Prevention of chronic ischemic heart disease. Ischemic heart disease: symptoms, treatment

Ischemic heart disease is one of the most common diseases today. Ischemia combines angina, heart attack and atherosclerotic cardiosclerosis.

Medicines in the question of how to treat cardiac ischemia, unfortunately, are not always effective.

Cardiologists are increasingly inclined towards complex treatment of this disease.

Causes

Cardiac ischemia develops due to insufficient supply of the coronary arteries, which occurs due to the narrowing of their lumen. Why does such a phenomenon occur? With age, cholesterol deposits accumulate in the inner lining of the coronary arteries. This is due, first of all, to human nutrition: the more fatty and fried foods he consumes, the faster “bad” cholesterol accumulates in the blood. Gradually, atherosclerotic plaques grow, obscuring the arterial lumen and impeding blood flow leading to the heart.

Due to insufficient blood flow to the heart muscle, chest pains occur - angina pectoris. If you do not pay attention to this symptom in time and do not learn how to treat cardiac ischemia, there is a risk of myocardial infarction. What factors provoke the development of coronary heart disease? Physicians divide them into two groups - external and internal. The presence of at least one of the following factors significantly increases the risk of developing cardiac ischemia and other disorders of the cardiovascular system:

External

• Unbalanced nutrition. Overeating, the predominance of animal fats and easily digestible carbohydrates in the diet predisposes to the deposition of cholesterol;
• Sedentary lifestyle. Regular exercise strengthens the heart muscle and significantly reduces the risk of ischemia and other heart diseases;
• Psycho-emotional overstrain (stress, depression);
• Smoking and alcohol. Bad habits have a detrimental effect on the cardiovascular system, not only increasing the risk of ischemia, but also myocardial infarction;
• Long-term use of hormonal contraceptives.

Internal

• Hypertension. High blood pressure increases the risk of developing coronary disease by 2-6 times;
• High blood cholesterol. Promotes the growth of cholesterol plaques and, as a result, the narrowing of the lumen;
• Obesity;
• Violation of water and electrolyte metabolism. Long-term intake of water, devoid of salts of magnesium, potassium, chromium and other minerals, creates the prerequisites for the development of ischemia;
• Decreased thyroid function;
• Cholelithiasis;
• Violation of the body's ability to absorb glucose.

Symptoms

Depending on the form of coronary heart disease can proceed in different ways. However, cardiologists identify a list of characteristic symptoms for this disease:

• Arrhythmia (decrease or increase in heart rate);
• physical weakness;
• Shortness of breath after low-intensity exercise;
• Feeling of tightness in the region of the heart;
• Nausea;
• Cold clammy sweat.

Mental manifestations are also characteristic of coronary heart disease: groundless feeling of anxiety, dreary mood and apathy, severe suffocation.

Treatment

In many countries of the world, cardiac ischemia is the most common cause of morbidity and mortality in the population. How to treat ischemia of the heart in modern conditions? With serious complications of the disease, when it comes to severe vasoconstriction, surgical methods are used. In other cases, cardiologists resort to an integrated approach, including taking medications and changing the patient's lifestyle.

Preparations

Drug therapy is aimed at restoring the blood supply to the heart, as well as preventing complications of coronary heart disease. How do doctors suggest treating ischemia of the heart? The following groups of drugs are widely used:

• Beta blockers. Reduce the heart rate, lower blood pressure. Help prevent heart attack
• Nitroglycerine. The action of this drug is aimed at reducing chest pain and reducing the heart's need for oxygen. With angina attacks, nitroglycerin acts instantly, maintaining a therapeutic effect for several hours;
• Statins. Reduce cholesterol in the blood, resulting in changes in the walls of blood vessels. Statin drugs slow down the course of ischemia, preventing repeated heart attacks.

How to treat coronary heart disease?

In this article, we will look at how to properly treat coronary heart disease in adults.

Medical treatment

Drug treatment of coronary artery disease consists in taking drugs that improve blood circulation in the heart, and exhibit vasodilating, diuretic, and blood-thinning effects. The main groups of these drugs are nitrates, antiplatelet agents, B - blockers, diuretics, cardiac, calcium channel blockers.

Nitrate preparations(nitroglycerin, nitrogranulong) have a rapid vasodilating effect, allowing you to stop (remove) an attack of angina pectoris for 3-5 minutes. after their sublingual (under the tongue) intake.

The permissible single dose of nitroglycerin should be no more than 3 tablets every 10 minutes. If after 3 times taking this drug, the effect does not occur (an attack of pain or compression behind the sternum has not been removed), then in this case it can be regarded as an acute myocardial infarction. in which you need to immediately call an ambulance and hospitalize the patient in the hospital.

Also, it should be remembered that nitroglycerin has a fairly strong hypotensive effect (lowers blood pressure), therefore, it should not be taken by patients whose blood pressure is less than 100/60 mmHg.

In addition, after taking nitroglycerin, headaches are possible as a result of a sharp effect on the vessels of the brain, so it is recommended to take it together with a validol tablet under the tongue at the same time as nitroglycerin.

Nitrate preparations are quite strong heart remedies, so they are recommended to be taken only in cases of emergency.

There are drugs similar to nitroglycerin containing its main composition of the therapeutic substance, but in a smaller amount, for example, corvalment or its analogue corvaltab.

Corvalment, like nitroglycerin, is a very good remedy for relieving such angina attacks, but unlike it, it has a rather beneficial effect on the body. It should be taken 1 capsule under the tongue until completely absorbed with a feeling of discomfort or pain in the heart area.

B - blockers in the complex treatment of coronary artery disease are indispensable components.

Their main therapeutic effect is aimed at improving the normal supply of oxygen to the muscles of the heart, namely to the myocardium.

This group includes bisoprolol, as well as metoprolol, etc. These drugs should be taken on an ongoing basis for 1 t. 2 r. for a day. The course of treatment is prescribed by the attending physician, since there are a fairly large number of various contraindications for taking these drugs, such as the presence of chronic bronchial asthma in a patient. or various infectious diseases of the lung cavity.

Taking antiplatelet agents(aspirin, cardiomagnyl) can significantly improve blood circulation in the cardiovascular system and prevent the formation of blood clots, by "thinning" the blood. Daily intake of aspirin avoids the development of serious complications of coronary disease, such as acute coronary insufficiency or myocardial infarction.

Cardiomagnyl is a combined preparation containing aspirin in its composition, as well as asparkam, which is needed to improve the functioning of the heart (contains potassium and magnesium, the main substances for normalizing the functioning of the heart).

Cardiomagnyl is recommended to take 1 tablet after meals, mostly at bedtime. The main course of treatment is prescribed by a cardiologist, on average it is 1-2 months with intervals of 1-1.5 weeks. After this period, the treatment course can be repeated.

Heart remedies prescribed in the complex treatment of the disease. They significantly improve the functioning of the heart and the cardiovascular system. The main drugs are digoxin, asparkam, verapamil. Asparkam preparations improve the functioning of the heart very well, due to the presence in their composition of trace elements of potassium and magnesium, which are necessary for the full functioning of the myocardial heart muscle.

Basically, they should be taken in 1 t. 2 - 3 r. per day for 1 - 2 months, then the treatment course can be repeated in consultation with your doctor - a cardiologist.

Diuretics (diuretics) drugs play an important role in the treatment of coronary artery disease. This group of drugs includes: furosemide, hypotazid, dibazol, veroshpiron, etc.

Taking these drugs can significantly improve the excretion of excess fluid from the body, which speeds up the overall period of rehabilitation (recovery).

Basically, furosemide is prescribed 1 tablet every other day along with asparkam, since it flushes out the potassium and calcium needed by the body, and asparkam restores it. The course of treatment with furosemide is generally 1-2 months. 1 ton every other day.

vitamins It is recommended to take to significantly improve the work of the cardiovascular system and strengthen the immune defenses of the body. The most effective cardiac vitamins are undevit, cardiofit, dekamevit, etc., which should be taken in 1 t. 2 r. per day for 1 month.

Attention: do not self-medicate coronary artery disease, as this can only aggravate the general course of the disease and provoke the development of undesirable complications, be sure to consult your cardiologist about treatment!

