Stratification of the risk of cardiovascular diseases
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ЧИТАТЬ ДАЛЕЕ ...
Stratification of the risk of cardiovascular disease: foundations and clinical application The stratification of the risk of cardiovascular disease (CVD) constitutes a Central Element of modern preventive medicine. Your goal is the identification of individuals with increased risk for cardiovascular events such as myocardial infarction, stroke, or sudden cardiac death is to preventive measures aimed to initiate. Fundamentals of risk stratification The risk assessment is based on the Integration of multiple factors, which can be divided into two main groups: Modifiable Risk Factors: Hypertension (blood pressure≥140/90 mmHg); Dyslipidemia (elevated LDL cholesterol, low HDL‑cholesterol values); Tobacco consumption (active and passive Smoking); Diabetes mellitus (elevated HbA 1c ); Overweight and obesity (BMI ≥25 kg/m 2 ); physical inactivity; unhealthy diet (high in salt, sugar and TRANS fat consumption). Non-modifiable risk factors: Age (men ≥45 years, women ≥55 years of age or after Menopause); Gender (higher risk in men, in younger age groups); family history of early CVD (incidents in first-degree Relatives: men, 55 years for women and 65 years ago). Instruments for risk estimation For the standardized risk assessment, different Scores are used: SCORE System (Systematic COronary Risk Evaluation): The 10‑year calculated risk for a fatal cardiovascular events on the Basis of age, gender, blood pressure, cholesterol and Smoking status. Framingham‑Risk Core: Determines 10‑year risk for coronary heart disease with the involvement of similar parameters. ASCVD risk calculator (Atherosclerotic Cardiovascular Disease): It is used mainly in the United States and taken into account in addition to HDL‑cholesterol. Stages of risk stratification On the basis of the calculated risk patients are divided values into the following categories: Low Risk: <1,0% (SCORE) — Health information and lifestyle advice. Moderate risk: 1,0–4,9% — more and better advice, if necessary, drug Intervention in the case of individual factors (e.g., hypertension). The high-risk range: 5.0–9.9% of the combined preventive strategies, medications for blood pressure and lipid-lowering. Very high risk: ≥10.0% or existing CVD — aggressive risk factor reduction, intensive Monitoring. Current developments and extensions In addition to the conventional Scores of additional markers will be discussed to improve the risk stratification: Coronary calcium Scoring (CAC Score) by means of CT; Measurement of high-sensitive C‑reactive Protein (hs‑CRP); Family history on the second-degree line; genetic-risk profiles. Conclusion The evidence-based stratification of cardiovascular risk allows for a differentiated prevention strategy. Through the identification of high-risk persons, the incidence of coronary heart can be reduced events significantly. The continuous development of risk models, and the Integration of new biomarkers will improve the precision of risk assessment in the future.
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Cardiovascular diseases: drugs as an important pillar of the therapy Cardiovascular diseases are among the leading causes of death worldwide and also in Germany, they represent a significant health challenge. High blood pressure, congestive heart failure, coronary heart disease or arrhythmias may limit the life of the Affected massively. However, thanks to modern medicines, many of these diseases can now be effectively treated and kept under control. The first measure in the case of cardiovascular problems, it is often in the regulation of medicines. These aim to reduce the workload on the heart, lower blood pressure, improve blood circulation, or to minimize the risk of thrombi. Among the most important groups of Drugs: ACE inhibitors (e.g., Enalapril, Ramipril): it can lower blood pressure and relieve the pressure on the heart by inhibiting the formation of a blood pressure-enhancing substance. Beta-blockers (e.g., Metoprolol, Bisoprolol): you can slow down the heart rate and lower blood pressure, thus reducing the work load of the heart decreases. Statins (e.g. Atorvastatin, Simvastatin): lower cholesterol levels and prevent the calcification of the vessels. Diuretics (water pills): they promote the excretion of water and salt, which lowers blood pressure and reducing Edema. Anticoagulants (e.g., warfarin, Rivaroxaban): they prevent the formation of blood clots and are particularly atrial fibrillation or after myocardial infarction is of great importance. Although these drugs are often life-saving, it is important to regularly and accurately in accordance with the instructions to take. Many patients tend to be taking for fear of side effects or because you have to cancel to feel better. However, this can be dangerous, and the risk for heart attacks or strokes increase. In addition to the drug treatment, the change in life-style plays a crucial role. A healthy diet, regular exercise, giving up Smoking, and moderate use of alcohol can enhance the effect of the medication and the health of the cardiovascular system, improve in a sustainable manner. In summary: drugs are a Central component of the treatment of cardiovascular diseases. They allow many patients, a dam will result in freer, and often longer life. However, their intake should always be done in consultation with the physician — only so the therapy can be optimally adapted to the individual patient and the possible risks are prevented.