balanced, regular (at least 4 times a day) diet with limited salt intake.

4. Reduce excess weight. Being overweight increases the risk of developing coronary heart disease and other atherosclerosis-related diseases. It is noteworthy 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 body mass index (BMI) formula. = weight (kg) / height (m2).

A BMI of up to 24.9 is a normal body weight.;

25-29,9 – overweight;

30-34.9 – grade I obesity;

35-39.9 – obesity of the II degree;

40 and over – grade III obesity.

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

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

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

5. Control HELL. Maintain blood pressure levels no higher than 140/90 mmHg.

6. Increase physical activity. At least 150 minutes per week of moderate aerobic (walking, swimming, cycling) physical activity (30 minutes per day 5 times a week) or 75 minutes per week of intense physical activity or a combination.

7. Monitor the parameters of lipid metabolism. Patients with very high CVD are recommended to achieve the target level of low-density lipoprotein cholesterol (LDL-C) <1.8 mmol/L or to reduce it by at least 50% if the baseline value was 1.8-3.5 mmol/L (ESC, 2016).
Patients with high CVD are recommended to achieve the target level of LDL-C <2.6 mmol/L or to reduce it by at least 50% if the baseline value was 2.6-5.1 mmol/L. In other patients, the target level of LDL-C is <3.0 mmol/L.

8. Limit alcohol intake. Less than 2 standard doses (1 dose – 12 g/ 18 ml of ethanol) per day for men and less than 1 standard dose for women per day, which approximately corresponds to 330 ml of beer, or 150 ml of wine, or 45 ml of strong drink.

9. Control glycemia. The level of glycated hemoglobin is < 6-6.5%.

10. Avoid prolonged stressful situations.

Even small lifestyle changes 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 shows signs of coronary heart 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.

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