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Heart Attack Prevention

Making lifestyle changes is the most effective way to heart attack prevention. There are 3 main steps you can take to help prevent a heart attack (as well as stroke): eat a healthy, balanced diet, do not smoke.

Lifestyle Changes
  • Stop smoking. If you smoke, quit.
  • Choose good nutrition. A healthy diet is one of the best weapons you have to fight cardiovascular disease.
  • Normalize your lipid profile.
  • Lower high blood pressure.
  • Be physically active every day.
  • Aim for a healthy weight.
  • Manage diabetes.
  • Reduce stress.

So, NICE recommend 150 minutes of moderate intensity aerobic activity per week, or 75 minutes of vigorous aerobic activity. They also advise muscle strengthening activities on two or more days per week. Heart attack prevention program should include reducing saturated fat intake, increasing monounsaturated fatty acids and five portions of fruit and vegetables per day. It’s also suggested a high fibre diet and two portions of fish per week.

cardiovascular risk assessment

CARDIOVASCULAR RISK ASSESSMENT

CARDIOVASCULAR RISK ASSESSMENT Read More »

Cardiovascular diseases such as ischemic heart disease, thrombosis, arterial hypertension with its complications – myocardial infarction and stroke – constitute a dynamic multistep process that is closely related to inflammation. It is well-known that CVD diseases rank first among all other diseases of mankind. Traditionally for making an accurate diagnosis, the patient must undergo a series of procedures, undergo lab tests so that the doctor can prescribe the necessary treatment. However, there is another way. Doctors can use cardiovascular risk assessment tools aimed at detecting the disease at an early stage. This time, not only will we consider different methods / risk calculators that are now used in clinical practice, but we will also make the corresponding calculations using a real example of a patient’s history. And, of course, let’s talk about why, given the presence of such intelligent systems, the CVD problem is still relevant. This article was last reviewed by Svetlana Baloban, Healsens, on January 24, 2020. This article was last modified on December 15, 2020. Why do you need cardiovascular risk assessments? Before proceeding to describe various calculation methods, let’s find out why they are needed at all. To begin with, we shall that most heart diseases develop completely asymptomatically over many years. In practice, it means that if one doesn’t feel any health problems, he or she simply does not go to the doctor unless a critical condition occurs. So, according to some estimates, 3.7 million Americans remain with undiagnosed heart disease. At the same time, the highest proportion of undiagnosed CVDs, which led to death from cardiovascular diseases, is among people aged 18–59 years. This is especially true when you consider that obesity, type 2 diabetes, and other risk factors are becoming more common at a young age. Second, understanding the risks allows for early diagnosis of CVD and, accordingly, preventive lifestyle interventions or treatment as needed. And thirdly, the assessment of risk factors can clearly demonstrate how the total risk changes if you switch to a healthier lifestyle. That is why, as early as in 1948, the Framingham Heart Study was initiated under the direction of the US National Heart, Lung, and Blood Institute. It was an ambitious medical research project that changed the medicine we know. As part of this study, the main risk factors for cardiovascular disease were identified. These include the following indicators: IN THIS ARTICLE 1 Why do you need cardiovascular risk assessments? 