Prevention against cardiovascular and circulatory diseases

Prevention against cardiovascular and circulatory diseases

     

At least half of all heart attacks, strokes and deaths can be avoided if you alone surrounded the lifestyle - without any tablet.

For diabetics and those who do not want to be, that is primarily:

• Increase in physical activity,.

• Reduction of body weight

• Non smoking

This is known to most diabetics. But there are a number of other risk and protective factors that ultimately determine the aging of our vessels. How you can influence them, experts have grouped together in a single guideline of multiple professional associations for the prevention of vascular disease and their

Guidelines are to provide security

"Guidelines" summarizes the State of knowledge in medicine for treatment or prevention of certain diseases. The guideline "Risikoadjustierte prevention of heart and circulatory diseases" is to help doctors to assess the classic risk factors for cardiovascular diseases and to take appropriate action. At this point, it is grouped together on diabetes-related issues for patients. Created, experts of all disciplines have the guideline: cardiology, hypertension, diabetes, obesity, Arteriosklerose research and Psychosomatic Medicine.

The connection between heart cardiovascular ailments and diabetes is closely

Cardiovascular diseases such as heart attack and stroke were the common terminal line of atherosclerosis and diabetes represent: both diseases cause damage to large and small vessels that typically trigger infarcts, so occlusions in heart or brain ("common soil" hypothesis). This is the most common cause of premature disability and death.

A person with diabetes has a high risk of a heart attack - similar to a non diabetic, has suffered even a heart attack. The most diabetics die of a cardiovascular disease. Compared to non diabetikern male diabetics have up to six more vulnerable to stroke and death, a female up to elffach higher risk.

Hazard detected - banned risk

Therefore, diabetics have a special right to be informed about an increased risk of heart attack or stroke. Only those who know the opportunities and risks, can take the impressionable risks to weaken and preventive measures. A special attention should be also the environment of the individual patient - so partners, children and family in a broader sense.

Who has an increased risk of vascular disease?

• Patients with Atherosclerotic vascular disease

• Patients with diabetes mellitus

• Related first degree of patients with vascular disease

• Persons in the family of patients with vascular disease

• Persons with several moderately increased risk factors

• Persons with individual strongly increased risk factors

What should they do?

Every participant should do is occasionally his health sake in mind:

• Adequate physical activity,

• healthy diet and

• non smoking

are the most important protective factors before infarction and stroke, partially against cancer. You have priority over any medication or should accompany them! Those at risk should be regularly vaccinate autumn against the influenza virus.

Properly treat risk factors

The importance of individual risk factors and the most important practical recommendations of the guideline:

1 Smoking: accelerated aging. Whoever smokes daily up to 20 cigarettes, has a 60 heart cardiovascular risk with 50 years of age. Smokers who every day create a parcel, losing up to the age of 60. 15 years. Smoke a few cigarettes per day or small quantities of tobacco is harmful, as well as passive smoking. Every single cigarette shortens the life to some 25-30 minutes! Recommended: Fully stop smoking. Where appropriate, the smoking cessation courses can be taken may be combined with nicotine patches, bupropion or varenicline also, in order the health insurance company.

2 Physical activity: The higher the physical fitness and activity, the lower the cardiovascular death rate. Experts can do that in Watts as expressed in the performance of a car. The increase in the physical fitness to about 15 watts reduces the mortality rate by 12%. Although the maximum preventive effect is reached for a training period of 6 to 7 hours on the intermediate level (energy consumption from 3000 to 3500 kcal \/ week). But also mild to medium intensity has obvious benefits.

Recommendation: Every adult should integrate throughout their lives every day at least 30 minutes of physical activity on medium load level in his daily routine. The training shall be primarily in dynamic endurance sports, up to 20% of the time also in strength training. Appears useful training in daily paths (jogging or bike to work) to complete and to take advantage of every opportunity to move (e.g. climbing stairs).

