World Heart Day is celebrated around the world on September 29th to raise citizens’ awareness of the importance of cardiovascular prevention. “Cardiovascular diseases represent the first cause of mortality in the world with over 20 million deaths every year, over 40% in our country, with around 230,000 deaths every year. Cardiovascular diseases are also the first cause of permanent disability, around five every thousand inhabitants in our country have a form of disability that derives from the cardiovascular disease they have been affected by”. Anmco, the National Association of hospital cardiologists, takes stock.
“In cardiovascular diseases, prevention is crucial because alongside non-modifiable risk factors such as age, sex and family history, there are also important modifiable risk factors, linked to behaviors and lifestyles, on which it is possible to intervene such as smoking, alcohol , incorrect diet and sedentary lifestyle, often in turn causing diabetes, obesity, hypercholesterolemia or arterial hypertension According to the latest data from the Istituto Superiore di Sanità – recalls Domenico Gabrielli, president of the Anmco Foundation for your heart and director of Cardiology at San hospital. Camillo of Rome – 98% of the Italian population aged between 18 and 69 has at least one cardiovascular risk factor including hypertension, hypercholesterolemia, sedentary lifestyle, smoking, diabetes and poor diet. It is therefore essential to change your own first lifestyle and correctly taking therapies, where prescribed, to drastically reduce cardiovascular morbidity and mortality; it will then be the doctor’s duty to suggest the tests deemed useful to the individual patient”.
“Among the main risk factors in the general population there is certainly hypertension, which affects over 60% of people in adulthood and if not controlled can lead to very serious consequences such as myocardial infarction, heart failure , atrial fibrillation, stroke, and renal failure. There is evidence – adds Gabrielli – that the reduction in blood pressure, whether obtained with pharmacological treatments or lifestyle interventions, is associated with a reduction in the risk of cardiac and cerebrovascular events, as well as mortality. Hence the importance of appropriate management of this important risk factor.”
“At the end of August, during the annual congress of the European Society of Cardiologythe new guidelines on arterial hypertension were presented – continues president of the Anmco Foundation for your heart – which, based on the most recent scientific evidence, indicate which parameters to consider for starting a therapeutic intervention, what are the values recommended targets during treatment and which drugs and strategies to implement to achieve the objectives.
The first novelty is precisely the title ‘Guidelines on the management of high blood pressure and hypertension‘, which underlines the need to manage “not only hypertension, defined by the presence of blood pressure values > 140/90 mmHg, but also the presence of blood pressure values that do not reach the aforementioned levels but are high (systolic blood pressure between 120 and 139 mmHg or diastolic between 70 and 89 mmHg), which often precede the development of hypertension and can contribute to the onset of cardiovascular diseases, especially if they are associated with other risk conditions. An important change – warns Gabrielli – compared to previous guidelines the goal of pharmacological treatment which, from blood pressure values lower than 140/90 mmHg indicated in the previous edition of the guidelines, has moved to systolic values between 120 and 129 mmHg, if tolerated by the patient. This is an important change since so far a two-step approach was recommended with a first goal of values below 140/90 mm Hg and, only after achieving this goal, should the goal of values below 130/80 mm Hg be considered. This change is due to evidence that has shown that treatments that reduce blood pressure more intensively allow for a greater reduction in the risk of cardiovascular events.”
The new Anmco guidelines on the management of high blood pressure and hypertension“focus heavily on interventions aimed at modifying lifestyle. In particular, they provide specific and more detailed indications regarding nutrition compared to the previous version. For example, a restriction in the intake of foods containing simple sugars is recommended, especially sugary drinks, which overall must not exceed 10% of the total calories consumed daily. Furthermore, in hypertensive subjects and without kidney disease, they suggest a low-sodium diet, taking in total no more than one teaspoon of salt per day. and rich in potassium, for example by consuming fruit and vegetables such as bananas and spinach”. This is suggested by Stefania Di Fusco, chairperson of the Cardiovascular Prevention area of the Anmco (the National Association of hospital cardiologists) and medical director at the Clinical and Rehabilitative Cardiology San Filippo Neri ASL Roma 1 Hospital in Rome, on the occasion of World Heart Day which celebrates September 29th.
According to Fabrizio Oliva, president of Anmco and director of Cardiology 1 of the Niguarda hospital in Milan, “Anmco, aware of the possible impact of the new recommendations on the clinical practice of the entire cardiology community, immediately considered the need to schedule meetings that are an opportunity of discussion between expert professionals to define the most appropriate ways to integrate the new recommendations into daily clinical activity in a way that is compatible with the current organizational structure”.
“Cardiovascular diseases are often associated with other pathological conditions such as diabetes, renal failure and obesity which further complicate the management of chronicity. These patients develop conditions of clinical lability and fragility which lead to frequent hospitalizations and a high number of deaths, which in 80 % of cases we could prevent by intervening on risk factors. It is therefore essential to launch educational campaigns on the importance of cardiovascular prevention and improve awareness of the relevance of therapeutic adherence, which is too often underestimated by the patient”, concludes Oliva.
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