2 SCORE Risk Chart (Systematic Coronary Risk Evaluation) 3 Framingham Risk Score 4 Reynolds Risk Score 5 ASCVD (Atherosclerotic Cardiovascular Disease) Risk Score 6 PROCAM Score (Prospective Cardiovascular Munster Study) 7 QRISK (QRESEARCH Cardiovascular Risk Algorithm) 8 The 65yo Patient’s CVD Risks 9 Effectiveness of Using CVD Risk Scoring RELATED ARTICLES Valuable information has also been obtained on the role of cholesterol, age, gender, and psychological problems. During this time, the risk assessment has changed and developed significantly. In this article, we will analyze what cardiovascular risk assessment means and what calculators are used now in medical practice. SCORE Risk Chart (Systematic Coronary Risk Evaluation) The European guidelines for cardiovascular disease (CVD) prevention recommend the use of modified SCORE risk charts. SCORE estimates the 10-year risk of fatal and non-fatal CVDs such as myocardial infarction, cerebrovascular disease, and congestive heart failure. The first Joint Working Group of European societies on coronary prevention used a simple risk chart. For their calculations, they considered the following categories: Then, the diagram became more complex in order to assess risks more accurately. So, in addition to total cholesterol, the ratio of cholesterol to HDL cholesterol was also taken into account in risk assessments. In addition, given the geographic variability in cardiovascular risk across Europe, two SCORE charts have been developed for countries with high and low CVD risk. Countries with low risk include countries such as Andorra, Austria, Belgium, Cyprus, Denmark, Finland, France, Germany, Greece, Iceland, Ireland, Israel, Italy, Luxembourg, Malta, Monaco, Netherlands, Norway, Portugal, San Marino , Slovenia, Spain, Sweden, Switzerland and the United Kingdom of Great Britain and Northern Ireland. Countries at high risk of CVD: Bosnia and Herzegovina, Croatia, Czech Republic, Estonia, Hungary, Lithuania, Montenegro, Morocco, Poland, Romania, Serbia, Slovakia, Tunisia and Turkey. And the group of countries with a very high risk (note that the diagrams may underestimate the risk in these countries) included such countries as: Albania, Algeria, Armenia, Azerbaijan, Belarus, Bulgaria, Egypt, Georgia, Kazakhstan, Kyrgyzstan, Latvia, North Macedonia , Moldova, Russian Federation, Syrian Arab Republic, Tajikistan, Turkmenistan, Ukraine and Uzbekistan. Due to this SCORE scale, the following cardiovascular diseases can be detected: stroke, myocardial infarction, pulmonary embolism, dissecting aortic aneurysm. Framingham Risk Score The Framingham Risk Scale (FRS) determines the presence of diseases such as angina pectoris, coronary heart disease, myocardial infarction, stroke. Like the SCORE scale, this system opens the door for making a forecast for the next 10 years. This scale was developed in North America. Thus, NCEP 4 recommends the Framingham Risk Score for cardiovascular risk assessment. You can also calculate it by yourself. The total risk on the Framingham scale is defined as: A value over 30% indicates a very high risk of cardiovascular disease. A 10-year risk estimate can be obtained as a percentage, which is then used to make decisions about disease prevention. This assessment is also evolving. For example, in 2009 CCS added additional risks to the Framingham risk scale. It included a family history of coronary heart disease in a first-line relative. It takes into account male first-degree relative younger than 55 years and female first-degree relative younger than 65 years old. For elderly patients, sensitive C-reactive protein results can also help to reclassify risks. Reynolds Risk Score If you are healthy and do not have diabetes, the Reynolds Risk Score is designed for your cardiovascular risk assessment. It may predict your risk of heart attack, stroke, or other serious heart diseases over the next 10 years. The risk calculation is designed for people aged 45 and over. The scale assesses the following risk factors: gender, age, systolic blood pressure, total and

