important a implementarii unui sistem de viata sanatos pentru prevenirea bolilor cardiovasculare in...

8/8/2019 Important A Implementarii Unui Sistem de Viata Sanatos Pentru Prevenirea Bolilor Cardiovasculare in Randul Adoles

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The importance of implementing a healthy lifestyle for preventionof cardiovascular diseases among adolescents

Dr. drd. Zuiac Silvia Sorina

Associate Professor drd. Universitatea Eftimie MurguResitaDrd. West University Vasile Goldis Arad

[email protected]

Every newborn child is entitled to live until the age of at least 65 years withoutsuffering a cardiovascular disease that can be prevented!.

European Charter for cardiovascular health

The heart is a strong pump, muscular, the size of a fist that pumps blood through thecirculatory system. Every day, the heart beats (expands and contracts) by about 100,000 times

and pumps 7,200 gallons of blood. In a life of 70 years, the heart beats more than 2.5 billiontimes.The circulatory system is a network of elastic tubes through which blood, carrying

oxygen and nutrients to all body cells. It consists of the heart, lungs, arteries, arterioles (smallarteries), capillaries (the smallest blood vessels), Venu (small veins) and veins, which return

blood to the heart. If all blood vessels were laid end to end, would be 100,000 km, enough tocircle the Earth twice.

The blood distributes oxygen and nutrients to all organs and tissues, including heart. Itis loaded with waste products from cells, which will be eliminated by the kidneys, liver andlungs.

Cardiovascular disease is a global problem, accounting for over 30% of deathsworldwide. According to statistics, in Romania, every four minutes a man dies fromcardiovascular disease.

Cardiovascular diseases are the leading cause of premature death in Europe. They arean important cause of disability and contributes substantially to the increasing costs of healthcare.

Death from cardiovascular disease often occurs suddenly, before providing access tohealthcare, so many are inapplicable or palliative therapeutic interventions health system.

Cardiovascular disease is ranked as a leading cause of mortality in Europe in bothwomen and men.It is responsible for almost half of all deaths in Europe causing over 4.35million deaths each year in the 53 Member States World Health Organization-EuropeanRegion and more than 1.9 million deaths each year in the EU. Cardiovascular disease is also amajor cause of disability and decreased quality of life. However, cardiovascular disease can

be prevented entirely. World Health Organization estimates that reducing blood pressure,obesity, smoking and cholesterol will decrease by more than half the incidence of cardiovascular disease.

While mortality and cardiovascular diseases are declining in northern, southern andwestern Europe, central and eastern countries not only are falling, but in some cases are evenincreasing. (European Heart Health Charter, the Charter of cardiovascular health-2007).

Even if the European Union, cardiovascular mortality rate is dropping, now thenumber of patients (men and women) with cardiovascular disease is growing. This paradox isdue to increased longevity and improved survival in people with cardiovascular disease.Cardiovascular disease kills more people than all cancers combined, with a percentage higher among women (55% of deaths) than among men (43% of deaths) and increased mortality

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among patients with a low socio-economic position. (European Heart Health Charter, theCharter of cardiovascular health - 2007).

Around the year 2000, cardiovascular diseases were the direct cause of over 4 milliondeaths in Europe (1.9 million in the European Union), being responsible for 43% of all deathsfrom all causes in men and 55% for women.

Sevencardiovascular diseases were, also the main cause of hospital discharge, with an average rateof 2557 per 100 000 inhabitants around the year 2002. Of these, 659-100 000 were caused byheart disease, 375-100 and 000 of stroke, but more than half were due to other forms of chronic heart disease. Cardiovascular disease mortality rates vary by age, gender, socio-economic status, ethnicity and geographic region. Mortality rates increase with age and arehigher in males, people with poor socio-economic status in Central and Eastern Europe andSouth Asian immigrants home. There are marked variations between European countries interms of morbidity and mortality from cardiovascular diseases, which are partly explained bysocio-economic differences in conventional risk factors such as smoking, blood pressure,cholesterol and glucose.

Since 1970, Western Europe, total cardiovascular disease mortality has declinedsignificantly, both the average ages and those advanced. Nine Central and Eastern Europe,mortality began to decline only in recent years, but remained however, very high. Malemortality by heart disease is still almost 10 times higher in Eastern Europe, compared withFrance, for the age group 35-74 years, and in terms of stroke mortality, mortality is 6 timeshigher .

Both Western Europe and in Eastern Europe, lower cardiovascular disease mortality islinked to behavioral changes at the population level in terms of diet and smoking. In WesternEurope, there is also a reduction in the incidence of heart disease and stroke, but in other countries, mainly in Eastern Europe and Spain, the incidence of heart disease is increasing.(European guidelines for prevention cardiovascular disease in clinical practice-2007).

European Union Directives, especially the 2004 EU Council conclusions on promotingheart health, emphasizes the importance of action at the population level both individually andin particular by identifying individual risk factors.

Council Conclusions are adopted under the Irish Presidency and the EuropeanCommission calls on Member States to ensure that appropriate measures are taken to addresscardiovascular disease.

