Factors of non-communicable diseases. Diseases of civilization

1. What do substances consist of? 2. What types of chemical bonds between atoms do you know? 3. What is a spatial crystal lattice?

4. How do crystalline substances differ from amorphous ones? 5. What is the difference between the melting temperature Tmel and the crystallization temperature Tcr 6. How are electrical materials classified according to their behavior in an electric field? 7. How is the strength of interaction of a substance with magnetic field? 8. What mechanical properties have conductive materials? 9. In what units are relative elongation and contraction measured? 10. How is the temperature coefficient of linear expansion calculated? 11. How are specific units related to each other? electrical resistance and specific electrical conductivity? 12. What high conductivity materials do you know and where are they used? 13. Which metal is the electrical standard? 14. Where are high resistance materials used? 15. Under what conditions do some materials go into a superconducting state? 16. What materials are considered non-metallic conductors? How do you get them? 17. What are contactols and what is their purpose? 18. What materials are used for breaking contacts? 19. How are metal coatings applied? 20. How does intrinsic conductivity differ from impurity conductivity? 21. What methods are used to produce single-crystal semiconductors? 22. What are the basic electrical properties of dielectrics? 23. What dielectrics are classified as organic? 24. What properties do thermoplastic and thermosetting dielectrics have? 25. What are plastics made of? 26. What dielectric materials are called film? 27. What are the raw materials for synthetic rubbers? 28. What properties does rubber have? 29. How do varnishes, enamels and compounds differ from each other? 30. How are fluxes classified according to their effect on the surfaces being joined? 31. Where are glasses, glass-ceramics and ceramics used? 32. What are the advantages and disadvantages of mineral electrical insulating oils? 33. How do active dielectrics differ from conventional ones? 34. What properties do magnetically soft and magnetically hard magnetic materials have? 35. What are materials for magnetic storage media? 36. How are magnetodielectrics obtained? 37. What are the magnetic properties of iron? 38. What steels are used as hard magnetic materials? 39. What are the features of permalloys? 40. What is the technology for producing magnetodielectrics? 41. What materials are called abrasive, what are their properties? 42. What materials are grinding pads and polishing pads made of? 43. What materials are used to remove contaminants from substrates? 44. What are the requirements for materials for substrates of hybrid film and multi-chip integrated circuits? 45. What are the main properties of materials used for the manufacture of microcircuit packages? 46. What materials are used to make printed circuit boards? 47. What materials are used to metalize the mounting holes? 48. What types of materials are substances divided into based on their electrical properties? 49. What types of materials are all substances divided into? magnetic properties? 50. List the features of semiconductors and dielectrics. 51. What currents determine the electrical conductivity of dielectrics? 52. How are losses assessed at alternating and direct voltages? 53. How are insulating materials divided according to their chemical nature? 54. What processes occur during the breakdown of solid, liquid and gaseous dielectrics? 55. How do transformer and capacitor oils differ from each other? 56. What advantage do synthetic dielectrics have over petroleum electrical insulating oils? 57. What groups are guides divided into? 58. What materials are classified as liquid conductors? 59. List the main parameters of conductors. 60. List the advantages of copper and copper alloys. 61. List the prospects for the use of superconductors? 62. List the main materials of high resistivity and indicate the scope of their application. 63. List alloys for thermocouples. What are the requirements for thermocouples? 64. List the physical phenomena used in semiconductors. 65. On what factors does the electrical conductivity of semiconductors depend? 66. Define composite materials and indicate their scope of application.

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Noncommunicable diseases (NCDs), also known as chronic diseases, are not transmitted from person to person. They have a long duration and usually progress slowly. The four main types of noncommunicable diseases are cardiovascular diseases (such as heart attack and stroke), cancer, chronic respiratory diseases (such as chronic obstructive pulmonary disease and asthma) and diabetes.

NCDs already disproportionately affect low- and middle-income countries, where about 80% of all NCD deaths, or 29 million, occur. They are the leading cause of death in all regions except Africa, but current projections indicate that by 2020 the largest increase in mortality from NCDs will occur in Africa. By 2030, the number of deaths from NCDs in African countries is projected to exceed total number deaths from infectious and nutrition-related diseases, as well as maternal and perinatal deaths, which are the leading causes of death.

Who is at risk for such diseases?

NCDs are common in all age groups and all regions. These diseases are often associated with older age groups, but evidence suggests that nine million people who die from NCDs are age group up to 60 years old. 90% of these “premature” deaths occur in low- and middle-income countries. Children, adults and older people are all vulnerable to risk factors that contribute to the development of noncommunicable diseases, such as unhealthy diets, lack of physical activity, exposure to tobacco smoke or harmful use of alcohol.

The development of these diseases is influenced by factors such as aging, rapid unplanned urbanization and the globalization of unhealthy lifestyles. For example, the globalization of unhealthy diets can manifest in individuals as high blood pressure, high blood glucose, high blood lipids, overweight and obesity. These conditions are called "intermediate risk factors" and can lead to the development of cardiovascular disease.

Risk factors

Modifiable behavioral risk factors

Tobacco use, lack of physical activity, unhealthy diet and harmful use of alcohol increase the risk of developing or lead to most NCDs.

Metabolic/physiological risk factors

These behaviors lead to four metabolic/physiological changes that increase the risk of developing NCDs, such as high blood pressure, overweight/obesity, hyperglycemia (high blood glucose levels) and hyperlipidemia (high blood fat levels).

In terms of attributable deaths, the leading risk factor for NCDs globally is high blood pressure (associated with 16.5% of global deaths(1)). This is followed by tobacco use (9%), elevated blood glucose (6%), lack of physical activity (6%) and overweight and obesity (5%). Low- and middle-income countries are experiencing the fastest growth in the number of children early age overweight.

