Modified Algorithm for the Risk of Coronary Heart Disease Estimation.

INTRODUCTION: Determination of the overall risk of coronary disease, enables the health professionals for planning the intensity of preventive action. AIM: The aim of this study is that by the results obtained using a modified algorithm with tables adopted by the European Society of Cardiology demonstrate the possibilities for assessment of the risk of coronary heart disease degree, for application to the targeted individual or risk factors groups. MATERIAL AND METHODS: The study was conducted as a retrospective, prospective and controlled (included two groups of 200 respondents). RESULTS: By comparing the presence of risk factors according to the representation of groups of diseases, or myocardial infarction, results showed that the European and SCORE table have significantly lower levels of risk factors, or those with sustained myocardial infarction are ranked in groups of low and present risk in relation to our algorithm which patients with myocardial infarction ranked as high and pronounced degree of risk. Results showed that the European and SCORE table significantly reduce the levels of risk or the persons with heart failure have been ranked in the group of low and present risks in relation to our algorithm which patients with coronary insufficiency ranked as pronounced degree of risk. CONCLUSION: Determination of the overall risk of coronary disease, enables the health professionals for planning the intensity of preventive action. The activities of primary prevention of risk factors, or already resulting disease, may be helpful in assessing the reduction in economic costs in healthcare, both due to lower morbidity, and reducing the total cost of treatment of patients with coronary disease.

Socio-medical Characteristics of Coronary Disease in Bosnia and Herzegovina and the World.

INTRODUCTION: Coronary heart disease and its etiology are complex socio-medical and clinical problem in this century. World Health Organization defined coronary artery disease as acute and chronic heart ailments due to disruption of flow and myocardial blood supply. Diseases of the cardiovascular system in spite of preventable risk factors are responsible for approximately 50% of all deaths in the developed world, and this ratio is higher in developing countries. RISK FACTORS: CORONARY HEART DISEASE RISK FACTORS CAN BE DIVIDED IN THOSE WHICH ARE NOT PREVENTABLE SUCH AS: personal and family history of cardiovascular diseases, age and gender and preventable risk factors including: high blood pressure, elevated blood cholesterol, smoking, reduced physical activity, elevated blood sugar, increased body weight, alcohol use, psychosocial factors and nutrition. There are also newly emerging risk factors which includes increased homocysteine, thrombogenic and inflammatory factors. Prevention of coronary heart disease risk factors: The concept of risk assessment factors, their reduction, initially begun in the Framingham Heart Study and refined in other models. Primary prevention relates to changing lifestyle and influencing preventable risk factors. Numerous studies and meta-analysis showed that lifestyle modification, risk reduction factors, particularly by changing diet, stopping smoking, increasing physical activity, blood pressure control can be effective in the prevention and reduction of coronary heart disease. Primary health care physicians i.e. family physicians need to take an active role in assessment of risk factors for coronary heart disease. CONCLUSION: The data in this paper, based on the findings from other studies, suggest the importance of using a modified algorithm in order to estimates the overall risk of coronary disease in high-risk groups among the patients in the primary health care settings.

[Obesity is a disease--the "School of Healthy Weight Loss" is therapeutic]. / Pretilost je bolest--"skola zdravog mrsavljenja" je terapija.

UNLABELLED: The aim of the work is to point to the healthcare problems of obesity in our population, to estimate the results of the edcative programmees, to emphasize the significance of feeding habits, the habits of the healthy life, in the reducing of the body weight, and by this reduce the risk for the development of the noninfectious diseases. The retrospective six-monthly (January-June) the research of the results, the reducing of the obesity by the educative programmee in patients and more years in the frame "The school of the healthy becoming thin" of the institution for health protection in Mostar. In the paper are used the data from the social medical questionnaire seven day diary of the feeding, the data about the physician examination as well as the results of the individual group educative interventions. The received data are being compared with the referral values who, are being registered the number and kind of the intervention, number and the intensity of the individual follow-up of the patients as well as the number data of the success of the reducing of body weight after six months, the data are processed in epi- info programme from the total number (126 examinees) was 34% males, 66 females. In the sample divided according to the arc and sexuality the most represented was the middle arc (40-49 years) with 64% of the examines (53% males and 52% females). The heart troubles are present in 48%, the troubles of the locomotor system present in 68% examinees. The increased values of sugar in blood in the blood pressure > 140/90 mmHg has 32%. The examination of the feeding habits shows the presence of food in nutrition which constrain the excess of fats 30%, butter, 90% milk with fat over 2%, cake takes every day 37%. The habits of the physical activities has only 37% of the examinees, at all has no physical activities 23%, while because of the health reasons has no physical activity 37%. The total number of the visits to the counseling is 160, from body weight from 120 kg. (240 ponds). CONCLUSION: The obesity is expressed public health problem and in our inhabitance. It is significant expressed the comorbidity with the other risk factors. It is connected with unhealthy feeding habits, reduced physical activity, deficiency of activity, deficiency of the individual knowledges and informations about the healthy risks, evidently is expressed the weakness of the work of healthy protection, particularly the primary one, which does not put the obesity problem enough at the priority consideration level. It is enough to create the complete assistance and attention of the healthcare workers for all which have problem of the excessive body weight and desire to reduce it.