Read the book Heart and Vascular Health (Anton Rodionov). Anton rodionov full course of medical literacy

Participants of the conference: Rodionov Anton Vladimirovich

According to the World Health Organization (WHO) in the world from cardiovascular disease over a billion people are suffering today. Every year everything more young people already have one or another pathology of cardio-vascular system. How to protect yourself and your loved ones? What are the symptoms of heart attack and stroke? What tests and studies should be carried out for the purpose of prevention and treatment? Answered these and other questions cardiologist Anton Rodionov.

Question: Ludmila07 19:07 10/09/2014

Hello, Anton Vladimirovich. I was diagnosed with PMK 2 degrees. Am I at risk? Can I have a heart attack or stroke due to this diagnosis?

Answers:

Rodionov Anton Vladimirovich 16:55 30/09/2014

Good afternoon, Lyudmila. Prolapse mitral valve often regarded as a variant of the norm. This phenomenon often occurs in tall, slender people and does not require any treatment. The risk of cardiovascular events does not increase.

Question: Pavel Leonidovich 22:48 10/09/2014

Over the last year after massive heart attack performed three operations on vascular stenting, but the improvement lasts 2-3 months after the operation, then the condition worsens (I follow all the recommendations for taking medications, nutrition and physical activity), in addition, immunity has greatly decreased (I began to catch cold often). Doctors say that stenting can no longer be done, that a bypass operation may have to be done. What is bypass surgery, how effective is bypass surgery, and when is bypass surgery recommended?

Answers:

Pavel Leonidovich, shunting is the imposition of a "bypass" around the narrowed area coronary artery. Used as a shunt own arteries or veins. it big operation, which is performed in situations where, despite full-fledged therapy, signs persist insufficient blood supply heart, and the possibilities of stenting have already been exhausted.

Question: Larisa Ivanovna Bondareva 15:13 11/09/2014

Hello, in last years(I am 54 years old) heart problems began: a year ago, the result of a 24-hour ECG was about 2 thousand extrasystoles, now 2700. The doctor only asked if I wanted to "poison drugs", of course, I do not want to poison myself. And so she sent me out of the office without an appointment, without any advice, recommendations. She also said that there is a pralapse, but also without an accent, somehow casually. So I didn't know if it was serious or not. What is your opinion? Thank you.

Answers:

Rodionov Anton Vladimirovich 16:56 30/09/2014

Larisa Ivanovna, in the absence of an organic heart disease (myocardial infarction, heart failure, cardiomyopathy, etc.), even several thousand extrasystoles is a completely benign phenomenon and does not always require treatment. So your doctor, without prescribing you antiarrhythmic drugs, is most likely right, although the phrase “poisoned with drugs” is pretty hard on the ear.

Question: jahon 03:19 09/12/2014

Hi. how to avoid stroke and heart attack

Answers:

Salute! Everything is simple. Don't smoke, give yourself physical activity at least 45 minutes a day, do not abuse alcohol. Control blood pressure, cholesterol and sugar.

Question: Terekhova Natalya Mikhailovna 12:02 12/09/2014

In 2005 - a heart attack, then stenting (2 stents) against the background of numerous cardiosclerosis (about 35%). Now - painless ischemia, therapy - atakand, niperten, preductal. Feeling normal. The question is how to control the development of atherosclerosis in those vessels that were still normal in 2005. After all, ischemia is painless, I do not feel the load.

Answers:

Rodionov Anton Vladimirovich 16:57 30/09/2014

Natalya Mikhailovna, not included in the treatment regimen essential drugs that affect the survival of patients after myocardial infarction - aspirin and statins (cholesterol-lowering drugs). Be sure to discuss with your doctor the need for their appointment. It is possible to control the development of clinically significant atherosclerosis with the help of stress tests (treadmill test), during which the electrocardiogram response to the maximum load is recorded.

Question: Altynai 15:52 12/09/2014

Tell Aspirin cardio, the truth is an effective means of preventing these diseases

Answers:

According to modern recommendations Russian and European cardiologists, aspirin is used to prevent heart attack and stroke only in cases where cardiovascular disease has already been identified (ischemic heart disease, cerebrovascular disease, intermittent claudication). healthy person“Just like that” you don’t need to drink aspirin.

Question: Sergey Vladimirovich Ts 04:35 13/09/2014

Please tell me I have NCD hypertonic type. I was prescribed to drink atenalol, enalopril - I want to know if the diagnosis is dangerous and if the treatment was prescribed correctly. I am 30.

Answers:

Rodionov Anton Vladimirovich 16:58 30/09/2014

Sergey Vladimirovich, there is no diagnosis of NCD on the planet, it is a kind of "garbage heap" in which therapists of the old school put everything that they are reluctant to deal with. Most often we are talking about psychosomatic disorders. The first thing you should do is change your doctor.

Question: Masha Zhirova 07:56 13/09/2014

Good afternoon. I am 53 years old height 168 weight 89 kg., ECG rhythm sinus, heart rate 63/min Vertical position EOS. Incomplete blockade left leg p. Gisa. Pronounced changes in the inferior wall. I drink 2 times a year and started drinking aspirin cardio, but it seems to me that asperin cardio causes very thin blood (I gave injections, terrible bruises). Tell me, is it serious or according to age? Very interested in how to avoid stroke and heart attack. Thanks

Answers:

Rodionov Anton Vladimirovich 16:58 30/09/2014

Good afternoon, Masha. To avoid stroke and heart attack, you need to follow following rules: monitor weight (you have obvious obesity), do not smoke, monitor blood pressure (indicators for home measurement should not exceed 135/85 mm Hg), cholesterol and glucose. Aspirin just like that, for prevention in the absence coronary disease hearts do not need to be taken, this is now being refused in the world - the benefits are vague, but the risk of bleeding increases. Preductal in your situation is even more useless. Detailed answers to your questions in my new book "How to live without a heart attack and stroke."

Question: Natalia Valentinovna 15:20 13/09/2014

I have moderate left ventricular hypertrophy. What can you recommend for this pathology of the heart?

