Cardiovascular Disease in Ukraine
Scientific Method
“A method of procedure that has characterized natural science since the 17th century, consisting in systematic observation, measurement, and experiment, and the formulation, testing, and modification of hypotheses”. (Google, 2014)
(Jensenius, 2011)
8 ways to prevent cardiovascular disease
This list has been provided by University of California Berkeley.
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Quit smoking.This is perhaps the single most effective step you can take. Smoking more than doubles your chance of eventually having a heart attack and increases the chance of dying from it by 70 percent; it is also the leading cause of sudden cardiac death. There is good news though: by quitting you can quickly reduce your CVD risk; within five to 10 years of quitting, your risk of heart attack declines to a level similar to that of people who never smoked, regardless of how long you smoked.
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Reduce your blood cholesterol. If you have high blood cholesterol, even decreasing that number by one percent creates a 2-3 percent decline in the risk of a heart attack.
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Avoid or control hypertension. High blood pressure is a risk factor for stroke and heart attack. For every one-point reduction in diastolic blood pressure, there's a 2 to 3 percent decline in the risk of heart attack. If you can reduce your blood pressure by making the appropriate lifestyle changes--including limiting intake of sodium, calories, and alcohol--the coronary benefits are likely to be particularly great.
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Stay active. Exercising is one of the best ways to protect against CVD, by helping the heart work more efficiently. Sedentary people who begin a regular program of exercise reduce their risk of a heart attack by 35 to 55 percent. Low-intensity activities, such as gardening or walking, if done regularly and over the long term, can decrease the risk of heart attack.
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Maintain a healthy weight. About one in three American adults is obese (weighing at least 20 percent above the "suggested" weight for their height), which doubles their risk for CVD at a given age. Obesity also increases the risk for diabetes, hypertension, and high blood cholesterol, which further worsen the risk for CVD.
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Avoid or control diabetes.Type 2 diabetes (non-insulin-dependent), which affects more than 14 million Americans, is an important risk factor for both CVD and hypertension. Diabetic men have two to three times the risk of having coronary heart disease than those without diabetes. Weight control and exercise can improve the utilization of blood sugar and prevent or slow down the onset of diabetes--and reduce the incidence of heart disease.
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Consider a drink a day. There's a growing consensus that light to moderate alcohol consumption--that is, two drinks or less a day for a man, one drink for a woman (a drink is defined as 12 oz. of beer, 4 oz. of wine, or 1.5 oz. of 80-proof spirits) can help prevent heart attacks. However, drinking more than that can increase the risk of heart attack and stroke, as well as cirrhosis, cancer, and accidents.
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Consider low-dose aspirin. The recommended regimen--a baby aspirin (81 milligrams) daily or half a regular aspirin (160 milligrams) very other day--can lower the risk of heart attack by about one-third by reducing the ability of platelets in the blood to stick together and thus form a clot. It is particularly advisable if you have an elevated risk of CVD.
By following this plan, research has shown that it will help prevent the chances of Cardiovascular diseases.
Health Interventions
Health interventions refers to the programs and/or policies/procedures (paradigms) used to address cardiovascular disease in Ukraine. It also refers to evidence with reliable data that shows the interventions are effective in Ukraine. The high incidence of cardiovascular disease in Ukraine is due to the lifestyle they live. Ukrainians are careless about their health, have bad habits of eating foods rich in salt, fat, and cholesterol, and are under constant stress.
Experts of the Amosov Research Institute of Cardiovascular Surgery believe that well over 35,000 patients need heart surgery, including adults and children. Each year six thousand Ukrainian children are diagnosed with congenital heart disease, while nearly forty thousand children aged under fourteen suffering from heart disorders are registered (Rudnieva, 2003). In regards to heart patients, Ukraine has seen some positive shifts in the medical field. Specialized inpatient care is becoming more accessible to rural population, and new effective drugs appear on the market (Rudnieva, 2003). Moreover, Ukraine has the required laws that provide for prevention and treatment of cardiovascular disease, and the Program of Prevention and Treatment of Arterial Hypertension is implemented (Rudnieva, 2003). Andriy Pidayev, Ukraine’s Health Minister, says that preventing CVD is a national priority in Ukraine, which is evidenced by a number of nationwide programs such as the Health of the Nation Program, Arterial Hypertension Prevention and Treatment Program, along with measures to develop heart surgery. Ukraine is working to increase public awareness of heart disease, encourage preventive treatment, enhance medical services, and upgrade medical equipment. For increasing public awareness, Pidayev says it should be done on the widest scale possible because most of Ukraine is in the high-risk group. He says informing the people that combating CVD is not medics alone, but early diagnosis and treatment is very important. Outpatient facilities also need to be functioning properly to reduce mortality rates regarding CVD (Rudnieva, 2003). Registered patients must have least one electrocardiogram and echocardiogram performed once a year, along with blood tests for lipids and sugars (Rudnieva, 2003).
