Cardiovascular disease and COVID-19. Where to look for reserves to reduce mortality from diseases of the circulatory system?

Participants of the round table "Cardiovascular Disease: New Perspectives in the Light of a Pandemic" discussed the impact of COVID-19 on the situation with cardiovascular mortality in Russia, the possibility of achieving the indicators outlined in the national health project, and the reserves for reducing mortality from circulatory diseases. The event was organized by the Roscongress Foundation's expert and analytical platform on healthcare and the Content Foundation. The event's information partner is the TASS news Agency.

The event was attended by: Dmitry Morozov, Chairman of the state Duma Committee on health protection, Sergey Boytsov, Director, National Research Centre for Preventive Medicine of the Ministry of Health of the Russian Federation, Evgeny Shlyakhto, Director Director of the Almazov Medical a Research Center, Vitaly Omelyanovsky, Professor, Director for Research and Medical Affairs of the State Research Center for Preventive Medicine under the Ministry of Health of the Russian Federation Oksana Drapkina, Director General of AstraZeneca, Russia and Eurasia, Irina Panarina, founder of the "School of heart sufficiency", a cardiologist from Pskov Zhanna Shlosberg.

"The beginning of the year was encouraging, the mortality rate from diseases of the circulatory system from January to March decreased by 7.5% and from myocardial infarction – by 9.2% relatively to the same period in 2019, – said Sergey Boytsov. – There were some good results in April as well, before the epidemic intervened. And, according to the registry offices, in May and June, there is a tendency for an increase of cardiovascular mortality."

One of the reasons for this forecast is insufficient monitoring of patients with chronic cardiovascular diseases, primarily with chronic heart failure (CHF). Thus, according to Yevgeny Shlyakhto, due to quarantine restrictions, the number of patients with coronary syndrome without ST segment elevation has decreased by about 40%.

"And this is a pathway to increase CHF," the expert noted.

Speaking about the reserves for reducing cardiovascular mortality, experts agreed that the organizational efforts of regional programs to combat cardiovascular diseases should be focused on chronic forms of these diseases, in particular, on the treatment of heart failure. In fact acute conditions make up a smaller share in the structure of mortality from circulatory system diseases, (according to data provided by Eugene Shlyakhto, myocardial infarction accounts for about 5-7% of circulatory system diseases mortality). Among the measures outlined by experts are equipping clinics in the regions, introducing new types of high-tech medical care, and widespreading usage of already used technology-intensive medical care

Evgeny Shlyakhto spoke about a project to provide integrative care for patients with chronic heart failure, which is being implemented in several Russian cities, including St. Petersburg. The essence of the project is to create a transparent system for managing patients with CHF, integrate outpatient and inpatient stages, make the system unified and transparent, so that it is possible to trace the patient at any stage and plan measures for its management. As part of the experiment, a system is already being developed to support medical decision-making at different stages of patient management. The CHF problem should be addressed comprehensively within the framework of future Risk Management Centers on the basis of large medical institutions, where not only patients with CHF, but also patients with resistant arterial hypertension and rhythm disturbances will be concentrated.

Sergei Boytsov added that work is now underway to improve the procedure for providing medical care to patients with сardiovascular disease.

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