Answers:

Natalya Valentinovna, left ventricular hypertrophy is most often the result of arterial hypertension (high blood pressure). In this situation, it is important to diagnose hypertension and choose adequate treatment. What kind of lifestyle is worth leading to hypertension, what non-drug methods can reduce blood pressure and what to remember when taking medication - you can read about this in my book “How to live without a heart attack and stroke”.

Question: Alexey, 49 years old 18:37 09/14/2014

Headache, severe, once before vomiting, appeared recently. I see no reason, I healthy lifestyle life.

Answers:

Rodionov Anton Vladimirovich 16:59 30/09/2014

New headache in an adult - very serious symptom. An urgent consultation with a neurologist is needed, possibly an MRI of the brain.

Question: Inessa Valerievna 15:15 15/09/2014

Good afternoon. Such a question: sometimes my heart hurts, it hurts to breathe for a minute. then it all goes away. I have been dealing with this problem to a cardiologist for a long time, the examination showed that everything is fine. But such small attacks have been going on with me for many years. Most often this happens after I was worried. What it is? And do I need to look for a doctor who can make an accurate diagnosis?

Answers:

Inessa Valerievna, stabbing pains not characteristic of cardiovascular disease. If these conditions do not spoil your life much, do not pay attention. If the problem looks serious, consult a neurologist.

Question: Natalia Borisovna, 65 years old, Krasnodar 19:27 15/09/2014

Please tell me if spasms (numbness) of the throat, tongue and jaws are a sign of cardiovascular disease

Answers:

Rodionov Anton Vladimirovich 17:00 30/09/2014

Natalya Borisovna, "spasms" is a very indistinct complaint. If this is due to physical activity, then angina pectoris should be ruled out. However, regardless of this, it makes sense to undergo a standard cardiac examination, which includes measuring blood pressure, assessment of the main biochemical indicators, electrocardiography, etc.

Question: Viktor, 25 years old 20:19 09/16/2014

Anton Vladimirovich, hello! I am 25. I smoke for 10-12 years. I have been playing football since the age of 18 (2 training sessions per week + 1-2 matches). In April, the heart "worried" - a feeling of constriction in the chest, a feeling that I could not breathe, etc. Spent complete diagnostics, including echocardiography and Holter. Everything is okay. (The only thing I worry about is the established atrial hypertrophy. But they said that this is a variant of the norm). Now I’m worried again, I read a lot on the Internet about cardiomyopathy, angina pectoris and myocarditis. I am an experienced hypochondriac. :) Tell me, please, is it worth worrying, maybe the doctors didn't notice something? Or is everything okay? When should you check your heart again? Thank you!

Answers:

Victor, it's not too late to change everything. Wish in young age endlessly examining the heart is a sign of a serious neurotic disorder which sometimes needs to be treated by specialists. The worst thing you have from a cardiologist's point of view is smoking. You are thus stealing 10 years of your life, and this is not a joke. More about cardiovascular prevention You can read it in my book How to Live Without Heart Attack and Stroke.

Question: Elena, 41 years old 15:16 09/17/2014

Anton Vladimirovich, good afternoon. During pregnancy, extrasystole was found (as they wrote in the card of extrasystole of pregnant women). Since then, for 10 years, there have been periods of arrhythmia .. ECHO of the heart is in order, but the cardiogram is sometimes not very good. Preductal, Egilok, Sotaleks were prescribed, but they only aggravate the allergy, but no improvement is visible. After another consultation, the doctor canceled them. Thyroid hormones are normal. Holter sometimes shows extrasystoles, sometimes not. Periodically a feeling of lack of air and dizziness. What examinations are needed? Thank you.

Answers:

Rodionov Anton Vladimirovich 17:01 30/09/2014

Good day, Elena. Extrasystole in young people, as a rule, is benign and does not always need antiarrhythmic therapy. I think that the abolition of drugs in your case - a good idea. In order to discuss the need for additional examination and treatment, you need to see the results of daily (Holter) ECG monitoring.

Question: Nelly, 67 years old/180914 22:35 09/19/2014

Hello, Anton Vladimirovich. I have shortness of breath even with a small load, and when walking up a hill or stairs, chest pain is also added. Doctors don't find anything, they say that the cardiogram is good and the heart is normal, but for some reason it's getting harder and harder for me to do anything and walk. Tell me what is the reason.

Answers:

Rodionov Anton Vladimirovich 17:05 30/09/2014

Nelly, a good ECG at rest does not exclude heart disease, sometimes it is necessary to confirm ischemia additional research(load tests). However, shortness of breath can be associated with lung diseases, obesity, and a decrease in hemoglobin levels. We need to continue the examination.

Question: Romanchikov Andrey Elvaldovich 22:33 20/09/2014

Thank you cardiologists for being you

Answers:

Thank you, Andrey Evaldovich, we are also very glad that we exist. And good health to you.

Question: Ruslan, 44 years old 15:27 09/21/2014

Good afternoon! I first noticed extrasystoles at the age of 16 and at the same time I was diagnosed with hypertrophy interventricular septum. A recent ultrasound of the heart showed that everything is normal, except for hypertrophy. Tortured tachycardia. Doesn't let you do anything. I used to endure it easily, but now during these attacks I feel every blow in chest and concomitant arrhythmia, it becomes scary for the health of the heart. A diagnosis of VSD was made. The quality of life has plummeted. I'm afraid to provoke again. What happened? From what to be treated, it is not clear ... I do not smoke now and do not use strong. Am I afraid of a heart attack or stroke? Thanks for answers.

Answers:

Rodionov Anton Vladimirovich 17:04 30/09/2014

Ruslan, the diagnosis of VVD does not exist in nature, it is such a “cesspool”, where they put everything that they are reluctant to deal with. In your situation, you need to start the examination with daily ECG monitoring (Holter monitoring). In addition, it is necessary to know the magnitude of hypertrophy of the walls of the left ventricle. If this hypertrophic cardiomyopathy- this is one story, if the values ​​\u200b\u200bare on the verge of the norm (for example, within the framework of a "sports heart") - this is another. There is no need to be afraid of a heart attack and stroke, you need to contact a cardiologist and clarify all the questions.