Prevention and control of NCDs

Reducing the impact of NCDs on people and society requires a comprehensive approach that requires all sectors, including health, finance, international affairs, education, agriculture, planning and others, to work together to reduce the risks associated with NCDs and to implement interventions to prevention and control.

One of the most important ways to reduce the burden of NCDs is to focus efforts on reducing the risk factors associated with these diseases. There are inexpensive ways to reduce common modifiable risk factors (mainly tobacco use, unhealthy diet and physical inactivity, and harmful use of alcohol) and map the NCD epidemic and its risk factors.(1)

Other ways to reduce the burden of NCDs include basic, high-impact interventions to strengthen early detection and timely treatment of diseases, which can be delivered through primary health care. Evidence suggests that such interventions are an excellent economic investment because, when implemented in a timely manner, they can reduce the need for more costly treatments. The greatest impact can be achieved by developing health-promoting public policies that promote the prevention and control of NCDs and reorient health systems to meet the needs of people with them.

Lower-income countries tend to have lower capacity to prevent and control NCDs.

High-income countries are four times more likely to have NCD services covered by health insurance than low-income countries. It is unlikely that countries with inadequate health insurance can ensure universal access to essential NCD interventions.

WHO activities

Action plan for the global strategy for the prevention and control of noncommunicable diseases 2008–2013. provides guidance to Member States, WHO and international partners on measures to take to combat NCDs.

WHO is also taking action to reduce risk factors associated with NCDs.

Countries' adoption of tobacco control measures outlined in the WHO Framework Convention on Tobacco Control can help significantly reduce people's exposure to tobacco.

WHO's Global Strategy on Diet, Physical Activity and Health aims to promote and protect health by empowering communities to reduce morbidity and mortality associated with unhealthy diets and physical inactivity.

WHO's Global Strategy to Reduce the Harmful Use of Alcohol proposes measures and identifies priority areas for action to protect people from the harmful use of alcohol.

In accordance with the UN Political Declaration on NCDs, WHO is developing a comprehensive global monitoring system for the prevention and control of NCDs, including indicators and a set of voluntary global targets.

In accordance with the World Health Assembly resolution, WHO is developing a Global Action Plan on NCDs 2013–2020, which will provide a framework for implementing the political commitments of the UN High-Level Meeting. A draft action plan will be presented for adoption at the World Health Assembly in May 2013.

Prevention of major non-communicable diseases

The concept of “major non-communicable diseases” is relatively new and reflects the changing picture of human morbidity during the development of civilization and innovations occurring in the sphere of human activity. Advances in medicine in the treatment of widespread infectious diseases and education of the population in measures to prevent them have reduced mortality. At the same time, the incidence and mortality of people from non-communicable diseases has increased.

The main non-communicable diseases primarily include:

Diseases of the circulatory system (for example, coronary heart disease, characterized by disturbances in the functioning of the heart, and hypertension - a disease with a persistent increase in blood pressure);

Malignant formations (cancer)

When analyzing the causes of mortality in Russia, there is a clear trend towards an increase in mortality from non-communicable diseases, which account for more than 80% of cases, including diseases of the circulatory system - more than 53%, and malignant tumors - about 18%.

Remember!
According to the World Health Organization (WHO), the main indicator of population health is life expectancy.

Statistics
Currently, the life expectancy of the Russian population is significantly less than in developed countries ah peace. Thus, according to data for 1994, the average life expectancy of the Russian population was 57.7 years for men and 71.3 years for women. By long-term forecasts it will remain close to this level. Thus, for men born in 2006, the average life expectancy will be 60.4 years, for women - 73.2 years. For comparison: the average life expectancy of the population of the USA and England is 75 years, Canada - 76 years, Sweden - 78 years, Japan - 79 years.

Everyone should know this

The main cause of non-communicable diseases is non-compliance with healthy lifestyle standards. Among the main reasons are:

High level of load on the nervous system, stress;

Low physical activity;

Poor nutrition;

Smoking, drinking alcohol and drugs.

According to medical statistics, all these factors contribute to a reduction in human life expectancy.

Smoking reduces the life expectancy of a smoker by an average of 8 years, regular use alcoholic drinks- for 10 years, poor nutrition (systematic overeating, abuse of fatty foods, insufficient intake of vitamins and microelements, etc.) - for 10 years, poor physical activity - for 6-9 years, stressful situation- for 10 years. This adds up to 47 years. If we take into account that on average a person is given up to 100 years of life by nature, then those who grossly violate all the norms of a healthy lifestyle cannot count on a long prosperous life. In addition, they need to be prepared to spend a lot of effort on treating non-communicable diseases.

A person’s lifestyle is one of the main factors influencing the preservation and promotion of health; it accounts for 50% among other factors (heredity - 20%, environment- 20%, medical care - 10%). Unlike other factors, lifestyle depends only on a person’s behavior, which means that 50% of your health is in your hands, and personal behavior affects its condition. Therefore, mastering the norms of a healthy lifestyle and forming your own individual system is the most reliable way to prevent the occurrence of non-communicable diseases.

When creating a healthy lifestyle, it is necessary to take into account a number of individual factors. This is primarily heredity, i.e. features physical development, certain inclinations, predisposition to certain diseases and other factors that were passed on to you from your parents. It is also necessary to take into account the factors of your environment (ecological, household, family, etc.), as well as a number of others that determine your ability to realize your plans and desires.

It should be noted that life requires each person to be able to adapt to a constantly changing environment and regulate their behavior in accordance with it. Every day presents us with new problems that need to be solved. All this is associated with certain emotional stress and the emergence of a state of tension. They appear in humans under the influence of strong external influences. The state of tension that arises as a response to external influences is called stress.