Surgery

• coronary bypass grafting (surgical intervention connects the coronary vessels of the heart);
• balloon angiography;
• coronary artery bypass grafting (connection of the aorta to the coronary arteries of the heart).

Prevention

• complete rejection of bad habits (alcoholism, smoking);
• complete, balanced diet (fruits, vegetables);
• physical therapy and sports;
• constant stabbing of your body (taking baths with cool water, etc.);
• timely treatment of chronic diseases of the body that contribute to the development of ischemic heart disease.

In this article, we found out how to treat coronary heart disease.

Treatment of the heart (angina pectoris, ischemia, heart pain) with folk remedies.

Angina pectoris or "angina pectoris" is one of the stages in the development of coronary heart disease. These are periodic contractions (spasms) of blood vessels and disturbances in the blood supply to the heart. Most often, angina pectoris develops in old age, and in men 3-5 times more often. This is explained by the fact that estrogens (female hormones) before the onset of menopause protect the body from cholesterol deposits on the walls of blood vessels. Ischemic heart disease (CHD) is a pathological condition characterized by an absolute or relative impairment of myocardial blood supply due to damage to the coronary arteries of the heart.

Treatment of angina pectoris, coronary artery disease, folk remedies:

Adonis from tachycardia. from pain in the heart. Prevention of heart disease.

Pour one quarter liter of water into a saucepan, boil water. As soon as the water boils, reduce the fire. While the boil is small (just a little near the edges of the saucepan), pour in 4-5 g (tablespoon) of Adonis spring grass (Adonis). Boil over low heat for no more than 3 minutes. Then cover the pan and put in a warm place for 20 minutes to infuse the broth. Strain and discard the herb. Drink 3 times a day, 1 tablespoon. The abnormal beating of the heart stops after taking this remedy.

You can take a course of prevention of heart disease adonis. 1 tbsp adonis pour 1 tablespoon of boiling water, boil for 5 minutes over low heat. Insist 5 hours. Strain. Drink 1 tsp. in the morning on an empty stomach before breakfast for 10-12 days. This remedy can be used as first aid for heart pain. Treatment should be carried out only in courses, strictly observing the dosage.

Relieve sudden heart pain.

• In half a glass of warm boiled water, stir 0.5 teaspoon of baking soda and drink.
• Put 10-12 drops of fir oil on the palm of your hand and rub into the heart area for 1-2 minutes.
• Massage your little fingers.
• Grasp the wrist of the left hand with the right hand, find the pulse on the left hand with the thumb and press it 10-12 times, give a push to the heart. Then, with the thumb and forefinger, rub the little finger of the left hand up and down, also 10-12 times. Sit quietly, and after 5 minutes the heart will calm down.

Ivan tea is harvested and dried from July to September. In winter, brew: 2 tbsp. spoons for 1 cup of boiling water. A pleasant and healthy tea for heart health.

Help the heart.

The infusion is prepared from hawthorn berries. 25 g of fruits should be poured into a thermos and pour 200 ml of boiling water. Infused for 4 hours. Then the infusion must be filtered. This is the daily dose. It should be drunk - in 4 doses of 50 ml before meals. The recipe is simple, but the effect is great. Sleep will improve, weakness will disappear, and consequently blood pressure will also normalize.

A prescription for atherosclerosis, angina pectoris, hypertension, ischemia and other heart diseases.

Two compositions are prepared separately. The first composition: natural honey - 500g. vodka 40% - 500g. Mix both components, heat over moderate heat until foam forms on the surface. Then remove from heat, let stand. Second composition: motherwort . cottonweed marshmallow, valerian root, knotweed . chamomile. Take a pinch of each herb, brew a liter of boiling water, leave to stand for 1-2 hours, then strain through cheesecloth. Mix the first composition with the second, then put the medicine in a dark place for three days. Take the first week on a teaspoon 2 times a day. Starting from the second week, take a tablespoon 2 times a day until used up. Keep refrigerated. After a 7-10 day break, prepare the elixir again and continue treatment, the full course is 1 year.

Rosehip and hawthorn for heart health.

In a 2-liter saucepan, put 7 tbsp. (with top) hawthorn berries and wild rose. pour water, boil over low heat for 15 minutes and wrap it warmly, insist for a day. Strain and refrigerate. Drink 0.5 - 1 glass 3 times a day after meals instead of tea.

Astragalus for angina attacks and chest pain.

10-15 gr. astragalus brew a glass of boiling water, leave for 1 hour. Take 1-2 tbsp. 3-4 times a day. This infusion will relieve venous pressure, increase blood flow, remove tachycardia, relieve swelling, and normalize blood pressure. After its regular intake, angina attacks and chest pains will pass. This infusion treats the kidneys.

Help the heart, blood vessels, nervous system.

To help the heart, blood vessels, nervous system, take fresh juice from leaves and roots from May to October dandelion. Pass the plant through a meat grinder, squeeze out the juice. Drink 30 drops 4 times a day. The walls of blood vessels are strengthened, memory improves, irritability decreases, and insomnia disappears.

Heart tincture.

Prepare like this. Buy in a pharmacy for 100 ml of tinctures peony evasive, valerian, hawthorn, motherwort and add 50 ml of tincture to them eucalyptus and 25 ml of tincture mint. Mix everything in a half-liter bottle and add 10 cloves (spice).

Put the bottle with the "cocktail" in a dark place for two weeks, shake occasionally. Take the medicine 3 times a day for 15-20 minutes. before meals, 20-25 drops, diluting with a small amount of water or dripping on sugar. The course of treatment is a month. After a short break, you can repeat.

The spectrum of action of such treatment is very extensive: it lowers intracranial pressure and normalizes arterial pressure, has an antispasmodic and anticonvulsant effect, helps with varicose veins, improves cerebral circulation, prevents the formation of blood clots, and stimulates hematopoiesis.

Remedy for heart disease.

Buy a glass of seeds carrots. Pour them with 70% alcohol and a glass of freshly squeezed carrot juice. Then pour everything into a bottle and put in a dark place for a week. Drink 3 times a day for 1 tbsp. 15-20 minutes before meals. Drink one bottle - a break for a week (during this time you will make a new tincture) and again take a course. Spend several courses and your doctor will like your cardiogram.

Kalina from heart failure.

People suffering from heart failure should have 3-4 courses of viburnum treatment per year for a month. There is viburnum both fresh and frozen, but this does not make it worse. You can prepare a healing infusion like this. 1 tablespoon berries viburnum mash a little to bring out the juice. Add a tablespoon of honey to this mass, mix and pour a glass of boiling water. Leave for 1 hour to infuse. Drink this infusion 2 times a day for half a glass. The course of treatment lasts a month. If you don't like this method, you can use any other. Kalina benefits the heart in any form.

Murraya for arrhythmia, tingling and pain in the heart.

For those with heart problems, grow a houseplant at home - murraya. Five ripe berries, cut in half, five crushed leaves and fallen flower petals, pour vodka in a 100-gram bottle and insist in a dark place for two weeks. Take 18-20 drops in 20 minutes. before meals. The condition will improve quickly. Pain, tingling in the heart disappear, arrhythmia disappears.

Tea that strengthens the heart.

First, such a mixture is prepared: 1 part of rose hips and squeezed berries sea ​​buckthorn(pulp without juice), 1/2 part hawthorn fruit. Then pour 2 teaspoons of the mixture with a glass of boiling water, leave for 2 hours and add honey to taste. To strengthen the heart, such tea should be drunk for at least a month, and better - constantly with breaks of two or three weeks. And in the fall, be sure to drink such tea. Since sea buckthorn must be fresh, you can mix rose hips and hawthorn in the required proportion, and already separately squeezed sea buckthorn with honey (store in the refrigerator).

