250 research outputs found
How much do Croatian Physicians and Croatian Population Know about Risk Factor for Cadiovascular Diseases?
The results of two studies about knowledge
and awareness of risk factors for cardiovascular diseases
(CVD) of 1382 Croatian primary care physicians, internists and
cardiologists as well as 882 citizens have been presented. The
results show that although a great majority of physicians think
that the guidelines for the prevention of CVD are useful, only
more than a half of them use them in their daily work. Although more than four-fifths of physicians think that they provide good treatment to their patients suffering from dyslipidemia, only a half of them know what are the LDL target values
in the patients with a high risk for CVD and which HDL concentration is risky for CVD. Although the population die because of CVD twice as much than of malignant disease, the respondents in the group of general population are much more
afraid of malign diseases, although many of them know that
CVD are the main cause of death. Only more than one fifth of
patients have received advice from their physician in connection with lipid disorders as the CVD risk factor, while more
than a half of respondents have received no instructions about
the risk factors. We may conclude that physicians should
know more about risk factors and guidelines for prevention of
CVD and that the awareness of and knowledge about these
factors in Croatian population should also be improved. The
transfer of information about CVD risk factors between physicians and patients should be improved as well
The perception and knowledge of cardiovascular risk factors among medical students
Aim To assess perceptions, knowledge, and awareness of
cardiovascular disease (CVD) risk factors among medical
students (freshmen and graduating students).
Methods A descriptive cross-sectional survey based on
an anonymous self-administered questionnaire was conducted
in 2008 on 443 medical students ā 228 freshmen
on their enrollment day and 214 students on the day of
their final exam at the University of Zagreb School of Medicine,
Croatia.
Results The perception and knowledge of some CVD risk
factors, eg, dyslipidemia, arterial hypertension, and metabolic
syndrome as well as of lipid-lowering therapy important
for CVD prevention was significantly better among
graduating students but was still not sufficient. Only 66%
of graduating students reported that they would prescribe
lipid-lowering therapy to high risk patients. Disappointingly,
many graduating students were smoking
(30.4%) and had low-awareness of obesity as an important
CVD risk factor.
Conclusion These results suggest an urgent need to improve
medical studentsā knowledge of obesity and low
physical activity as important CVD risk factors and of the
methods for increasing low high-density lipoprotein-cholesterol
and for smoking cessation. All this provides a rationale
for modifying the university core curriculum to include
more information concerning these issues
METABOLIC SYNDROME, MORBIDITY AND MORTLITY IN THE ERA OF COVID-19 PANDEMIC
The prevalence of obesity, diabetes, arterial hypertension and cardiovascular and cerebrovascular diseases is increasing
worldwide. Nowdays we are witnessing a pandemic of metabolic syndrome and obesity and an epidemic of these diseases in Croatia
as well. Moreover, every second Croatian citizen dies because of cardiovascular diseases. Visceral obesity, diabetes, dyslipidemia
and arterial hypertension tend to cluster forming a syndrome that we call metabolic syndrome. The concept of metabolic syndrome
was defined several decades ago as visceral type of obesity, hypertriglyceridemia, low HDL-cholesterol, arterial hypertension and
diabetes mellitus (insulin resistance). Most widely used definition is the one by National Education Cholesterol Program, NCEP -
Adult treatment Panel III - ATP III . Therefore, visceral obesity is considered as one of the greatest risks for mortality worldwide.
COVID pandemia increased the risk od deaths especially among patients with metabolic syndrome. Pandemia perpetuated several
other socio-economical risk factors (stress, depression, physical inactivity, devian strongly influence
cardiovascular health. Unfortunately, SARS-COV-2 virus enters the host (human) cell using signaling pathways (ANG II Rc) known
very well from the metabolic syndrome research and connecting those two entities predesponing these patients for a much worse
prognosis when infected with SARS-COV-2 virus. To conclude - chronic obesity pandemia goes hand by hand with novel COVID-19
pandemia dramatiacally increasing the risk of severe morbidity and mortality
PorodiÄna hiperkolesterolemija - mislimo li dovoljno o ovoj teÅ”koj bolesti? [Familial hypercholesterolemia - do we think enough about this severe disease?]
