[危机情况下的初级保健中的心血管预防:在SARS-COVID-19大流行之前,期间和之后的多中心比较研究]
Bárbara Moreno Caballero1, M Victoria Castell Alcalá2, Alicia Gutiérrez Misis3
1Centro de salud Guayaba. Dirección Asistencial Centro. Servicio Madrileño de Salud, Madrid, España.
Atencion primaria
|October 8, 2023
概括
心血管预防活动,包括生活方式,检查和实验室测试,在SARS-COV-2大流行之前是有限的,并在它期间显著下降. 这些基本的初级保健服务需要改进.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 初级医疗保健医学 一级医疗保健医学
背景情况:
- SARS-COV-2 流行病引入了医疗保健中的重大破坏和组织变化.
- 初级保健机构在预防心血管疾病方面发挥着至关重要的作用.
- 评估大流行对预防服务的影响对于医疗保健规划至关重要.
研究的目的:
- 评估SARS-COV-2流行病和初级保健组织变化对心血管预防活动的影响.
- 分析40-74岁患者心血管风险评估的生活方式,检查和实验室数据的趋势.
- 为了比较预防策略在流行前,流行后和过渡时期的实施情况.
主要方法:
- 在35个初级保健中心进行了三年 (2019-2022) 的回顾性多中心描述性研究.
- 从电子健康记录中分析了1008名患有高血压,糖尿病和/或脂质失调的患者 (40-74岁) 的数据.
- 变量包括生活方式因素,血压和分析参数,在使用麦克内马尔测试的流行前,流行和过渡阶段进行了比较.
主要成果:
- 与生活方式,体检和实验室测试相关的预防活动在疫情期间显著下降.
- 生活方式活动登记率从大流行前的17.9%下降到大流行期间的2.9%.
- 在疫情期间,体检登记从39%降至13.2%,分析记录从3.3%降至1%.
结论:
- 即使在大流行之前,初级保健中的心血管预防活动也不足.
- 疫情导致基本心血管预防服务大幅减少.
- 迫切需要在初级保健层面加强和恢复这些预防性服务.
相关概念视频
01:26Coronary Artery Disease IV: Preventive Measures
23
Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
23
01:28Acute Coronary Syndrome IV: Interprofessional Care
11
IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
11
01:30Introduction Cardiac Emergencies
22
Cardiac emergencies are critical situations involving the heart that require immediate medical intervention to prevent severe complications or death. These emergencies often arise from underlying heart conditions that impair the heart's ability to function correctly.Types of Cardiac EmergenciesThe most common types of cardiac emergencies include Acute Coronary Syndrome (ACS), myocardial infarction (MI), cardiac arrest, and heart failure.Acute Coronary Syndrome (ACS)Acute Coronary Syndrome (ACS)...
22
01:27Coronary Artery Disease V: Interprofessional Care
9
Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
9
01:29Cardiomyopathy V: Interprofessional Care
14
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
14
01:26Acute Coronary Syndrome V: Nursing Management
16
Nursing Assessment:Nursing management of acute coronary syndrome (ACS) involves taking the patient's history, focusing on primary complaints such as chest pain, dyspnea, and excessive sweating (diaphoresis), as well as other symptoms like back or jaw pain, nausea, vomiting, palpitations, dizziness, and fatigue. The nurse also reviews the patient's history of cardiac events, risk factors such as hypertension, diabetes, smoking, family history, and current medications.In the objective assessment,...
16