Jaundice will relieve heart disease.

jaundice- a find and salvation for a sick tired heart. He can overcome "angina pectoris" (angina pectoris), he restores the heart muscle affected by a heart attack, is necessary for heart defects, myocarditis, acute and chronic heart failure, calms the central nervous system, improves mood, brings a good, restful sleep. Jaundice stops hypertensive crises, stabilizes blood pressure, eliminates arrhythmia, tachycardia, shortness of breath. raises people after heart attacks, strokes. And in addition, the work of the pancreas is normalized. For a month, 2-3 kg of excess weight are dumped. Jaundice is also needed for varicose veins, thrombophlebitis. Drink jaundice to prevent a heart attack. There are many species of jaundice, but gray and levkoy are the most healing (they have similar properties). You can grind the grass and take dry powder 0.1 g (at the tip of a teaspoon) 3 times a day 10-15 minutes before meals. The course of treatment is 2 months, a break of 3 weeks. Drink several courses. You can take kvass from jaundice

Herbal collection for angina pectoris, heart failure, rhythm disturbances.

Herbal collection will help from many heart problems. It contains herbs that dilate blood vessels, relieve heart pain, normalize heart rate and blood pressure: odorous rue . spring book(rank), gray jaundice, arnica mountain and zyuznik European. All components are taken in equal parts in a dry crushed form. 2 tsp with the top of the collection pour 2 tbsp. boiling water, leave for an hour, strain. Drink 3 times a day for 0.5 tbsp. adding 0.5 tsp. honey. The treatment cycle is a month. Break 8-10 days and repeat 1-2 cycles again. It is desirable to conduct at least two courses of treatment per year.

Sochevichnik spring regulates cardiac activity and relieves heart pain. Jaundice gray reduces blood pressure, increases the rate of coronary blood flow, is the best remedy for dropsy.

Arnica mountain improves heart function in angina pectoris, myocarditis and cardiosclerosis. It is very effective in hypertension.

Zyuznik European normalizes the heart rate during tachycardia, has a strong calming effect, relieves the feeling of causeless fear and insomnia.

Rue is an excellent antidepressant. It relieves spasms of blood vessels, improves blood supply to internal organs. It is used for angina pectoris, hypertension, atherosclerosis and nervous excitability.

Together with the herbal collection, drink mummy. Shilajit is necessary for heart diseases, atherosclerosis and hypertension. It perfectly relieves spasms of the heart vessels in coronary disease and dilates the vessels of the retina.

You need to take mummy 0.2 g each (if it is a pharmacy drug, then one tablet each), put under the tongue and dissolve with a small amount of honey. The pain in the heart immediately passes, it brightens in the eyes. The effect is much more effective than from validol. Therefore, it is useful for all cores to have this natural product in the home medicine cabinet. But mummy should be treated regularly, in cycles, take the remedy in the morning on an empty stomach and in the evening before going to bed. Ten days to drink, five days - a break. And so - three cycles.

Collection from heart failure.

Take 2 tablespoons of rose hips, dry leaves raspberries . currants black and cranberries. Grind everything well and brew 750 ml of boiling water. Put on fire and simmer on low heat for 10-15 minutes. After this, the broth must be insisted for another 4 hours. Then strain through 2 layers of gauze. It is necessary to take a decoction in half a glass 3 times a day. It is advisable to add 3 tbsp to each dose of decoction right before use. light low-alcohol beer. It, together with a healing decoction, has a very good effect on the cardiovascular system. The course of treatment is 4 weeks. After that, you need to take a break for a month or two and repeat if necessary. Carry out such treatment every year. Very good result.

Collection for the health of the cardiovascular system.

The herb cudweed marsh is mixed with lemon balm. valerian root, buds hops. flowers lindens. grass oregano. motherwort and seed coriander. All herbs are taken in equal proportions - 1 tbsp. l. Then you need to brew the collection in a thermos at the rate of 1 tbsp. l. (with top) collection of 0.5 liters of boiling water. Insist night. You need to drink this portion per day in 2-3 doses as desired. In addition to strengthening the immune system, this collection relieves arrhythmia, improves the state of the cardiovascular system. Drink this tea 3 times a week constantly if you have heart problems.

If you have verified folk recipes for the treatment of heart failure, angina pectoris, coronary artery disease and other heart diseases, write. Thanks in advance.

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The heart is not in vain compared to the engine of the human body. And if this engine malfunctions, it can disable the entire body. The heart, as a mechanism, is characterized by high reliability, however, it can also be susceptible to various diseases. The most dangerous of them is ischemic disease. What are the manifestations of this disease, and what does it threaten a person with?

Description of the disease

Everyone knows that the purpose of the heart muscle (myocardium) is to supply the body with oxygenated blood. However, the heart itself needs blood circulation. The arteries that deliver oxygen to the heart are called coronary arteries. There are two such arteries in total, they depart from the aorta. Inside the heart, they branch into many smaller ones.

However, the heart does not just need oxygen, it needs a lot of oxygen, much more than other organs. This situation is explained simply - because the heart works constantly and with a huge load. And if a person may not particularly feel the manifestations of a lack of oxygen in other organs, then a lack of oxygen in the heart muscle immediately leads to negative consequences.

Circulatory failure in the heart can occur for only one reason - if the coronary arteries pass little blood. This condition is called coronary heart disease (CHD).

In the vast majority of cases, the narrowing of the vessels of the heart occurs due to the fact that they are clogged. Vasospasm, increased blood viscosity and a tendency to form blood clots also play a role. However, the main cause of CAD is atherosclerosis of the coronary vessels.

Atherosclerosis used to be considered a disease of the elderly. However, this is far from the case now. Now atherosclerosis of the heart vessels can also manifest itself in middle-aged people, mainly in men. With this disease, the vessels are clogged with deposits of fatty acids, forming the so-called atherosclerotic plaques. They are located on the walls of blood vessels and, narrowing their lumen, impede blood flow. If this situation occurs in the coronary arteries, then the result is an insufficient supply of oxygen to the heart muscle. Heart disease can develop imperceptibly for many years, not particularly manifesting itself, and without causing much concern to a person, except in some cases. However, when the lumen of the most important arteries of the heart is 70% blocked, the symptoms become apparent. And if this figure reaches 90%, then this situation begins to threaten life.

Varieties of coronary heart disease

In clinical practice, several types of coronary heart disease are distinguished. In most cases, coronary artery disease manifests itself in the form of angina pectoris. Angina pectoris is an external manifestation of coronary heart disease, accompanied by severe pain in the chest. However, there is also a painless form of angina pectoris. With it, the only manifestation is fatigue and shortness of breath even after minor physical exercises (walking / climbing stairs several floors).

If attacks of pain appear during physical exertion, then this indicates the development of angina pectoris. However, in some people with coronary artery disease, chest pain occurs spontaneously, without any connection with physical activity.

Also, the nature of changes in angina symptoms may indicate whether coronary disease develops or not. If the coronary artery disease does not progress, then this condition is called stable angina. A person with stable angina, with proper behavior and appropriate supportive care, can live for several decades.

It is quite another thing when angina pectoris becomes more and more severe over time, and the pain is caused by less and less physical activity. Such angina is called unstable. This condition is a reason to sound the alarm, because unstable angina inevitably ends in myocardial infarction, and even death.

In a certain group, vasospastic angina or Prinzmetal's angina are also distinguished. This angina is caused by spasm of the coronary arteries of the heart. Often spastic angina occurs in patients suffering from atherosclerosis of the coronary vessels. However, this kind of angina may not be combined with such a symptom.

Depending on the severity, angina pectoris is divided into functional classes.

Signs of coronary heart disease

Many people do not pay attention to the signs of coronary heart disease, although they are quite obvious. For example, it is fatigue, shortness of breath, after physical activity, pain and tingling in the heart area. Some patients believe that “it should be so, because I am no longer young / not young.” However, this is an erroneous point of view. Angina pectoris and shortness of breath on exertion are not normal. This is evidence of a serious heart disease and a reason to take action as soon as possible and see a doctor.

In addition, IHD can also manifest itself with other unpleasant symptoms, such as arrhythmias, dizziness attacks, nausea, and fatigue. Heartburn and abdominal cramps may occur.

Pain in ischemic heart disease

The cause of pain is irritation of the nerve receptors of the heart by toxins formed in the heart muscle as a result of its hypoxia.

Pain in coronary heart disease is usually concentrated in the region of the heart. As mentioned above, pain in most cases occurs during physical exertion, severe stress. If pain in the heart begins at rest, then with physical exertion, they usually increase.

Pain is usually observed in the retrosternal region. It can radiate to the left shoulder blade, shoulder, neck. The intensity of pain is individual for each patient. The duration of the attack is also individual and ranges from half a minute to 10 minutes. Taking nitroglycerin usually helps relieve pain.