Each person has their own optimal level of stress. Within these limits, stress is mentally beneficial. It adds interest to life, helps you think faster and act more intensely, feel useful and valuable, having a certain meaning in life and specific goals, to which we should strive. When does stress go beyond boundaries? optimal level, it depletes the mental capabilities of the individual and disrupts human activity.

It has been noted that severe stress is one of the main causes of non-infectious diseases, as it disrupts the functioning of the body’s immune systems and leads to an increased risk of various diseases (stomach and duodenal ulcers, as well as diseases of the circulatory system). Thus, the ability to manage your emotions, resist the effects of severe stress, develop emotional stability and psychological balance in behavior in various life situations - this is the best prevention of the occurrence of non-communicable diseases.

Let us note that different people react to external irritation in different ways, but nevertheless, there are general directions for dealing with stress that ensure psychological balance, that is, the ability to contain stress at an optimal level.

Let's list some of them. The fight against stress begins with developing the belief that only you are responsible for your spiritual and physical well-being. Be optimistic, because the source of stress is not the events themselves, but your correct perception of them.

Exercise and play sports regularly. Physical exercise has positive influence not only on physical condition, but also on the psyche. Constant physical activity promotes psychological balance and self-confidence. Physical exercise is one of the best ways to overcome severe stress.

Exercise and play sports regularly. Athletic people are less susceptible to stress.

Set yourself feasible tasks. Look at things realistically, don't expect too much from yourself. Understand the limits of your capabilities, do not take on an unbearable burden in life. Learn to say a firm “no” if you are unable to complete a task.

Learn to enjoy life, enjoy the work itself, how well you do it, and not just what it will give you.

Eat right. Get enough sleep. Sleep plays a very important role in coping with stress and maintaining health.

Attention!
The ability to manage your emotions and maintain psychological balance in any life situations will provide you with a good mood, high performance, respect from the people around you, and therefore spiritual, physical and social well-being, which will significantly reduce the risk of non-communicable diseases.

Key Facts

Noncommunicable diseases (NCDs) kill 38 million people every year.

About 75% - 28 million deaths from NCDs occur in low- and middle-income countries.

16 million people dying from NCDs are under the age group of 70 years. 82% of these premature deaths occur in low- and middle-income countries.

Cardiovascular diseases account for the majority of deaths from NCDs, killing 17.5 million people each year. They are followed by cancer (8.2 million), respiratory diseases (4 million) and diabetes (1.5 million).

These 4 groups of diseases account for approximately 82% of all deaths from NCDs.

Tobacco use, physical inactivity, harmful use of alcohol and unhealthy diets increase the risk of illness and death from NCDs.

NCDs already disproportionately affect low- and middle-income countries, where about 75% of all NCD deaths, or 28 million, occur.

Who is at risk for such diseases?

NCDs are common in all age groups and all regions. These diseases are often associated with older age groups, but evidence suggests that 16 million people who die from NCDs are in the under 70 age group. 82% of these premature deaths occur in low- and middle-income countries. Children, adults and older people are all vulnerable to risk factors that contribute to the development of noncommunicable diseases, such as unhealthy diets, lack of physical activity, exposure to tobacco smoke or harmful use of alcohol.

The development of these diseases is influenced by factors such as aging, rapid unplanned urbanization and the globalization of unhealthy lifestyles. For example, the globalization of unhealthy diets can manifest in individuals as high blood pressure, high blood glucose, high blood lipids, overweight and obesity. These conditions are called intermediate risk factors, which can lead to the development of cardiovascular disease.

Risk factors

Modifiable behavioral risk factors

Tobacco use, lack of physical activity, unhealthy diet and harmful use of alcohol increase the risk of developing NCDs.

Tobacco causes nearly 6 million deaths each year (including exposure to second-hand smoke) and this number is projected to rise to 8 million by 2030.

About 3.2 million annual deaths can be attributed to insufficient physical activity.

Half of the 3.3 million annual deaths from harmful use of alcohol are due to NCDs.

1.7 million annual deaths from cardiovascular causes in 2010 were attributed to excessive salt/sodium intake.

Metabolic/physiological risk factors

In terms of attributable deaths, the leading risk factor for NCDs globally is high blood pressure (associated with 18% of global deaths). This is followed by overweight and obesity and elevated blood glucose. Low- and middle-income countries are experiencing the fastest increases in the number of overweight young children.

What are the socioeconomic impacts of NCDs?

NCDs threaten progress towards achieving the UN Millennium Development Goals and post-2015 efforts. Poverty is closely linked to NCDs. The rapid increase in the burden of these diseases is projected to hamper poverty reduction initiatives in low-income countries, especially as household costs increase medical care. Vulnerable and socially disadvantaged people get sick more and die earlier than people in higher social positions, especially because they are at higher risk of exposure to harmful products such as tobacco or unhealthy foods and have limited access to health services.

In resource-limited settings, the cost of treating heart disease, cancer, diabetes, or chronic lung disease can quickly deplete family resources and push families into poverty. The exorbitant costs of NCDs, including often lengthy and expensive treatment and the loss of breadwinners, push millions of people into poverty every year, hindering development.

In many countries, harmful drinking and unhealthy diets and lifestyles occur in both high- and low-income groups. However, high-income groups have access to services and drugs that protect them from the highest risks, while for low-income groups such drugs and services are often unaffordable.

Prevention and control of NCDs

Reducing the impact of NCDs on people and society requires a comprehensive approach that requires all sectors to work together, including health, finance, international relations, education, agriculture, planning and others, in order to reduce the risks associated with NCDs, as well as to carry out activities to prevent and combat them.

One of the most important ways Reducing the burden of NCDs is to focus efforts on reducing the risk factors associated with these diseases. There are inexpensive ways to reduce common modifiable risk factors (mainly tobacco use, unhealthy diet and physical inactivity, and harmful use of alcohol) and map the NCD epidemic and its risk factors.

Lower-income countries tend to have lower capacity to prevent and control NCDs.

