What should hypertensive patients abide by? Is this a hereditary disease? Are there any stroke prevention programs in Ukraine? To answer these and other questions ForUm addressed the chief physician of the Healthcare Ministry of Ukraine, Doctor of Medical Science, Professor Vasyl Netyazhenko.
- What is the current stroke morbidity rate in Ukraine?
- The total number of hypertensive patients in the country is 12 million people, and we register about 110 thousand stroke cases annually. I can note that for the last ten years, the number of such cases has reduced by 20 thousand, but for a country with 46 million people of population, such figures are insignificant. There is a possibility that a certain part of such patients have been wrongly diagnosed. At the same time, the number of stroke patients started growing again.
- Why does it happen?
- The majority of Ukrainians does not look after their health. In particular, they do not control their blood pressure. According to statistics, only 60% of adults know that they have high blood pressure. The other 40% do not know their blood pressure, as they have never even measured it. However, delayed treatment of hypertension (persistent high blood pressure - Ed.) in most cases has a detrimental impact on health and causes complications such as stroke. This implies another problem - patients seek doctors’ help too late.
If we reduce, taking preventive measures, the average blood pressure of the population, for example, from 160 to 140 Mmhg, the number of strokes will be declined by 38%. If the average blood pressure is reduced to 120 Mmhg, the number of strokes will be declined by 50%.
- What can an ordinary man do to prevent the disease?
- It's simple. Firstly, it is necessary to control the blood pressure regularly. Secondly, it is important to have a balanced diet: eat less bread and potato and more fruit and vegetables. Thirdly, it would not hurt to control the amount of alcohol a person drinks. A hypertensive patient, for example, can drink maximum 50 g of vodka occasionally. Everything above the limit can cause negative consequences. Some literature says red wine helps to reduce the risk factor, but remember that this thesis has never been medically proved. Alcohol can help you to relax and calm down, but nothing more...
Moreover, people should control their weight, do physical exercises (without exaggeration though) and not smoke. If everyone follows these rules, the average life expectancy in our country will increase by 15 years.
- In social networks there are forums and blogs providing the whole list of first stroke symptoms. Is it so easy to suspect a coming stroke?
- I can tell you that there is no such notion as first stroke symptoms. It is almost impossible to predict that this or that patient may have a stroke soon. The only case is a 65-year-old hypertensive patient with excessive weight and high blood sugar level. However, even in this case we can only speak about stroke diathesis.
- Is stroke a diagnosis for life?
- Unfortunately, yes. A source of damage remains in brain after stroke. However, complete recovery of all functions is observed quite often. In this case, stroke requires constant preventative control. Sometimes people go to the hospital, having suffered not the first stroke. That is, they were not even aware of suffering the first stroke on the go. The figure of 110 thousand people, which I mentioned before, indicates "rough" strokes, with which people seek medical help. Moreover, there is another form of strokes - the so-called transient ischemic attack, symptomized by unsteadiness of gait and often headaches. Although a person with such symptoms does not pay enough attention to his state of heath.
- Is this a hereditary disease?
- As a rule, no, but patients, whose parents or close relatives suffered hypertension, heart attacks or strokes, fall into high risk group.
- You've mentioned before that patients seek medical help at the last moment. Is there any way or program to awaken people to care more about their health?
- Firs of all, it is necessary to teach people to care not only their health, but also about health of their parents and relatives. There is, for example, a student initiative, introduced in Vinnytsya region. Future graduates of medical universities should take blood pressure of their relatives, friends and neighbors; define the high risk group and send these people to a doctor.
It is also necessary to raise the level of awareness about negative consequences of hypertension. It concerns not only people who ignore their blood pressure, but also those who has undergone a short treatment, but then given it up.
To raise the level of awareness of patients about cardiovascular diseases we issue special booklets, being distributed in every hospital and health center.
- Are there any hypertension prevention programs working in Ukraine?
- Last year we started a pilot project on arterial hypertension I am responsible for. According to its regulations, every village, every regional center starts fighting this disease. A patient can come to a doctor and control his blood pressure. In case of hypertension, this patient will have possibility to undergo monthly treatment free of charge or at very low cost.
This project meets the needs of all social categories, including low-income citizens who cannot afford expensive medicines. According to the Cabinet's decree, pharmacies set referential prices for antihypertensive medicine and the government compensates the costs. Thus, if an antihypertensive medicine costs within 10-12 hryvnias, patients will get it free of charge. If a person takes more expensive drugs, he will have to pay the difference between the referential and maximum prices.
This pilot project includes seven molecules of antihypertensive medicine, widely used for treating hypertension.
- What about financing?
- Last year the government allocated money for the project. Every region got financial support of this project, which will continue this year.
- What programs are implemented now to reduce the incidence of stroke?
- The Health Ministry developed and approved a relevant manual. This is actually a great book, which explains everything about stroke: what it is and how to fight it. In addition, every doctor should be familiar with a special protocol. It contains recommendations for family physician and other professionals. We try to improve the situation in such a way.
In addition, we are developing recommendations for emergency medical care. Special stroke centers are being established in large cities, sometimes in large regional centers.
- Are there any consultation centers for hypertensive patients?
- Yes, there is a hot line on arterial hypertension, open in every regional department of Healthcare Ministry and working 24 hours.
Remember that health is the basis of your life. Timing is important not only at work, but also in health. If you feel sickish, do not delay the visit to a doctor until the last moment. Take care of yourself and your health.
The number of patients with cardiovascular diseases has increased by 8.5% for the last five years.
The number of Ukrainians suffering diseases of the circulatory system in 2011 made 26 431000 people.
The number of heart attack cases registered in 2011 made 49978. Heart attack morbidity rate has increased by 2.5%for the last five years.
The number of stroke cases among adult population registered in 2011 in Ukraine made 110753. Stroke morbidity rate has increased by 5.9% for the last five years.
Among causes of death, diseases of the circulatory system head the list and made 63% of death cases in 2011.
Спасибо за Вашу активность, Ваш вопрос будет рассмотрен модераторами в ближайшее время