In men, pain in the abdomen is often observed, which is why angina pectoris can be mistaken for some kind of gastrointestinal disease. Also, pain in angina pectoris most often occurs in the morning.

Causes of coronary artery disease

Coronary heart disease is often considered inevitable for people who have reached a certain age. Indeed, the highest frequency of diseases is observed in people over 50 years of age. However, not all people fall ill with coronary artery disease at the same time, for some it occurs earlier, for some later, and someone lives to an advanced age without encountering this problem. Therefore, the development of IHD is influenced by many factors. And in fact, there is no single cause of coronary heart disease. Many factors have an impact:

• bad habits (smoking, alcoholism);
• overweight, obesity;
• insufficient physical activity;
• wrong diet;
• genetic predisposition;
• some concomitant diseases, for example, diabetes mellitus, hypertension.

All of these causes may play a role, but the immediate precursor to coronary atherosclerosis is an imbalance in the various types of cholesterol in the blood and an extremely high concentration of so-called bad cholesterol (or low-density lipoprotein). When the value of this concentration is above a certain limit, a person with a high degree of probability develops atherosclerosis of the vessels, and as a result, coronary heart disease. That is why it is important to monitor blood cholesterol levels. This is especially true for people who are overweight, hypertensive, sedentary and have bad habits, as well as those who among their relatives had many deaths from cardiovascular diseases.

A certain negative factor is the male gender. Statistics show that coronary heart disease is much more common in men than in women. This is due to the fact that women in the body produce female hormones that protect blood vessels and prevent the deposition of cholesterol in them. However, after the onset of the female menopause, the amount of estrogens produced by the female body falls, and therefore the number of women suffering from coronary artery disease rises sharply, almost comparing with the number of men suffering from this disease.

Separately, one should dwell on such a prerequisite for the disease as an improper diet. As you know, the highest percentage of the incidence of coronary artery disease - in developed countries. Experts mainly attribute this fact to the fact that in Europe and America people consume more animal fats and simple, easily digestible carbohydrates. And this, together with a sedentary lifestyle, leads to obesity, to an excess of cholesterol in the blood.

Doctors knowingly warn about foods containing bad cholesterol. These products include fatty meats, butter, cheese, eggs, caviar. The amount of these products in the diet of each person should be limited, they should not be consumed every day, or in small quantities. Although, on the other hand, only a small proportion of harmful cholesterol enters the body from the outside, and the rest is produced in the liver. So the significance of this factor should not be exaggerated, not to mention the fact that bad cholesterol can be called very conditionally, since it takes part in many metabolic processes.

Why is IBS dangerous?

Many people suffering from coronary artery disease get used to their illness and do not perceive it as a threat. But this is a frivolous approach, because the disease is extremely dangerous and without proper treatment can lead to serious consequences.

The most insidious complication of coronary heart disease is what doctors call sudden coronary death. In other words, this is a cardiac arrest caused by electrical instability of the myocardium, which, in turn, develops against the background of coronary artery disease. Very often, sudden coronary death occurs in patients with a latent form of coronary artery disease. In such patients, symptoms are often either absent or not taken seriously.

Another way of developing coronary heart disease is myocardial infarction. With this disease, the blood supply to a certain area of ​​\u200b\u200bthe heart deteriorates so much that its necrosis occurs. The muscle tissue of the affected area of ​​the heart dies, and scar tissue appears in its place. This happens, of course, only if the heart attack does not lead to death.

Heart attack and coronary artery disease in itself can lead to another complication, namely, to chronic heart failure. This is the name of a condition in which the heart does not adequately perform its functions of pumping blood. And this, in turn, leads to diseases of other organs and violations of their work.

How is IHD manifested?

Above, we indicated what symptoms accompany coronary heart disease. Here we will address the question of how to determine whether a person has atherosclerotic changes in the vessels in the early stages, even at a time when obvious evidence of coronary artery disease is not always observed. In addition, such a symptom as pain in the heart is not always indicative of coronary heart disease. Often it is caused by other causes, for example, diseases associated with the nervous system, spine, and various infections.

Examination of a patient complaining of negative phenomena typical of coronary heart disease begins with listening to his heart sounds. Sometimes the disease is accompanied by noises typical of IHD. However, often this method fails to detect any pathology.

The most common method of instrumental study of the activity of the heart is a cardiogram. With its help, you can track the spread of nerve signals through the heart muscle and how its sections are reduced. Very often, the presence of coronary artery disease is reflected in the form of changes on the ECG. However, this is not always the case, especially in the early stages of the disease. Therefore, a cardiogram with a stress test is much more informative. It is carried out in such a way that during the removal of the cardiogram, the patient is engaged in some kind of physical exercise. In this state, all pathological abnormalities in the work of the heart muscle become visible. Indeed, during physical exertion, the heart muscle begins to lack oxygen, and it begins to work intermittently.

Sometimes the method of daily Holter monitoring is used. With it, the cardiogram is taken over a long period of time, usually within a day. This allows you to notice individual deviations in the work of the heart, which may not be present on a conventional cardiogram. Holter monitoring is carried out using a special portable cardiograph, which a person constantly carries in a special bag. At the same time, the doctor attaches electrodes to the human chest, exactly the same as with a conventional cardiogram.

Also very informative is the echocardiogram method - ultrasound of the heart muscle. With the help of an echocardiogram, the doctor can assess the performance of the heart muscle, the size of its departments, and blood flow parameters.

In addition, informative in the diagnosis of coronary artery disease are:

• general blood analysis,
• blood chemistry,
• blood glucose test,
• blood pressure measurement,
• selective coronography with contrast agent,
• CT scan,
• radiography.

Many of these methods make it possible to identify not only the ischemic heart disease itself, but also its concomitant diseases that aggravate the course of the disease, such as diabetes mellitus, hypertension, blood and kidney diseases.

IHD treatment

Treatment of IHD is a long and complex process, in which sometimes the leading role is played not so much by the skill and knowledge of the attending physician, but by the desire of the patient himself to cope with the disease. At the same time, it is necessary to be prepared for the fact that a complete cure for IHD is usually impossible, since the processes in the vessels of the heart are in most cases irreversible. However, modern methods make it possible to extend the life of a person suffering from a disease for many decades and prevent his premature death. And not just to prolong life, but to make it full, not much different from the life of healthy people.

Treatment in the first stage of the disease usually includes only conservative methods. They are divided into drug and non-drug. Currently, in medicine, the most modern is the treatment regimen for the disease, called A-B-C. It includes three main components:

• antiplatelet agents and anticoagulants,
• beta blockers,
• statins.

What are these drug classes for? Antiplatelet agents prevent platelet aggregation, thereby reducing the likelihood of intravascular thrombus formation. The most effective antiplatelet agent with the largest evidence base is acetylsalicylic acid. This is the same Aspirin that our grandparents used to treat colds and flu. However, conventional Aspirin tablets as a regular medication are not suitable in case of coronary heart disease. The thing is that taking acetylsalicylic acid carries the risk of stomach irritation, peptic ulcer and intragastric bleeding. Therefore, acetylsalicylic acid tablets for cores are usually covered with a special enteric coating. Or acetylsalicylic acid is mixed with other components that prevent its contact with the gastric mucosa, as, for example, in Cardiomagnyl.

Anticoagulants also prevent the formation of blood clots, but have a very different mechanism of action than antiplatelet agents. The most common drug of this type is heparin.

Beta-blockers prevent the action of adrenaline on special receptors located in the heart - adrenaline receptors of the beta type. As a result, the patient's heart rate decreases, the load on the heart muscle, and as a result, its need for oxygen. Examples of modern beta-blockers are metoprolol, propranolol. However, this type of drug is not always prescribed for IHD, as it has a number of contraindications, for example, some types of arrhythmias, bradycardia, hypotension.

The third class of first-line drugs for the treatment of coronary artery disease are drugs to lower bad cholesterol in the blood (statins). Atorvastatin is the most effective statin. For six months of therapy with this drug, atherosclerotic plaques in patients are reduced by an average of 12%. However, other types of statins, such as lovastatin, simvastatin, and rosuvastatin, may be prescribed by your doctor.

