Who Is Interested In?
Preventive cardiology deals with those with heart disease in the family, hypertension, metabolic syndrome, high cholesterol and smokers. After the examination and tests, the patient is evaluated according to his/her risk group and a personalized care and treatment plan is determined for each person. Not everyone with these problems has the same risk. Risk reduction is achieved by educating the patient about lifestyle changes before the patient's cardiovascular disease occurs or the disease progresses, medication treatment if necessary, and regular monitoring.
Risk Assessment
It can already be predicted that even after 20-30 years, vascular diseases such as heart attack and stroke will always be the biggest culprit.
The disease does not occur suddenly but goes through stages over the years, leading to heart attack and stroke. The process, which first begins with a line in the vessel, results in plaques with slight fat and cholesterol accumulation, and then stenosis and blockages in which the cells that come here to clean these residues interfere. The earlier the precaution or treatment is started at any of these stages, the more effective and cheaper it will be.
Determining who will have a heart attack is one of the most basic study and research subjects of cardiology. However, despite all this progress, it is impossible to predict 100% who will have a heart attack and when. However, significant progress has been made in retrospective statistical studies and observational studies conducted with large numbers of people regarding who is at risk. Everyone agrees that hypertension, diabetes, a lazy lifestyle and smoking cause arteriosclerosis. For this purpose, using statistical information, different risk calculation formulas were developed according to age, gender and finally race. In summary, it is necessary to put each person in a separate category, evaluate them according to their risk, and request medication or examination.
The most comfortable example that can be given on this subject is today's discussion about high cholesterol and cholesterol medications. One group argues that cholesterol is the most important cause of heart diseases, and the other group argues that cholesterol is not harmful and therefore medication use is not necessary. I think both sides are right in some aspects on this issue. I think so. Let me explain with an example. Today, all institutions, including the social security institution, take into account the value called LDLcholesterol or bad cholesterol as a condition for paying for cholesterol medication. For example, if the LDL value is 190 and above, any institution can easily pay for your prescription, but should everyone with these values use medication? It becomes very important to decide based on risk assessment or individual differences. In other words, Ali's high cholesterol and Veli's cholesterol high are not the same even if the numbers are exactly the same!!
- Let's consider theLDLvalue above. Whose LDL value belongs to? A 35-year-old woman?
- Or a 52-year-old man who just had a heart attack? What is the total cholesterol and HDLvalue, also known as good cholesterol?
Although there is almost universal consensus on starting medication for male patients, it is important for female patients to have problems such as smoking, diabetes and hypertension. If there is no additional risk factor, it would be a mistake to start medication. The truth is that in all world-accepted risk calculation tables, the total cholesterol/good cholesterol (HDL) ratio is taken into account, not the cholesterol-related LDL value.
A quality interview taking this information into consideration will significantly reduce the use of angiograms, stress tests and similar examinations and unnecessary medication use.
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