толщина комплекса интима–медиа сонных артерий

Carotid Intima-Media Thickness Test

Carotid Intima-Media Thickness Test Read More »

Although countries are focusing on fighting cardiovascular disease (CVD), the burden of coronary artery disease continues to rise globally. Atherosclerosis, the precursor of CV events, keeps progressing insidiously without symptoms. Let’s take a look at the reasons why this is happening, as well as at the solutions for the problem. Among other things, we will introduce some proposals from the expert group of Heart Attack Prevention and Education (SHAPE). We will also dwell on a simple non-invasive test, TCIM (Carotid Intima-Media Thickness), which appeared on the list of recommendations. This article was last reviewed by Svetlana Baloban, Healsens, on January 24, 2020. This article was last modified on 7 February 2020. We will start by looking back in history. So, the thickness of the intima-media of the carotid artery as a marker of atherosclerosis appeared not so long ago. It wasn’t until 1986 that Italian investigators decided to compare the arterial wall thickness aorta to common carotid arteries. They described the results and came to the conclusion that this approach may be useful. Since then, calculation of carotid IMT (CIMT) has been widely used as non-invasive measure of atherosclerosis. The Essence of Carotid Intima-Media Thickness Test Carotid intima-media thickness (CIMT) is a screening test for atherosclerosis. In adults, CIMT is predictive of myocardial infarction and stroke. In children and adolescents, CIMT is used to assess vascular changes in the presence of CVD risk factors. IN THIS ARTICLE 1 The Essence of Carotid Intima-Media Thickness Test 2 The relation between carotid intima-media thickness and diseases 3 Who is recommended to take this test? 4 How to calculate cardiovascular risk 5 The Screening for Heart Attack Prevention and Education (SHAPE) Task Force RELATED ARTICLES To understand what is measured with this test, let’s look at the structure of the coronary artery wall. It consists of three layers. The inner layer is called intima, the middle layer is called media, and the outer one is known as the adventitia. The layers of intima and media lie the deepest. So an increase in their thickness can be a sign of plaque formation. It is the thickness of the intima-media complex of the carotid neck arteries which feed the brain that is usually measured. Clinical Note CIMT screening is easily, safely, reliably, and inexpensively done with ultrasound. The relation between carotid intima-media thickness and diseases Interestingly, some studies have shown that cIMT is strongly and linearly related to age. Up to 25 years, the thickness is not higher than 0.6 mm. But by the age of 45 years, the CMM is on average higher than 0.8 mm. Some other studies have also indicated that CAIMT <0.8 mm is associated with normal healthy individuals, and value of CAIMT at or above 1 mm is associated with atherosclerosis and a significantly increased cardiovascular disease risk in any age group. Meanwhile, in the ESH/ESC hypertension guidelines (2013), carotid IMT > 0.9 mm has been reconfirmed as a marker of asymptomatic organ damage. The American Society of Echography (ASE) task force recommends that IMT ≥ 75th percentile is considered a high cardiovascular risk. Values from the 25th to the 75th percentile are an average cardiovascular risk. And values ≤ 25th percentile are considered low risk. Moreover, the CMM thickness is also associated with insulin resistance in healthy individuals, gallstone disease, the risk of progression of mild cognitive impairment and even Alzheimer’s disease. In other words, the larger CIMT the greater the risk of cardiovascular disease. The process is also associated with aging. However, you should not think that since aging is inevitable, then there is no point in measuring CIMT, since the good news is that recent studies suggest this process can be influenced and even reversed by increasing physical activities and treating it with medications. Who is recommended to take a carotid intima-media thickness test? Despite the many benefits and a wealth of information, screening for IMT has not yet been added to the CVD prevention guidelines. In early 2007, Circulation magazine published a report with the conclusion that IMT of the carotid arteries is a serious factor in the development of stroke and heart attack. Nevertheless, a few months later, the American Preventive Task Force recommended asymptomatic people not to undergo an IMT test regularly. Therefore, the traditional approach involves identifying people at risk of CVD. In this case, if you fall into a risk group (it also matters how great this risk is), then you are recommended to take this test. And vice versa, respectively. Moreover, the problem is that there is no uniform risk assessment system. Therefore, different organizations offer their own options. We’ve already reviewed different Cardiovascular Risk Assessment approaches but let’s take a look at some of them once more. How to calculate cardiovascular risk? As we mentioned above, there is currently no unified risk assessment system. At the same time, there are various risk calculators such as Framingham scores, Reynolds risk scores, ASCVD, SCORE, etc. So, the European guidelines on cardiovascular disease prevention suggest taking this test to people with moderate cardiovascular risk. Most asymptomatic middle-aged adults fall into this category. You can calculate this risk using the Healsens application, or on your own. At the same time, the NCEP recommends estimating the risk using the Framingham risk score. You can calculate it as well. On the other hand, the American Society of Echocardiography recommended adding the following extra criteria: We wrote more about various risk calculators separately. But what is their importance? Why are we looking at these tools in such detail? The answer is simple. Based on the calculated risk, the doctor will decide whether to initiate preventive treatment. Indeed, as we wrote above, atherosclerotic cardiovascular disease can be prevented. However, cardiovascular disease remains the leading cause of death and severe disability worldwide. What’s the matter? What’s the problem with the traditional approach? It turned out that traditional methods of preventing A-CVD have proven largely insufficient. Indeed, studies indicate that traditional risk calculations explain only 60-65% of CVD risk. In addition, it was shown that

checking homocysteine serum levels

Checking Homocysteine Serum Levels

Checking Homocysteine Serum Levels Read More »