Question: Natalia, 54 y 17:46 09/21/2014

Good afternoon! Since the age of 13, she has been ill with psoriasis, coronary artery disease, secondary cardiomyopathy, d. hypertension stage 2, risk 4 HCh. I take Vals 160/12.5 in the morning for 1 tab, in the evening Lerkamen 10 for 1/2. Not everything is suitable for psoriasis, it immediately aggravates, severe peeling and itching.

Answers:

Rodionov Anton Vladimirovich 17:04 30/09/2014

Natalia, come to the reception, we will think about how to help you. The choice of therapy in such difficult situation- This is not for online consultation.

Question: Valeria, 24 years old 17:53 09/22/2014

Hello, Anton Vladimirovich! I am 24 years old, a year ago I quit smoking due to the fact that I suddenly started to worry about causeless tachycardia. During the examination, the cardiologist said that he does not see any problems or irregularities on the cardiogram and everything is in order. Now I smoke periodically one cigarette, about once a week or two, when I really want to. Tell me if there is serious danger for the heart and blood vessels

Answers:

Rodionov Anton Vladimirovich 17:04 30/09/2014

Valeria, there is a danger and a serious one. Even one cigarette does its dirty work - it causes inflammation of the blood vessels; in the altered vessels, atherosclerotic plaques are much more likely to form. Alas, safe dose smoked cigarettes do not exist.

Question: Olesya, 25 18:00 22/09/2014

Anton Vladimirovich, please tell us how to prevent diseases of the heart and blood vessels in a person without visible problems with heart? What foods are best for heart health? Perhaps there are vitamins that strengthen the heart and blood vessels that can be purchased at the pharmacy?

Answers:

Olesya, the secret is extremely simple: 45 minutes a day of aerobic physical activity, unlimited vegetables and fruits, do not smoke or allow smoking near you, maintain normal weight body, after 35 years to control blood pressure and cholesterol levels. But pharmacy vitamins to strengthen the heart and blood vessels in nature does not exist. If they strengthen anything, it is only the well-being of their producers.

Question: Andrey AN, 52 y 17:46 09/23/2014

Hello! Tell me, I have been drinking Betaloc for 7 years, is it not addictive? And yet, in the morning the pressure is good (120/80, sometimes less), by 11-13 hours it rises to 145/95-100, after lunch (meal) it again decreases to an acceptable 130-135/90-95 and no longer rises. What can cause the noon peak? As always. There are no obvious reasons.

Answers:

Rodionov Anton Vladimirovich 17:03 30/09/2014

Andrey, cardiological drugs do not cause "addiction" in the conventional sense of the word, they can be taken for years and decades. You describe the normal (physiological) dynamics of blood pressure - in any person during the day, the pressure fluctuates between 40-50 mm Hg. Art. (You can read more about this and with illustrations in my book How to Live Without a Heart Attack and Stroke). It might make sense to do daily monitoring blood pressure to decide if therapy needs to be adjusted.

Question: Stanislav, 86 years old 22:52 24/09/2014

Eight years ago I had a bypass (four shunts), since then I have practically forgotten about the pain in my heart. A year ago, a pacemaker (AV blockade) was installed. Now everything seems to be normal: I walk a lot and quickly, I do everything around the house, I drive a car, I don’t follow a special diet, I drink, well, not every day, up to 50 grams of vodka or cognac, which was recommended to me by the cardio surgeon who operated on me. Your advice and my life perspectives. Thank you.

Answers:

Rodionov Anton Vladimirovich 17:03 30/09/2014

Stanislav, if you follow the recommendations of doctors, then life prospects are quite optimistic. Tips are simple: keep the pressure at the level<140/90 мм рт. ст, принимать статины и аспирин. Со спиртным не увлекайтесь, это не лучший метод кардиопрофилактики.

Question: Levadnaya Lydia Vasilievna 12:22 25/09/2014

Hello! By what sensations can you determine that cholesterol is rising (without passing the test)?

Answers:

Rodionov Anton Vladimirovich 17:03 30/09/2014

Hello. No way. You can “feel” an increase in cholesterol only when a heart attack or stroke occurs. Until that time, "cholesterol does not hurt." A cholesterol test is half an hour of work for a decent lab.

Question: Natalia, 72 years old 08:53 09/26/2014

Recently made Holter, more than 3000 extrasystoles are registered. To my surprise, the cardiologist did not even react to this fact. Do you think there is cause for concern or is it acceptable? To be honest, I'm worried. His condition is average, there is no angina pectoris, but obviously there are some problems.

Answers:

Natalia, it all depends on the background state of the heart and the type of extrasystoles. If these are supraventricular (supraventricular) extrasystoles, then they do not need to be treated. If these are ventricular extrasystoles, then the question of the need for treatment should be decided individually.

Question: Tatyana 61 years old 13:47 26/09/2014

Is it possible to do without surgical intervention and what does it threaten? They are referred for coronary artery bypass grafting, the diagnosis of coronary artery disease. Angina pectoris 3 FC. PICS from 2012 Ischemic cardiomyopathy. Occlusion at the mouth of the proximal segment of the AAD (calcification). Stenosis of more than 50% of the proximal segment of the OA. Up to 50% of the average PKA segment. Stenosis of more than 95" in the middle part of the PA (CCG dated 16.08.14). Aneurysm of the apex of the left ventricle. Concomitant diseases: Hypertensive disease stage 3, risk 4. Type 2 diabetes mellitus. CKD stage 2.

Answers:

Rodionov Anton Vladimirovich 17:02 30/09/2014

They do the right thing by directing. In your situation, there is a chance that coronary artery bypass surgery will increase life expectancy.

