Position of cardiovascular rehabilitation programs in the global burden of cardiovascular diseases

Kardiovaskularne bolesti (KVB) i dalje ostaju glavnim uzrokom pobolijevanja i smrtnosti u Republici Hrvatskoj. U 2010. godini prema podacima Državnog zavoda za statistiku Republike Hrvatske (Statistički godišnjak za 2010.) bolesti srca i krvnih žila bile su uzrok 25 631 smrti zbog KVB-a s udjelom od 49,2 % u ukupnom mortalitetu, što u konačnici, iako ne zadovoljava, predstavlja pad u mortalitetu koji je godinama (prema istom izvoru) bio iznad 50 %. Poimanje problema vremenom se kroz smjernice stručnih društava mijenjao u smisao kontinuiranog višesustavnog procesa, odnosno “kardiovaskularnog kontinuuma”, a pristupanje ukupnim preventivnim i sveobuhvatnim rehabilitacijskim mjerama u bolesnika s razvijenom kardiovaskularnom bolešću, s ciljem postizanja maksimalnog zdravlja, osobne i obiteljske dostatnosti, kao i sprječavanja novog kardiovaskularnog incidenta, postali su glavni zadaci organizirane zdravstvene djelatnosti kardiološke rehabilitacije. Ona predstavlja sveobuhvatni program kliničkog liječenja, unapređenja funkcionalnog kardiorespiratornog kapaciteta i maksimalne korekcije rizičnih navika. Koristi ovakvih programa dokazano su predstavljene smanjenjem simptoma bolesti, poboljšanjem radnog kapaciteta i globalnog rizičnog profila te ukupnom promjenom dinamike aterosklerotskog procesa, smanjenjem pobola i smrtnosti, a u konačnici i troškova liječenja.Cardiovascular disorders (CVD) are still the leading cause of morbidity and mortality in Republic of Croatia. According to report of the Croatian Bureau of Statistics (Statistical Yearbook 2010) cardiovascular diseases were the leading cause of death in 2010; with 25 631 deaths i.e. 49.2 % of total mortality. Although the figures are far from satisfying, this was the first decline in cardiovascular mortality rates, which persisted above the 50 % for over years earlier. On the other hand global perspective of CVD was transferred from localized single organ disease to chronic multi-organ process and dysfunction known as the ”cardiovascular continuum”. The main objectives of rehabilitation programs in patients with secondary cardiovascular prevention include comprehensive continuous approach in preventive and rehabilitation efforts, in order to attain the condition that is the best closest to healthy, including professional and social functioning, improvement in quality of life, as well as the prevention of major cardiovascular events recidivism. Rehabilitation became inevitable component of overall treatment, which improved physical fitness and upmost control of modifiable risk factors. There is a well established level of clinical evidence for improvement in symptoms, work ability, along with amelioration of atherosclerotic process, morbidity, mortality and the costs of health care