Fibrate class drugs are also designed to reduce bad glycerol. However, the mechanism of their action is not direct, but indirect - thanks to them, the ability of high-density lipoproteins to process “bad” cholesterol increases. Both types of drugs - fibrates and statins can be prescribed together.

Also, with IHD, other drugs can be used:

• antihypertensive drugs (if coronary heart disease is accompanied by hypertension),
• diuretics (with poor kidney function),
• hypoglycemic drugs (with concomitant diabetes mellitus),
• metabolic agents (improving metabolic processes in the heart, for example, mildronate),
• sedatives and tranquilizers (to reduce the amount of stress and relieve anxiety).

However, nitrates are the most commonly used type of medication, taken right at the time of the angina attack itself. They have a pronounced vasodilating effect, help relieve pain and prevent such a formidable consequence of coronary artery disease as myocardial infarction. The most famous drug of this type, used since the last century, is nitroglycerin. However, it is worth remembering that nitroglycerin and other nitrates are symptomatic drugs for a single dose. Their continuous use does not improve the prognosis of coronary heart disease.

The second group of non-drug methods of dealing with coronary artery disease is physical exercise. Of course, during the period of exacerbation of the disease, with unstable angina, any serious exercise is prohibited, since they can be fatal. However, during the rehabilitation period, patients are shown therapeutic exercises and various physical exercises, as prescribed by the doctor. Such a dosed load trains the heart, makes it more resistant to lack of oxygen, and also helps to control body weight.

In the event that the use of medications and other types of conservative therapy do not lead to improvement, then more radical methods are used, including surgical ones. The most modern method of treating coronary heart disease is balloon angioplasty, often combined with subsequent stenting. The essence of this method is that a miniature balloon is inserted into the lumen of the narrowed vessel, which is then inflated with air and then blown off. As a result, the lumen of the vessel expands significantly. However, after some time, the lumen may narrow again. To prevent this from happening from the inside, the walls of the artery are strengthened with a special frame. This operation is called stenting.

However, in some cases angioplasty is powerless to help the patient. Then the only way out is the operation of coronary artery bypass grafting. The essence of the operation is to bypass the affected area of ​​the vessel and connect two segments of the artery in which atherosclerosis is not observed. For this purpose, a small piece of a vein is taken from the patient from another part of the body and transplanted in place of the damaged part of the artery. Thanks to this operation, the blood gets the opportunity to get to the necessary parts of the heart muscle.

Prevention

It is well known that it is always more difficult to be treated than to avoid the disease. This is especially true for such a severe and sometimes incurable disease as coronary artery disease. Millions of people around the world and in our country suffer from this heart disease. But in most cases, it is not an unfavorable combination of circumstances, hereditary or external factors that is to blame for the occurrence of the disease, but the person himself, his wrong way of life and behavior.

Recall once again the factors that often lead to early incidence of coronary artery disease:

• sedentary lifestyle;
• a diet high in bad cholesterol and simple carbohydrates;
• constant stress and fatigue;
• uncontrolled hypertension and;
• alcoholism;
• smoking.

To change something on this list, making it so that this problem would go out of our lives and we would not have to be treated for coronary artery disease, is within the power of most of us.

Distinguish between primary and secondary prevention of coronary heart disease.

Primary prevention of coronary heart disease consists in carrying out special measures before the onset of the disease (the impact on risk factors to slow the progression of the atherosclerotic process).

Secondary prevention of coronary disease is carried out in the presence of an existing disease to prevent the progression of the disease and prevent subsequent complications. Currently, secondary prevention of coronary artery disease prevails, since primary prevention requires the implementation of a state policy on a healthy lifestyle.

Risk Factors for Coronary Heart Disease

Existing risk factors for coronary disease are divided into changeable (modifiable) and unchangeable (constant, non-modifiable).

Family history of coronary artery disease

The risk of developing coronary disease is increased:

• close relatives of a patient with IHD (more important for first-degree relatives - parents, brothers, sisters, sons, daughters than for second-degree relatives - uncles, aunts, grandparents);
• with a large number of patients with coronary artery disease in the family;
• when IHD occurs in relatives at a relatively young age.

Age

A linear relationship was found between age and signs of coronary heart disease (the older the age, the more pronounced atherosclerosis and the higher the incidence of coronary artery disease).

Up to 55 years, the incidence of coronary disease among men is 3-4 times higher than in women (the exception is women suffering from arterial hypertension, hyperlipidemia, diabetes mellitus, with early menopause). After 75 years, the incidence of coronary artery disease among men and women is the same.

Smoking

Smoking increases the risk of developing coronary heart disease by 2 times. Smoking causes a transient increase in blood levels of fibrinogen, narrowing of the coronary arteries, platelet aggregation, a decrease in blood HDL cholesterol and an increase in LHTONHT cholesterol. In addition, substances contained in tobacco smoke can damage the endothelium and promote the proliferation of smooth muscle cells (resulting in the formation of foam cells). According to autopsy data, in smokers who died from causes not related to coronary heart disease, atherosclerosis of the coronary arteries is more pronounced than in non-smokers. Smoking cessation results in a 50% reduction in the incidence of myocardial infarction in the population. However, smoking has a major impact on the incidence of sudden cardiac death.

Cessation of smoking leads to a reduction in the risk of cardiovascular disease, which can reach the level of non-smokers within one year of abstinence.

Signs of arterial hypertension

High blood pressure (both systolic and diastolic) increases the risk of CHD by 3 times.

Diabetes

In type I diabetes mellitus, insulin deficiency leads to a decrease in the activity of LGOTases and, accordingly, to an increase in the synthesis of triglycerides. With symptoms of type II diabetes mellitus, there is type IV dyslipidemia with an increase in VLDL synthesis. In addition, diabetes mellitus is often combined with obesity and arterial hypertension.

Sedentary lifestyle

A sedentary lifestyle significantly increases the risk of developing coronary artery disease.

Obesity

Obesity predisposes to the symptom of dyslipidemia, arterial hypertension and diabetes mellitus.

Estrogen deficiency in coronary heart disease

Estrogens have a vasoprotective effect. Before menopause, women have higher LHTP cholesterol, lower LDL cholesterol, and a 10-fold lower risk of CHD than men of the same age. In menopause, the protective effect of estrogens decreases and the risk of coronary artery disease increases (which dictates the need to replenish estrogens from the outside).

Assessment of risk factors

The presence of several risk factors leads to signs of an increased risk of developing coronary heart disease by several times, and not just to the summation of the degrees of risk. When assessing the risk of developing coronary heart disease, the following parameters are determined:

• Unchangeable risk factors are age, sex, family history, presence of atherosclerotic manifestations.
• The patient's lifestyle - smoking, physical activity, dietary features.
• The presence of other risk factors - overweight, hypertension, lipids and glucose in the blood.

To assess body weight, you can focus on such a sign as body mass index - the ratio of body weight (in kg) to body surface area (in m2).

Secondary prevention of coronary heart disease

Secondary prevention in a patient with coronary artery disease consists in lifestyle changes, exposure to risk factors, and the use of JTC.

• Lifestyle change
• Smoking cessation.
• Dieting.
• Reducing the consumption of animal fats up to 30% of the total energy value of food.
• Reducing saturated fat intake to 30% of total fat.
• Cholesterol intake not more than 300 mg/day.
• Replacing saturated fats with polyunsaturated and monounsaturated vegetable and marine sources.
• Increased consumption of fresh fruits, plant foods, cereals.
• Limiting total calorie intake when overweight.
• Reducing salt and alcohol intake in high blood pressure.
• Increased physical activity. The following physical activities are recommended: brisk walking, jogging, swimming, cycling and skiing, tennis, volleyball, dancing with aerobic exercise. In this case, the heart rate should be no more than 60-70% of the maximum for a given age. The duration of physical exercises should be 30-40 minutes: 5-10 minutes warm-up, 20-30 minutes aerobic phase, 5-10 minutes final phase. Regularity 4-5 times a week (with longer sessions - 2-3 times a week).

