PREVENTION OF THE REPETITIVE AFFECTION OF BRAIN BLOOD CIRCULATION AND PECULIARITIES OF ITS PHARMACOLOGICAL CORRECTION

Abstract

Full Text

Cardiovascular diseases (CVD) are the leading cause of death worldwide. In 1996 15 million people in the world died of CVD, and experts predict that by 2020 this figure may reach 25 million. Secondary prevention of recurrent stroke is an important medical and social problem. Epidemiological studies in recent years have shown that the risk of recurrent ischemic stroke (IS) increases 9-12 times in the individuals of the same age and gender in the general population of patients is maximum during the first three days after the first episode. It is known that a second stroke is more severe and more often ends with death than the primary. All this determines the relevance of secondary prevention of stroke. According to D.G. Hackam, J.D. Spence (2007), appropriate use of a set of core prevention strategies will reduce the relative risk of cardiovascular events in patients at high risk of stroke by 94%. Despite the fact that recurrent stroke occurs more frequently during the first year after the primary frequency repetitive AI depends on the presence and severity of persistent violations, indicating the need for lifelong secondary prevention of stroke. Purpose of the work was to optimize the pharmacological prevention of recurrent AI evaluation of the level of anxiety and depression in patients undergoing AI, identification of the reasons for the ineffectiveness of the therapy. Exclusion criteria included dementia; expressed cognitive disorders; total aphasia; the absence of consent. Materials and methods of the study: the study involved 100 patients who suffered a stroke of ischemic type and a transient ischemic attack (TIA), who after a year or more were hospitalized in the neurological department “GKB SMP” no 25. All patients were evaluated using hospital anxiety and depression scale (HADS). We compiled a questionnaire and conducted the analysis of the data obtained about constancy of standard therapy and its effectiveness. Results: the study produced the following results. 60% of patients had "severe subclinical anxiety / depression", and 40% of patients did not show significantly pronounced symptoms of anxiety and depression. It was also found that patients with "subclinical expressed anxiety / depression," had no commitment to the therapy. Only 30% of patients underwent a constant antihypertensive therapy (20% were noted with stable hemodynamics rates, 10% is a figures liability of blood pressure and heart rate). Dyslipidemia, hypercholesterolemia was diagnosed in 30% of patients and hemostatic disorders with hypercoagulability and hyperfibrinogenemia in 20% on the therapy. Conclusions: in some cases the patients who underwent AI, need the prescription of antidepressants taking into consideration the hospital anxiety and depression scale (HADS), counseling therapist to the effectiveness of secondary prevention require. Antihypertensive and lipid-lowering therapy is recommended for all patients who have had a TIA and AI, regardless of arterial hypertension and cholesterol level.