High-income countries are four times more likely to have NCD services covered by health insurance than low-income countries. Countries with inadequate health insurance are unlikely to achieve universal access to essential NCD interventions.

4. Prevention of non-communicable diseases is ensured by:

1) development and implementation of programs for promoting a healthy lifestyle and prevention of non-communicable diseases, including programs to reduce the prevalence of the main risk factors for their development, as well as prevention of consumption narcotic drugs and psychotropic substances without a doctor’s prescription;

2) implementation of measures for the prevention and early detection of non-communicable diseases, risk factors for their development, including early identification of the risk of harmful alcohol consumption, and the risk of consumption of narcotic drugs and psychotropic substances without a doctor’s prescription, measures to correct identified risk factors for the development of non-communicable diseases, as well as dispensary monitoring citizens with chronic non-communicable diseases or a high risk of developing them.

5. Prevention of non-communicable diseases and the formation of a healthy lifestyle among citizens, including minors, include a set of the following measures:

1) carrying out activities on hygienic education, information and communication activities on maintaining a healthy lifestyle, prevention of non-communicable diseases and consumption of narcotic drugs and psychotropic substances without a doctor’s prescription;

2) identification of violations of the basic conditions for maintaining a healthy lifestyle, risk factors for the development of non-communicable diseases, including the risk of harmful alcohol consumption, and the risk of consuming narcotic drugs and psychotropic substances without a doctor’s prescription, determining the degree of their severity and danger to health;

3) provision of medical services for the correction (elimination or reduction of levels) of risk factors for the development of non-communicable diseases, prevention of complications of non-communicable diseases, including referral of patients for medical reasons to medical specialists, including specialized medical organizations, referral of citizens with an identified risk of harmful alcohol consumption , the risk of consuming narcotic drugs and psychotropic substances without a doctor’s appointment with a psychiatrist-narcologist at a specialized medical organization or other medical organization providing drug treatment;

4) conducting medical examinations and preventive medical examinations;

5) conducting dispensary observation of patients with non-communicable diseases, as well as citizens with a high risk of developing cardiovascular diseases.

Stress (from the English stress - load, tension; state of increased tension) is a set of nonspecific adaptive (normal) reactions of the body to the influence of various unfavorable stressors (physical or psychological), disrupting its homeostasis, as well as the corresponding state of the body's nervous system (or the body as a whole). In medicine, physiology, and psychology, positive (eustress) and negative (distress) forms of stress are distinguished. According to the nature of the impact, neuropsychic, heat or cold (temperature), light, hunger and other stresses (irradiation, etc.) are distinguished.

Whatever the stress, “good” or “bad”, emotional or physical (or both), its effect on the body has common non-specific features.

Common Misconceptions

There has been a tendency among non-specialists to equate stress (and especially psychological stress) simply with nervous tension (partly to blame for this is the very term “tension” in English). Stress is not just mental anxiety or nervous tension. First of all, stress is a universal physiological reaction to enough strong impacts, having the described symptoms and phases (from activation of the physiological apparatus to exhaustion).

In the second half of the twentieth century, non-communicable diseases, primarily diseases, became the main danger to public health and a problem for healthcare. cardiovascular system, which are currently the leading cause of morbidity, disability and mortality in the adult population. There has been a “rejuvenation” of these diseases. They began to spread among the population of developing countries.

In most economically developed countries, diseases of the cardiovascular system occupy first place among the causes of morbidity, disability and mortality, although their prevalence varies significantly in different regions. In Europe, approximately 3 million people die annually from cardiovascular diseases, in the USA - 1 million, this is half of all deaths, 2.5 times more than from all malignant neoplasms combined, and ¼ of those who died from cardiovascular diseases diseases are people under 65 years of age. The annual economic loss due to death from cardiovascular disease in the United States is $56,900 million.

In Russia, these diseases are the main cause of mortality and morbidity among the population. If in 1939 in general structure Causes of mortality they accounted for only 11%, then in 1980 - over 50%.

Diseases of the cardiovascular system are numerous. Some of them are diseases primarily of the heart, others - mainly of the arteries (atherosclerosis) or veins, and others affect the cardiovascular system as a whole (hypertension). Diseases of the cardiovascular system can be caused by congenital malformations, trauma, inflammation, and others. Congenital defects in the structure of the heart and large vessels, often called congenital heart defects, are recognized by doctors in children in infancy, mainly by a murmur heard over the heart.

There are also diseases of the cardiovascular system, which are based on the inflammatory process. Occasionally, this inflammation turns out to be bacterial. This means that bacteria multiply on the inner lining of the heart valves or on the outer lining of the heart, causing purulent inflammation of these parts of the heart.

I chose this topic because my future profession related to medicine. I would like to learn more about human diseases in general and the reasons that cause this or that disease.

I took this topic because it is relevant today. Every third person has some kind of heart disease. Many scientists have devoted themselves to studying heart disease.

The cardiovascular system consists of the heart and blood vessels filled with liquid tissue - blood. Blood vessels are divided into arteries, arterioles, capillaries and veins. Arteries carry blood from the heart to the tissues; they branch tree-like into smaller and smaller vessels and turn into arterioles, which break up into a system of thinnest capillary vessels. Small veins begin from the capillaries, they merge with each other and become stronger. Cardiovascular systems provide blood circulation necessary for its transport functions - delivery to tissues nutrients and oxygen and removal of metabolic products and carbon dioxide. At the center of the circulatory system is the heart; the greater and lesser circles of blood circulation originate from it.

The systemic circulation begins with a large arterial vessel, the aorta. It branches into large number arteries average size, and these are thousands of small arteries. The latter, in turn, break up into many capillaries. The capillary wall has high permeability, due to which there is an exchange of substances between blood and tissues: nutrients, substances and oxygen pass through the capillary wall into the tissue fluid, and then into the cells, in turn the cells are released into the tissue fluid carbon dioxide and other metabolic products entering the capillaries.

