Jembrek-Gostović Mirjana, Jonke Vladimir, Gostović Mladen, Heim Inge
Polyclinic for Cardiovascular Prevention and Rehabilitation, Zagreb, Croatia.
Acta Med Croatica. 2009 Feb;63(1):89-92.
Coronary heart disease is a chronic disease with multifactorial etiology. The risk depends on several, already well-known, risk factors such as hypertension, diabetes mellitus, dyslipidemia, smoking, obesity, physical inactivity, stress, etc. Multiple risk factors will increase the risk. The variety of risk factors requires a multidisciplinary approach--a team of different experts guided by a cardiologist who ensures an appropriate rehabilitation program. This should include secondary prevention as an important part of coronary heart disease patient treatment. It is based on the generally accepted medical, professional and scientific principles and long standing international experience. Papers written by experts and published on behalf of the World Health Organization, European Society of Cardiology, European Society of Hypertension, European Association for Cardiovascular Prevention and Rehabilitation, and other societies, define the basic characteristics of cardiac rehabilitation programes: aims, forms, content, indications and ways of implementing it in order to make it comprehensive, and to help regain the patients' temporarily lost ability to return to normal life and work. The cardiac patient will be fully educated to manage his exercise program and secondary prevention for life. Taking into account the situation that we have in our country, in relation to social structure, demography, legislation and types of health insurance, we would recommend that post-acute coronary syndrome patients undergo a cardiac rehabilitation program, which includes secondary prevention. After the education and rehabilitation program, aimed at individual needs, patients will continue under the guidance of his/her GP, consulting the specialist only when needed. In this way, the positive effects of cardiac rehabilitation will be long lasting.
冠心病是一种病因多因素的慢性疾病。其风险取决于多种已为人熟知的危险因素，如高血压、糖尿病、血脂异常、吸烟、肥胖、缺乏体育活动、压力等。多种危险因素会增加患病风险。危险因素的多样性需要多学科方法——由心脏病专家指导的不同专家团队，确保制定适当的康复计划。这应包括二级预防，作为冠心病患者治疗的重要组成部分。它基于普遍接受的医学、专业和科学原则以及长期的国际经验。由专家撰写并代表世界卫生组织、欧洲心脏病学会、欧洲高血压学会、欧洲心血管预防与康复协会及其他学会发表的论文，界定了心脏康复计划的基本特征：目标、形式、内容、适应症以及实施方式，以使其全面，并帮助患者恢复暂时丧失的回归正常生活和工作的能力。心脏病患者将接受全面教育，以管理其终身的运动计划和二级预防。考虑到我国在社会结构、人口统计学、立法和医疗保险类型方面的情况，我们建议急性冠状动脉综合征后患者接受包括二级预防的心脏康复计划。针对个体需求的教育和康复计划结束后，患者将在其全科医生的指导下继续治疗，仅在需要时咨询专科医生。通过这种方式，心脏康复的积极效果将持久。