Familial hypercholesterolemia is the most common genetic metabolic disorder and is associated with significant morbidity and mortality from cardiovascular disease, in particular coronary heart disease (CHD). Gene mutations for LDL receptor, APOB or PCSK9 are the main causes of the disease. The incidence of homozygous form of disease is 1:1000000 and ofheterozygous 1:500. Some of the patients have clinical signs like xanthomas, xanthelasmas and corneal arcus. More predictive for the diagnosis are elevated serum LDL cholesterol values and positive family history of early CHD. Identification of the causative mutation provides definitive diagnosis. Diet, statins, combined therapy (statins and ezetimibe) are the first line of treatment, mostly in high doses. LDL apheresis is the procedure of mechanical removal of LDL particles from plasma and has to be performed in patients with homozygous or severe heterozygous form of the disease together with drug treatment. There is a need to increase the awareness of this disease in Croatia but also worldwide with one main goal: to early diagnose and prevent cardiovascular morbidity and mortality
Statins in Primary and Secondary Prevention of Coronary Heart Disease
Iako je opÄeprihvaÄena opravdanost davanja
inhibitora HMG-CoA reduktaze (statina) radi smanjenja
ukupnog i LDL-kolesterola u serumu bolesnika s koronarnom
boleÅ”Äu srca (KBS) i onih koji zbog hiperlipidemije imaju
poveÄani rizik, donedavno nije bilo tako jasno treba li statine
davati i osobama s manje izraženim rizikom. Rezultati novijih
velikih kliniÄkih ispitivanja i gotovo dva desetljeÄa kliniÄkih
iskustava sa statinima pokazuju da su oni vrlo djelotvorni u
smanjenju rizika za KBS i u primarnoj i u sekundarnoj prevenciji,
i to bez ÄeÅ”Äih i znaÄajnijih neželjenih nuspojava. Korisni
uÄinci statina nadmaÅ”uju one postignute u ranijim ispitivanjima
s drugim antilipemicima i pojavljuju se prerano da bi se
mogli pripisati samo snižavanju koncentracije lipida u serumu.
Stoga se smatra da do toga ne dolazi samo zbog jaÄeg smanjenja
lipida u serumu, veÄ zbog tzv. pleiotropnih protuaterosklerotskih
uÄinaka statina. Novija kliniÄka ispitivanja
jasno su pokazala da se davanjem statina ne postiže samo
lijeÄenje hiperlipidemije, veÄ uistinu smanjenje pobola i pomora
od KBS-a u osoba s poveÄanim rizikom. MeÄutim, u nekoliko
je ispitivanja uoÄeno da mnogi bolesnici s KBS-om (a joÅ”
viÅ”e onih koji samo imaju velik rizik) ili uopÄe ne dobivaju
statin, ili se u njih zbog preniske doze statina ne postižu
ciljne, odnosno preporuÄene vrijednosti lipida. BuduÄi da je
hipodoziranje statina važan problem, osobito u nas, tomu
valja posvetiti posebnu pozornost.Although treatment with HMG-CoA reductase
inhibitors (statins) to reduce total and LDL-cholesterol is
clearly indicated in patients with coronary heart disease (CHD)
and those with increased risk due to hyperlipidemia, the
requirements of patients with lower risk were until recently
less straightforward. The results of recent large clinical trials
with statins and almost two decades of clinical experience
have shown that statins are effective and well tolerated in
reducing CHD risk for both primary and secondary prevention.