Question: Alexander 64 10:45 28/09/2014

Hello! He suffered a heart attack 8 years ago and then in the same year he underwent heart surgery and 4 shunts were installed. 2 months ago, it suddenly became difficult to bend in the lower back - namely, there is a dull pain in the upper abdomen in the diaphragm area, after straightening the pain goes away but not immediately, the pressure immediately rises to 180-190 / 90-110. This especially happens after taking food. At rest, the pressure is 140-150 / 70-90. The same sensations if you start walking after a meal and in this case I can walk 50-100 meters and then you need to rest .. If after eating 1.5-2 hours, then the pain is much weaker and after the start of walking after 15-20 minutes an unpleasant sensation passes and you can move on. Often at this time there is pain behind the sternum. I walk 2-4 kilometers every other day in hilly terrain, 1.5-2 hours after eating, I choose the distance according to my well-being. I am 64 years old. What is your opinion and what would you advise me. Thank you very much, regards, Alexander.

Question: Eduard (Vyborg) - 24 years old 09:27 30/09/2014

Anton Vladimirovich, hello. I run long distances and occasionally go to the gym. Please tell me, do intense aerobic (running in my case) loads and training with weights (lifting barbells, dumbbells) have a negative effect on the cardiovascular system? How can this impact be minimized? How to determine the line when physical activity becomes harmful? Please advise popular medical literature that should be read for general education, it is possible in English. Thanks

Answers:

Rodionov Anton Vladimirovich 16:54 30/09/2014

Eduard, excessive loads are always harmful for the heart (there is a “sports heart” syndrome that predisposes to the development of arrhythmias and heart failure). The so-called aerobic exercise is considered safe and useful, in which the heart rate is kept at submaximal values ​​(you can easily find a table by age on the Internet). In November, my second book entitled "Health of the Heart and Vasculars" will be published, where these issues are discussed in detail.

Question: Elena 41 years old 13:51 09/30/2014

Anton Vladimirovich, hello. I already asked my question, now I want to ask about the child. My father has coronary artery disease, high blood pressure. The second grandfather has high blood pressure. I have arrhythmia and extrasystole. up to 30 years, the pressure was elevated. After pregnancy mostly 100/70. My daughter has had perioral cyanosis since birth. On the cardiogram, a shortening of the PQ interval, sinus tachycardia. On ultrasound - a false notochord. My daughter, from the age of 6, began to feel dizzy, now we drive in cars with difficulty. The daughter is very tall for her age. 160 cm. Now, at the age of 10, headaches began, although the pressure is 110/70. To the neuropathologist addressed, REG and the encephalogram are in order. What should you pay attention to, taking into account the fact that there may be heredity for pressure and cardiovascular diseases? What to control except for a cardiogram every six months and an ultrasound of the heart once a year?

Answers:

Rodionov Anton Vladimirovich 16:52 30/09/2014

Good day, Elena. Most likely, you should leave a healthy child alone. An ECG and an ultrasound every six months or a year are money thrown away (yours or the CHI system). Everything that you describe can be considered as a variant of the norm. Overexamination, overtreatment, and overprotection are always harmful.

Anton Vladimirovich Rodionov

Heart and vascular health

I dedicate to the bright memory of my legendary teachers - Professors Vladimir Ivanovich Makolkin and Stanislav Alekseevich Abbakumov

Scientific editor - Svetlana Petrovna Popova, Candidate of Medical Sciences, Lecturer at the Department of Peoples' Friendship University of Russia (PFUR)

Introduction,

prompted by phone call

At the very moment when I was sitting at the computer and thinking about where to start this book, I got a call from an old acquaintance, a poetess, whom I consulted a year ago after suffering a transient ischemic attack (in Russian it is “pre-stroke” or “micro-stroke”) , with an unexpected question.

- Anton, - she asked, - tell me, in what dose should I take ... (then came the name of the popular drug for cholesterol)? I lost your appointment record.

“Lena,” it’s time for me to be surprised, “how did you take your medicine all this time?” After all, it's been almost a year.

- I must confess to you that my husband and I (and I also consulted him and prescribed treatment!) Didn’t take medicine all this time, we thought that it would come down like that, but we were afraid to admit it to you. And yesterday my husband was taken away with a massive heart attack ... ( whimper.) Honestly, we will now accept everything you say!

If my unfortunate patients had followed simple recommendations, there would have been one less heart attack that day.

However, maybe it's my fault? Failed to find the right words, did not explain well enough, did not warn what would happen if everything was left to chance? Didn’t call back in a month, didn’t ask if everything was in order, was the treatment well tolerated? Alas, every normal doctor is obliged to ask himself these questions when some kind of trouble happens to his patient.

Is 10-15 years of life really such a trifle for you? Do you want me to help you save them? Trust me, it's completely real.

To be honest, in the modern world, an outpatient doctor does not always have enough time to “talk” with the patient all the nuances of prevention and treatment, paperwork eats up. Patients are annoyed with doctors: they say, “they write, they write, they won’t even talk,” and doctors complain about the system ...

I really hope that this book will partly make up for the lack of time in live communication between the doctor and the patient, in it I will try to consider in detail important issues - what you need to pay attention to so that the heart and blood vessels remain young and healthy as long as possible. This, believe me, is not so difficult.

And two more lines as an introduction. There is such « commonplace » phrase: "How many doctors - so many opinions." There is nothing wrong (even good!) if a patient in a difficult situation visits two or three doctors and gets a reasoned “second opinion”, but if five doctors give five completely different recommendations, this is too much.

An experienced doctor is great, but if a doctor in his clinical practice focuses only on his own experience, this is unacceptable. During the time he cured 100 people, 100 thousand people have already been cured in the world and not only cured, but also processed this data, analyzed it, wrote articles and published recommendations. So, in order to effectively treat a patient in the 21st century, a good doctor should be guided not only by his own, but by the entire world experience set out in special literature.

What I will talk about in this book is not only my own experience and not the fruits of my imagination, but information based on the recommendations of the Russian and European Societies of Cardiology 2011-2013. on the prevention, treatment of lipid disorders and arterial hypertension.

Do you want to live long?

Yes, man is mortal, but that would be half the trouble. The bad thing is that he is sometimes suddenly mortal, that's the trick!

M.A. Bulgakov. The Master and Margarita

Probably, for a very long time, dreams of human immortality will remain dreams. But at the same time, not a single anniversary is complete without the wishes of “health and long life”.