Arteries are elastic tubes of various calibers. Their wall consists of three shells - outer, middle and inner. The outer shell is formed by connective tissue, the middle one - muscle - consists of smooth muscle cells and elastic fibers. The smooth inner membrane lines the inside of the vessel and is covered on the lumen side with flat cells (endothelium). Thanks to the endothelium, unimpeded blood flow is ensured and its liquid state is maintained. Blocked or narrowed arteries lead to severe circulatory problems.

Veins have the same structure as arteries, but their walls are much thinner than arterial ones and can collapse. In this regard, there are two types of veins - amuscular and muscular. Through veins of the non-muscular type (veins of the meninges, eyes, spleen, etc.) blood moves under the influence of gravity, through veins of the muscular type (brachial, femoral, etc.) - overcoming gravity. The inner lining of the veins forms folds in the form of pockets - valves, which are arranged in pairs at certain intervals and prevent the reverse flow of blood.

The heart is a hollow muscular organ located in the chest cavity, behind the sternum. Most of the heart (about 2/3) is located in the left half of the chest, a smaller part (about 1/3) is in the right. In an adult man, the average heart weight is 332 g, in a woman - 254 g. The heart pumps about 4-5 liters of blood per minute.

The wall of the heart consists of three layers. The inner layer - the endocardium - lines the cavities of the heart from the inside, and its outgrowths form the heart valves. The endocardium consists of flattened, smooth endothelial cells. The middle layer - the myocardium - is formed by a special cardiac striated muscle tissue. The outer layer, the epicardium, covers the outer surface of the heart and the areas of the aorta, pulmonary trunk and vena cava closest to it.

The atrioventricular openings are closed by valves that have a leaflet structure. The valve between the left atrium and the ventricle is bicuspid, or mitral, and between the right atrium it is tricuspid. The edges of the valve leaflets are connected to the papillary muscles by tendon threads. There are semilunar valves near the openings of the pulmonary trunk and aorta. Each of them looks like three pockets that open in the direction of blood flow in these vessels. When the pressure in the ventricles of the heart decreases, they fill with blood, their edges close, closing the lumens of the aorta and pulmonary trunk and preventing the return of blood into the heart. Sometimes heart valves, damaged by certain diseases (rheumatism, atherosclerosis), cannot close tightly, heart function is disrupted, and heart defects occur.

I. Diseases of the cardiovascular system.

Atherosclerosis.

The basis of many lesions of the cardiovascular system is atherosclerosis. This term comes from the Greek words there - wheat gruel and sclerosis - hard and reflects the essence of the process: the deposition of fatty masses in the arterial wall, which subsequently acquire the appearance of mush, and the development of connective tissue with subsequent thickening and deformation of the arterial wall. Ultimately, this leads to a narrowing of the lumen of the arteries and a decrease in their elasticity, which makes it difficult for blood to flow through them.

Atherosclerosis - chronic disease arteries of large and medium caliber, characterized by the deposition and accumulation of plasma atherogenic apoprotein-B- containing lipoproteins in the intine, followed by reactive proliferation of connective tissue and the formation of fibrous plaques. Atherosclerosis usually primarily affects large arteries: the aorta, coronary arteries, arteries supplying the brain (internal carotid arteries). With atherosclerosis, the lumen of the artery narrows, the density of the arterial wall increases, and its distensibility decreases; in some cases, aneurysmal stretching of the artery walls is observed.

It has been established that many external and internal factors, in particular hereditary ones, cause the development of atherosclerosis or adversely affect its course. One of the causes of atherosclerosis is considered to be a disproportion in the content of various classes of lipoproteins in the blood plasma, some of which contribute to the transfer of cholesterol into the vascular wall, i.e. are atherogenic, others interfere with this process. The occurrence of such disorders and the development of atherosclerosis is facilitated by long-term consumption of food containing excess animal fats rich in cholesterol. The factor of excess fat consumption is especially easily realized when the liver produces insufficient enzymes that destroy cholesterol. Having spoiled, in people with high activity of these enzymes, atherosclerosis does not develop even with prolonged consumption of food containing large amounts of animal fats.

There are more than 200 factors described that contribute to the occurrence of atherosclerosis or adversely affect its course, however highest value have arterial hypertension, obesity, lack of physical activity and smoking, which are considered major risk factors for the development of atherosclerosis. According to data from mass population surveys, atherosclerosis is much more common among patients with arterial hypertension than among people with normal blood pressure.

The earliest manifestations of atherosclerosis are lipid spots, or lipid streaks; often detected already in childhood. These are flat spots of a yellowish color, of various sizes, located under the inner lining of the aorta, most often in its thoracic region. The yellowish color of the spots is given by the cholesterol they contain. Over time, some lipid stains resolve, while others, on the contrary, grow, occupying an increasingly larger area. Gradually, the flat spot turns into a cholesterol plaque protruding into the lumen of the artery. Subsequently, the plaque becomes denser, sprouting connective tissue, and calcium salts are often deposited in it. A growing plaque narrows the lumen of the artery, and sometimes completely clogs it. The supplying vessels at its base are traumatized by the plaque and can rupture with the formation of hemorrhage, which raises the plaque, exacerbating the narrowing of the lumen of the artery until complete closure. Insufficient blood supply to the plaque itself often leads to its contents being partially necrotic, forming mushy detritus. Due to insufficient blood supply, the surface of the fibrous plaque sometimes bulges, and the endothelium covering the plaque sloughs off. Blood platelets that do not adhere to the intact vascular wall settle in an area devoid of endothelium, giving rise to the development of a blood clot.