The beneficial effects of statins outweigh those seen in earlier
trials with other hypolipemic drugs and occur too early in
treatment to be due to lipid lowering mechanism alone. Therefore
this happens presumably not only because of the greater
reduction in lipids but because of their so-called āpleiotropicā
antiatherogenic effects. Recent clinical trials have proved that
lipid lowering therapy with statins is no longer just a matter of
hyperlipidemia treatment but rather a way of lowering risk of
CHD morbidity and mortality in a large number of individuals
at high risk. However, the data from several studies have
shown that many CHD patients (and even more individuals at
high risk) either receive no treatment at all, or are not treated
to recommended lipid goals. Since undertreatment is a big
problem, particularly in Croatia, this issue should be strongly
addressed
Atherosclerosis ā the Cause of Every Second Death in Croatia
Ateroskleroza je bolest kod koje dolazi do lokalnih zadebljanja stijenke arterija koje se nazivaju ateromi ili plakovi (od franc. plaque ā ploÄa, jer na stijenci žile aterosklerotiÄne naslage Äesto izgledaju kao masne ploÄe). Ateroskleroza je najÄeÅ”Äe oÅ”teÄenje arterija, pa su ona i bolesti koje nastaju kao njena posljedica, a to su bolesti srca i krvnih žila, vodeÄi uzroci smrti i velik javnozdravstveni problem ne samo u Hrvatskoj veÄ i u veÄini zemalja svijeta. Bolesti srca i krvnih žila uzrokovane poglavito aterosklerozom bolesti su koje osobito Äesto pogaÄaju muÅ”karce, pa je tako od 26.019 muÅ”karaca umrlih 2009. godine s prebivaliÅ”tem u Hrvatskoj 4.885 umrlo od ishemijske bolesti srca, a 3.268 od cerebrovaskularne bolesti. Glavni je cilj u borbi protiv bolesti srca i krvnih žila sprijeÄiti da uopÄe nastane aterosklerotiÄka nakupina, Å”to se postiže suzbijanjem i lijeÄenjem Äimbenika rizika. Pri tome se osim na Äimbenike rizika koji su veÄ odavno poznati, kao Å”to je poveÄani ukupni i LDL kolesterol u krvi, u zadnje vrijeme sve veÄa pozornost posveÄuje i drugima, primjerice poremeÄaju masnoÄa u krvi obilježenom poveÄanim trigliceridima i smanjenoj koliÄini zaÅ”titnog HDL kolesterola u krvi.Atherosclerosis is a disease manifested through local artery wall thickenings called atheroma or plaques (French plaque ā plate, since arteriosclerotic layers on the arterial wall often resemble fatty plates). In the majority of cases, atherosclerosis develops from damage to the arteries, so that together with cardiac and cardiovascular diseases, which occur as its effects, it remains the leading cause of death and a major problem for public health, not only in Croatia, but also in the majority of the countries worldwide. Cardiac and cardiovascular diseases caused mostly by atherosclerosis are diseases from which men suffer more frequently than women; out of 26,019 male Croatian residents, who died in 2009, 4,885 died of ischemic cardiac diseases, while 3,268 died of cerebrovascular diseases. The main objective in fighting cardiac and cardiovascular diseases is to prevent the occurrence of arteriosclerotic layers, which may be achieved by preventing and curing risk factors. Apart from the already well-known risk factors, such as increased total and LDL cholesterol, recently the attention has ever more been paid to others, such as blood fat disorder marked by increased triglycerides and reduced protective HDL cholesterol
Changing Peopleās Habits-Main Factor in the Treatment of Hyperlipidemias
U sklopu strategije primarne i sekundarne prevencije
koronarne bolesti srca od kljuÄne je važnosti promjena
naÄina života. Osobito je važno djelovati na hiperkolesterolemiju
koja je jedan od najvažnijih Äimbenika rizika za
