Mweveloba, maRali arteriuli wneva da kardio-vaskuluri riski profesori beJan winamZRvriSvili

mweveloba,

maRali arteriuli wneva

da kardio-vaskuluri riski

profesori profesori beJan winamZRvriSvilibeJan winamZRvriSvili

Copyright ©2003 American College of Cardiology Foundation. Restrictions may apply.

Braunwald, E. J Am Coll Cardiol 2003;42:2031-2041

Prediction of the relative impact of interventions and prevention

Deaths by cause, all ages, Georgia, 2002Deaths by cause, all ages, Georgia, 2002

75%

1%

2%

2%4%

5%

11% Cardiovascular disease

Cancer

Chronic respiratory disease

Diabetes

O ther chronic disease

Communicable, maternal andperinatal deficienies

Injuries

Diseases of the circulatory system, morbidity rates per 100000 Diseases of the circulatory system, morbidity rates per 100000

population, Georgia 2000-2007population, Georgia 2000-2007

Prevalence of circulatory system diseases, Georgia, 2000-2007Prevalence of circulatory system diseases, Georgia, 2000-2007

1860,5

2173,42410,4

2730,6

3108,2

3620,53861,5

4142,9

356,3343,5

334 358,8 350,6 378,8471,2 455,8

1397,51613,3

1760,81875,7

2373,22213,2

1955,1

2239,8

217,6

195,5

235,6 244,2 289,9 344,7 345,5341

0

500

1000

1500

2000

2500

3000

3500

4000

4500

2000 2001 2002 2003 2004 2005 2006 2007

RheumaticdiseasesHypertension

IHD

Cerebrovasculardiseases

2030 wels saqarTveloSi 2030 wels saqarTveloSi

sikvdilis SemTxvevaTa sikvdilis SemTxvevaTa

92.2% gamowveuli 92.2% gamowveuli

iqneba aragadamdebi iqneba aragadamdebi

daavadebebiT; daavadebebiT;

CVDCVD – 70.4%, – 70.4%,

kibo – 12.9%, kibo – 12.9%,

sxva qronikuli sxva qronikuli

daavadebebi – 8.9%daavadebebi – 8.9%

Shares of total deaths and DALYs attributable to 10 leading risk factors in the WHO European Region, 2002

GE

OR

GIA

1. High blood pressure 48.8 1. High blood pressure 23.5 2. High cholesterol 22.9 2. High cholesterol 11.9 3. High BMI 17.3 3. High BMI 11.9 4. Low fruit and vegetable intake 11.1 4. Tobacco 9.2 5. Physical inactivity 10.6 5. Low fruit and vegetable intake 5.8 6. Tobacco 9.3 6. Alcohol 5.8 7. Alcohol 4.6 7. Physical inactivity 5.6 8. Urban outdoor air pollution 2.6 8. Illicit drugs 2.6 9. Lead 1.5 9. Unsafe sex 1.6 10. Unsafe sex 0.7 10. Lead 1.6

GE

RM

AN

Y

1. High blood pressure 25.9 1. Tobacco 13.7 2. Tobacco 18.3 2. High blood pressure 11.2 3. High cholesterol 15.1 3. Alcohol 7.5 4. High BMI 9.9 4. High cholesterol 7.2 5. Physical inactivity 5.9 5. High BMI 7.1 6. Low fruit and vegetable intake 4.1 6. Physical inactivity 3.2 7. Unsafe sex 0.7 7. Low fruit and vegetable intake 2.2 8. Urban outdoor air pollution 0.6 8. Illicit drugs 1.7 9. Occupational airborne particulate matter 0.4 9. Unsafe sex 0.8 10. Illicit drugs 0.4 10. Iron deficiency 0.5

AZ

ER

BA

IJA

N

1. High blood pressure 21.6 1. High BMI 7.8 2. High cholesterol 17.8 2. Tobacco 6.9 3. High BMI 15.8 3. High cholesterol 6.8 4. Tobacco 9.9 4. High blood pressure 6.7 5. Low fruit and vegetable intake 9.0 5. Alcohol 3.8 6. Physical inactivity 8.5 6. Low fruit and vegetable intake 3.5 7. Alcohol 5.1 7. Physical inactivity 3.4 8. Indoor smoke from solid-fuel use 2.5 8. Indoor smoke from solid-fuel use 3.3 9. Urban outdoor air pollution 2.0 9. Childhood and maternal underweight 2.7 10. Childhood and maternal underweight 1.7 10. Iron deficiency 2.5