Homocysteine is produced in our body (it is not contained in food) through the metabolism of an essential amino acid called methionine. Normally, formed homocysteine quickly turns into other, harmless substances – vitamins B6, B12, and folic acid are needed for these transformations. But in elevated concentrations, homocysteine provides a whole range of adverse effects, which we will discuss in detail below. Also, Also, this article describes who and why may benefit from checking homocysteine serum levels in terms of improving health. Firstly, it can directly damage vascular walls by making them loose. Thus, the damaged surface is subject to cholesterol and calcium depositing, which form an atherosclerotic plaque. Thus, blood coagulation is activated, and this, in turn, leads to the development of atherosclerosis, arterial and venous thromboses. Secondly, folic acid deficiency, which almost always accompanies an increase in homocysteine, can lead to gross malformations of the fetal nervous system during pregnancy – anencephaly (lack of the brain), and neural tube failure. It is for the prevention of these defects that all pregnant women are prescribed folic acid preparations. IN THIS ARTICLE 1 Which level of Homocysteine passes for normal? 2 Causes for High Homocysteine Levels 3 How Often Should You Check? RELATED ARTICLES Thirdly, homocysteine in high concentrations has a direct toxic effect on trophoblast cells, from which the placenta is subsequently formed, causing their death and a decrease in the production of hCG – the pregnancy hormone. This can lead to termination of pregnancy (usually in the first trimester) or to impaired placental development, which further increases the risk of placental insufficiency, fetal growth retardation, preeclampsia, placental abruption, pregnant hypertension, and kidney damage. Elevated homocysteine levels are also associated with increased thrombus formation, as well as higher risks of heart attacks, cerebral accidents, peripheral arterial diseases, and fractures. Doctors measure homocysteine levels as a possible cardiovascular risk factor, to diagnose homocystinuria, thrombosis, diabetes mellitus, senile dementia and Alzheimer’s, and obstetric pathology. The testing is necessary in a number of situations since elevated homocysteine levels are cytotoxic. Which level of Homocysteine passes for normal? The “ideal” homocysteine level levels of about 5-7 µmol/L. “Good” levels of less than 10 µmol/L. So, homocysteine > 10 μmol/L is associated with some risk factors like peripheral microvascular endothelial dysfunction (PMED), higher major cardiovascular events, etc. The normal range of homocysteine levels are less than 15 micromoles per liter (mcmol/L). Higher levels are: Moderate (15 to 30 mcmol/L); Intermediate (30 to 100 mcmol/L); Severe (greater than 100 µmol/L). Any higher than 15 and you will want to work with your Health Coach to further investigate the cause. The latest studies show that homocysteine is an independent risk factor of cardiovascular diseases. Clinical research shows that a 5 umol/L elevation in homocysteine concentration in blood plasma increases the vulnerability to cardiovascular disease and total mortality by 1.3 – 1.7 times. Lowering of elevated homocysteine levels in blood plasma can prevent cardiovascular complications. If levels of homocysteine are found to be elevated, it is advisable to measure the levels of creatinine, thyroid stimulating hormones, folacin, cobalamine to define probable causes of hyperhomocisteinemia and suggest appropriate treatment. Causes for High Homocysteine Levels At first, don’t panic if your homocysteine level is above the norm values. Just because you have high homocysteine doesn’t mean you will develop heart disease or a neurological condition tomorrow, next week or even next month. That’s the beauty of functional lab tests; they often allow us to catch patterns of disease and imbalance in the body before they become chronic or diagnosable. And if you’re already dealing with a chronic disease, then by examining your homocysteine levels, you’ve gotten one big step closer to uncovering the root cause and getting your health back on track. It’s worth mentioning that smokers are more vulnerable to hyperhomocysteinemia. Moreover, high coffee consumption is one of the most powerful factors increasing homocysteine in blood. Those who drink more than six cups of coffee a day have 2-3 umol/L higher homocysteine levels than people who drink no coffee. Elevated homocysteine levels are often associated with a sedentary lifestyle. So, moderate physical activity lowers homocysteine levels in case of hyperhomocysteinemia. Vegan diet can also decrease its levels by 13% without any supplements. However, the most frequent cause of high homocysteine levels is folacin deficit. The deficit of cobalamine (vitamin В12) may also lead to homocysteine accumulation. However, the effectiveness of using vitamins is a subject of debate among researchers. Several major randomized experiments showed that relatively easy lowering of homocysteine levels through taking supplements did not result in lowering vulnerability to cardiovascular diseases. How Often Should You Check? As with all lab work, how often to re-test is highly individual. Yet, there is a number of indications for investigation, such as: – cerebral accident, heart attack, thrombosis, atherosclerotic cardiovascular disease in family history;– blood-clotting disorder;– neurological disorders in childhood;– preparation for IVF, pregnancy;– chromosomal abnormality of the fetus, congenital defects, complications;– smoking;– age higher than 75 years old. Typically, if your levels are on the high-side your Health Coach will recommend re-testing after about 6 months. In conclusion, some estimates suggest that if homocysteine levels decreased by 40% would lead to an extra 8 years of life per 1000 men, and 4 years of life per 1000 women. Ordering Blood Tests in the Netherlands If you are interested in checking your Homocystein level, you can easily purchase a blood test kit from Healsens. 1 Download the Healsens App from Google Play or the App Store, depending on your device. 2 Complete the registration process in the app. 3 Go to the “Profile” page via the bottom menu of the application. 4 Tap on the test you need — ”List of Available Tests” 5 Find the Cholesterol Pack & Tap on the “Add to Cart” button. Proceed with the ordering process. » Discover how to check and improve your health with Healsens preventive checkup plan. Note If you want to assess your homocystein level but are not residing

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+31 6 12683966
contact@healsens.com

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