Widespread and significantly pronounced atherosclerosis and atheromatosis of the aorta can cause the development of its aneurysm, which is manifested by symptoms of compression of the organs adjacent to the aorta. The most dangerous complications of an aortic aneurysm are its dissection and rupture.

The basis for the prevention of atherosclerosis is a rational lifestyle: a work and rest schedule that reduces the likelihood of mental stress; exclusion of physical inactivity, health-improving physical education classes; quitting smoking and drinking alcohol. Proper nutrition is of great importance: ensuring the stability of normal body weight, excluding excess animal fats from food and replacing them with vegetable fats, sufficient vitamin content in food, especially vitamin C, limited consumption of sweets. Timely detection of arterial hypertension is important in the prevention of atherosclerosis, as well as diabetes mellitus, predisposing to the development of vascular lesions, and their systematic, carefully controlled treatment.

Myocardial infarction.

Myocardial infarction is an acute heart disease caused by the development of one or more foci of necrosis in the heart muscle and manifested by impaired cardiac activity. It is most often observed in men aged 40-60 years. Usually occurs as a result of damage to the coronary arteries of the heart due to atherosclerosis, when their lumen narrows. Often this is accompanied by blockage of blood vessels in the affected area, as a result of which blood completely or partially stops flowing to the corresponding part of the heart muscle, and foci of necrosis (necrosis) form in it. In 20% of all cases of myocardial infarction, it is fatal, and in 60-70% - in the first 2 hours.

In most cases, myocardial infarction is preceded by severe physical or mental stress. More often it develops during exacerbation of coronary heart disease. During this period, called pre-infarction, angina attacks become more frequent, and the effect of nitroglycerin becomes less effective. It can last from several days to several weeks.

The main manifestation of myocardial infarction is a prolonged attack of intense pain in the chest of a burning, pressing, less often tearing, burning nature, which does not disappear after repeated administration of nitroglycerin. The attack lasts more than half an hour (sometimes several hours), accompanied by severe weakness, a feeling of fear of death, as well as shortness of breath and other signs of cardiac dysfunction.

In most cases, myocardial infarction is accompanied by characteristic changes in the electrocardiogram, which may be delayed, sometimes appearing several hours or even days after intense pain subsides.

If acute chest pain occurs that does not disappear after taking nitroglycerin, it is necessary to urgently call ambulance. Based on a thorough examination of the patient, including electrocardiography, the disease can be recognized. Before the doctor arrives, the patient is provided with maximum physical and mental rest: he should be laid down and, if possible, calmed down. If suffocation or lack of air occurs, the patient must be given a semi-sitting position in bed. Although nitroglycerin does not completely eliminate pain during myocardial infarction, its repeated use is advisable and necessary. Distractions also bring noticeable relief: mustard plasters on the heart and sternum, heating pads on the legs, warming the hands.

From a preventive point of view, it is important that any sudden acute cardiovascular weakness, especially an attack of cardiac asthma in the elderly and senile, should first of all cause a medical worker to think about the development of a painful myocardial infarction.

Gastrological or abdominal myocardial infarction rarely occurs. It manifests itself as sudden abdominal pain, vomiting, bloating, and sometimes intestinal paresis. This type of myocardial infarction is the most difficult to diagnose. Localization of abdominal pain may lead to misdiagnosis of acute abdomen. There are known cases of erroneous gastric lavage in such patients.

With the “cerebral” version of myocardial infarction, described by the Soviet clinician N.K. Bogolepov, the clinical picture is dominated by signs of cerebral vascular catastrophe. Such cerebral phenomena during a heart attack appear to be based on a reflex spasm of cerebral vessels and short-term disturbances in heart rhythm.

Sometimes myocardial infarction is clinically manifested only by heart rhythm disturbances.

During myocardial infarction the following periods are distinguished:

- pre-infarction;

- acute (7-10 days);

- subacute (up to 3 weeks);

- restorative (4-7 weeks)

- period of subsequent rehabilitation (2.5-4 months);

- post-infarction.

There are many complications associated with myocardial infarction. Among the early complications of a heart attack, the most important are various shapes shock (collapse), often there are also heart failure, severe heart rhythm disturbances, external and internal ruptures of the heart muscle.

A patient in the acute period of the disease needs constant supervision by staff. The first attack is often followed by repeated, more severe ones. The course of the disease may be complicated by acute heart failure, cardiac arrhythmias, etc.

A system for providing care to patients with myocardial infarction has been developed. It provides for a medical ambulance team to visit the patient, carry out medical measures at the site of the attack, and, if necessary, continue them in the ambulance. Many large hospitals have created departments (wards) intensive care patients with acute myocardial infarction with round-the-clock electrocardiographic monitoring of the state of cardiac activity and the ability to immediately provide assistance in threatening conditions.

Care and regimen for myocardial infarction.

Meals are small and varied, but in the first days of illness it is better to eat less, preferring less high-calorie foods; Fruit and vegetable purees are preferred. Foods that cause intestinal bloating, such as peas, milk, kvass, are excluded from the diet, since the resulting rise in the diaphragm impedes the functioning of the heart. Fatty meats, smoked meats, salty foods, and any types of alcoholic beverages are prohibited.

From the first days of treatment, in the absence of complications, the doctor prescribes an individually selected complex of physical therapy. It is necessary to ensure that the air in the room where the patient is located is always fresh.

Rehabilitation therapy, aimed at preparing a patient with myocardial infarction for an active lifestyle, begins from the first days of treatment. It is carried out under the guidance and supervision of a physician.

The daily routine should be strictly regulated. It’s better to wake up and go to bed at the same time every day. Sleep duration is at least 7 hours. Meals should be four times a day, varied, rich in vitamins and limited in calories (no more than 2500 kcal per day). Quitting smoking and alcohol abuse are necessary conditions for the prevention of myocardial infarction. These “rescuer” events often cause harm. The nature of health treatment should be agreed upon with your doctor.