Impact on risk factors for coronary heart disease

With a body mass index of more than 25 kg/m2, weight loss is required through diet and regular exercise. This leads to signs of a decrease in blood pressure, a decrease in blood concentrations of total cholesterol and LDL cholesterol, an increase in HDL cholesterol, an increase in glucose tolerance and insulin sensitivity.

With increased blood pressure, antihypertensive drugs are prescribed in the absence of the effect of non-drug treatment. BP is considered optimal below 140/90 mm Hg. Art.

With hypercholesterolemia or a complex form of dyslipidemia, it is necessary to reduce the concentration of total cholesterol to 5 mmol / l (190 mg%) and LHTNP cholesterol to 3 mmol / l (115 mg%) with the help of dietary measures, and then with the help of antihyperlipidemic drugs (especially in the presence of pronounced manifestations of CAD). After myocardial infarction, the appointment of antihyperlipidemic agents is recommended 3 months after its onset (the time required to stabilize blood lipid levels and evaluate the effect of dietary measures).

In the presence of symptoms of type I diabetes mellitus, the optimal glucose concentration is considered to be 5.1-6.5 mmol / l (91-120 mg%), the optimal peak glucose concentration is 7.6-9 mmol / l (136-160 mg%). It is also necessary to prevent serious hypoglycemic conditions. For patients with type I diabetes mellitus, lower blood glucose values ​​are recommended.

The use of drugs

• Acetylsalicylic acid (minimum dose 75 mg).
• beta-blockers are necessary for patients after myocardial infarction (especially with complications during myocardial infarction in the form of arrhythmias), even in the absence of angina pectoris.
• ACE inhibitors are indicated in patients after myocardial infarction with signs of heart failure or left ventricular dysfunction.
• Anticoagulants are indicated for patients after myocardial infarction with an increased risk of thromboembolism.

Primary prevention of coronary heart disease

The absolute risk of developing coronary disease in the next 10 years can be estimated using special coronary risk charts developed by the International Societies for Coronary Prevention. To do this, it is necessary to determine such signs as age, gender, the presence of a smoking habit, systolic blood pressure and the concentration of total cholesterol.

Primary prevention is carried out in individuals with an increased risk of developing coronary artery disease. Measures for the primary prevention of coronary artery disease are lifestyle changes and exposure to risk factors. They are similar to the above measures of secondary prevention of coronary artery disease.

Prevention of ischemic

heart diseases

Prevention of coronary heart disease is a series of complex measures aimed at preventing the onset of the disease, the development and occurrence of possible (predictable) complications, which can be even fatal.

Prevention of coronary heart disease is indicated for both sick people and healthy people who are at risk of developing the disease. People who have a predisposition to the occurrence of coronary heart disease include those who have at least 1 of the unchangeable, and 1-2 of the changeable causes. If there are more than two causes, both changeable and unchangeable, then the risk of the disease increases. At the same time, people who have even a minimal risk of coronary heart disease, who have crossed the 40-year age limit, should not neglect regular preventive visits to a cardiologist.

Patients diagnosed with coronary heart disease are shown non-drug treatment, which is a complete or partial exclusion of causes that can be changed (refusal of nicotine, increased physical activity, rationalization of nutrition, refusal of hormonal contraceptives, etc.) or corrected (normalization blood pressure, cholesterol levels, etc.).

Prevention of coronary heart disease can also be characterized as an improvement in the quality of life. It's no secret that with such bad habits as overeating and malnutrition, a sedentary lifestyle, smoking and excessive alcohol consumption, a person is simply doomed to the occurrence of various abnormalities, the appearance of diseases that can later become chronic. It is important to understand that the prevention of coronary heart disease is necessary and at the same time generally available.

Quitting nicotine

It is known that smoking, incl. and passive smoking (inhalation of tobacco smoke) is the cause of a wide variety of diseases. Smoking affects the cardiovascular system in the most negative way. Smoking impoverishes the blood, reduces the oxygen content in the blood, contributes to thrombosis, the appearance of atherosclerotic plaques. Inhaled nicotine and carbon monoxide increases the pressure in the vessels, contributes to metabolic disorders. The resins contained in nicotine smoke provoke the heart muscle to accelerate contraction, have an antispasmodic effect on blood vessels. It is important to know that the risk of death in a smoker is 5 times higher than in a non-smoker.

Avoiding excessive alcohol consumption

Alcohol consumption should be kept to a minimum. The limit for alcohol consumption for men is 30 grams. and for women 20 gr. in terms of pure alcohol.

Nutrition normalization

It is necessary to lower blood cholesterol, to reduce body weight, as well as to normalize blood pressure. You can normalize nutrition without going to extremes (vegetarianism, fasting, etc.). Normal nutrition is when a harmonious balance is established between calories consumed and calories burned. Such nutrition does not allow the body to accumulate excess adipose tissue. Proper balanced nutrition also does not lead to an increase in blood cholesterol. Restriction in high-calorie, fatty foods, increased consumption of vegetable fats and foods, fresh fruits and vegetables allows the body to remove excess cholesterol. Reducing the consumption of table salt per day to 4 grams. makes it possible to reduce blood pressure to 6 mm Hg. Also, be sure to use clean, non-chlorinated water - up to two liters per day.

Increase physical activity

This system of measures is necessary to strengthen the heart muscle, improve the overall tone of the body and reduce excess body weight. Affordable and easy physical activity - walking, jogging, cycling, swimming, skiing, as well as classes in the gym are shown to everyone without exception, including people with the initial stage of coronary heart disease.

Improvement of the psycho-emotional background

Regular visits to the cardiologist. A competent and attentive approach to one’s own health, periodic visits to a cardiologist in case of a risk of coronary heart disease (based on an assessment of the existing causes of the disease), when the very first and minor symptoms of the disease are detected, can not only reduce the risk of occurrence, but also completely avoid the disease .

Risk factors and prevention

Risk factors are any predisposing factors that increase the likelihood of developing or worsening a disease. In Europe and the USA, there are specially developed scales for assessing cardiovascular risk, the main ones being the Framingham scale and the SCORE scale. They allow predicting the risk of a heart attack or other heart damage in the next 10 years with an accuracy of several percent. To some extent, these scales are applicable to other countries, but only after careful calibration and modification. For Russia, such a scale has not been developed.

Risk factors for coronary heart disease are fundamentally divided into removable and non-removable.

Fatal risk factors:

• Age - over 40 years old
• Gender - men are most at risk, as well as older women after the onset of menopause.
• Heredity - the presence of relatives who died from heart disease, as well as genetic mutations detected by modern screening methods.

Eliminable Risk Factors:

• Smoking
• High blood pressure
• Elevated blood cholesterol
• Diabetes or high blood sugar
• Improper nutrition
• Overweight and obesity
• Low physical activity
• Alcohol abuse

The main task of preventing the development of coronary heart disease is the elimination or maximum reduction in the magnitude of those risk factors for which this is possible. To do this, even before the onset of the first symptoms, it is necessary to adhere to recommendations for lifestyle modification.

Prevention

Lifestyle Modification:

• To give up smoking. Complete cessation of smoking, including passive. The overall risk of death in those who quit smoking is halved within two years. After 5 to 15 years, it levels off with the risk in those who have never smoked. If you cannot cope with this task on your own, contact a specialist for advice and help.
• Physical activity. All patients with coronary artery disease are recommended daily physical activity at a moderate pace, such as walking - at least 30 minutes a day, household activities such as cleaning, gardening, walking from home to work. If possible, endurance training is recommended 2 times a week. Patients at high risk (for example, after a heart attack or with heart failure) need to develop an individual program of physical rehabilitation. It must be adhered to throughout life, periodically changing on the recommendation of a specialist.
• Diet. The goal is to optimize nutrition. It is necessary to reduce the amount of solid animal fats, cholesterol, simple sugars. Reduce your sodium (table salt) intake. Reduce the total caloric content of the diet, especially if you are overweight. To achieve these goals, you must adhere to the following rules:

1. Eliminate or limit as much as possible the consumption of any animal fat: lard, butter, fatty meat.
2. Limit (or better yet, completely eliminate) fried foods.
3. Limit the number of eggs to 2 eggs per week or less.
4. Reduce the intake of table salt to 5 g per day (salt in a bowl), and in patients with hypertension to 3 grams or less per day.
5. Limit confectionery, pastries, cakes, etc. as much as possible.
6. Increase your intake of cereals, as minimally processed as possible.
7. Increase the amount of fresh vegetables and fruits.
8. Eat sea fish at least three times a week instead of meat.
9. Include omega-3 fatty acids (ocean fish, fish oil) in your diet.

