Kardiovaskularna prevencija i rehabilitacija: gdje smo i kuda idemo? Cardiovascular prevention and rehabilitation: where are we and where are we heading to?

SAAEETAK: U Republici Hrvatskoj tijekom 2010. godine zabiljeaeeno je 25.631 smrti zbog kardiovaskularnih bolesti (KVB), s udjelom od 49,2% u ukupnom mortalitetu. Pristupanje ukupnim preventivnim, dijagnostiEkim, terapijskim i sveobuhvatnim rehabilitacijskim mjerama u bolesnika koji imaju razvijenu aterosklerotsku KVB, s ciljem postizanja maksimalnog zdravlja, osobne, obiteljske i socijalne dostatnosti, kao i sprjeEavanja novog kardiovaskularnog dogaaja, glavni su zadaci organizirane zdravstvene djelatnosti sekundarne prevencije. Uspjeπno provedeni, oni dovode do znaEajnog poveEanja preaeivljenja, poboljπanja kvalitete aeivota, smanjenja potrebe za intervencijskim, kirurπkim ili perkutanim zahvatima, uz krajnje znaEajnu redukciju ukupnog druπtvenog i ekonomskog optereEenja. U skladu s opEeprihvaEenim konceptom kontinuuma u razvoju aterosklerotske bolesti i definicijom KVB kao izoliranog dogaaja unutar navedenog neprekinutog slijeda, temeljni pristup prevenciji treba donekle zanemariti tradicionalnu podjelu na “primarnu” i “sekundarnu” prevenciju, barem u naEelnim razmatranjima ovog tematskog podruEja. Suvremena strategija nameEe dva osnovna cilja: opEu populacijsku preventivnu strategiju, te strategiju preventivnih mjera u visokoriziEnih bolesnika izjednaEenih s onima koji su veE oboljeli od KVB. Navedeno je temelj profiliranja suvremenih opEih i specifiEnih preventivnih planova u zaπtiti od KVB. U svjetlu porasta znaEaja prevencije kardiovaskularnih bolesti, rehabilitacija kardiovaskularnih bolesnika imat Ee sve veEu vaaenost u cjelokupnom zbrinjavanju i sprjeEavanju pobola i smrtnosti od kardiovaskularnih bolesti, uz smanjenje troπkova i poveEanje kvalitete aeivota. KLJU»NE RIJE»I: kardiovaskularne bolesti, kardioloπka rehabilitacija, prevencija. SUMMARY: In 2010, there were 25,631 deaths caused by cardiovascular diseases (CVD), which accounted for 49.2% of total mortality in the Republic of Croatia. Applying the total preventive, diagnostic, treatment and comprehensive rehabilitation measures in patients who have developed atherosclerotic CVD aimed at achieving maximum health, personal, family and social sufficiency and prevention of new cardiovascular event are the main tasks of organized health activity of secondary prevention. When successfully conducted, they lead to a significant increase in survival, improvement of life quality, reduction in the need for interventional, surgical or percutaneous interventions, with an utmost significant reduction in overall social and economic burden. In accordance with generally accepted continuum concept in the development of atherosclerotic diseases and CVD definition as an isolated event within the specified uninterrupted continuum, the basic approach to the prevention should ignore the traditional division into “primary” and “secondary” prevention to a certain extent, at least in principal considerations of this thematic area. Contemporary strategy suggests the two basic objectives: the general population preventive strategy and the strategy of preventive measures in high risk patients equalized with those who are already suffering from CVD. The above is the foundation for modern profiling of contemporary general and specific preventive plans in protection from CVD. In the light of an increasing importance of prevention of cardiovascular diseases, the rehabilitation of cardiovascular patients will have an increasing importance in the overall management and prevention of morbidity and mortality from cardiovascular diseases, while reducing costs and improving the life quality.