koronarnu bolest. Na koronarnu bolest može se utjecati promjenom
naÄina prehrane, prestankom puÅ”enja, poticanjem tjelesne
aktivnosti, smanjenjem pretjeranog konzumiranja alkohola
i smanjenjem prekomjerne tjelesne težine te lijeÄenjem
poviÅ”enoga krvnog tlaka i Å”eÄerne bolesti. Promjena naÄina
prehrane treba se temeljiti na smanjenju unosa masti, posebno
zasiÄenih masnih kiselina i kolesterola, uz relativno poveÄanje
unosa viÅ”estruko i jednostruko nezasiÄenih masnih kiselina
te poveÄanje unosa prehrambenih vlakana i antioksidanata
biljnog ili mineralnog podrijetla. U ovom se preglednom
Älanku podrobno razmatraju uÄinci dijete na serumske lipide, a
posebna pozornost posveÄena je uÄincima trans-masnih kiselina,
omega-3 viÅ”estruko nezasiÄenih masnih kiselina, dijetnim
vlaknima, vitaminima E i C, flavonoidima, ÄeÅ”njaku, alkoholu,
Äaju, kavi i oraÅ”astom voÄu. Daju se i detaljne upute o tjelesnoj
aktivnosti kojom se može utjecati na hiperlipidemiju.Intervention strategies for coronary heart
disease (CHD) must include attention to life-style factors and
changing people\u27s habits. Since hypercholesterolemia is one
of the most important risk factors for CHD, the modification
of this risk factor including dietary factors, cessation of smoking,
improving exercise, sensible drinking, attainment of ideal
body weight as well as control of hypertension and diabetes
is essential. The dietary changes should include reduction in
intake of total fat, saturated fat and cholesterol, relative
increase in intake of poly- and monounsaturated fats, and an
increase in intake of dietary fibre, vitamin and mineral antioxidants.
In this review article the effect of diet on serum lipids
is discussed and particular attention is payed on trans fatty
acids, omega-3 polyunsaturated fatty acids, dietary fibre, vitamins
E and C, flavonoids, garlic, alcohol, tee, coffee and
nuts. The recommendations concerning an exercise regime
are also presented
Uloga prehrane u prevenciji i terapiji kardiovaskularnih bolesti
Zdrava se prehrana veÄ odavno povezuje s manjim rizikom od kardiovaskularnih bolesti izazvanih aterosklerozom, poglavito rizikom od koronarne bolesti i infarkta miokarda. Tijekom posljednjih se desetljeÄa poveÄalo zanimanje za takve uÄinke hrane i u literaturi se danas može naÄi niz podataka o sastojcima razliÄitih namirnica i piÄa, kao i epidemioloÅ”ki podaci o njihovim moguÄim uÄincima. Rijetka su, meÄutim, velika dobro kontrolirana kliniÄka ispitivanja djelovanja pojedinih namirnica u dobro defi niranih skupina ispitanika pa stoga i nema nedvojbenih dokaza o koristi veÄine namirnica u prevenciji
kardiovaskularnih bolesti osim za omega-3 masne kiseline iz riba i mediteransku prehranu. DapaÄe, rezultati nekih ispitivanja su razoÄarali, kao primjerice oni o djelovanju protuoksidacijskih
vitamina E, A i C. Kako se ipak konzumiranje nekih vrsta hrane može povezati s povoljnim, ali i nepovoljnim uÄincima na kardiovaskularne bolesti, u ovom su preglednom Älanku u sažetu obliku prikazane suvremene spoznaje o uÄincima razliÄitih masnih kiselina, topljivih prehrambenih vlakana ukljuÄujuÄi psilijum, beta-glukan, pektin i guar, likopena ā karotenoida iz rajÄice, antioksidacijskih vitamina, ÄeÅ”njaka, oraha i kikirikija, bjelanÄevina iz soje i fitosterola, polikozanola, Äaja, kakaa i kave te alkohola i kuhinjske soli. Poseban je naglasak dan na protuoksidacijske i protudislipidemiÄke uÄinke razliÄitih namirnica te one u smislu popravljanja disfunkcije endotela i utjecaja na arterijski tlak, Å”to sve pridonosi prevenciji kardiovaskularnih bolesti, uz navoÄenje niza praktiÄnih podataka važnih za kliniÄare
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