RESUMEN
This article presents the results of a comparative prospective study of 276 subjects at the age between 40 and 65 years presenting with risk factors (RF) of atherosclerosis and its preclinical stages (APC). All of them were reckoned to be at a moderate risk of developing APC based on the results of evaluation with the use of the SCORE scale which implied the necessity of their differential non-pharmacological treatment during a two-year period with the application of a variety of preventive therapeutic strategies. The patients were allocated to three different (initially comparable) groups. The main group (group 1) was comprised of 98 subjects who received the optimized combined treatment including climatotherapy, dietary therapy, psychotherapy, hydrotherapy, physiotherapy, and hypoxytherapy; in addition, they were involved in the program of therapeutic physical exercises and in the educational program. The group of comparison (group 2) consisted of 88 subjects who were advised to withstand pernicious habits, to keep to the prescribed diet, and intensify the physical activity. The subjects included in the control group 3 were given no preventive treatment whatsoever. The optimized system for the early diagnostics and identification of the risk factors and/or ACD was employed for examining the members of group 1. By the end of the study, risk factors of atherosclerosis and APC were documented in 86.2% and 76.6% of the patients of group 1, respectively. The number of disability days averaged 7.2 per person versus 16.3 and 22.6 in comparison and control groups, respectively. There were no newly diagnosed cases of cardiovascular diseases (CVD) over the study period among the patients of group 1, in contrast to 11.4% and 25.6% such cases in groups 2 and 3, respectively. The results of this study give evidence that the optimized strategy of non-pharmacological correction of the risk factors and the preclinical stages of atherosclerosis at the level of the health resort-based primary care has advantages over the standard therapy because it makes it possible to reduce the frequency of development of new cases of cardiovascular diseases and to decrease the disability rate. It is concluded that the proposed approach enhances the effectiveness of primary prophylaxis of cardiovascular diseases associated with atherosclerosis and relieves the burden of this pathology. It can therefore be recommended for the more extensive application at the level of the health resort-based primary care settings.
Asunto(s)
Aterosclerosis , Colonias de Salud/normas , Servicios Preventivos de Salud/métodos , Atención Primaria de Salud/métodos , Adulto , Anciano , Algoritmos , Aterosclerosis/diagnóstico , Aterosclerosis/etiología , Aterosclerosis/prevención & control , Humanos , Persona de Mediana Edad , Servicios Preventivos de Salud/normas , Atención Primaria de Salud/normas , Estudios Prospectivos , Factores de Riesgo , Federación de RusiaRESUMEN
Cardiovascular diseases remain the leading cause of death in most countries, including Russia. Non-pharmacological-modalities intended for the primary prevention of cardiovascular disease including hypertension and atherosclerosis currently acquire special significance. The objective of the present*study was to develop a system of methods for early diagnostics, prevention and treatment of the preclinical stages of atherosclerosis and hypertension Another objective was to estimate the effectiveness of these methods. A total of 310 patients at risk-of arterial hypertension and atherosclerosis or with pre-clinical stages of these conditions were examined during a two year observation period. The system of early diagnosis and non-pharmacological primary prevention of cardiovascular disease was developed and evaluated using climatotherapeutic and physiotherapeutic methods in combination with and personalized dietary therapy, hypoxic-hypercapnic factors and educational programs. The study has demonstrated that the proposed system allowed to significantly (p < 0.05) reduce cardiovascular morbidity. The patients of the main group experienced the reduction of abdominal obesity and blood pressure along with the improvement of the blood lipid profile and other indicators. These parameters remained unaltered in the patients comprising the control group. In the main group, the incidence of coronary heart disease and hypertension was 62.5% and 81.25% lower respectively than in the control group.