3 Diet: The energy consumption is reduced over the years: from the 30s to the pensioners he decreases by 25%, at the same level of activity. Each of kalorische diet, especially, if it is badly put together, promotes cardiovascular and cancer. Healthy eating is not a luxury, but a stand-alone health effect.

The original Mediterranean diet (no meals), the cardiovascular event rate will be reduced regardless of the cholesterol levels in patients after heart attack by up to 45%. The cancer and osteoporosis rate decrease with high life expectancy.

Recommendation: The diet should calorie-friendly, rich in fruit and vegetables (fibre > 20 g per day), monounsaturated fats and Omega-3 fatty acids, poor in saturated fats (< 7% of total calories) and cholesterol (< 300 mg \/ day) be. Accordingly, saltwater fish, whole grains, vegetable oils and nuts play an important role.

4 Alcohol: Alcohol in moderation is probably beneficial to health.

Recommendation: For healthy men are up to 30 g of alcohol a day (~ 1/4 litre of wine or beer 0.5 l) harmless. In women, the limit is located at about 20 g alcohol\/day.

5 Obesity: Obesity (obesity, body mass index > 30) favoured the early development of arteriosclerosis and is more frequently associated with type 2 diabetes, hypertension, heart disease and gallstones. The prognostic most convenient BMI lies in healthy male never smokers between 23.5 and 25.9 and women between 22.0 and 23.4. A waist size of 94 cm in men and over 80 cm for women increases the risk of metabolic disorders.

Recommendation: As a realistic goal in losing weight applies: a kilogram of body weight in 14 days. A moderately, but permanently reduced-calorie diet will help. To opt out are short-term "diets", which have the typical Yo-Yo effect of: lb down, pounds up

6 .Lipid metabolism: Particularly damaging to your heart is the LDL (low density lipoprotein) - cholesterol. Improve cardiovascular prognosis by cholesterol lowering is clear. Statins as Cholesterinsynthesehemmer are the most important treatment. The combination of Statins with a cholesterol Resorptionshemmer, possibly also with Nicotinic Acid can be effective in severe hypercholesterolaemia.

Recommendation: The LDL targets in patients with coronary heart disease (CHD) or with diabetes see cardiologists CHD and diabetes rockers before at the same time on the favourite among 100 mg / dl., should be brought to the LDL even under 70 mg / dl.

7 .Blood pressure: High blood pressure is an risk factor for the stroke. The normal blood pressure goal is irrespective of age: below 140 / 90 mmHg (measured at the doctor for self-monitoring of the value is approximately 5 mmHg lower). Recommended: People with diabetes or renal impairment should mmHg be below the blood pressure 130 / 80. The blood pressure decreases but also without medication for

• Increase in physical activity by endurance training,.

• Increased reduction in body weight,

• less salt consumption (maximum 6 g / day).

8. Blood sugar: Who has diabetes in the family, should be especially aware of the early signs of the disease:

• Thirst

• frequent urination

•Ket(azid)OSE

• Weight loss

• and casual blood glucose of 200 mg \/ dl (capillary Hemangioma whole blood).

Be seen as precursors of diabetes: increased fasting glucose (< 90 mg \/ dl) and impaired glucose tolerance (> 140 mg \/ dl in the glucose drink test). A manifest type 2 diabetes (glucose sober > 110 mg \/ dl in the hydration test > 200 mg \/ dl) corresponds to prognostic a manifest cardiac or vascular disease:

Recommendations: The manifestation of a type 2 diabetes can be delayed or prevented by

• Increase in physical activity,.

• Reduction of body weight,.

• Administration of Alpha-Glukosidasehemmern, pioglitazone and metformin,.

• Close to the standard blood glucose setting (sober 80 to 120 mg \/ dl and HbA1c < 6.5%) can prevent the progression of atherosclerosis and diabetes-typical organ complications.

• Metformin, pioglitazone, and acarbose seem to have pleiotropic effects kardioprotektiv.

• For a 10-year heart attack risk 20% = should aspirin (SSA), in contraindication Clopidogrel be given - in diabetics even without signs of heart disease (CHD).

Updated: Autumn 2007