CARDIOVASCULAR RISK ASSESSMENT IN FAMILY MEDICINE PATIENTS AND THE ROLE OF ABPM IN PREVENTION OF CARDIOVACULAR EVENTS

Autor: Nemarnik, Nenad
Přispěvatelé: Diminić-Lisica, Ines, Bukmir, Leonardo, Popović, Branislava, Ljubotina, Aleksandar
Jazyk: chorvatština
Rok vydání: 2019
Předmět:
Popis: Kardiovaskularne bolesti vodeći su uzrok smrti u cijelome svijetu. U velikoj mjeri su progresivne bolesti koje se mogu prevenirati ili je moguće usporiti njihov razvoj - razvoj simptomatske bolesti ili komplikacija. Pušenje, smanjena tjelesna aktivnost, prekomjerna konzumacija alkohola te neuravnotežena, nezdrava prehrana najvažniji su uzročnici razvoja KV bolesti i povećanog rizika od KV događaja. Kontrola spomenutih rizičnih čimbenika uz kontrolu arterijskog tlaka, razine glukoze i kolesterola u krvi osnova su u početku liječenja i sprječavanja budućih KV događaja. Postoje različiti sustavi za procjenu rizika. Svi sustavi temelje se na glavnim čimbenicima rizika – spol, dob, pušački status, arterijski tlak te razina kolesterola u krvi. Za procjenu kardiovaskularnog rizika u obiteljskoj medicini danas se najčešće koristi SCORE (Systematic Coronary Risk Evaluation) tablica. Ova metoda procjene rizika kreirana je za asimptomatske, relativno zdrave pacijente koji nisu u prošlosti bolovali od kardiovaskularne bolesti, nemaju diabetes melitus tipa I ili tipa II sa subkliničkim oštećenjem ciljnih organa te kroničnom bubrežnom bolešću. Kontinuirano mjerenje arterijskog tlaka danas se sve više primjenjuje u kliničkoj praksi. Radi se o mjerenju arterijskog tlaka uređajem kojeg pacijenti nose 24 sata, a on vrši mjerenja u pravilnim intervalima. Time se eliminiraju različiti nepovoljni faktori prilikom konvencionalnog mjerenja tlaka u ordinaciji kao što je „efekt bijele kute“ i maskirana hipertenzija. Osim toga, metoda je povoljna za procjenu „dipping statusa“ koji korelira s kardiovaskularnim rizikom te za provjeru djelotvornosti antihipertenzivne terapije. KMAT je pouzdana, objektivna metoda za dijagnozu hipertenzije i procjenu kardiovaskularnog rizika s zanemarivim brojem nedostataka u odnosu na informacije koje pruža.
Cardiovascular diseases are the main cause of death in the world. These are progressive diseases that are possible to prevent or it is possible to slow down their development. Smoking, reduced physical activity, alcohol, and unbalanced diet are the most important causes of development of a cardiovascular disease. Control of the above-mentioned risk factors, including blood pressure, blood sugar and cholesterol levels, are at the beginning of treatment and prevention of CV events. There are many different risk assessment systems. All systems are based on the main risk factors - sex, age, smoking status, blood pressure and cholesterol levels. Most commonly used risk assessment system in family medicine today is the SCORE (Systematic Coronary Risk Evaluation) table. This risk assessment method is designed for asymptomatic, relatively healthy patients with negative history of cardiovascular disease, have no type I or type II diabetes with subclinical target organ damage and chronic kidney disease. Ambulatory blood pressure monitoring is increasingly being applied in clinical practice. It is a measure of arterial pressure with a device that patients carry for 24 hours, and it performs measurements at regular intervals. This eliminates various adverse factors of conventional office measurement, such as "white coat effect" and masked hypertension. In addition, the method is best for evaluating "dipping status" correlated with cardiovascular risk and for checking the efficacy of antihypertensive therapy. ABPM is a reliable, objective method for diagnosing hypertension and assessing cardiovascular risk with a negligible number of cons in relation to the information it provides.
Databáze: OpenAIRE
Externí odkaz: