Deaths from cardiovascular diseases jumped by a quarter during a pandemic
According to official statistics, cardiovascular diseases have increased by a quarter since the beginning of the year! Or maybe it's all about crafty statistics? Definitely: the new virus has accelerated the death of these people, according to advanced cardiology experts. But if this is so, then the view on the problem of an unprecedented increase in the death of cores by 25% in just the past 10 months should be different. What should be done today, when COVID-19 has a "second wind"? What measures should health organizers take? And what depends on ourselves? There are a lot of questions. The answers to them were voiced at one of the recent conferences, held in an online format and bringing together leading cardiologists in Russia.
Photo: AGN "Moscow"
"For cores - special coins"
- The interaction of a heart attack and the epidemiology of a heart attack against the background of COVID-19 is not an easy question, - says the leading researcher of the National Medical Research Center of Cardiology of the Ministry of Health of Russia, Doctor of Medical Sciences, Professor Roman SHAKHNOVICH. - There is reason to believe that against the background of coronavirus infection, the risk of myocardial infarction increases due to the fact that blood clots increase. A parallel can be drawn with the flu: with a severe respiratory infection, the risk of heart attack also increases.
But - a paradox: during the coronavirus pandemic, the number of hospitalizations of patients with heart attack fell worldwide. Let's say in Italy - 50%! And the point is not that at that time such patients were doing well. Not. The availability of medical care for such patients was lower - there were not enough beds in hospitals. Definitely: the cores need to be allocated special hospital beds, the expert said.
But the patients themselves with heart disease in the conditions of a raging covid infection are afraid to go to doctors, as they are afraid of getting infected. And these fears are justified. Therefore, we have yet to find out how this infection affected myocardial infarction. But what is known for sure: the hospital death prognosis increases several times! If before the pandemic, both in Europe and in Russia in the best hospitals, the mortality rate was 3–6%, then against the background of covid infection it increased to 10–15%.
The risk of repeated heart attacks is also higher due to the increased thrombotic load. Hypoxia associated with lung damage is also added.
On the other hand, the coronavirus infection itself affects not only the lungs, but also the heart. Against the background of intoxication, there is a direct defeat of myocarditis by the virus. There are molecules that must fight viruses. But with a large release of them, viruses also attack the heart. Therefore, against the background of covid, the risk of developing cardiovascular diseases also increases.
So we only have to state: from January to October 2020, mortality from cardiovascular diseases increased by 25%. Moreover, we are talking not only about heart attacks, but also about direct damage to the heart by covid infection. And it is being broadcast all over the world. The statistics, to put it mildly, are unfavorable, concluded Professor Shakhnovich.
REFERENCE "MK"
Today mortality from cardiovascular diseases in Russia ranks first among all deaths and accounts for 47% of all causes. In 2019, 841 thousand people died because of this, and almost 20% of them (every fifth!) Are Russians of working age. And in connection with the emerging new virus, mortality "from the heart" has dramatically crept up. In Europe, according to WHO, as of September 13 of this year, the vast majority of deaths (88%) are people aged 65 and over, more than half (57%) are men: 95% of all deaths had at least one concomitant disease and 76% - cardiovascular.
Caution: restrictions!
The fact that in Russia, against the background of the coronavirus threat, mortality from cardiovascular diseases has increased, the other day the chief freelance cardiologist of the Ministry of Health of Russia, President of the Russian Cardiological Society, Academician of the Russian Academy of Sciences Evgeny SHLYAKHTO spoke. He cited curious statistics on this score: more than 220.7 thousand people died from coronary heart disease in just six months in Russia - this is almost 17 times more than those who died during the same time from COVID-19. Although by the beginning of the pandemic, there was even a decrease in heart disease in our country. The pandemic, according to the academician, influenced the increase in mortality from heart ailments not only directly, but also indirectly - the number of planned operations was reduced, emergency hospitalization was limited, and strict self-isolation was introduced. And elsewhere in the world, the number of sudden deaths of people with cardiovascular disease at home rose sharply during the pandemic.
“The re-profiling of hospitals significantly influenced both the treatment of patients with heart disease to doctors, and the frequency of heart attacks and strokes,” says cardiologist Yevgeny Shlyakhto, “but the isolation of people with risk factors also affected. In a number of regions, self-isolation of the elderly led to cerebrovascular diseases and strokes. The vessels of the brain are affected, the supply of oxygen to the brain cells is disrupted, and oxygen starvation begins. This gives the highest rates of mortality and disability.
Therefore, according to the expert, restrictions should be introduced very carefully, since it is psychologically difficult for people to endure the lack of live communication with relatives and friends. Yes, self-isolation reduces the spread of coronavirus infection, but it affects the psychological state of people. And this is extremely important for human health, especially with heart disease.
Indeed, how justified was the spring decision to repurpose most clinics and medical centers, including cardiological ones, to fight COVID-19, while other diseases were ordered to wait? At this time, the heart, however, like many other chronic patients, were left without the help of doctors. Here is a new deadly virus and primarily mowed down those who are weaker. As it turned out now, the cores and lungs were the first to fall under the distribution.
Those patients who have already suffered myocardial infarction belong to the high-risk group, it was repeatedly sounded at the conference. One in four of them may die within four years, and almost 50% have severe complications. In case of cardiac accidents, the time factor is very important: if, after the onset of a heart attack, the patient seeks doctors after 3 hours or later, the effect of therapy will be minimal. But the coronavirus epidemic has made its own adjustments here: such patients, fearing to get infected, do not immediately seek medical help. Hence the surge in cardiac deaths against the background of COVID-19 - myocardial infarction manifests itself even more severely.
On this score, world statistics are curious: if more than a million people have died from covid since the beginning of the pandemic, then from cardiovascular diseases during the same time - almost 20 million. It turns out that the mortal risk from CVD is 20 times higher than from coronavirus infection. And this is not only the fault of the new virus and the late appeal of the sick for medical help, but also of various abuses inherent in Russians. And these are such risk factors as smoking, alcohol, physical inactivity, unhealthy diet, summed up the conference participants. We must get rid of them.
It's easy to say. But cardiology experts are convinced: "Most deaths from the heart are preventable."
Medicines are available, but not available to everyone
An ambiguous situation with medicines, including for the treatment of coronavirus-infected hearts, has developed recently in our country. It has become problematic to buy effective antiviral drugs and antibiotics from the pharmacy. Although they are supposedly available in warehouses. But the failures in the launched from July 1 of this year are to blame. drug labeling system. But what to do for those who are treated at home, and there are many of them now. And not only from the coronavirus. And someone buys medicines to take them as a prevention of ARVI.
Yes, today there is a specially developed preferential drug program that allows us to provide preferential modern drugs to citizens suffering from cardiovascular diseases. He spoke about this at a conference on the prevention of cardiovascular diseases and complications in high-risk patients in a pandemic, the first deputy. Director General of the Federal State Budgetary Institution "National Medical Research Center of Cardiology" of the Ministry of Health of the Russian Federation, Corresponding Member of the Russian Academy of Sciences, Professor Philip PALEEV. From January 1, 2020, those patients who have suffered a myocardial infarction or stroke, as well as invasive intervention on the coronary vessels, can receive key drugs for treatment (these are 23 drugs included in the list of free and vital). This program operates throughout the Russian Federation, except for Moscow, which has its own preferential program.
This is encouraging. The deadly virus will not wait.
At this conference, the chief physician of the GKB im. IV Davydovsky, professor Elena VASILIEVA. The expert spoke about the specifics of heart attacks in case of coronavirus disease and about the capital's preferential program of drug provision for citizens suffering from cardiovascular diseases. For the first time, patients with high-risk cardiovascular diseases will be provided with such drugs free of charge from the Moscow budget. And for heart patients over 65, these medicines are delivered by volunteers or social workers directly to their homes.
The human heart suffers more often than other organs without the pressure of the newly-discovered COVID-19 infection. And much of his well-being depends on us. According to WHO, 41% of deaths "from the heart" are preventable. Every third case of coronary heart disease occurs against the background of low physical activity. Ideal: you need to give your body physical activity every day. And not only at a young age. From 18 to 64 years of age, experts recommend a minimum of 150 minutes of moderate aerobic activity per week or 75 minutes of vigorous exercise weekly. And also - do not drink, do not smoke, get enough sleep And you will be happy!
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