Cardiac arrhythmias.

Cardiac arrhythmias are various deviations in the formation or conduction of excitation impulses in the heart, most often manifested by disturbances in the rhythm or rate of its contractions. Some cardiac arrhythmias are detected only with the help of electrocardiography, and in cases of disturbances in the rhythm or tempo of heart contractions, they are often felt by the patient himself and are detected by listening to the heart and by palpating the pulse in the arteries.

Normal, or sinus, heart rhythm is formed by excitation impulses that arise at a certain frequency in special cells in the right atrium and spread through the conduction system to the atria and ventricles of the heart. The occurrence of cardiac arrhythmia can be caused by the formation of excitation impulses outside the sinus node, their pathological circulation or slowdown in conduction through the conduction system of the heart due to congenital anomalies of its development, or due to disturbances in the nervous regulation of activity or heart disease.

Cardiac arrhythmias are varied in their manifestations and unequal in clinical significance. The main arrhythmias of the heart include extrasystole, paroxysmal tachycardia, bradycardia during heart block, as well as atrial fibrillation. The latter is in most cases associated with heart disease and is often observed with some rheumatic heart defects.

Atrial fibrillation manifests itself as a complete irregularity of heart contractions, most often in combination with their acceleration. It can be permanent and paroxysmal in nature, and paroxysms of arrhythmia sometimes precede its permanent form for several years.

In elderly and senile people, cardiac arrhythmias usually occur against the background of cardiosclerosis, but ischemic myocardial dystrophy is often involved in their origin. Organic changes in the myocardium most contribute to the occurrence of cardiac arrhythmia when they are localized in the region of the sinus node and in the conduction system. Cardiac arrhythmias can also be caused by congenital anomalies these formations.

In the pathogenesis of cardiac arrhythmia, a major role is played by shifts in the ratio of the content of potassium, sodium, calcium and magnesium ions inside myocardial cells and in the extracellular environment.

Coronary heart disease.

Coronary heart disease is an acute and chronic damage to the heart caused by a decrease or cessation of blood supply to the myocardium due to the atherosclerotic process in the coronary arteries. The term was proposed in 1957. by a group of WHO specialists. In the vast majority of cases, the cause of this is a sharp narrowing of one or more branches of the coronary arteries supplying the heart due to damage to them by atherosclerosis. Restricting the flow of blood to the myocardium reduces the delivery of oxygen and nutrients to it, as well as the removal of waste metabolic products and waste products.

Depending on the combination of several factors, the manifestations of coronary heart disease can be different. Its first manifestation may be sudden death or myocardial infarction, angina pectoris, heart failure, or cardiac arrhythmia. Often this disease affects young people (aged 30-40) who lead an active lifestyle, leading to enormous moral and economic losses. The annual mortality rate from coronary heart disease ranges from 5.4 to 11.3% and depends on the number of affected arteries and the severity of coronary atherosclerosis.

The prevalence of coronary heart disease reached epidemic proportions in the second half of the twentieth century, although its individual manifestations have been known for a long time.

Coronary heart disease can occur in both acute and chronic forms. The widespread prevalence of this disease among people of the most working age has turned coronary heart disease into an important social and medical problem. The increased incidence of coronary disease is associated, first of all, with a decrease in people’s physical activity, hereditary predisposition, excess body weight and other risk factors. The prevalence of coronary disease is higher among people who have a constant desire for success in all areas of activity and long-term work overload. This set of features is sometimes called the “coronal personality profile.”

The course of the disease is long. It is characterized by exacerbations, alternating with periods of relative well-being, when the disease may not subjectively manifest itself. The initial signs of coronary artery disease are angina attacks that occur during physical activity. In the future, they may be joined by attacks that occur at rest. The pain is paroxysmal, localized in the upper or middle part of the sternum or retrosternal region, along the left edge of the sternum, in the precordial region. The nature of the pain is pressing, tearing or pinching, less often stabbing.

Electrocardiographic research methods are widely used in the diagnosis of coronary heart disease. A 12-lead ECG is usually recorded at rest, either once or repeatedly.

Therapy for coronary heart disease is aimed at restoring the lost balance between blood flow to the heart muscle. Diet plays a significant role in the prevention of coronary heart disease. Its basic principles: limitation total number and calorie content of food, allowing you to maintain normal body weight, significant limitation of animal fats and easily digestible carbohydrates, exclusion of alcoholic beverages; food fortification vegetable oils and vitamins C and group B. With moderate physical activity, it is recommended to eat food four times a day, at regular intervals, with a daily caloric intake of 2500 kcal. The diet should include foods containing large amounts of complete protein, raw vegetables, fruits and berries.

Hypertension.

Hypertension is a disease of the cardiovascular system, characterized by constant or periodic blood pressure. Unlike other forms of hypertension, this increase is not a consequence of another disease.

Hypertension is a disease of the twentieth century. In the United States in the 70s, there were 60 million people with high blood pressure, and only ¼ of the adult population had “ideal” blood pressure. The prevalence of “actual hypertension” among men in Russia (Moscow, Leningrad) is higher than in the USA, but the percentage of those on drug treatment is 2-3 times lower.

The cause of hypertension is not fully understood. But the main mechanisms leading to persistently high blood pressure are known. The leading one among them is the nervous mechanism. Its initial link is emotions, mental experiences, which are also accompanied by various reactions in healthy people, including increased blood pressure.

Another mechanism - humoral - regulates blood pressure through active substances released into the blood. Unlike neural mechanisms, humoral influences cause more long-term and sustainable changes in blood pressure levels.

To prevent further development hypertension, it is necessary to reduce nervous tension and discharge the accumulating “charge” of emotions. This release occurs most naturally in conditions of increased physical activity.