A couple of hundred years ago, people mostly died from infectious diseases and injuries. Infant mortality was also huge. A person who lived to the age of 40 was already considered a long-liver. Pushkinists considered that the old nanny Tatyana Larina could have been only 42 years old.

The emergence of hygiene skills, vaccines, antibiotics has significantly changed this situation. In the 21st century, the population of developed countries is dying mainly from cardiovascular and oncological diseases, and doctors around the world are trying to ensure that people die as late as possible. That is, in the "rough" language of statistics, any medical intervention should ideally be aimed at reducing overall mortality or at least cardiovascular mortality.

Now in Russia, the word "medical examination" has become very popular in near-medical circles. A huge amount of money is invested in the purchase of unimaginable equipment, crowds of healthy people run around the clinics from office to office, going to the doctor with a single phrase: "I was told to pass you." Well, what can I say? "Come in!" Medical examination ends with the issuance of a "health passport" and a feeling of wasted time.

What do the world do when they want to increase life expectancy? Launch a large-scale national campaign to combat the most significant risk factors. Let's see how this is done with a few examples.

Americans in the 1980s began an uncompromising fight against cholesterol. All the media talked about cholesterol, all clinics and outpatient clinics did cholesterol tests, everywhere they promoted diets aimed at lowering cholesterol, doctors prescribed anti-cholesterol drugs. Bottom line: between 1980 and 2000, there was a significant reduction in mortality from coronary heart disease, and 25% of this success is associated with a reduction in cholesterol on a nationwide scale.

Another example. Everyone is well aware that butter and milk contain saturated animal fats that are unhealthy, but most believe that they consume them in such quantities that they can not harm health in any way. Just think, a couple of sandwiches with butter, milk porridge, a piece of cheese ... In 1970, Finland topped the list of countries with high mortality, with the highest mortality being in the North Karelia region, so this area was chosen as the site for the experiment. Prior to the start of the project, it was found that the population of North Karelia, as well as the whole of Finland, consumed a lot of saturated animal fats, which led to an increase in cholesterol levels and the development of atherosclerotic changes in the vessels. A lot of work has been done to promote healthy eating. Lectures, television and radio programs were devoted to this. This was told by teachers at school and educators in kindergarten. Five-minute health sessions were held at workplaces and in clubs. Moreover, the state stopped subsidizing the dairy industry and began to support the production of vegetables and vegetable oil. The result of the North Karelia project is an 80% reduction in mortality from cardiovascular diseases and an increase in life expectancy for the population as a whole.

The second risk factor that Finns are quite successfully fighting is alcohol. Everyone who has been to Finland knows that alcohol is sold only in special alcohol stores, which work for a limited time, and it is very expensive.

Europeans quite successfully solve the problem of smoking among the population. Active educational work, combined with rather serious restrictive measures, has led to the fact that you will hardly see people smoking on the streets of many European cities, especially Germany, Austria, Scandinavian countries, the Baltic states.

We have to state with great regret that almost no one is interested in talking about how to reduce the impact of risk factors in Russia. Last summer alone, journalists from various television companies called me ten times asking me to answer the age-old question that worries humanity: “How to survive a hot summer?” Each time I patiently explained to the TV people that this problem is far-fetched, it is not worth either my time or the time of the viewers. People die not from the weather, but from diseases. I say: let's better spend airtime discussing serious medical issues! No… we are not interested now.

They die not from the weather, not from a hard life, and not even from old age, but from specific diseases. It is very sad to die from those diseases that can be prevented.

Seven years ago, I was invited to host a new television program whose working title was Do You Want to Live Long? It was supposed to be an analogue of the New Zealand reality show dedicated to a healthy lifestyle. The idea was this: we took a young man or girl, analyzed his or her lifestyle, risk factors, took him to the clinic, conducted an examination, identified beginning health problems (curvature of the spine, decreased vision, overweight, etc.), and then they gave some interesting and non-standard recommendations for changing their lifestyle. Instead of exhausting "laps around the stadium", our heroes trained on the climbing wall, engaged in exotic dances ... When we finally made a pilot release of the program, the TV channel refused to air this program. “There will be no rating,” was the answer. By the way, five years after us, this program was still released on Channel 2 with a much larger budget than ours. It lasted exactly two episodes. It turned out that viewers did not really want to live long.

Anton Rodionov - cardiologist, Candidate of Medical Sciences, Associate Professor of the Department of Faculty Therapy No. 1 of the First Moscow State Medical University. I. M. Sechenov. Member of the Russian Society of Cardiology and the European Society of Cardiology (ESC).

Scientific editor - Svetlana Petrovna Popova, Candidate of Medical Sciences, Lecturer at the Department of Peoples' Friendship University of Russia (PFUR).

Two years ago, on a February evening, Alexander Leonidovich Myasnikov called me and something like this dialogue took place between us:

- Hello Anton! Here's the thing: I have a presentation of a new book at the Young Guard bookstore tomorrow...

- Oh, congratulations! (I thought he wanted to invite).

- No, listen to me. The fact is that the event is scheduled, advertising is given everywhere, and I need to be at a meeting at the Ministry of Health at this time. Can you do the presentation for me?

– Eee… I can do a lot of things in life, but the presentation of your book, which I have never seen, without you, tomorrow… How do you imagine it?

As a result, the presentation took place (the video report can still be found on the Internet if you make a request "Anton Rodionov in the Young Guard"). The next day, Olga Shestova, editor of the medical literature department of the EKSMO publishing house, called me, and the dialogue between us was no less amusing:

- Anton, do you want to write something for patients yourself?

- No I do not want to. I don't like to write. I can tell “in any direction of your soul,” but I can’t stand writing.

- But you can first slander into the recorder, and then decipher.

“Hmm, well, let's try, besides, a long time ago we made a pamphlet on hypertension for patients, which at one time was in great demand. Maybe I can recycle it.

- That is great. Just in order to “launch a new author”, there must be at least five books.

In the end, I agreed, believing, as in the classic parable, that in the process of work either the donkey will die or the shah will die.

