What are the primary symptoms of Irritable Bowel Syndrome. How does IBS affect daily life. Can IBS be effectively managed through lifestyle changes. What role does stress play in IBS symptoms. Are there specific dietary triggers for IBS. How is IBS diagnosed by healthcare professionals. What are the latest treatment options for managing IBS.

Decoding Irritable Bowel Syndrome: A Comprehensive Overview

Irritable Bowel Syndrome (IBS) is a common gastrointestinal disorder that affects millions of people worldwide. It is characterized by a group of symptoms that occur together, including abdominal pain and changes in bowel habits. While the exact cause of IBS remains elusive, researchers have identified several factors that may contribute to its development and exacerbation.

The Hallmark Symptoms of IBS

IBS manifests through a variety of symptoms, with the most common being:

• Abdominal pain or discomfort, often related to bowel movements
• Changes in bowel habits (diarrhea, constipation, or alternating between both)
• Bloating
• A feeling of incomplete bowel evacuation
• Presence of whitish mucus in the stool

For many women with IBS, symptoms tend to worsen during menstrual periods, highlighting a potential hormonal connection to the disorder.

The Brain-Gut Axis: A Key Player in IBS

One of the leading theories behind IBS involves the complex interplay between the brain and the gut, known as the brain-gut axis. This bidirectional communication system plays a crucial role in regulating digestive processes and can be disrupted in individuals with IBS.

How does the brain-gut axis influence IBS symptoms?

The brain-gut axis affects IBS symptoms through several mechanisms:

1. Altered gut motility: The brain may send signals that cause the intestines to move food too quickly or too slowly, leading to diarrhea or constipation.
2. Increased visceral sensitivity: People with IBS may have heightened sensitivity to normal amounts of gas or stool in the gut, resulting in pain or discomfort.
3. Stress response: The brain’s stress response can directly impact gut function, potentially triggering or exacerbating IBS symptoms.

Unraveling the Potential Causes of IBS

While the exact cause of IBS remains unknown, researchers have identified several factors that may contribute to its development:

Genetic Predisposition

Recent studies suggest that genetics may play a role in IBS susceptibility. Certain genetic variations may make individuals more prone to developing the condition, although more research is needed to fully understand this connection.

Early Life Experiences and Psychological Factors

Stressful or traumatic events during childhood, such as physical or sexual abuse, have been linked to an increased risk of developing IBS in adulthood. Additionally, certain mental health conditions, including depression, anxiety, and somatic symptom disorder, are more prevalent among individuals with IBS.

Gastrointestinal Infections and Bacterial Imbalances

Bacterial infections in the digestive tract and small intestinal bacterial overgrowth (SIBO) have been associated with the onset of IBS symptoms in some individuals. These disruptions to the gut microbiome may contribute to the development and persistence of IBS.

The Role of Diet in IBS: Navigating Food Intolerances and Sensitivities

Food intolerances and sensitivities can play a significant role in triggering or exacerbating IBS symptoms. Many individuals with IBS find that certain foods can provoke digestive discomfort, leading to the need for dietary modifications.

Common dietary triggers in IBS

While triggers can vary from person to person, some common culprits include:

• FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols)
• Dairy products
• Gluten-containing foods
• Caffeine
• Alcohol
• Spicy foods

Working with a healthcare professional or registered dietitian can help identify specific dietary triggers and develop an individualized nutrition plan to manage IBS symptoms effectively.

Stress and IBS: Understanding the Connection

The relationship between stress and IBS is complex and bidirectional. While stress does not cause IBS, it can significantly impact symptom severity and frequency. Conversely, living with IBS can also increase stress levels, creating a potential cycle of symptoms and distress.

How does stress influence IBS symptoms?

Stress can affect IBS through several mechanisms:

1. Increased gut sensitivity: Stress can heighten the perception of pain and discomfort in the digestive tract.
2. Altered gut motility: Stress hormones can affect the speed at which food moves through the intestines.
3. Changes in gut microbiome: Chronic stress may lead to changes in the composition of gut bacteria, potentially contributing to IBS symptoms.
4. Increased inflammation: Stress can trigger low-grade inflammation in the gut, which may exacerbate IBS symptoms.

