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Interdisciplinary Approach to Cardiovascular Diseases for Research and Everyday Clinical Practice Purposes

Interdisciplinary Approach to Cardiovascular Diseases for Research and Everyday Clinical Practice Purposes

Aleksander Goch (Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Poland & Military Clinical Hospital No. 10, Poland), Anna Rosiek (Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Poland), Krzysztof Leksowski (Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Poland & Military Clinical Hospital No. 10, Poland), and Emilia Mikołajewska (Nocolaus Copernicus University in Toruń, Poland & Military Clinical Hospital No. 10 and Polyclinic, Poland)
Copyright: © 2016 |Pages: 33
DOI: 10.4018/978-1-4666-9658-7.ch015
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Abstract

Cardiovascular Diseases (CVD) are perceived a leading cause of death globally. Scientists and clinicians still search for more efficient prevention, treatment, rehabilitation and care programs suitable for patients with CVD. Common social awareness and interdisciplinary effort may significantly improve current situation, but the problem is more complex. This chapter, based on research and own experiences of authors, tries to answer the question: how maximize professional resources and optimize outcomes in clinical practice. Aim of this chapter is discuss current issues which may potentially influence efficiency of CVD prevention and therapy, including prevention, modifiable and non-modifiable risk factors, ways of cardiac rehabilitation (CR) and cardiac telerehabilitation (CTR), influence of researcher-subject relationship and patient-therapist relationship as far as placebo effect.
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Introduction

Each year cardiovascular diseases cause over 4 million deaths in 53 European countries belonging to World Health Organization. In Poland cardiovascular diseases are responsible for 50% of all deaths. This problem is a challenge for Societies of Cardiology, this is why in 2007 European Heart Health Charter was established. Its aim is to reduce cardiovascular diseases burden in European Union and to reduce inequalities in access to therapies in individual countries and between countries.

Etiology of cardiovascular diseases is complex. Important role in their occurrence play risk factors. They are possible to measure traits associated with greater likelihood of cardiovascular diseases occurrence in the future. Lack of risk factors does not exclude possibility of the disease.

Risk factors may be related in a cause - effect relationship with the occurrence of the disease and their reduction reduces this risk (LDL – cholesterol concentration, hypertension). They might also be related with the disease occurrence but not be a cause of the disease, therefore having only prognostic value.

Basic practical division of risk factor covers non-modifiable and modifiable factors (tab.1).

Table 1.
The main cardiovascular risk factors
Non-modifiableModifiable
• Age
• Gender
• Family history for premature (in men <55 years of age, in women <65 years) prevalence of cardiovascular disease.
• Genetic factors
• History of cardiovascular disease		• Hypertension
• Increased levels of total cholesterol and LDL - cholesterol and a decreased level of HDL - cholesterol
• Diabetes
• Obesity
• Inflammatory and prothrombotic factors

Age

In the lifetime numerous environmental stressors influence blood vessels causing deterioration of their function. Aging increases number of cardiovascular risk factors (arterial hypertension, hypercholesterolemia, diabetes mellitus) which leads to increase in lipid peroxidation, endothelial dysfunction and progression of arteriosclerosis.

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