And now the project "Academy of Dr. Rodionov" has existed for two years. During this time, five promised books have been written and published, which are devoted not only to cardiovascular medicine, but also to topical problems of internal diseases in general. The total circulation of books is approaching 150 thousand, which means that about half a million people have become students of the Academy, since according to statistics, three people read one book.

During this time, I received a huge number of letters (it was not in vain that I left an e-mail address) with reviews, wishes, comments, requests for advice. I tried to answer everyone. There were also very thoughtful readers who literally looked at the books "under a magnifying glass", discovering flaws that escaped the attention of the editors.

The current edition is an attempt not only to formally combine the five books of the "Academy of Dr. Rodionov" under one cover, but to creatively rework the material, make it more structured, and eliminate some repetitions. I was very attentive to all the comments of my colleagues and readers: I corrected some inaccuracies, removed references to drugs that are no longer used in practice, and, on the contrary, added those that have appeared in recent years. Some chapters had to be almost completely redone. For example, instead of three separate chapters on cholesterol in different books, one large chapter appeared in the first section. I also combined the chapters on diabetes and obesity. In the last section "Assorted" there were new chapters that were written later.

So, dear readers, good luck towards health!

Dear readers! I draw your attention to the fact that the book mentions many drugs, many of which are prescription. Please consult your doctor. This book is not a self-healing guide.

Your doctor Rodionov

Good afternoon, Anton Vladimirovich! Thank you for your book "Deciphering tests: how to make a diagnosis on your own." The book is very informative, intelligibly presented, timely and relevant! Unfortunately, the realities of our provincial medicine are such that when visiting a doctor in a “free” clinic, you come across complete indifference, and in a “paid” medical center you encounter endless (how right you are!) examinations. The result in both cases is a preliminary (!) Diagnosis and prescription of many medications, sometimes mutually exclusive, and, as a rule, prescribed without taking into account existing chronic diseases. The problem remains unresolved, you go to another doctor - and again an examination (since the clinic is different and trust only to its specialists and laboratory assistants), and again a preliminary diagnosis ... A vicious circle, but as a result, the health problem remains, the funds are spent, and in disappointment and despair...

After reading your book, I found answers to many questions that interested me, some of my problems disappeared by themselves, others were not as dramatic as our doctors explained to me, the methods of examination and my actions regarding my chronic diseases became absolutely clear to me. Thank you very much for this! And no matter how strange it sounds, but on the eve of the New Year, I can’t imagine a better gift than your previous books.

Natalia N., Penza

Why do you think cardiologists treat their patients? Strange question, isn't it? So that the heart does not hurt and there are no interruptions in its work, so that the head does not spin, so that the pressure is stable.

And here it is not. More precisely, not really. Of course, alleviating the symptoms of the disease is a very noble cause that patients expect from us, but in fact we are doing something completely different. In medicine of the 21st century, it is no longer enough to simply make the patient feel better, improve the “quality of life” (there is such a strange term that has firmly taken root in our dictionary). Every time I prescribe some kind of treatment, I must answer myself and my patient a simple question: how will my treatment affect a person's life expectancy? Will I be able to prevent heart attack, stroke, heart failure and kidney failure?

It is especially important for me, a cardiologist, to explain this to you, my dear reader, because in cardiovascular medicine, many conditions do not affect well-being at all. High cholesterol “does not hurt”, high blood pressure is often not accompanied by symptoms, many arrhythmias do not disrupt the usual course of life at all. Yes, don't be surprised!

So, the cardiologist treats the patient not so much in order to improve well-being, but in order to increase life expectancy.

Once I received a call from an old acquaintance, a poetess, whom I consulted a year ago after suffering a transient ischemic attack (in Russian it is “pre-stroke”, or “micro-stroke”), with an unexpected question.

– Anton, – she asked – and tell me, in what dose to take ... (then came the name of a popular drug for lowering cholesterol)? I lost your appointment record.

– Lena, – it's time for me to wonder – How have you been taking your medication all this time? After all, it's been almost a year.

– I must confess to you that my husband and I (and I also consulted him and prescribed treatment!) didn’t take medicine all this time, we thought that it would come down like that, but we were afraid to admit it to you. And yesterday my husband was taken away with a massive heart attack ... (Sobbing.) Honestly, now we will accept everything you say!

If my unfortunate patients had followed simple recommendations, there would have been one less heart attack that day.

We understand the causes of loss of strength, fatigue and drowsiness, which have become a real scourge of the inhabitants of the metropolis, together with Anton Rodionov, cardiologist-therapist, candidate of medical sciences, associate professor of the Department of Faculty Therapy, PMSMU IM. Sechenov.

Almost every day in social networks you can find complaints about bad weather and poor health - fatigue, drowsiness, loss of strength. People sigh, they say, they don’t have the strength to work, they want to lie on the floor, cover themselves with a sheet and spend the rest of the day like this. What is this attack? Meteorological dependence?

I will quote one of my teachers who, during my student days, told us: “Never blame the poor health of your patients on age and weather.” Weather sensitivity is a myth that was invented in the 90s of the last century and is still very actively cultivated by journalists. In fact, people feel bad not because of the weather, but because of some diseases, sometimes obvious, sometimes not so much.

When they try to convince me once again of the existence of meteosensitivity, I always suggest: tell me that specific physical factor that can affect your well-being. Atmospheric pressure is not explicitly one of them, because when it changes from "clear" to "stormy", this difference can be a maximum of 40-50 mmHg. For Moscow, for example, 748 mm Hg is considered normal average atmospheric pressure. 760 mm is already very clear, great weather, 710–720 mm is disgusting weather, a cyclone. As we can see, the difference is quite small.

When we fly in an airplane (and almost everyone flies in airplanes) at an altitude of 9,500-11,000 m (this is the usual height of flights for civil aviation), the pressure drop in the cabin of the aircraft can reach 150 mmHg, which corresponds to climbing uphill on 2000–2500 m. And, as a rule, nothing bad happens to anyone. Even such a drop in atmospheric pressure is quite well tolerated by people. This is just one example.

