September 29th is celebrated World Heart Day (World Heart Day) with the aim of informing and raising citizens’ awareness of the importance of taking care of their heart to prevent cardiovascular diseases.
The 2023 campaign, with the theme “Use ❤️ know ❤️” – “Use the ❤️ know the ❤️“, focuses on the need for each individual to know their own heart and know how to behave to effectively combat cardiovascular diseases, 80% of which are preventable, because, from a perspective of empowerment, it is with knowledge that choices can be made conscious to take care of themselves and improve their health.
Cardiovascular diseases, facts and figures
Cardiovascular diseases represent the leading cause of death in Italy and in the world and also have a significant impact in terms of morbidity and disability, constituting a challenge of primary importance for global healthcare systems, burdened by growing and increasingly unsustainable costs.
In fact, it is estimated that in 2019 they were responsible for approximately 18.6 million deaths globally, with an incidence of 55.5 million cases and a prevalence of 523 million cases.
In Europe, according to data from the fifth edition of the European Cardiovascular Disease Statistics, over 80 million people are affected by cardiovascular diseases (48% men and 52% women), which are responsible for 3.9 million deaths per year (45% of all causes of death).
Istat data indicates that even in 2020, the year in which the COVID-19 pandemic began, diseases of the circulatory system were the main cause of death in our country (30.5% of all deaths).
Main risk factors
Among the most important risk factors modifiable are:
smoking (smoking and use of other tobacco products) sedentary lifestyle/insufficient physical activity incorrect diet (unbalanced and high-calorie; rich in fats, sugars and salt; low in fruit and vegetables) overweight and obesity arterial hypertension dyslipidemia (increased cholesterol levels and /or triglyceridemia) diabetes mellitus
Prevention of cardiovascular diseases
Adopt healthy lifestyles (practice adequate physical activity daily, avoid risky and harmful consumption of alcohol, do not smoke or use other tobacco products, follow a healthy diet) it is the best choice to counteract the onset and progression of cardiovascular diseases, in particular the most widespread ones caused by atherosclerosis, which correlate with advancing age and include acute myocardial infarction and angina pectoris.
As regards physical activity, despite its clear protective role at all ages against numerous pathological conditions, it is estimated that 28% of the world‘s population is sedentary, especially women. According to ISTAT data relating to 2021 in Italy the share of sedentary people is 33.7% and is higher in women (36.9%) than in men (30.3%).
Furthermore, according to the Report developed by the WHO for World Heart Day, in collaboration with the World Heart Federation and the University of Newcastle in Australia, the tobacco is held responsible for 20% of deaths from coronary heart disease.
The report highlights that even i smokeless tobacco products are harmful to health (it is estimated that they cause 200,000 deaths per year from coronary heart disease), as well as the use of e-cigarettes and heated tobacco products is associated with an increased risk of cardiovascular disease.
For prevention, it is also essential to identify early and adequately manage the so-called intermediate risk factors (arterial hypertension, diabetes mellitus, dyslipidemia, overweight/obesity).
For people with intermediate risk factors and/or already suffering from cardiovascular diseases, it is important not only to adopt and maintain healthy behaviors, but also to take the prescribed medications and carry out tests and check-ups within the times indicated by the doctor.
The Ministry of Health supports the prevention of cardiovascular diseases as a priority objective for combating chronic non-communicable diseases, in particular through the National Prevention Plan (PNP) 2020-2025 and the Italian Alliance for cardio-cerebrovascular diseases.
The National Prevention Plan 2020-2025
Il National Prevention Plan (PNP) 2020-2025adopted with the State-Regions Agreement of 6 August 2020, in continuity with the previous ones, confirms the intersectoral approach, by setting and by life cycle, consolidating the Regions’ commitment to promoting health and strengthening interventions aimed at identifying of subjects at risk for chronic non-communicable diseases, including cardiovascular diseases, and to direct them towards adequate “taking charge”.
The PNP also aims to act on the social determinants of health (socio-economic and cultural conditions, urbanisation, environmental policies, poverty, etc.) which in turn strongly influence modifiable behavioral risk factors (smoking, sedentary lifestyle, risky and harmful consumption of alcohol, poor diet) of chronic non-communicable diseases, including cardiovascular diseases, which therefore only partly depend on individual choices. In fact, the PNP promotes a model based not only on the provision of healthcare services, but which is aimed at proactively promoting people’s health as a value for society and a resource for daily life. All the Regions and Autonomous Provinces have prepared and adopted their Regional Prevention Plan (PRP) by 31 December 2021, which outlines the contents, objectives and lines of action of the 2020-2025 PNP. The implementation of the PRPs within the territorial contexts is underway and the evaluation of the level of progress of the regional programs is one of the obligations required by the system for verifying compliance with the Essential Levels of Assistance (LEA).
The Italian Alliance for Cardio-Cerebrovascular Diseases
Established in 2017 at the Ministry’s General Directorate of Health Prevention, it is a voluntary Alliance that aims to bring the institutional level closer to the clinical one by bringing together all the main stakeholders in a permanent discussion table with the common objective of promoting and implementing promotional interventions of health, prevention and control of cardio-cerebrovascular diseases, in line with the Program “Gaining health: making healthy choices easy” (DPCM 4 May 2007), the National Prevention Plan and the National Chronicity Plan, in order to reduce the incidence, morbidity and mortality in the long term. The Alliance currently includes forty-eight Federations/Societies of cardiology and neurology, internal medicine, general practitioners, paediatricians, pharmacists, as well as patient associations and other bodies. The Alliance has developed the scientific document “Prevention of cardiovascular disease across the lifespan”, published in October 2021, and the information brochure for citizens “How to prevent cardiovascular diseases”, published on the occasion of World Heart Day 2022 to encourage the dissemination of essential and easy-to-remember messages on the topic. 4 working groups have recently been activated aimed at implementing the new operational lines (therapeutic adherence as a necessary tool to guarantee an effective treatment path; assessment of individual cardiovascular risk: examination of the available calculators and adoption of the most congenial and usable tools in our country; development of a low-intensity rehabilitation care model for the long-term care of stroke survivors; impact of air pollution on cardiovascular diseases).
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