Source: The European Health report 2005 Public health action For healthier children And populations

Countries with the highest figures of arterial pressure among Countries with the highest figures of arterial pressure among populationpopulation

kardiovaskuluri daavadeba kardiovaskuluri daavadeba – – paTologiuri SemTxvevebis TanmimdevrobapaTologiuri SemTxvevebis Tanmimdevroba

risk-faqtorebi:hipertenziadislipidemia

insulinrezistentobaTambaqos weva

endoTeliumis disfunqcia

aTerosklerozi

koronaruli daavadeba

miokardiumis iSemia

koronaruli Trombozi

miokardiumis infarqti

End-stage heart disease

SegubebiTi gulis ukmarisoba

ventrikuluri dilatacia

kardialuri remodelireba

ariTmia da kunTovani qsovilis kargva

From Circulation 2006;114:2850-70.

kardiovaskulur daavadebaTa kontinuumi

riskis Sesafasebeli cxrilebiriskis Sesafasebeli cxrilebi ((EU guidelinesEU guidelines))

mwevelobamaRali arteriuli

wneva

kardio-vaskuluririsk-faqtorebi

saerTo da kardio-vaskuluri

sikvdiloba

maRali maRali arteriuliarteriuliwnevis wnevis

gavrcelebagavrcelebamsoflios msoflios

mosaxleobismosaxleobis30%-Si30%-Si

daaxloebiT daaxloebiT mosaxleobis mosaxleobis

5%-Si5%-SiaRiniSneba aRiniSneba orive risk-orive risk-faqtorisfaqtoris

TanaarsebobaTanaarseboba

mwevelobis mwevelobis Cvevis Cvevis

gavrcelebagavrcelebamsoflios msoflios

mosaxleobis mosaxleobis 30%-Si30%-Si

GgavrcelebaGgavrceleba

GsikvdilobaGsikvdiloba

7 mln-ze meti 7 mln-ze meti sikvdilobis SemTxveva sikvdilobis SemTxveva msoflioSi Tanxlebulia msoflioSi Tanxlebulia maRali arteriuli wneviTmaRali arteriuli wneviT

5 mln-ze meti 5 mln-ze meti sikvdilobis sikvdilobis SemTxveva SemTxveva msoflioSi msoflioSi Tanxlebulia Tanxlebulia mwevelobis CveviTmwevelobis CveviT

mwevelobisa da maRali arteriuli wnevis

gavlena kardio-vaskulur riskze

wvis produqtebiwvis produqtebi _ nikotini, naxSirbadis _ nikotini, naxSirbadis monoqsidi, oqsidantebi, kadmiumimonoqsidi, oqsidantebi, kadmiumi

safuZvels uqmnis organoTa dazianebis paTofizio-safuZvels uqmnis organoTa dazianebis paTofizio-

logiur meqanizmebslogiur meqanizmebs

zogi maTgani dakavSirebulia arteriuli wnevis zogi maTgani dakavSirebulia arteriuli wnevis regulaciis fiziologiur meqanizmebTanregulaciis fiziologiur meqanizmebTan

aqedan gamomdinare saxezea mwevelobis aqedan gamomdinare saxezea mwevelobis

kazualuri gavlena hipertenziis ganviTarebazegavlena hipertenziis ganviTarebaze

wnevis 24 saaTiani monitorirebis Sedegi

mwevelebsa da aramwevelebSi

urTierTqmedeba mwevelobasa da sxva urTierTqmedeba mwevelobasa da sxva kardio-vaskulur risk-faqtorebs Soriskardio-vaskulur risk-faqtorebs Soris

1. sisxlis wneva1. sisxlis wneva

1.1. izrdeba mwevelobasTan erTad1.1. izrdeba mwevelobasTan erTad

1.2. hipertenziis mqone mwevelebSi:1.2. hipertenziis mqone mwevelebSi:

rTuldeba optimaluri kontrolis miRwevarTuldeba optimaluri kontrolis miRweva

prognozi mZimeaprognozi mZimea

aTerosklerozuli renovaskularuli hipertenziis aTerosklerozuli renovaskularuli hipertenziis

ganviTarebis riskiganviTarebis riski

avTvisebiani hipertenziis ganviTarebis riski avTvisebiani hipertenziis ganviTarebis riski

izrdebaizrdeba


2. sisxlis Sratis lipidebi2. sisxlis Sratis lipidebi

2.1. momatebulia:2.1. momatebulia:

