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Heart disease - preventable complications!

Myocardial infarction, angina pectoris and stentbehandling of heart coronary arteries means that there is coronary artery disease. Preventive treatment in these patients results in fewer deaths, fewer heart attacks and fewer other complications.

What is coronary artery disease?
Coronary artery disease is a collective term for diseases caused by narrowing or blockages in the coronary arteries, coronary arteries. Angina pectoris and myocardial infarction constitute the vast majority of cases of coronary artery disease.

By angina pectoris is the narrowing of one or more coronary arteries. At rest, the blood supply to the heart satisfactorily during physical exertion in which the heart needs increased blood supply, blood supply for the poor, which makes the patient in the form of chest pain, angina.

At an acute heart attack blocking a coronary artery completely, and the area of the heart muscle that receive blood supply its from this artery, it "dies" - there is an infarction of the myocardium.

How frequent is coronary artery disease?
Coronary artery disease is one of the leading causes of death. Estimates suggest that between 12 000 and 15 000 persons receiving acute myocardial infarction every year. In 2008 died, according to Public Health 3004 men and 2632 women with coronary artery disease, it was barely 14 percent of all deaths that year (a total of 41 716 deaths).

Several survive coronary disease today
Advances in treatment have improved survival after the acute myocardial infarction or angina pectoris, but people with established coronary artery disease have a high risk of future cardiovascular events 1 . Research shows that people with coronary artery disease can reduce their risk of subsequent cardiovascular events by implementing preventive measures (so-called secondary prevention) reduces mortality and improves quality of life.

What are the preventive measures?
Treatment is directed towards three main areas: improvement in lifestyle, lessened the influence of underlying risk factors and drug therapy. Lifestyle measures are smoking cessation, increased physical activity, healthy diet, any weight reduction. Underlying risk conditions that must be handled satisfactorily high blood pressure and diabetes. The drug treatment consists in thrombosis prophylaxis (antithrombotic therapy), the use of beta blockers and statins to lower cholesterol.

Lifestyle measures
Physical activity and exercise
Regular physical activity is an important part of secondary prevention of coronary disease. It increases the physical capacity, treating underlying risk factors and improve the quality of life. Fewer of those who exercise regularly, die, compared with those who do not exercise. Physical exercise decreases the amount of fats in the blood, it lowers blood pressure.

You should exercise or use body moderately intense 30-60 minutes, for example in the form of brisk walking or cycling, most, preferably all days of the week. You can start training soon after a heart attack or after you have been blocked up a narrow coronary artery. And for most such training can take place outside the hospital.

Weight and nutrition consultations
Obesity (BMI over 30) increases mortality from coronary disease and adversely affect cardiac function and other risk factors. Long-term weight control is best achieved by being physically active on a regular basis as well as having a diet with moderate calorie intake. Improvement in risk factors for coronary disease seen even by moderate weight reduction.

Smoking Cessation
Smoking cessation has been shown to reduce the incidence of death among patients with established coronary artery disease. A person with myocardial infarction or coronary surgery can reduce risikioen of death by at least one third, and smoking cessation is at least as useful as modifying other risk factors.

Risk Conditions for coronary artery disease
High blood pressure
If your blood pressure is forhøyt, it will bring down your blood pressure decrease mortality. U.S. recommendations indicate treatment indication by BT of 140/90 or 130/80 in patients with diabetes or chronic kidney disease. It is recommended to start treatment with beta-blocker or ACE inhibitor with additional medication as needed.

Mortality from coronary heart disease is higher among patients with diabetes than in those without diabetes. Recent studies suggest that intensive glucose control (HbA1c less than 7) is unfavorable and increases mortality,. Secondary prevention of coronary artery disease in patients with diabetes also includes the treatment of high blood pressure, high cholesterol and blood clot inhibiting.

Depression is common in patients after a heart attack than the general population, and it is indicated that 15-20% of hospitalized patients with acute myocardial infarction meet the criteria for depression. Studies have shown that depression is associated with higher risk of new heart attacks for 1-2 years after a heart attack. It is uncertain whether treatment with antidepressants have no effect on the forecast.

Preventive medications by coronary artery disease
Platelet Inhibitors
The use of platelet inhibitors, Albyl-E in doses of 75-100 mg is recommended for all in secondary prevention of coronary artery disease. In a large meta-analysis reduced platelet inhibitors risk of new cardiovascular disease by 25%. Treatment with Albyl-E should start immediately after the diagnosis of coronary artery disease is set and resume life. Another type of platelet inhibitor, clopidogrel (Plavix) is an effective alternative for patients who can not take Albyl-E. A combination of ASA + kopidogrel recommended for up to 12 months after an acute coronary event with insertion of stents in coronary artery. or percutaneous coronary intervention with stent placement.

Anyone with myocardial infarction is recommended treatment with beta blockers lifetime in the absence of contraindications. A number of studies have shown that beta-blockers reduce the risk of having another heart attack, sudden death and death in connection with a new heart attack.

Statin therapy
Statin is a common name for the medicines we use today to reduce the amount of cholesterol in the blood. Statins, such as simvastatin, is recommended for virtually everyone with coronary artery disease regardless of cholesterol value, and in any case the total cholesterol higher than 5.0 mmol / L or LDL cholesterol higher than 3.0 mmol / L. Reduction of cholesterol levels reduces the risk of new coronary disease. Those at highest risk have the greatest gain.

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