Diagnosing IBS: A Process of Elimination

Diagnosing IBS can be challenging as there is no single definitive test for the condition. Instead, healthcare providers rely on a combination of symptom assessment, medical history, and exclusion of other potential causes.

The Rome Criteria: A Diagnostic Tool for IBS

The Rome Criteria is a set of diagnostic criteria used by healthcare professionals to identify IBS. The current version, Rome IV, defines IBS as recurrent abdominal pain associated with two or more of the following:

• Related to defecation
• Associated with a change in frequency of stool
• Associated with a change in form (appearance) of stool

These symptoms must be present for at least three months, with symptom onset at least six months prior to diagnosis.

Additional Diagnostic Procedures

To rule out other conditions that may mimic IBS symptoms, healthcare providers may recommend additional tests, such as:

• Blood tests to check for celiac disease, inflammatory markers, or other abnormalities
• Stool tests to rule out infections or inflammatory bowel diseases
• Colonoscopy, especially for individuals over 50 or those with alarming symptoms like rectal bleeding or unexplained weight loss

Treatment Approaches: Managing IBS Effectively

While there is no cure for IBS, various treatment strategies can help manage symptoms and improve quality of life. Treatment plans are often individualized and may involve a combination of approaches.

Dietary Modifications

Dietary changes can play a crucial role in managing IBS symptoms. Some effective strategies include:

• Following a low FODMAP diet under the guidance of a healthcare professional
• Identifying and avoiding personal food triggers
• Increasing fiber intake gradually to improve bowel regularity
• Staying well-hydrated

Stress Management Techniques

Incorporating stress-reduction strategies can help alleviate IBS symptoms. Effective techniques may include:

• Mindfulness meditation
• Cognitive-behavioral therapy (CBT)
• Regular exercise
• Progressive muscle relaxation
• Yoga or tai chi

Medications

Depending on the predominant symptoms, healthcare providers may recommend various medications to manage IBS:

• Antispasmodics to relieve abdominal pain and cramping
• Laxatives for constipation-predominant IBS
• Anti-diarrheal agents for diarrhea-predominant IBS
• Low-dose antidepressants to address pain and alter gut motility
• Probiotics to support gut health

Living with IBS: Strategies for Long-term Management

While IBS can be challenging to live with, implementing long-term management strategies can significantly improve quality of life. Some effective approaches include:

Maintaining a Symptom Journal

Keeping a detailed record of symptoms, food intake, stress levels, and other potential triggers can help identify patterns and guide management strategies. This information can be valuable when working with healthcare providers to optimize treatment plans.

Regular Exercise

Engaging in regular physical activity can help regulate bowel function, reduce stress, and improve overall well-being. Aim for at least 150 minutes of moderate-intensity exercise per week, or as recommended by your healthcare provider.

Sleep Hygiene

Prioritizing good sleep habits can help manage stress and potentially reduce IBS symptoms. Aim for 7-9 hours of quality sleep each night and maintain a consistent sleep schedule.

Complementary Therapies

Some individuals with IBS find relief through complementary therapies such as:

• Acupuncture
• Herbal supplements (under the guidance of a healthcare provider)
• Gut-directed hypnotherapy
• Peppermint oil

It’s important to discuss any complementary therapies with a healthcare provider before incorporating them into an IBS management plan.

The Future of IBS Research and Treatment

As our understanding of IBS continues to evolve, researchers are exploring new avenues for diagnosis and treatment. Some promising areas of research include:

Microbiome-based Therapies

Investigating the role of the gut microbiome in IBS and developing targeted therapies to restore microbial balance.

Personalized Medicine

Utilizing genetic and biomarker information to tailor treatment approaches to individual patients.

Novel Pharmacological Treatments

Developing new medications that target specific aspects of IBS pathophysiology, such as gut-brain interactions or visceral hypersensitivity.