saerTo qolesterinisaerTo qolesterini

LDL LDL qolesteriniqolesterini

Tavisufali cximovani mJavebiTavisufali cximovani mJavebi

trigliceridebitrigliceridebi

2.2. Semcirebulia:2.2. Semcirebulia:

HDL HDL qolesteriniqolesterini

3. simsuqne3. simsuqne

rogorc wesi, mwevelebSi sxeulis wona ufro rogorc wesi, mwevelebSi sxeulis wona ufro

dabaliadabalia

4. hemoreolgia4. hemoreolgia

4.1. momatebulia:4.1. momatebulia:

fibrinogeni fibrinogeni

sisxlis siblantesisxlis siblante

hematokritihematokriti

Trombocitebis agregaciaTrombocitebis agregacia



5. peroraluri kontraceptivebi5. peroraluri kontraceptivebi

miokardiumis infarqtis, insultisa da miokardiumis infarqtis, insultisa da

Tromboemboluri garTulebebis maRali riskiTromboemboluri garTulebebis maRali riski

6. hormonaluri cvlilebebi6. hormonaluri cvlilebebi

estradiolis (mamakacebSi) da estradiolis (mamakacebSi) da

vazopresinis gazrdili Semcveloba plazmaSi da vazopresinis gazrdili Semcveloba plazmaSi da

glukozisadmi daqveiTebuli tolerantobaglukozisadmi daqveiTebuli tolerantoba

1. kardiuli efeqtebi1. kardiuli efeqtebi 1.1. koronaluri arteriebi1.1. koronaluri arteriebi fataluri da arafataluri miokardiumis infarqtifataluri da arafataluri miokardiumis infarqti

ganmeorebiTi infarqti ganmeorebiTi infarqti munji iSemia munji iSemia

angoplastikis Semdgomi restenoziangoplastikis Semdgomi restenozi Suntirebuli sisxlZarRvebis aTeroskleroziSuntirebuli sisxlZarRvebis aTerosklerozi

1.2. uecari sikvdili1.2. uecari sikvdili

1.3. arastabiluri stenokardia1.3. arastabiluri stenokardia

1.4. kardiomiopaTia1.4. kardiomiopaTia

mwevelobis gavlena kardio-vaskulur riskzemwevelobis gavlena kardio-vaskulur riskze


2. cerebruli efeqtebi2. cerebruli efeqtebi

2.1. Tavis tvinis infarqtebi2.1. Tavis tvinis infarqtebi

2.2. subaraqnoiduli sisxlCaqceva2.2. subaraqnoiduli sisxlCaqceva

2.3. tranzitoruli iSemia2.3. tranzitoruli iSemia

2.4. saZile arteriis endartereqtomiis Semdgomi 2.4. saZile arteriis endartereqtomiis Semdgomi

stenozistenozi

3. sxva arteriuli paTologia3. sxva arteriuli paTologia

3.1. aortis aTerosklerozi3.1. aortis aTerosklerozi

3.2. ilio-femoraluri aTerosklerozi3.2. ilio-femoraluri aTerosklerozi

3.3. xangamoSvebiTi koWloba3.3. xangamoSvebiTi koWloba

3.4. qvemo kiduris iSemia _ amputacia3.4. qvemo kiduris iSemia _ amputacia

3.5. muclis aortis anevrizma3.5. muclis aortis anevrizma

3.6. Tirkmlis arteriolaruli hiperplazia3.6. Tirkmlis arteriolaruli hiperplazia

3.7. uteroplacentaruli arteriuli hiperplazia3.7. uteroplacentaruli arteriuli hiperplazia

3.8. diabeturi mikroangiopaTia3.8. diabeturi mikroangiopaTia


maRali arteriulimaRali arteriuliwnevawneva endoTeluri disfunqciaendoTeluri disfunqcia

sisxlZarRvebis yvela donissisxlZarRvebis yvela donisremodelirebaremodelireba

mwevelobmwevelobaa

cerebro-vaskuluri cerebro-vaskuluri paTologiapaTologia

koronaruli koronaruli daavadebis riskidaavadebis riski

Tirkmlis Tirkmlis ukmarisobisukmarisobisganviTarebaganviTareba

dramatulad gazrdili dramatulad gazrdili koronaluri koronaluri

daavadebis riskidaavadebis riski

SedarebiTi dabaliSedarebiTi dabali cerebro-vaskuluri cerebro-vaskuluri

riskiriski

mwevelobis Sewyveta aris kardio-vaskulur mwevelobis Sewyveta aris kardio-vaskulur

daavadebaTa marTvis aucilebeli daavadebaTa marTvis aucilebeli

komponenti. samwuxarod, mTeli rigi komponenti. samwuxarod, mTeli rigi

kvlevebis Sedegad dasturdeba samedicino kvlevebis Sedegad dasturdeba samedicino

personalis inertuloba da pacientTa personalis inertuloba da pacientTa

SezRuduli CarTuloba Tambaqos SezRuduli CarTuloba Tambaqos

sawinaaRmdego samkurnalo qmedebebSi.sawinaaRmdego samkurnalo qmedebebSi.

