ABSTRACT
2021 ESC Guidelines on cardiovascular disease prevention in clinical practice provides a comprehensive view on preventive cardiology. It presents strategies to reduce the burden of atherosclerotic cardiovascular disease (CVD), both at the individual level and at the population level. Healthy lifestyle and aggressive control of cardiovascular risk factors remain the cornerstone of prevention. Classification of individuals into risk groups based on their clinical characteristics followed by a stepwise treatment-intensification is a novel recommended approach. Updated risk charts - SCORE2 and SCORE2-OP - are intended for estimation of 10-year fatal and non-fatal CVD risk in apparently healthy individuals. Targets and goals for LDL cholesterol, blood pressure, and glycaemic control remain as recommended in recent ESC Guidelines.
Subject(s)
Atherosclerosis , Cardiology , Cardiovascular Diseases , Hydroxymethylglutaryl-CoA Reductase Inhibitors , Humans , Cholesterol, LDL , Cardiovascular Diseases/epidemiology , Risk Factors , Atherosclerosis/drug therapy , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic useABSTRACT
Arterial hypertension together with dyslipidemia, diabetes and smoking are the most severe risk factors for cardiovascular (CV) disease. The Czech Republic is among the countries with a high risk of cardiovascular disease. To reduce cardiovascular mortality and morbidity in our patients, a comprehensive approach to treatment and, in most cases, aggressive control of all risk factors is needed. This article summarizes current diagnostic and therapeutic procedures for arterial hypertension and dyslipidaemia, as well as the concept of vascular age, which can help us to communicate CV risk with patients.
Subject(s)
Cardiovascular Diseases , Diabetes Mellitus , Dyslipidemias , Hypertension , Humans , Dyslipidemias/drug therapy , Hypertension/complications , Hypertension/drug therapy , Cardiovascular Diseases/complications , Risk FactorsABSTRACT
(1) Background: The aim of this study was to evaluate the lifestyle and occurrence of psychosocial factors in patients with a high risk of sudden cardiac death (SCD) and to explore their effect on the occurrence of the adequate therapy of an Implantable Cardioverter Defibrillator (ICD). (2) Methods: In this retro-prospective single-centre study, a group of patients aged 18-65 years old, who underwent the first ICD implantation for primary (PP) or secondary (SP) prevention between 2010-2014, was studied. The control group consisted of pair-matched (age ± 5 years, gender) respondents without a high risk of SCD. Information was obtained using a self-reported questionnaire and hospital electronic health records. The adequacy of ICD therapy was evaluated regularly until 31 January 2020. Multivariate logistic regression models were employed to assess the risk of SCD. (3) Results: A family history of SCD, coronary artery disease, diabetes mellitus and depression significantly aggravated the odds of being at a high risk of SCD. The occurrence of an appropriate ICD therapy was significantly associated with being in the SP group, BMI, education level and TV/PC screen time. (4) Conclusions: Lifestyle and psychosocial factors have been confirmed to affect the risk of SCD. Early identification and treatment of coronary artery disease and its risk factors remain the cornerstones of preventive effort. Further research is needed to evaluate the complex nature of psychosocial determinants of cardiac health.
Subject(s)
Coronary Artery Disease , Defibrillators, Implantable , Adolescent , Adult , Aged , Death, Sudden, Cardiac/epidemiology , Death, Sudden, Cardiac/etiology , Death, Sudden, Cardiac/prevention & control , Follow-Up Studies , Humans , Life Style , Middle Aged , Prospective Studies , Risk Factors , Young AdultABSTRACT
Sudden cardiac death (SCD) is a major medical, economic and social problem. The estimated annual number of SCDs is approximately 4 million cases worldwide. Approximately 50% of SCDs are unexpected first manifestations of cardiac disease. The survival rate after out-of-hospital cardiac arrest is low even in countries with the most advanced health care systems. It all emphasizes the importance of prevention, in which implantable cardioverter-defibrillators play a dominant role. However, our ability to recognize high-risk patients remains insufficient. Moreover, a declining rate of shockable rhythm as the initial recording has been reported in the last decades. Despite numerous SCD studies and undisputed progress, there are still many unanswered questions.
Subject(s)
Defibrillators, Implantable , Out-of-Hospital Cardiac Arrest , Death, Sudden, Cardiac/etiology , Death, Sudden, Cardiac/prevention & control , Humans , Out-of-Hospital Cardiac Arrest/etiology , Out-of-Hospital Cardiac Arrest/therapy , Survival RateABSTRACT
OBJECTIVE: An excess of deaths from cardiac causes are reported after many natural disasters. Despite the fact that floods are the most common and most destructive natural disaster worldwide, little is known about their effect on human health. We analyzed the influence of the greatest floods in the Czech Republic on cardiac mortality in the affected area. METHODS: This was a retrospective case-control study. We analyzed persons whose autopsies proved they had died of cardiac causes during the month of the flood, 2 months before the flood, 1 month after the flood, and during the same period in the 3 previous years. RESULTS: A total of 207 of 985 autopsy reports met the criteria for inclusion in the study. There were no significant differences in the proportions of men and women (P=0.819) or in age (P=0.577). During the month of the flood, an increase in cardiac mortality was observed; however, the increase was not statistically significant (P=0.088). CONCLUSIONS: According to our findings, the 1997 Central European flood did not significantly affect cardiac mortality.