Then what is the reason for the deterioration of health in inclement weather?

First, when we evaluate the weather, the first thing we look at is whether the sun is in the sky or not. The sun is there - the mood is good. There is no sun, it is cloudy, it is raining - the mood is bad. I don't know if you can call it weather sensitivity. Rather, it is our emotional attitude to the weather.

Not without reason in northern countries, in particular in Norway, where a certain part of the year is a polar night, that is, a long period when there is almost no sun, the number of depressions and even suicides increases in winter. It is not for nothing that they try to highlight cities artificially, to decorate houses with panels of bright, cheerful colors. Can we call it weather sensitivity? Not sure.

Often people simultaneously begin to say: “Yes, yes, my head has been spinning for two days! Just the weather!” That's a coincidence?

I think most of the time it's a way to keep the conversation going. My colleagues once conducted a study: at an ambulance substation, they tried to analyze how the frequency of calls for hypertensive crises changes depending on the fall or rise in atmospheric pressure. It turned out that nothing has changed. The dependence of blood pressure on atmospheric pressure is a fairly common misconception.

Could low energy and drowsiness be related to hypotension?

First of all, it must be said that the term "hypotension" is used in everyday life much more often than in medicine. There is no lower limit of normal pressure for a healthy person. Low blood pressure can be a real problem in patients with heart failure, certain medications, etc. In these cases, the blood supply to the brain is disturbed, dizziness and even fainting occur. But, I repeat, for a healthy person there is no lower limit of blood pressure.

So 90/60 is the norm?

It can be the norm and 90/60, and 80/50. There are many people, especially young women, who live with this kind of pressure almost all the time. Generally speaking, an attempt to link well-being with the readings of a tonometer is one of the biggest medical misconceptions, this applies to both high and “low” blood pressure.

Another thing is that there are some diseases that can predispose to the development of low blood pressure. For example, this is a decrease in thyroid function (hypothyroidism). One of the studies that must be done to a person who complains of poor health and has low blood pressure is to determine the level of thyroid-stimulating hormone (TSH). This indicator reflects the function of the thyroid gland. If TSH is elevated, then thyroid function is reduced (negative feedback principle). Hypothyroidism is a fairly common disease, especially in many Russian regions with iodine deficiency, so the determination of TSH is included in the mandatory minimum examination.

The second quite common condition is iron deficiency, the severity of which can vary from asymptomatic tissue iron deficiency to severe iron deficiency anemia. Therefore, the second analysis to be done is a complete blood count (aka clinical blood test). It is needed to look at hemoglobin. For a woman, normal hemoglobin should be at least 120 g / l.

In addition to hemoglobin, do you also need to check the level of iron?

Quite right. Hemoglobin is just the tip of the iceberg. When a person develops anemia, it means that there is already very little iron in the body. However, a situation often occurs when hemoglobin is normal, and there is not enough iron in the tissues. In order to determine the presence of iron in the body, you need to look at a few more indicators. Firstly, it is serum iron, and secondly, it is a protein called ferritin, which reflects tissue stores of iron.

It is tissue iron deficiency that often causes general weakness, dry skin, hair loss, brittle nails, frequent colds, and sore throat. Thus, the minimum amount of examinations for patients with complaints of weakness, hypotension and meteorological dependence is a complete blood count, as well as blood tests for iron, ferritin and TSH.

What to do if iron deficiency is detected?

If iron deficiency is proven, iron preparations are prescribed, because, alas, the human body cannot synthesize iron on its own. When iron deficiency is clinically pronounced, then, unfortunately, it cannot be replenished with food alone: ​​we cannot eat enough iron to increase its reserves.

Contrary to popular belief, there is practically no iron in pomegranates, beets and red wine, and there is also very little iron in apples. To replenish the reserves of this element in the body, mankind has invented tablet preparations that are quite well tolerated and with the help of which iron is normally absorbed.

Pregnant women often discuss that this or that iron preparation is not suitable for them. Is there any difficulty in choosing a drug?

Yes, there is a certain difficulty. There are a lot of drugs, not always a particular drug is well tolerated. It happens that iron preparations cause "dyspepsia" (abdominal pain, nausea). But, as a rule, this problem is solvable, because now the pharmaceutical industry offers a dozen and a half different iron preparations. You can always individually choose the drug that will be well tolerated. In extreme cases, with severe iron deficiency, iron preparations can be administered intravenously.

During pregnancy, the need for iron increases, so most pregnant women should receive it additionally. Let's recall the three components of drug support during pregnancy: 1) folic acid in the first trimester of pregnancy; 2) iodine preparations (not dietary supplements!) for the prevention of mental retardation in children, since most regions of Russia are in the zone of iodine deficiency; 3) iron supplements, which most women need. Taking iodine and iron supplements should be continued during breastfeeding. Of course, the treatment should be fully prescribed by a doctor under the control of laboratory parameters, since there are people for whom iodine and iron are contraindicated.

And what is known to modern medicine about the so-called chronic fatigue syndrome?

This is probably the strangest disease on the planet, because, on the one hand, in textbooks and all manuals, it is distinguished as a separate disease, on the other hand, all doctors admit that this disease is quite mysterious, and its nature is not fully understood.

I specifically looked at the latest American publications on this problem (by the way, they gave it an exotic name - "systemic exercise intolerance disease", systemic exertion intolerance disease). Symptoms include general weakness, cognitive decline, poor tolerance for physical and mental stress with muscle and joint pain. But the nature of this disease is completely incomprehensible. It is believed that widespread viruses, such as Epstein-Barr virus, cytomegalovirus, human T-lymphotropic virus, and others, can play a role.

So far, it is quite obvious that drug treatment of chronic fatigue syndrome is ineffective. Neither antiviral drugs nor immunomodulators will work in this case. At the end of the 20th century, there were even attempts to treat these patients with hormones. The condition improved, but, unfortunately, the hormones quite often gave side effects. So far, everyone agrees that treatment is mainly psychotherapy, dosed physical activity, yoga, and similar non-drug techniques.

