The World Bank had predicted that by 2030, the number of stroke patients in China will reach more than 30 million, and the number of patients with coronary heart disease will exceed 22 million. The recently published "Chinese Cardiology Report 2017" shows that almost one in five Chinese people suffer There are cardiovascular diseases. The report pointed out that despite the initial success of cardiovascular disease prevention and control in China, it still faces severe challenges. How to improve disease prevention and control through health management? The reporter of the "Life Times" interviewed the former chairman of the American Heart Association, North Carolina. University Medical Professor Sidney C Smith.
Life Times: In terms of cardiovascular disease prevention, what do you think are the major changes in the United States in the past decade? What are the experiences?
Smith: In these years, the main work we did was focused on two aspects. One was to improve the quality of hospital treatment, and the other was public education and social advocacy. The former focused on therapy and the latter focused on prevention. The American Heart Association passed evidence-based medical research. , Formulate a series of 'guides' to regulate in-hospital treatment.
In terms of prevention, we conduct public education and hope that the public will know how to discern signs and symptoms of heart disease, stroke, etc. Know how the heart attack occurs, how to reduce risk through reasonable nutrition, when to seek help, etc. Except for adults, at school Students are the most important aspect of science education. At the same time, the government has launched a series of advocacy campaigns to prevent cardiovascular diseases, further standardize food labels, and require explicit labeling of how much salt and fat are contained in foods; and advocate the establishment of smoke-free restaurants. Smoke-free public areas; actively carry out environmental pollution control.
Because of the above measures, the cardiovascular disease prevention and treatment work in the United States has achieved good results in the past decade: The mortality rate of myocardial infarction after 30 days decreased by 30%, the mortality rate after heart failure decreased by 16% after 30 days, and the stroke survival rate increased by 5%.
Life Times: How do you evaluate China's progress in the prevention and treatment of cardiovascular disease?
Smith: I was impressed by the progress of prevention and treatment in China. The Chinese government has recognized that the incidence of cardiovascular disease is increasingly severe in the country. To this end, it has adopted a series of targeted measures, such as smoking prevention, air governance, and China’s progress. Big. I have been in Beijing for 4 days this time. The air is good and the sky is blue. This shows that in terms of controlling pollution, China can do it, just like Los Angeles in the past.
Life Times: As far as the current situation in China is concerned, what do you think is more pressing when hospital treatment improvement and public education are promoted?
Smith: These two are complementary and they are all very important. From the patient's point of view, the improvement of hospital treatment quality is even more important; from the prevention point of view, educating the public may be more important because they need relevant knowledge to identify danger signs and Learn how to establish a healthy lifestyle. At present, many countries have developed their economies and have realized that instead of doing medical hardware improvement, it is better to do more preventive work because the cost of treatment is higher than the cost of prevention. A lot.
Treatment and prevention are complementary systems engineering. For example, when a patient develops a heart attack, he needs to first determine his condition and promptly call for help. The hospital will have to play a greater role in the hospital and treatment process. Statistics show that About 80% of the patients participating in our quality improvement program can be sent to the hospital within 30 minutes.
Life Times: Due to traffic congestion, in Beijing and other large cities, it is very difficult to control the time for patients to get medical treatment within 30 minutes. What's your suggestion?
Smith: The traffic jam in big cities has always been a big problem. Beijing is like this. I have been to Mumbai, India, Sao Paulo, Brazil, including New York, USA, too. This is when the public first signs signs of illness and it is especially important to seek help. .
In addition, we need to consider how to increase the efficiency of the use of medical resources, actively respond to congestion, and then reduce the mortality rate. For example, some ECG monitoring devices can now directly transmit the patient’s ECG status to doctors, helping doctors to understand the situation in a timely manner and winning for the rescue. Time. As far as I know, some companies are designing a system that allows taxi drivers to find out where the nearest hospitals with salvage credentials are. This method can be used later to promote Uber and Dribbling.
Life Times: Can you give Chinese people some life-saving advice?
Smith: There are seven main aspects of healthy life: non-smoking, non-obesity, exercise, diet, cholesterol control, blood pressure, and fasting glucose. Specifically, the concept of non-obesity is the body mass index BMI (weight/height). The square of) is less than 25; more exercise refers to 150 minutes of mid-weekly exercise or 75 minutes of high-intensity exercise, each exercise must be guaranteed at least 15 minutes in order to truly play an effective role; reasonable diet consists of 5 dietary indicators, ie daily fruits and vegetables More than 4.5 (approximately 1 fist size), eats more than 3.5 ounces of fish per week (approximately 100 grams), eats cellulose-rich grains daily, intake of sodium does not exceed 1500 mg per day, sugary drinks The calorie intake does not exceed 450 calories a week.