The steady progression of hypertension can be stopped and even reversed with timely treatment. Constant restriction or exclusion of salty foods from food is the most important real and available measure to counteract arterial hypertension. Medicine has a variety of means that enhance the kidneys' excretion of table salt in the urine. Therefore, patients with hypertension are often prescribed diuretics.

It is reliably known that for an overweight person suffering from hypertension, sometimes it is enough to get rid of excess body weight in order blood pressure returned to normal without medication. Indeed, with the disappearance of adipose tissue, the branched network of tiny vessels that developed in this tissue as it grows is eliminated as unnecessary. In other words, fat deposits force the heart muscle to work under conditions of increased pressure in the blood vessel system.

So, each person can independently prevent the development of hypertension without resorting to medications. This has been proven by observations of in large groups patients who strictly followed recommendations regarding physical activity, low-calorie nutrition and limiting sodium in food. A one-year follow-up period showed that the majority of people had normalized blood pressure, decreased body weight, and no longer needed to take antihypertensive drugs.

Hypertension is not an incurable disease. The arsenal of modern medicine is sufficient to maintain blood pressure at the required level and thereby prevent the progression of the disease.

Measures to prevent hypertension coincide with recommendations for those who are ill. They are especially necessary for people with a hereditary predisposition to this disease.

II. Risk factors for cardiovascular disease.

Smoking.

South America is considered the birthplace of tobacco. Tobacco contains the alkaloid nicotine. Nicotine increases blood pressure, constricts small blood vessels, and speeds up breathing. Inhalation of smoke containing tobacco combustion products reduces the oxygen content in arterial blood.

In the second half of the twentieth century, cigarette smoking became a common habit. Observation of the mortality rate of men aged 45-49 years for 6 years showed that the overall mortality rate of regular smokers was 2.7 times higher than that of non-smokers. According to American scientists, cigarette smoking contributes to 325 thousand premature deaths annually in the United States.

One study showed that the average number of cases of cardiovascular disease per year per 1000 people aged 45-54 years among non-smokers is 8.1, when smoking up to 20 cigarettes per day - 11.2, and when smoking more than 20 cigarettes - 16.2, i.e. twice as much as non-smokers.

Nicotine and carbon monoxide appear to be the main damaging factors. Cigarette smoke contains up to 26% carbon monoxide, which, when entering the blood, binds to hemoglobin (the main oxygen carrier), thereby disrupting the ability to transport oxygen to tissues.

The harm of smoking is so significant that in recent years measures have been introduced against smoking: the sale of tobacco products children, smoking in public places and transport, etc.

Psychological factors.

This factor has always been given and is given great value in the development of cardiovascular diseases. In recent years, the peculiarities of human behavior have been carefully studied. A type of human behavior was identified (type A*)

“Type A” behavior is an emotional motor complex observed in people engaged in endless attempts to do more in less and less time. These people often have elements of “freely expressed” hostility, which easily arises at the slightest provocation. Individuals with Type A* behavioral characteristics have certain symptoms. These people often do several things at the same time (read while shaving, eating, etc.); during a conversation, they also think about other things, without paying full attention to the interlocutor. They walk and eat quickly. Convincing such people to change their lifestyle is very difficult for several reasons:

They are usually proud of their behavior and believe that the success they have achieved in work and society is associated with this type of behavior.

Individuals with Type A* behavior tend to be pragmatic and have difficulty understanding how their behavior can lead to heart disease.

In most cases, these are energetic, hard-working people who bring great benefit to society. And the challenge is to convince them to adopt habits that will counteract the adverse effects of their behavior on health.

Excess body weight.

In most economically developed countries, overweight has become common and represents serious problem for healthcare. The reason for this in most cases is seen in the discrepancy between food intake large quantity calories and low energy consumption due to a sedentary lifestyle. Prevalence overweight body, being minimal in 20-29 year olds (7.8%), with age it steadily increases to 11%, in 30-39 year olds, up to 20.8% in 40-49 year olds and up to 25.7 % - in 50-59 year olds.

The relationship between excess body weight and the risk of developing the cardiovascular system is quite complex, since it was an independent risk factor.

Excess body weight has attracted a lot of attention due to the fact that it can be corrected without the use of any medications. Definition of normal body weight, because there are no uniform criteria for these purposes.

Reducing excess body weight and maintaining it at a normal level is a rather difficult task. When controlling your body weight, you need to monitor the amount and composition of food and your physical activity. Nutrition should be balanced, but food should be low in calories.

Increased blood cholesterol levels.

Cholesterol circulates in the blood as part of fat-protein particles - lipoproteins. A certain level of cholesterol in the blood is maintained due to cholesterol coming from food products, and its synthesis in the body. The limit of normal blood cholesterol level identified in practice is arbitrary. A blood cholesterol level of up to 6.72 mmol/l (260 mg%) is considered normal. Lower blood cholesterol levels, 5.17 mmol/l (200 mg%) and below, are less dangerous.

Elevated blood cholesterol levels are quite common. A blood cholesterol level of 6.72 mmol/l (260 mg%) or higher in men 40-59 years old occurs in 25.9% of cases.

Conclusion

The rapid change in lifestyle in the 20th century associated with industrialization, urbanization and mechanization largely contributed to the fact that diseases of the cardiovascular system have become a mass phenomenon among the population of economically developed countries.

Modern principles of prevention of cardiovascular diseases are based on the fight against risk factors. Large preventive programs carried out in our country and abroad have shown that this is possible, and a decrease in mortality from cardiovascular diseases has been observed in recent years in some countries, the best for that proof. It should be especially emphasized that some of these risk factors are common to a number of diseases.

Basic lifestyle habits are formed in childhood and adolescence, so it is especially important to teach children a healthy lifestyle in order to prevent them from developing habits that are risk factors for cardiovascular diseases (smoking, overeating and others).