Such a diet has a high protective effect on blood vessels and prevents further development of atherosclerosis.

Weight loss. The goals of the weight loss program for IHD are to achieve a body mass index in the range of 18.5 - 24.9 kg/m 2 and an abdominal circumference of less than 100 cm in men and less than 90 cm in women. To achieve these indicators, it is recommended to increase physical activity, reduce the calorie content of food, and, if necessary, develop an individual weight loss program and stick to it. At the first stage, it is necessary to reduce the weight by at least 10% of the initial one and keep it.

With severe obesity, it is necessary to contact a specialist nutritionist and endocrinologist.

Decreased alcohol consumption. In accordance with the latest WHO recommendations, the amount of alcohol taken should not exceed one bottle of dry wine per week.

Control of key indicators

Arterial pressure. If it is within the normal range, it is necessary to check it twice a year. If blood pressure is elevated, measures should be taken on the advice of a doctor. Very often long-term use of drugs that reduce blood pressure is required. The target blood pressure level is less than 140/90 mm Hg in people without comorbidities, and less than 130/90 in people with diabetes or kidney disease.

Cholesterol level. The annual examination should include a blood test for cholesterol. If it is elevated, it is necessary to start treatment on the recommendation of a doctor.

blood sugar. It is especially necessary to control blood sugar levels in the presence of diabetes or a tendency to it; in such cases, constant monitoring by an endocrinologist is necessary.

Coronary heart disease annually causes the death of millions of people, being the rightful leader in the list of diseases with the highest number of deaths.

The key task in reducing the indicators of this sad statistics was the prevention of coronary artery disease. It is a set of measures that prevent the occurrence of disease and death. Prevention of ischemia is usually divided into primary and secondary.

It is a series of measures that reduce the risk of ischemia. The priority direction of prevention is the elimination or mitigation of risks that can have a negative impact on health and become a cause. These include:

• insufficient motor activity;
• smoking;
• lack of rational principles in nutrition;
• excess weight;
• diabetes.

Primary prevention of coronary disease is intended to be carried out among a healthy population at risk. It is the influence of these negative factors that can further lead to the development of ischemia. To avoid this, the following measures are taken:

• eating healthy food;
• maintaining adequate weight;
• normalization of blood sugar levels;
• compliance with the mode of physical activity;
• normalization of blood pressure.

Primary prevention of coronary heart disease is a task of the state level. Its solution is based on the introduction of health improvement programs for the population. Unfortunately, at the moment this issue is not sufficiently developed.

Factors that increase the risk of developing coronary artery disease

Body weight control

Every year the number of overweight people is increasing.

Excessive body weight puts an extreme strain on the heart and causes hypertension, which contributes to the development of coronary heart disease.

In addition, overweight is often a consequence of diabetes mellitus, which also serves in coronary artery disease.

Primary prevention of CHD necessarily includes weight control. To do this, it is recommended to use the calculation of BMI (body mass index). The indicator is obtained by dividing the mass (in kilograms) by the height (in meters) squared (that is, multiplied by itself).

Table. Body mass index, interpretation and recommendations.

Indicator	Meaning	Recommended Activities
19-23	Weight is normal	Maintenance
23-27,5	Overweight	decline
27,6-30,0	1 degree of obesity	decline
30,0	2 degree of obesity	decline

Calculation example:
Initial data: height 180 cm, weight 65 kg.
Calculation of the BMI indicator: 65 / (1.8 × 1.8) \u003d 65 / 3.24 \u003d 20.06.

Proper nutrition

The following nutritional principles are distinguished in the prevention of coronary artery disease, which help reduce the risk of ischemia:

1. The main rule is to refuse or limit sugar intake.
2. A balanced diet plays an important role in the prevention of coronary artery disease.
3. The number of calories consumed should not exceed the number burned. This will prevent the formation of excess adipose tissue.
4. Restriction of food with an increased amount of animal fat. It is these lipids that cause an increase in cholesterol levels.
5. Prevention of coronary artery disease involves moderate salt intake. It is recommended to limit to 4 grams per day. This has a beneficial effect on blood pressure indicators.
6. It is recommended to drink enough water - up to 2 liters per day.

To give up smoking

Passive and active smoking increase the risk of coronary heart disease by 57 percent. At the same time, the number of deaths among smokers is 5 times higher than among those who are indifferent to cigarettes.

It is extremely important to prevent smoking among children and young people. Those suffering from a bad habit can resort to the following ways to solve the problem:

• taking nicotine-replacing drugs (cytisine, tabex, etc.);
• taking homeopathic remedies that relieve intoxication and reduce cravings for cigarettes;
• the use of antidepressants in case of severe psycho-emotional dependence;
• visiting a psychologist for advice.

Regular physical activity

Prevention of coronary artery disease necessarily includes physical activity. They help to increase muscle tone, improve blood supply to all organs, including the heart itself. It is extremely important to understand that physical activity in the prevention of coronary artery disease should be dosed.

Excessive physical activity will give a negative result. Hardening or games with a sports bias would be appropriate. Also, daily morning exercises are suitable for the prevention of coronary heart disease. It is possible to perform the following exercises:

1. You need to stand up straight and place your hands on your belt. Spread your arms to the sides, inhale and return to the starting position. You can repeat the exercise up to 10 times. In this case, it is important to monitor the respiratory rhythm. It must be stable.
2. The starting position is similar to exercise 1. You need to raise your hands up, then inhale. Next, bend over and exhale. Repeat up to 10 times at an average pace.
3. It is necessary to stand up, stretch your arms forward, then part and inhale. After returning to the starting position, exhale. Perform the exercise slowly, up to 10 times.
4. Sit on a chair, bend your leg at the knee, clap your hands under the knee. Repeat with the second leg. The cycle includes 5-7 repetitions.
5. Stand next to a chair. Sit down on the exhale, stand up on the inhale. The cycle includes 5-7 repetitions.

Secondary prevention of coronary artery disease

For patients diagnosed with ischemia, secondary prevention of coronary artery disease plays an important role. It pursues the following goals:

• prevention of recurrence of the disease;
• prevention of spasm of the coronary arteries;
• stabilization of the rhythm of the heart muscle;
• Exercise therapy for IHD for recovery;
• pharmacological rehabilitation therapy.

Education

It is extremely important in prevention to educate patients with the basics of maintaining a proper lifestyle. The specialist should monitor the patient's condition on a regular basis, making adjustments to habits and behavior. Understanding the foundations of a healthy lifestyle is laid in childhood and is supported with the help of special programs. Following the basic rules of a healthy lifestyle and giving up bad habits can significantly reduce mortality from coronary artery disease.

Diet and weight control

For patients with coronary heart disease and it is extremely important to eat right. becomes a key moment in the organization of rehabilitation therapy of the patient and prevention. Recommended:

• reduce the amount of fat in food of animal origin (eat lean foods with no more than 20 grams of fat per 100 grams of product);
• consume polyunsaturated fatty acids (found in fish, nuts, vegetable oils);
• reduce salt intake.

You can control body weight based on the methodology described earlier, guided by the BMI index.

Healthy lifestyle

A healthy lifestyle is based on a combination of several factors at once. First of all, for secondary prevention of ischemia it is necessary:

• stop smoking;
• do not drink alcoholic beverages;
• observe the motor mode;
• do swimming or gymnastics;
• spend enough time outdoors;
• pay attention to strengthening immunity and hardening;
• in coronary heart disease, it is recommended to take vitamins for prevention.

Rules for a healthy lifestyle

exercise therapy

A set of exercise therapy exercises for IHD allows you to increase blood circulation in order to further normalize heart functions. The training program for prevention is developed based on the patient's belonging to a certain group:

• group 1 (for patients with angina pectoris);
• group 2 (cardiosclerosis after myocardial infarction);
• group 3 (left ventricular aneurysm after myocardial infarction).

For the first group, in the prevention of coronary artery disease in patients, a dynamic load of all muscle groups with full amplitude is allowed. Classes can last up to half an hour.