How exactly does psychotherapy help?

For example, it relieves symptoms of anxiety and depression. The problem of "chronic fatigue" is closely related to neurotic disorders, and its symptoms may actually be symptoms of depression. Sometimes a decrease in efficiency, a loss of lust for life is nothing more than a symptom of depression, a common disease of the nervous system. We often refer patients with such complaints to psychotherapists or even psychiatrists. Some patients need talking psychotherapy, some need antidepressants, and there is nothing to worry about.

In your practice, do you notice people's need for psychotherapeutic help?

Often. In the therapeutic practice of people who actively need serious help from psychiatrists and psychotherapists, according to the most conservative estimate, about 15%. By the way, there is nothing wrong with this, because the head is the same organ as the heart, stomach and liver. Unfortunately, as a legacy from the Soviet regime and from the system of punitive psychiatry, we inherited some kind of panicky horror in front of psychiatrists.

And the last question. If I, a relatively healthy person, have tests like an astronaut, but from time to time I feel that in the morning my head is “cast iron”. Is there any recipe for cheerfulness? Or will save only a healthy lifestyle?

The recipe for cheerfulness is to drink morning coffee and stomp to work. And do not occupy your head with any nonsense like "meteorological sensitivity". When a person has a lot of work, when he is in demand, then there is absolutely no time to deal with the chronic fatigue of a loved one. Packed up and went to work. And after work, do not forget about physical activity (fitness, walking, swimming pool), because often weakness and fatigue are associated with a lack of physical activity.

Difficult? And no one said that being healthy is very easy ...

Thanks a lot!

Interviewed by Anastasia Khramuticheva

Photo by Anna Danilova

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Doctor of the highest qualification Anton Rodionov states: “In medicine of the 21st century, it is no longer enough just to make the patient feel better, to improve the “quality of life” (there is such a strange term that has firmly taken root in our dictionary). Every time I prescribe some kind of treatment, I must answer myself and my patient a simple question: how will my treatment affect a person's life expectancy? Will I be able to prevent heart attack, stroke, heart failure and kidney failure?

“The Complete Course of Medical Literacy” is the material of 5 vital books of the “Academy of Dr. Rodionov” series, structured and creatively revised by the author himself for your convenience. You will remember:

- what factors affect the cardiovascular system and when an increase in pressure is dangerous and when not;

– how to assess your risk at any age and what can really be done right now to reduce it;

- how to strengthen blood vessels and what pseudo-methods will only clear your wallet;

- why an ECG should not be done for a healthy person, how to understand the doctor's conclusion and how to help with a heart attack;

- whether cancer tests are needed, how to check the condition of internal organs and when deviations themselves are the norm;

- what medicines should be in the home first aid kit so as not to harm - and prolong the life of yourself and your loved ones.

"Complete Course of Medical Literacy" - your personal family doctor, who can be contacted for advice and assistance at any...

• May 26, 2016, 22:00

Genre: ,

"Academy of Dr. Rodionov" - a series of 5 books written specifically for ordinary people without medical education, each contains valuable information directly from a doctor of the highest qualification category. Thanks to the book "How to live without a heart attack and stroke" you learned how to properly treat hypertension. "Health of the heart and blood vessels" relieved the fear of cholesterol plaques and postponed a face-to-face meeting with a cardiologist.

In the new book, Dr. Rodionov explained in accessible words what an ECG is and what diseases are recognized with its help. You will learn everything about heart failure, arrhythmias, angina pectoris, myocardial infarction, ischemia, cardiomyopathy. Just find the diagnosis in the alphabetical index and open the specified page. Now you can independently understand the conclusions of the ECG and the phrases found in them such as sinus arrhythmia or incomplete right bundle branch block.

Many readers will learn with a sigh of relief that their ECG changes are normal and do not require treatment. Well, those who take pills “from the heart” will do an important homework: they will sort out the first-aid kit and understand the meaning of using each drug.

Read, analyze and be...

• April 29, 2016, 13:00

• December 12, 2015, 14:00

Genre: ,

Any person sooner or later comes to the pharmacy for a remedy for colds, pressure, cough, heartburn ... How to choose the right drug? How to make sure that self-medication does not harm health, and protect yourself from unnecessary expenses? These questions will be answered by the fifth book of the "Academy of Dr. Rodionov" - "Medicines: how to choose the right and safe drug", you can start right with it.

Dr. Rodionov will honestly talk about the effectiveness and side effects of drugs used to treat all the most common diseases. You will learn unexpected facts: how sore legs were cured with a drug for depression, when you still need to take antibiotics, and what really should be in your home first-aid kit and when traveling to the country, so as not to violate the most important principle "Do not ...

• December 24, 2014, 04:19 PM

Genre: ,

"Health of the heart and blood vessels" - the 2nd book of the course for the elimination of medical illiteracy "Academy of Dr. Rodionov". She answers the question that is most often asked to Dr. Rodionov at receptions, in letters, on television and radio broadcasts: “So how can I strengthen my blood vessels?” World cardiology knows the answer, so abroad those who follow medical recommendations live up to 80–90 years. The reader of this book also has the opportunity not to waste time and money on unverified means.

Anton Vladimirovich Rodionov is an authoritative doctor, cardiologist, candidate of medical sciences, member of the Russian Society of Cardiology and the European Society of Cardiology, author of more than 50 publications in the Russian and foreign press, a regular participant in many television and radio programs. He tells in simple words what doctors know to add many years to your life in a healthy body.

Anyone who carefully reads the book "Health of the Heart and Vessels" will successfully complete the 2nd year of the Academy of Health and will be able to expect that he will not soon meet with a cardiologist at a face-to-face appointment.

Live long without...

• November 18, 2014, 03:06 PM

Genre: ,

In this book, Dr. Rodionov, Candidate of Medical Sciences, clearly explains what are the causes and symptoms of a heart attack and stroke, how they can be avoided, and how, if necessary, to find a good doctor.

This book, the first in the Doctor Rodionov Academy series, provides an opportunity to rise to the first level of medical literacy. It is available to all people without any special ...