Abstract

Dr.Stefan Farsky

Ischaemic heart disease and stroke are the world’s biggest killers. The good news is that 80% of cardiovascular diseases can be prevented with healthy lifestyle habits. The most effective approach to improve this situation is the reduction of risk factors levels.   Small positive shifts of risk factors, across a whole population consistently leads to greater reductions in disease burden than the huge investment to the  new drugs and devices including invasive procedures.  Motivation is a key element of cardiovascular prevention. It means in practice  non-smoking, support for nutrition changes, regular and effective physical activities and  obesity management mainly.

As for nutrition how much  people with high risk  profile for  Ischaemic heart disease and stroke know the role of saturated fatty acids and  their recommended maximal daily intake (cca 30g) ?  How much from them monitor their content on food labels?  But the decrease of their intake about 10% leads to decline cardiovascular risk about 20-30%! How much people know that adding 30 g unsalted nuts daily decreases cardiovascular risk about 30%?  The  same accounts for increasing the fiber content.  We present some concrete examples of daily menu and  adequate proposals how to  change to reach recommended values. 

Regular and effective physical activities mean 150 to 300 min. of moderate-intensity exercise or 75 to 150 minutes of vigorous-intensity exercise each week for health benefits. This translates into an energy expenditure of 7.5 to 15 MET hours per week. That leads to a 31% reduction in all-cause  mortality.  The benefit concerns not cardiovascular diseases only but the metabolic and oncological protection too.  Clinical evaluation, including exercise testing, should be considered for sedentary people with risk factors who intend to engage in vigorous physical activity. Specialized  prevention programmes such as complex cardiovascular rehabilitation (including cardiotraining,  education and cognitive-behavioural methods), home-based cardiac rehabilitation and yoga are  very effective. 

The nutrition and physical activity changes are two milestones of obesity management. The increase of BMI about 5kg/m2 leads to increase of mortality risk about 30% and about 40% risk of ischemic heart disease, stroke and other vascular diseases. Weight decrease in obese patients leads  not only to reduction  of these parameters,  but moreover, to reduction of drug intake, hospitalisations  and diagnostic and therapeutic procedures rate. It means significant economical benefit.