For the second group of patients, it is necessary to focus on breathing exercises and the load of the muscle groups of the heart at a slow or medium pace. The duration of the load is up to 25 minutes with obligatory rest breaks.

For the third group, in the prevention of coronary artery disease, the duration of the exercise is set to no more than 15 minutes with an incomplete amplitude. The pace is slow, pauses are required.

Therapeutic exercise for prevention is contraindicated in:

• acute heart failure;
• pulmonary edema;
• severe shortness of breath;
• severe pain sensations;
• elevated temperature;
• deterioration detected on the electrocardiogram.

Spa treatment

Treatment in sanatorium-resort institutions is complex. Therapy is aimed at restoring the full functioning of the heart and blood vessels.

Preventive treatment of ischemia is carried out at the Caucasian Mineralnye Vody: in Kislovodsk, Pyatigorsk, Zheleznovodsk.

The following procedures are prescribed in the sanatorium:

• visiting the pool;
• health path;
• oxygen therapy;
• mud treatment;
• circular shower;
• enhanced external counterpulsation (in the absence of contraindications).

The average cost of IHD prevention in sanatoriums with full board for 14 days ranges from 40 thousand to 300 thousand, depending on the level of the institution. It is also possible to purchase kursovka (treatment only). In this case, the price for 2 weeks will be 10-50 thousand rubles. However, with angina pectoris 3-4 classes, prevention in sanatoriums is contraindicated.

Dispensary registration at the cardiologist

When detected, it is extremely important to ensure regular monitoring of the patient by a cardiologist. Only a specialist is able to take preventive measures on the basis of an examination and a planned study. It is recommended to visit a cardiologist as a preventive measure 1-2 times a year, in complicated cases 2-4 times.

Useful video

For more information about the treatment and prevention of coronary heart disease, see this video:

Conclusion

1. Coronary heart disease is easier to prevent than to treat. The best option would be competent prevention of this disease.
2. Compliance with the rules of a healthy lifestyle, proper nutrition, dosed loads can have a positive impact.
3. If IHD has already been identified, then it is important to carefully monitor your health and eliminate risk factors. For this, sanatorium treatment, exercise therapy, and the rejection of bad habits are recommended.
4. If the recommendations are followed, the patient will be able to live for many years.

Ischemic heart disease is a serious problem. It is one of the most common causes of sudden death. Everyone should know the symptoms of this disease, since no one is immune from this disease. Prevention of coronary heart disease will help to avoid the development of this disease.

Cardiac ischemia

Ischemia begins its development with insufficient saturation of the heart with oxygen. It is accompanied by shortness of breath and pain. It is worth noting that this is the most common heart disease, which in its severe form can lead to death. Therefore, the prevention of the disease should be started as early as possible, without waiting for its first symptoms.

The cause of the disease can be high blood pressure, high cholesterol. Alcohol and smoking are the enemies of a healthy heart. Frequent stress and exposure to depression can also lead to ischemia.

There are a lot of reasons for the development of coronary artery disease, in order to prevent the development of the disease, it is important to know what can serve as an impetus for its onset.

Risk factors

Risk factors are predisposing causes that increase the likelihood of a disease or its exacerbation. Risk factors for coronary heart disease are divided into two groups. One of them includes inevitable causes that cannot be eliminated. Risk factors for coronary heart disease include:

• age, people over 40 are more susceptible to heart disease;
• gender, the risk group includes mainly men;
• heredity, the disease in most cases is inherited.

The second group includes factors that can be regulated:

• smoking;
• excess of cholesterol in the blood;
• excessive alcohol consumption;
• obesity;
• sedentary lifestyle;
• high blood pressure.

To reduce the risk of developing the disease, it is necessary, if possible, to reduce or completely eliminate the factors that make up the second group. This will significantly reduce the possibility of getting ischemia.

Types of IHD prevention

Prevention of coronary artery disease is expressed in two ways: primary and secondary prevention of coronary artery disease. In the first case, preventive measures are aimed at eliminating the possibility of the occurrence of such a disease as coronary artery disease.

In the second case, preventive measures are aimed at avoiding the exacerbation of an already formed disease.

This means that primary prevention of CHD is given to people who do not have coronary heart disease, and secondary prevention concerns those who already have CHD.

Primary prevention

Primary prevention of coronary artery disease is carried out among healthy people. The main goal of this procedure is to prevent the disease, reduce the risk factors for its development.

With coronary heart disease, prevention should begin with the organization of proper nutrition. Elevated blood cholesterol is the cause of many cardiovascular diseases. It is possible to control the level of cholesterol in the blood with the help of a special diet.

In some cases, cholesterol can be regulated with the use of drugs - statins. You also need to make sure that the blood glucose level is not exceeded.

A special diet is one of the important points in the prevention of ischemia and deserves special attention.

The principle on which a preventive diet for IHD is built is to reduce the amount of fat, sugar, salt in the diet. To do this, consider the following recommendations:

• limit or completely remove animal fats from the daily menu;
• eat fried foods as little as possible, and it is better to completely refuse it;
• limit salt intake;
• do not eat a lot of eggs, it is enough to eat no more than two pieces a week;
• do not abuse confectionery;
• useful cereals, especially those that have undergone minimal processing;
• increase the intake of vegetables and fruits;
• replace meat with sea fish, ocean fish and fish oil are also no less useful.

With such a diet, the vessels will be reliably protected, and this is a good prerequisite for heart health.

It is important not to abuse excessively high-calorie foods in order to prevent excess weight. The number of calories consumed should match the calories expended.

It is necessary to properly organize the daily routine. It should have time for daily physical procedures. It is important not to allow overwork, a person needs proper rest and sleep. Stress and emotional overload worsen the general condition of a person and lead to heart disorders.

In addition, preventive measures should include the following:

• if the pressure is increased, it needs to be normalized, in order to do this, you will need to consult a doctor;
• in smokers, heart disease is much more common, so it is important to fight smoking;
• excessive alcohol intake, drinking strong coffee in large quantities increases the risk of developing an illness, these drinks must be eliminated;
• upon reaching the age of 40, it is required to make a preventive visit to a cardiologist at least once a year.

With a responsible approach to business and the implementation of all recommendations for the prevention of coronary artery disease, the risk of developing the disease can be reduced several times.

Secondary prevention

Secondary prevention concerns people who have a diagnosis of coronary heart disease. In this case, all possible measures should be taken to prevent an exacerbation of the disease.

Patients diagnosed with ischemia need to lead a correct lifestyle in order to prevent deterioration of their health.

Secondary prevention measures:

• compliance with all the points that are part of primary prevention;
• prevention of spasms of coronary vessels with the help of drugs;
• taking measures to prevent heart failure;
• treatment aimed at the prevention and elimination of various types of arrhythmias;
• surgical measures that have to be resorted to in extreme cases.

Preventive measures for ischemia should include taking medications that will satisfy myocardial oxygen demand. Such medicines include:

• acetylsalicylic acid;
• statins;
• beta blockers;
• ACE inhibitors.

Everyone who suffers from ischemia should have nitroglycerin in the medicine cabinet. It is used both in the treatment and prevention of ischemia.

The action of the drug is aimed at improving the contractile work of the heart muscle and reducing its oxygen demand.

These procedures are aimed at eliminating exacerbations of the disease, improving the quality of life in the presence of a diagnosis of coronary artery disease, as well as preventing sudden death from an attack of coronary heart disease.
It is important that the patient takes his health seriously and responsibly, follows all the doctor's recommendations.

Secondary prevention is carried out under the supervision of a doctor who will monitor the patient's condition.

When to start taking preventive measures

Some preventive procedures can be started already in childhood. It is important to ensure that a teenager does not start smoking at an early age. Smoking in itself, and even more so at an early age, is a risk factor for the development of coronary artery disease.

Healthy eating habits should be taught to children at an early age. This will subsequently save not only from coronary artery disease, but also from many other diseases.

From adolescence, blood pressure should be monitored.

Thus, primary preventive work should be started as early as possible, accustoming the child to a healthy lifestyle. People who have crossed the 40-year threshold should strengthen the prevention of ischemia, since at this age the risk of developing the disease is very high.