The incidence of grave and dangerous cardiovascular diseases is growing year after year. However, cutting-edge healthcare technologies have been instrumental in successfully dealing with them and extending lifespan for patients. The Seventh Congress of the Uzbekistan Association of Cardiologists will focus on the introduction of these technologies in Uzbekistan.
As a result of ongoing socially oriented measures, the average life expectancy for men and women in Uzbekistan has increased from 67 to 73 and 75 years respectively. The growth in the number of elderly people comes with the need to boost fighting cardiovascular disease and mortality rates. As the practical experience of top cardiology centers, including the National Specialized Center for Cardiology, shows, the monitoring of blood pressure helps to reduce the incidence of myocardial infarction by 40 to 50% and that of strokes by 60%.
Thanks to the creation in Uzbekistan of a unified network of cardiology services and a system of emergency medical aid, and introduction of modern standards of diagnostics and treatment, in-hospital acute myocardial infarction mortality has dropped by 9-10% over the past five years.
The pivot for the development of cardiovascular disease prevention and treatment is the cardiological service. It is represented by the National Specialized Center for Cardiology with branches in Kashkadarya and Khorezm Regions, nine regional cardiology clinics, the Namangan Regional Center for Cardiology, 321 cardiology units in multidisciplinary healthcare institutions, and specialized cardiology first aid brigades. An important role in the improvement of the quality of cardiology aid belongs to the Vakhidov National Center for Surgery, Emergency Medical Aid, Therapy and Medical Rehabilitation. Just as important in this process is the role played by general practitioners from rural medical posts and city family clinics.
“In Uzbekistan, cardiology is one of the popular professions; there are over 700 of us,” says Ravshanbek Kurbanov, Director of the Center for Cardiology and Chairman of Uzbekistan Association of Cardiologists. “But we understand full well that problems of reducing the incidence of cardiovascular diseases and mortality cannot be solved without general practitioners. The key potential in improving the health of the population lies in primary healthcare and teaching general practitioners skills in detection and fighting of cardiovascular disease risk factors. Thanks to collaborative efforts in clinics and rural medical posts, the percentage of detection of patients with high blood pressure has increased by an average of 3-5% and the coverage of people with modern treatment methods has increased. And we intend to achieve further progress in our work.”
In 2013, in an effort to enhance the interactions of the specialized center with regional doctors, the Ministry of Health of Uzbekistan issued orders “On the Improvement of Detection and Provision of Aid for Patients with Acute Coronary Syndromes” and in late 2014 “On the Improvement of Detection and Provision of Aid for Patients with Arterial Hypertension”. These documents regulate standards of providing aid for people with the coronary syndrome on the ground as well as measures to improve detection and treatment of patients with arterial hypertension. Under the guidance of the Ministry of Health, work is under way to fight arterial hypertension.
The Center for Cardiology has set up permanent cardiology schools as well as blood pressure and arrhythmia schools. Participants of the courses are cardiologists of clinics and hospitals of all Tashkent districts. The training schedule includes seminars and master classes throughout the republic.
With an eye to further introducing advanced diagnostics standards in practice, which would help detect hidden types of diseases, Project Health 3 will see all district-based medical association equipped with echocardiographs, Holter monitors and cycle ergometers.
“If you want to prolong a patient’s life, it is not enough just to detect diseases; it should be treated using the most effective technologies,” says Ravshanbek Kurbanov. “Modern treatment is not just about drug-induced therapy, but also high technologies that are receiving primary attention in Uzbekistan nowadays.
There has been a big boom as of late in the development of technologies based on therapeutic and surgical methods that are united under the concept of “intervention cardiology”. These treatment maneuvers are carried out with the help of special tools that are used to deal with affected areas through vessel lumens.
Virtually everyone in the country knows of a procedure called coronary angiogram that helps to see the inside of vessels as well as methods aimed at restoring blood flow in areas affected by narrowing – angioplasty and stenting. Demand for this sort of aid is growing. Therefore, Uzbekistan is according a lot of attention to the use of new equipment. The purchase of two units has considerably boosted the capacities of the Center for Surgery. Thanks to the growth of doctors’ professionalism and training of specialists, the amount of assistance provided by emergency aid centers and cardiology has significantly expanded. In 2014, the Center for Cardiology alone conducted 1,400 coronary angiograms and 940 tests of coronary arteries, including over 40 interventions on the left trunk of the coronary artery. At the beginning of the year a National Specialized Scientific and Practical Medical Center for Therapy and Rehabilitation was set up. The new facility joined the ranks of centers that provide this sort of medical aid. Last year, similar procedures were conducted in regions for the first time. The first procedure was carried out by the Namangan Regional Center for Cardiology. The Khorezm regional branch is in the middle of introducing it. Branches in Bukhara and Ferghana are next in line. Since 2008, Uzbekistan has been successfully developing another cardiological technique – treatment of arrhythmia by influencing disease locus with high-frequency current impulse. As a result, patients become less dependent on arrhythmia medication. The first experience in introducing these techniques belongs to the Center for Cardiology. Starting from last year, the Center for Surgery started this sort of interventions as well.
In what has become a good tradition in Uzbekistan, cardiology forums present innovations. This time it will center on heart surgery. The Cardiology Center has become Uzbekistan’s seventh clinic that conducts heart surgeries.
In the two weeks of the new department’s work, ten patients have been operated on. Nine surgeries were coronary artery bypass grafting. Four of the nine were conducted on a working heart, and the rest were carried out with a heart-lung machine on. Also, a 30-year-old patient with an interatrial septum was operated on. Usually, this sort of surgeries is conducted in childhood as doctors prefer not to operate on adults due to the high risk of complications. All the patients are safe and have been sent home.