ACADEMIC RESEARCH IN MODERN SCIENCE
International scientific-online conference
148
PRIMARY PREVENTION OF ISHCEMIC HEART DISEASES
Xalilov Azizjon Marufjonovich
Vice-rector for treatment of Central Asian Medical University
https://doi.org/10.5281/zenodo.13365093
Annotation
Although there has been substantial improvement in atherosclerotic
cardiovascular disease (ASCVD) outcomes in recent decades, ASCVD remains the
leading cause of morbidity and mortality globally. Ischemic heart diseases is a
constellation of disorders in which myocardial ischemia is the common
pathophysiologic mechanism. In the vast majority of cases, this ischemia results
from obstruction of coronary artery blood flow by atherosclerosis, but its
severity and consequences are affected by other factors that affect myocardial
oxygen demand (e.g., concurrent valvular disease, chronic hypertension, blood
oxygenation, microvascular disease.
Key words:
political, economic, social factors, atherosclerotic vascular
disease, heart failure, healthy diet.
Ischaemic heart disease has a multifactorial etiology and can be prevented
from developing in populations primordially, and in individuals at high risk by
primary prevention. The primordial approach focuses on social determinants of
health in populations: political, economic, and social factors, principally
unplanned urbanisation, illiteracy, poverty, and working and living conditions.
Implementation of the UN Sustainable Development Goals can lead to major
improvements in cardiovascular health, and adequate health-care financing and
universal health care are important for achieving these goals.
1. The most important way to prevent atherosclerotic vascular disease, heart
failure, and atrial fibrillation is to promote a healthy lifestyle throughout life.
2. A team-based care approach is an effective strategy for the prevention of
cardiovascular disease. Clinicians should evaluate the social determinants of
health that affect individuals to inform treatment decisions.
3.Adults who are 40 to 75 years of age and are being evaluated for
cardiovascular disease prevention should undergo 10-year atherosclerotic
cardiovascular disease (ASCVD) risk estimation and have a clinician–patient risk
discussion before starting on pharmacological therapy, such as antihypertensive
therapy, a statin, or aspirin. The presence or absence of additional risk-
enhancing factors can help guide decisions about preventive interventions in
select individuals, as can coronary artery calcium scanning.
ACADEMIC RESEARCH IN MODERN SCIENCE
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4.All adults should consume a healthy diet that emphasizes the intake of
vegetables, fruits, nuts, whole grains, lean vegetable or animal protein, and fish
and minimizes the intake of trans fats, red meat and processed red meats,
refined carbohydrates, and sweetened beverages. For adults with overweight
and obesity, counseling and caloric restriction are recommended for achieving
and maintaining weight loss.
5. Adults should engage in at least 150 minutes per week of accumulated
moderate-intensity physical activity or 75 minutes per week of vigorous-
intensity physical activity.
6. For adults with type 2 diabetes mellitus, lifestyle changes, such as improving
dietary habits and achieving exercise recommendations are crucial. If
medication is indicated, metformin is first-line therapy, followed by
consideration of a sodium-glucose cotransporter 2 inhibitor or a glucagon-like
peptide-1 receptor agonist.
7. All adults should be assessed at every healthcare visit for tobacco use, and
those who use tobacco should be assisted and strongly advised to quit.
8. Aspirin should be used infrequently in the routine primary prevention of
ASCVD because of lack of net benefit.
9. Statin therapy is first-line treatment for primary prevention of ASCVD in
patients with elevated low-density lipoprotein cholesterol levels (≥190 mg/dL),
those with diabetes mellitus, who are 40 to 75 years of age, and those
determined to be at sufficient ASCVD risk after a clinician–patient risk
discussion.
10. Nonpharmacological interventions are recommended for all adults with
elevated blood pressure or hypertension. For those requiring pharmacological
therapy, the target blood pressure should generally be <130/80 mm Hg.
All in all, Sustainable political, economic, and social policies are central to
cardiovascular health. Interventions are best delivered by a health-in-all-policies
approach working cross-sectorally within governments. The primordial strategy
addresses social determinants of health: illiteracy, poverty, urbanisation,
agriculture and pollution, elimination of tobacco, providing heart-healthy foods,
discouraging unhealthy foods, and promoting physical activity.
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