Quiz Time

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QuizTime
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Quiz

• 1. Which is the most common death reason in
  Europe?
• A. Cancer
• B. Cardiovascular Diseases
• C. Accidents

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Quiz

• 1. Which is the most common death reason in
  Europe?
• A. Cancer
• B. Cardiovascular Diseases
• C. Accidents

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Quiz

• 2. How many people dies in Europe every year
  because of CVD?
• A. 1.9 million
• B. 11.1 million
• C. 4.3 million

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Quiz

• 2. How many people dies in Europe every year
  because of CVD?
• A. 1.9 million
• B. 11.1 million
• C. 4.3 million

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Quiz

• 3. What is the main risk factor in CVD?
• A. Use of tobacco
• B. Obesity
• C. Inactivity

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Quiz

• 3. What is the main risk factor in CVD?
• A. Use of tobacco
• B. Obesity
• C. Inactivity

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Quiz

• 4. Which are the only countries in Europe where
  the main cause of death among men is not the CVD?
• A. Switzerland, Ireland, Luxembourg
• B. Germany, Denmark, Austria
• C. Spain, France, Netherlands

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Quiz

• 4. Which are the only countries in Europe where
  the main cause of death among men is not the CVD?
• A. Switzerland, Ireland, Luxembourg
• B. Germany, Denmark, Austria
• C. Spain, France, Netherlands

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Public Health

• Cardiovascular Diseases and Prevention

Ana Lúcia Ramos - Portugal Balogh
Edina-Hungary Heikki Ojala-Finland Inês Moreira
Portugal Kristin Røsand-Norway Takács
Hajnalka-Hungary
ICHCI, 10 February 2009
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Contents

• 1. Cardiovascular diseases
• 2. Statistics
• 3. Risk Factors
• 4. Prevention (global, nacional and local level)
• 5. Multidisciplinary Work
• 6. Discussion
• 7. References

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Cerebrovascular Disease/Stroke
cvd
Coronary Heart Disease
Aortic Aneurysm and Dissection
Rheumatic Heart Disease
Peripheral Arterial Disease
Other Cardiovascular Diseases
Deep Venous Thrombosis and Pulmonary Embolism
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StaTISTITICS DEATH CAUSED BY cvd

• Finland 19 464(2005)
• Hungary 70 938 (2005)
• Norway 15 862 (2004)
• Portugal 36 723 (2005)
• EU 2 million (2008)
• Europe 4.3 million (2005)
• Globally 17.5 million (2005)

WHO, 2008
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Mortality due to CVD in Europe
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Economic Costs with CVD in EU

• Total Costs 110 billion (WHO, 2006)
• Non health care costs are not included

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CVD a public health problem

• The CVD should be regarded as one of the most
  important of the public health problems requiring
  solution.
• Multidimensional character, severe negative
  and direct consequences for the
  individual, for society and for the health
  system itself.

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Why is it important to deal with this
problem?How can we prevent CVD on a local,
national and global level?
CVD a public health problem
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Risk Factors
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Prevention!

• The 3 main risk factors that causes CVD

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Global Level

• WHO/EU
• Epidemiology
• Guidelines for assessment and management of
  cardiovascular risk

(WHO, 2007)
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Prevention on a nacional Level

• What has been done?
• What are the countries doing now to prevent the 3
  main risk factors?
• Norway
• Hungary
• Portugal
• Finland

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Hungary

• Smoking
• Law
• Primary Health Care minimal intervention
• Professional Care
• Physical Activity
• Sport Days
• Coca Cola Running Days
• Fittness Days in the University of Physical
  Activity

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Hungary

• Nutrition
• To organise Healthy Days
• To protest teaching of children in the elementary
  schools
• To spread the cardioprotective foods
• Nestle-Nutrikid
• Healthy buffet in the schools

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National Programme for the Prevention and Control
of the CVD
Portugal

• Prevent Diseases
• Prolong Active Life

Society mobilization 1. media 2. opinion
leaders 3. educators 4. artists 5. scientific
societies 6. professional and patients
associations
(Directorate-General of Health Portugal, 2006)
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Intervention Strategies

• Information campaigns
• Technical guidance for health professionals
• Software inter-active application on healthy
  eating and on regular life-long physical activity
• Evolvement of local authorities in order to
  create favorable conditions for exercise
  practice
• Coronary Fast Lane
• Guidelines for post-CVA rehabilitation

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Study case finland

• In the 1960s in Finland coronary heart disease
  mortality rates were the highest in the world.

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Study case finland

• What happened in 30 years?
• What were the keys to success?

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Study case finland

• Key Factors
• 1. Finding the problem
• 2. Making a systematic program
• 3. Getting every part of the society involved
• 4. Analyzing results

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Finland North Karelia Project

• 1972-1997
• Main Results
• Smoking in male population 52 31
• 90 butter consume 5 butter consume

Vegetable oil
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Finland North Karelia Project
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Multidisciplinary work
Nurses
Dietitians
Physiotherapists
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Role of the Dietitian

• Educate people about healthy diets
• Ways
• 12 guidelines of a healthy diet
• Individual counseling
• Organised collective counseling
• Tasks
• To protect the health
• To define the diet

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Role of the Dietitian

• - Tasks
• To compile the diet
• To establish the patients nutritional state
• To calculate the suitable nutrients content
• To supply the diet continously
• How can the dietetic counseling be more
  effective?
• Food shows
• Food store visiting
• Instructor kitchen

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What kind of physical activity can people do?
Role of the physiotherapist
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Local Level

• Thematic
• Days

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National Institute of Cardiology
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Gellert Spa
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discussion

• Could and should a country completely ban the use
  of tobacco?
• Is there a limit where promotion turns against
  itself?

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References

• Allender, S., Scarborough, P., Peto, V., Rayner,
  M. (2008) European Cardiovascular Disease
  Statistics. European HeartNetwork
• Ministry of Health - Portugal. Directorate-General
  of Health (2006) National programme of
  prevention and control of the cardiovascular
  diseases Lisbon. ISBN 972-675-178-6
• National Public Health Institute Finland The
  North Karelia Project pioneering work to improve
  National Public Health
• Wister, A. et al (2007) One-year follow-up of a
  therapeutic lifestyle intervention targeting
  cardiovascular disease risk. CMAJ.
  DOI10.1503/cmaj.061059
• World Health Organization (2004) Global Strategy
  on diet and physical activity. WHO Geneva.
• World Health Organization (2007) Prevention of
  Cardiovascular Disease Guidelines for assessment
  and management of cardiovascular risk. ISBN 978
  92 4 154717 8

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Thank you
Köszönöm
Tack
Kiitos
Obrigado