Luxembourg Declaration, adopted under the Luxembourg presidency, has establishedan agreement between representatives of the Ministry of Health, and national representativesof European Societies of Cardiology and Foundations in the field of cardiology attending the

meeting in Luxembug. This agreement refers to initiating or strengthening trackingcardiovascular prevention plans and to ensure that all European countries are implementedeffective measures are taken all the political and interventions required in this regard. Severalresolutions of the World Health Organization have been taken to effectively addresscardiovascular disease.

Furthermore, the purpose of health protection and improvement of quality of life in theEuropean population by reducing the impact that cardiovascular diseases were registered inthe European Union Pact and objectives of the Lisbon Agenda the European Union. This isstipulated in the regulations and the integration of these measures in the health programs of the Member States, expressed the European Council conclusions of 30 November 2006 under the Finnish Presidency.

Cardiovascular disease is a multifactorial condition and it is essential that alldeterminants of cardiovascular risk factors to be treated at both the individual and social.

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Characteristics associated with cardiovascular health include:- nonsmoking status;- adequate physical activity: at least 30 minutes three times per week;- healthy eating habits;- without extra pounds;

- blood pressure below 140/90 mmHg;- blood cholesterol


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promote cardiovascular health. The most important measures include lifestyle modifications,as follows:

1. Recommended measures to reduce smoking:- forbidding of the ban advertisements for tobacco / cigarettes - a priority

recommendation;

- increasing taxes on tobacco, cigarettes;- development of legislation on banning smoking in public places;- the obligativity of the harmful effects of tobacco on all products it

containing;- supplement funding for programs of health promotion and smoking cessation.

2. Recommendations for optimizing diet:General measures at European level:- promoting trans-fats and replacing saturated fat contained in foods with mono-and

polyunsaturated fats;- adequate supply market sales of fruit and vegetables and encourage public access to

these products- reduce salt content in foods sold through national action and regional cooperation in

order to obtain the producers;- promote increased physical activity in everyday life role of the European population,

to reduce body mass index. National Strategies:- population approach;- multidisciplinarity integrating various sectors involved and their complementary

action;- interventions at different levels: industrial, community, political and environmental;- synchronization monitoring systems at EU level;- development of individual strategies on diet and physical activity for specificcategories;

- information and continuing education.3. Recommended measures to promote physical activity

- awareness of physical activity in cardiovascular prevention among healthcare personnel;

- informing the public about the role of physical activity benefit from even lowintensity, which can be achieved through integrated activities in daily life;

- developing ways and means to promote physical activity with community character,allowing direct access of all population groups regardless of age, ethnicity, social status;

- design of draft amendments to the existing infrastructure to incorporate physical

activity in everyday life (eg going to work on foot or by bicycle, the possibility of physicalactivity at work);- construction of facilities for sport and recreational physical activities, not only for

individual participation by community members but also the whole family - the developmentof educational and training programs that promote physical activity necompetiional character and develop skills and habits necessary for life physically active;

- encouraging the elderly and other groups at high risk of complications duringexercise (eg coronary patients) to participate in physical activities specifically designed for them, to improve quality of life and independence in daily activities;

- creation of special sports programs for people with physical disabilities.The strategy involves both high-risk general population screening to identify patients

at high risk of developing cardiovascular disease (objective met partly by the Ministry of Health in 2007-2008 through the National Assessment of Health Status of Population, which

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allowed identification of high risk based on laboratory tests) and recommended theestablishment of preventive strategies in patients with increased cardiovascular risk.

Identifying high-risk patients is recommended to be based on global cardiovascular risk assessment using risk charts SCORE (Systematic Coronary Risk Evaluation), which meetand correlate statistical data from several large European prospective studies, and allow

prediction of fatal atherosclerotic events a period of 10 years. Risk factors are taken intoaccount: sex, age, smoking, systolic blood pressure, total cholesterol and geographic region(part of Romania with high-risk populations in Europe). Threshold beyond which we can saythat the patient has a high risk of cardiovascular mortality in the next 10 years is defined as

being equal to or greater than 5%. (Cardiovascular disease prevention health promotion,2007).

Recommended preventive measures in patients with high cardiovascular risk relatingto:

- Changing lifestyles by implementing the measures listed in the population strategy;- optimum treatment of patients with hypertension, dyslipidemia and diabetes mellitus;- selective use of prophylactic drug therapy with proven effect in preventing CV:

angiotensin converting enzyme inhibitors, lipid lowering agents, beta blockers and aspirin.

All these measures provided for Cardiovascular Disease Prevention European Guide(2007), reduce morbidity and mortality in patients with cardiovascular diseases and alsoreduce the risk of developing these diseases.

Conclusions:Prevention is of primary importance in cardiovascular health and social life, and thus

recognized as an essential component in the management of patients at risk or with variousforms of cardiovascular disease. Applicability prevention entire life spans, as they representthe most effective way of reducing the risk of cardiovascular disease.

Prevention is thus the most effective long term intervention on cardiac patients andthose with multiple cardiovascular risk factors.It needs a clear and effective strategies thatcombine individual attitudes (assessment, cardiovascular risk stratification, the application of intervention, reassessment results) with the population (increased accessibility tocardiovascular prevention measures) against a socio-political framework conducive tonational and Europe aimed at fundamentally reducing morbidity and mortality.

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