DEJAVNIKI TVEGANJA ZA SRČNOŽILNE BOLEZNI PRI BOLNIKIH Z OKVARO HRBTENJAČE PO KONČANI PRIMARNI REHABILITACIJI. (Slovenian)

Background: Persons after spinal cord injury are under increased risk for cardiovascular diseases (CVD), which is related to early atherosclerosis in these patients. The aim of our study was to analyse the classical risk factors for CVD in a group of persons with spinal cord injury after discharge from primary rehabilitation, and to compare our findings to the CINDI nation-wide population health programme carried out in the period 2002-2006. Methods: The study included 48 patients after spinal cord injury upon discharge from primary rehabilitation at the University Rehabilitation Institute in Ljubljana. Among the clinical CVD risk factors, we measured blood pressure and the body mass index; among the laboratory factors, we determined the four-fraction lipid profile and fasting blood sugar. Smoking status was also recorded. The results were compared with the findings of the CINDI programme. Results: The proportions of patients with elevated blood pressure, total cholesterol and blood sugar and a body mass index above 25 were lower than in the general population. The proportions of patients at risk for atherosclerosis-based CVD in the forthcoming 10 years was also lower than in the general population, but the proportion of smokers was higher. Conclusion: Because of specific physiological and morphological changes, the Framingham Risk Score and the SCORE Risk underestimate the risk for cardiovascular events in persons with spinal cord injury after discharge from primary rehabilitation. Specific risk chartsshould be designed for this population, and CVD prevention programmes should be carried out more often for persons with spinal cord injury than for the general population. [ABSTRACT FROM AUTHOR]

Izhodišča: Osebe z okvaro hrbtenjače imajo povečano tveganje za srčno-žilne bolezni, saj je pri njih zaradi sprememb v nekaterih fizioloških mehanizmih prisotna zgodnja ateroskleroza. Namen raziskave je bil analizirati klasične dejavnike tveganja za srčno-žilne bolezni pri skupini oseb z okvaro hrbtenjače po odpustu s primarne rehabilitacije in ugotovitve primerjati z rezultati programa CINDI (nacionalni program primarne preventive srčnožilnih bolezni), izvedenega v letih od 2002 do 2006. Metode: V raziskavo smo vključili 48 bolnikov z okvaro hrbtenjače ob odpustu s primarne rehabilitacije z URI - Soča. Od kliničnih dejavnikov tveganja smo izmerili krvni tlak in izračunali indeks telesne teže, od laboratorijskih dejavnikov tveganja pa smo določili štirifrakcijski lipidogram in krvni sladkor na tešče. Določili smo še kadilski status in ogroženost za nastanek srčno-žilne bolezni, povezane z aterosklerozo, v prihodnjih desetih letih (točkovnik Framingham). Delež bolnikov z določenim dejavnikom tveganja smo primerjali z rezultati CINDI. Rezultati: Deleži bolnikov s povišanimi vrednostmi krvnega tlaka, celotnega holesterola in krvnega sladkorja ter indeksom telesne teže nad 25 so bili nižji kot v splošni populaciji. Prav tako je bil nižji delež bolnikov z ogroženostjo za koncenrazvoj srčno-žilne bolezni, povezane z aterosklerozo, v prihodnjih desetih letih. Delež kadilcev je bil višji kot v splošni populaciji. Zaključek: Zaradi specifičnih fizioloških in morfoloških sprememb je ocena srčno-žilne ogroženosti po točkovnikih Framingham in SCORE pri osebah z okvaro hrbtenjače podcenjena. Izdelati bi bilo treba nove tabele srčno-žilne ogroženosti, prilagojene osebam z okvaro hrbtenjače. Program preventive srčno-žilnih bolezni bi bilo treba izvajati pogosteje kot v splošni populaciji. [ABSTRACT FROM AUTHOR]

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