2009 wlis dokumentSi `saqarTvelos jandacvis 2009 wlis dokumentSi `saqarTvelos jandacvis

sistemis efeqturobis Sefaseba~ sistemis efeqturobis Sefaseba~ (WHO EUROPE(WHO EUROPE,, Sromis, Sromis,

janmrTelobisa da socialuri dacvis saministro) janmrTelobisa da socialuri dacvis saministro)

aRniSnulia, rom qveyanaSi mwevel qalTa raodenoba aRniSnulia, rom qveyanaSi mwevel qalTa raodenoba

swrafi tempiT matulobs, bolo 16 wlis ganmavlobaSi swrafi tempiT matulobs, bolo 16 wlis ganmavlobaSi

mwevel qalTa raodenoba 6-jer gaizarda.mwevel qalTa raodenoba 6-jer gaizarda.

M meore damoukidebuli faqti, reproduqciuli asakis M meore damoukidebuli faqti, reproduqciuli asakis

qalTa sikvdilobis mizezTa Semswavleli kvlevis qalTa sikvdilobis mizezTa Semswavleli kvlevis

((GERAMOS-06)GERAMOS-06) 2009 w. SedegebSi kardio-vaskuluri 2009 w. SedegebSi kardio-vaskuluri

sikvdiloba III, xolo maRal asakobriv sub-jgufebSi sikvdiloba III, xolo maRal asakobriv sub-jgufebSi

(40-44 w.w. da 45-49 w.w.) Sesabamisad II da I (40-44 w.w. da 45-49 w.w.) Sesabamisad II da I

adgilzea. adgilzea.

aragadamdeb daavadebaTa risk-faqtorebis aragadamdeb daavadebaTa risk-faqtorebis

kvleva saqarTvelo, 2006-2007 ww.kvleva saqarTvelo, 2006-2007 ww.

SedegebiSedegebi

yoveldRiuri mwevelebis 21.3%-s ar surs yoveldRiuri mwevelebis 21.3%-s ar surs mowevisaTvis Tavis danebeba, xolo 24.0% ar mowevisaTvis Tavis danebeba, xolo 24.0% ar aris darwmunebuli, da mxolod 33.8%-s surs aris darwmunebuli, da mxolod 33.8%-s surs sigaretisaTvis Tavis danebebasigaretisaTvis Tavis danebeba

yoveldRiuri mwevelebis 39.1%-s arasdros yoveldRiuri mwevelebis 39.1%-s arasdros ucdia mowevisaTvis Tavis danebebaucdia mowevisaTvis Tavis danebeba

yoveldRiur mwevelTa mxolod 28.4%-ma yoveldRiur mwevelTa mxolod 28.4%-ma miiRo rCeva eqimisagan TambaqosTvis Tavi miiRo rCeva eqimisagan TambaqosTvis Tavi danebebis Sesaxebdanebebis Sesaxeb

aragadamdeb daavadebaTa risk-faqtorebis aragadamdeb daavadebaTa risk-faqtorebis

kvleva saqarTvelo, 2006-2007 ww.kvleva saqarTvelo, 2006-2007 ww.

SedegebiSedegebi

ukanaskneli 1 wlis ganmavlobaSi respondentTa ukanaskneli 1 wlis ganmavlobaSi respondentTa

mxolod 12.5%-ma miiRo rCeva eqimisagan mxolod 12.5%-ma miiRo rCeva eqimisagan

Tambaqoze Tavis danebebasTan dakavSirebiTTambaqoze Tavis danebebasTan dakavSirebiT

respondentTa mxolod 11.5%-ma scada respondentTa mxolod 11.5%-ma scada

TambaqosaTvis Tavis danebebaTambaqosaTvis Tavis danebeba

respondentTa mxolod 4.6%-ma uari Tqva respondentTa mxolod 4.6%-ma uari Tqva

TambaqozeTambaqoze

Documents

Mweveloba, maRali arteriuli wneva da kardio-vaskuluri riski profesori beJan winamZRvriSvili