Technological Interventions

Exploring the potential of digital health technologies, such as mobile apps and wearable devices, to support IBS management and symptom tracking.

As research progresses, individuals with IBS can look forward to more targeted and effective treatment options in the future. In the meantime, working closely with healthcare providers and implementing comprehensive management strategies can help improve quality of life and minimize the impact of IBS on daily activities.

Symptoms & Causes of Irritable Bowel Syndrome

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What are the symptoms of IBS?

The most common symptoms of irritable bowel syndrome (IBS) are pain in your abdomen, often related to your bowel movements, and changes in your bowel movements. These changes may be diarrhea, constipation, or both, depending on what type of IBS you have.

Other symptoms of IBS may include

• bloating
• the feeling that you haven’t finished a bowel movement
• whitish mucus in your stool

Women with IBS often have more symptoms during their periods.

IBS can be painful but doesn’t lead to other health problems or damage your digestive tract.

To diagnose IBS, you doctor will look for a certain pattern in your symptoms over time. IBS is a chronic disorder, meaning it lasts a long time, often years. However, the symptoms may come and go.

What causes IBS?

Doctors aren’t sure what causes IBS. Experts think that a combination of problems may lead to IBS. Different factors may cause IBS in different people.

Functional gastrointestinal (GI) disorders such as IBS are problems with brain-gut interaction—how your brain and gut work together. Experts think that problems with brain-gut interaction may affect how your body works and cause IBS symptoms. For example, in some people with IBS, food may move too slowly or too quickly through the digestive tract, causing changes in bowel movements. Some people with IBS may feel pain when a normal amount of gas or stool is in the gut.

Certain problems are more common in people with IBS. Experts think these problems may play a role in causing IBS. These problems include

• stressful or difficult early life events, such as physical or sexual abuse
• certain mental disorders, such as depression, anxiety, and somatic symptom disorder
• bacterial infections in your digestive tract
• small intestinal bacterial overgrowth, an increase in the number or a change in the type of bacteria in your small intestine
• food intolerances or sensitivities, in which certain foods cause digestive symptoms

Research suggests that genes may make some people more likely to develop IBS.

Last Reviewed November 2017

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This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.

The NIDDK would like to thank:
Lin Chang, M.D., David Geffen School of Medicine, University of California Los Angeles

What’s causing your IBS – Harvard Health

While the exact cause of irritable bowel syndrome, or IBS, is unknown, studies have suggested that IBS might be related to a few specific changes in the body. Some symptoms may be caused by spasms, uncontrolled contractions in the muscles of the colon. The nerve endings in the intestines also may become unusually sensitive, magnifying pain. The reasons for these changes are not always known, but factors that have been linked with IBS include bacterial overgrowth, use of antibiotics, and stress, among others.

Psychological factors. The brain and gut are intimately connected. Your thoughts and emotions can trigger symptoms in the gut, and the health of your gut can shape your mental well-being. Stress can cause more contractions in the intestines and increase sensitivity. It’s not clear whether stress or other psychological factors may be a cause of IBS or vice versa. However, we do know that people with IBS often have higher levels of stress and anxiety and that this distress also can make IBS symptoms worse. A 2017 study in the Journal of Neurogastroenterology and Motility found that people with IBS have higher levels of depression and anxiety compared with those who don’t have the disorder. IBS also is more common among people who experienced psychological trauma as children.

Antibiotics. The human digestive tract contains trillions of bacteria, viruses, and fungi known collectively as the gut microbiota or gut flora. These microorganisms play several critical roles in our health, including digestion and immune system function. When we take antibiotics to combat bacterial infections, the drugs also kill helpful bacteria in the gut. Repeated treatments or long-term use of antibiotics may alter the gut flora in a way that disrupts the colon’s normal function. Some animal and human research suggests that this disruption may lead to IBS in some cases. However, studies have not had consistent results, so more research is needed.