Hennady Knyshov, director of the Amosov Research Institute of Cardiovascular Surgery and academician of the Ukrainian National Academy of Sciences, says that the levels are heart surgery are being improved by upgrading equipment and increasing the salaries of surgeons and assistants. Also, number of heart surgeries is increasing by setting goals and achieving them. Amosov Institute can perform a maximum of five thousand surgeries a year, so plans are being made to expand. The regional centers in Donetsk, Zaporizhzhia, Dnipropetrovsk, Lviv, Kharkiv, and Odesa are on the verge of expanding (Rudnieva, 2003). There are also plans to open a similar center in Cherkasy (Rudnieva, 2003). The structural divisions should perform simple surgeries, while the institute will do research, introduce new methods, and perform complex surgeries (Rudnieva, 2003) Illia Yemets, director of the Research and Practical Medical Center of Children’s Cardiology and Cardio surgery, explains that the government has made it possible to open a separate Center of Children’s Cardiology and Cardio Surgery. This has significantly improved the functioning of children’s cardio surgeries. 10 million dollars worth of equipment has been bought for the center, which had its resuscitation unit, diagnostics department, and artificial blood circulation laboratory re equipped (Rudnieva, 2003). Since September 1, 2003 it has performed 92 surgeries and provided consultations to 392 patients (Rudnieva, 2003). Congenital heart disease is a complex pathology that has been on the rise of late and before the center was opened, only 20 to 30% of all children under one year who need surgery could undergo one (Rudnieva, 2003). Yemets says we would like to develop the cardiologic service across Ukraine, pursue research in the sphere of similar pathologies, introduce screening for expectant mothers, build major inpatient units, where we could monitor postoperative patients.
In October 2012, pictorial warnings appeared on cigarette packs in Ukraine for the first time. The warnings cover 50% of one side of the pack; the other side has a text warning covering 50% of the pack. Previously, only text warnings covered 30% of both sides (New pictorial warnings, 2012). Included among the 10 graphic labels is one image on the cardiovascular harms of tobacco showing artery damage that can be caused by smoking, with the text message: “Smoking destroys arteries and causes heart attacks and strokes.” (New pictorial warnings, 2012). The World Heart Federation says about one quarter of all Ukrainian smokers are still unaware that smoking increases their risk of heart disease and stroke. In a country with catastrophically high rates of premature CVD mortality (the highest age-adjusted rates of mortality from CHD before age 65: over ten times higher than countries like the Netherlands and Portugal), this is an extremely dangerous gap in knowledge which compromises Ukrainians’ ability to protect themselves from early death from heart disease (New pictorial warnings, 2012). Another huge step is that on December 17, 2012, all Ukrainian cafés, bars and restaurants became 100% smokefree. This reduces second hand smoke which is another important cause of premature CVD mortality (New pictorial warnings, 2012).
Chernobyl Children’s project International is also another health intervention that is working to help CVD in Ukraine. CCI (Children’s Chernobyl International) manages and delivers a world-recognised Cardiac Programme that has saved the lives of thousands of children (Medical Programmes). In collaboration with the American cardiac surgeon Dr. William Novick, CCI has reduced a waiting list for cardiac surgeries from 7,000 to less than 2,500 children in just five years (Medical Programmes). Volunteer surgical teams travel throughout the Ukraine to perform surgeries that save lives, and CCI provides financial and logistical support to the cardiac surgeons in order for them to make the vital trips to the effected areas (Medical Programmes). CCI also trains local physicians and gives them technologically advanced medical equipment. This training develops local capacity and skills, enabling local surgical teams to treat the children in their own area more effectively and with more success (Medical Programmes).
