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“One of the main reasons for the persistence of diseases is the high frequency and risk of high risk factors such as high blood pressure, low cholesterol, diabetes, smoking, obesity, immobility and metabolic syndrome.
Doctors have a winged saying that patients are treated with ultrasound, not by changing their lifestyle and taking prescription drugs. Diagnosis is important, but no less significant, and the patient’s efforts to adhere to the treatment regimen without arbitrary adjustments, regular use of all prescription drugs, as drug treatment and lifestyle changes last the rest of the life.
We need to trust the doctor, not consult a doctor from Google: doctors study at university for 10 years, constantly read medical literature, improve their grades, so online information will not replace the doctor’s consultation in any way ” says cardiologist prof. Gintarė Šakalytė.
According to her, another reason is the increase in average life expectancy, since age is an important risk factor, although not modified, for cardiovascular disease. 2001 Life expectancy for men was 65.9 years, for women 77.4 years and in 2020 – 71.5 m respectively. and 81 m.
High blood pressure affects one in three people
In Lithuania, arterial hypertension (AH) is diagnosed in about a third of adults, it is more common in the elderly; even if blood pressure is normal after age 50, the probability that it will increase in the future is 9 out of 10. 10. G. Šakalytė says that without AH treatment, half of his patients would die of ischemic heart disease, a third – from stroke, 10-15 percent. – due to kidney failure.
“Variable risk factors for the development of HA are overweight and obesity, immobility, high-fat and salty foods, alcohol consumption, nervous tension, smoking and night work. A healthy lifestyle can prevent the development of HA or delay the rise in blood pressure.
HA patients should limit their salt intake to 5 g per day, thus reducing their sodium intake by 1 million. the number of patients with HA would be reduced and the risk of cardiovascular disease would be reduced by up to 13%. It’s important to estimate the sodium content on food labels, even at 80 percent. salts are present in prepared foods and only 10 percent. added during cooking or extra food ”, says the cardiologist.
Alcohol consumption should not exceed 14 units per week for men and 8 units. for women, when 1 unit is 125 ml of wine or 250 ml of beer. Patients should control a normal body mass index of 20-25 kg / m2 and a waist circumference of less than 102 cm for men and 88 cm for women. When changing the diet, it is recommended to eat at least 300 g of vegetables a day, consume low-fat dairy products, more fruits, fish, nuts, reduce red meat.
“Another risk factor for significant change is the increase in low-density cholesterol. Patients diagnosed with dyslipidemia often do not take or regularly take cholesterol-lowering medications, instead choosing supplements and believing in scientific techniques to lower cholesterol. Sometimes it is also wrong for doctors to prescribe too low doses of drugs, not to prescribe drug combinations or the most recent drugs, “says prof. G. Šakalytė.
The treatment of dyslipidemia has been greatly facilitated by the recent appearance of a new class of drugs on the Lithuanian market: PCSK9 inhibitors, which help treat very high-risk patients for whom conventional statin treatment and ezetimibe is not effective enough. These drugs, which are administered subcutaneously every two weeks, greatly help reduce mortality from cardiovascular diseases, but are not yet reimbursed in Lithuania.
Teacher. According to G. Šakalytė, the contribution of pharmaceutical companies to the research and development of new medicines is important for the success of the health of cardiac patients. “One of them is Sanofi, which developed and introduced the first angiotensin converting enzyme (ACE) inhibitor to the Lithuanian and world markets 20 years ago, which not only has a blood pressure lowering effect, but also protects the heart and kidneys.
Another example is the world’s second most popular anti-aspirin antiplatelet agent for reducing blood clotting. The drug, which has been used for more than 20 years by patients with heart attack, stroke, acute coronary syndrome or peripheral arterial disease to prevent atherothrombosis and thromboembolic events, has saved millions of lives ”, comments the professor.
Myocardial Infarction Care – 24/7
HA and dyslipidemia are among the main risk factors for the development of chronic coronary syndromes, formerly known as ischemic heart disease.
Chronic coronary syndromes are the most common heart disease and the cause of death. According to Eurostat, in 2016 In the European Union, deaths from these syndromes accounted for 11.9%: from acute myocardial infarction to 4.3% and from other syndromes to 7.6%.
“Irreversible risk factors for chronic coronary syndromes are an inherited predisposition to heart disease, older age, and gender; men are more likely to get it. Dyslipidemia, HA, diabetes, smoking, obesity, low mobility, metabolic syndrome are changing risk factors, which means that eliminating them can reduce the risk of diseases, ”says the professor of medicine.
The cause of myocardial infarction is an acute blockage of a blood vessel in the heart, which must be opened as soon as possible, restoring blood flow to the heart, preserving the muscle, thus avoiding possible complications and death.
Therefore, if you feel a depressing pain behind the sternum, spreading to the left arm or neck, accompanied by a cold sweat, intensified by physical exertion, it is necessary to immediately call an ambulance.
According to prof. G. Šakalytė, in Lithuania since 2014 all patients with myocardial infarction are transported for five 24 hours for immediate vascular opening. 24 hours a day, 7 days a week in Kaunas, Vilnius, Klaipėda, Šiauliai and Panevėžys.
Scientific innovation is essential
The last 20 years, according to prof. G. Šakalytė, brought many new scientific achievements and innovations to the daily practice of cardiologists. The novelty of the 21st century in cardiology has become long-acting injectable drugs for the treatment of lipid disorders.
Imaging studies have been improved: from a linear cardiac ultrasound examination to a two-dimensional and three-dimensional ultrasound, in which the size of the heart, the function and the condition of the valves are evaluated in detail.
The state of the cardiovascular system is assessed with the help of a CT scan, and MRI of the heart has become a necessity. The professor says that today the possibilities of cardiac patient research in Lithuania do not differ from those applied in the best clinics in the world.
“In terms of treatment, interventional cardiology is progressing, especially when catheters dilate narrow blood vessels, implant stents, replace heart valves, as well as cardiac surgery: surgeons in our country implant cardiac replacement devices, transplant hearts and lung in more complex patients.
Electrophysiology has vastly improved: various arrhythmias are treated with catheters, and electro-stimulators and defibrillators are implanted. So that we have the most perfect equipment, our hospitals employ the most qualified specialists, the most modern instrumental methods and medical treatment are applied ”, assures prof. G. Šakalytė.