Bacterial overgrowth. Some people with IBS also have a surplus of bacteria in the small intestines, a condition called small intestinal bacterial overgrowth (SIBO). It’s unclear whether SIBO can be a cause of IBS, but people with IBS are more likely than others to test positive for SIBO. In addition, some research has found that IBS symptoms often decrease after antibiotic treatment that focuses on bacteria in the small intestine.

SIBO occurs when extra bacteria in the colon back up into the small intestine. In this situation, people often have symptoms typical of IBS such as bloating, constipation, abdominal pain, and diarrhea. Estimates vary about how many people diagnosed with IBS also have SIBO, but research in the March 2017 issue of Gut and Liver suggested it may be between 19% and 37%. Most studies diagnose SIBO with a breath test that measures gases released by the body’s breakdown of sugars such as glucose and lactulose. There is a debate, however, about the reliability of the test results.

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No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

causes, symptoms and treatment at the FSCC FMBA

General description

Ischemic heart disease (CHD) is the leading cause of death worldwide. According to experts, in 2030 more than 23 million people will die from CVD.

Coronary artery disease (CHD) is a disease caused by insufficient supply of oxygen and nutrients to the heart (myocardium), which occurs due to impaired blood supply to the myocardium due to damage to the coronary arteries. Clinical manifestations of coronary artery disease are diverse: from acute manifestations in the form of myocardial infarction or sudden cardiac death to long-term chronic diseases – angina pectoris (periodic retrosternal pain), postinfarction cardiosclerosis, chronic heart failure.

Causes

IHD occurs as a result of atherosclerosis of large (epicardial) coronary (cardiac) arteries of varying degrees: from a slight narrowing of the lumen in the vessel to its complete blockage by atheromic (cholesterol, fatty) masses or a thrombus that has developed at the site of a “vulnerable” (damaged) atherosclerotic plaque (ASP) . Other causes of coronary artery disease are spasm of the coronary arteries and damage to the microvasculature in the myocardium. In most cases, they also develop against the background of existing atherosclerosis.

It is possible to identify the most susceptible to the development of coronary heart disease (CHD) groups of the population: people suffering from high blood pressure; addicted to smoking; suffering from high cholesterol; diabetes mellitus; with chronic kidney disease. Male sex and advanced age are also powerful risk factors for developing coronary artery disease.

Symptoms of coronary heart disease

The main, but far from the only symptom of coronary artery disease is pressing or squeezing pain behind the sternum or in the region of the heart. In chronic coronary artery disease, pain occurs initially during exercise and causes a gradual decrease in its tolerance. In the acute form of coronary heart disease, myocardial infarction or a pre-infarction state (unstable angina pectoris) develops.

During an attack of coronary artery disease, the patient may also feel:

• pain or burning in the chest, under the shoulder blade, in the back, in the upper abdomen;
• feeling of heaviness in the chest;
• sensation of uneven heartbeat, irregular heartbeat, palpitations;
• feeling of sinking heart;
• shortness of breath;
• weakness;
• nausea;
• dizziness and fainting;
• sweating.

The discomfort may disappear or disappear completely after the completion of physical activity. With myocardial infarction or with unstable angina, the connection between complaints and physical activity is lost, and complaints can develop at rest and last for a long time (tens of minutes, hours). Usually, all of the above symptoms do not appear at the same time. In various forms of coronary heart disease, a certain feeling of discomfort dominates.

If you notice such sensations in yourself, contact your cardiologist as soon as possible. If chest pain or other symptoms described above do not disappear within 10 minutes at rest, call the ambulance team. IHD progression can develop slowly over years. At the same time, in some patients, coronary disease is asymptomatic or with erased or atypical symptoms.

To prevent disturbances in the work of the heart or the development of severe forms of coronary artery disease, undergo a comprehensive examination of the heart at our center of the Federal Research and Clinical Center of the Federal Medical and Biological Agency. Running coronary disease is very dangerous! At a later stage, it can lead to a fatal heart attack or severe heart failure with severe disability.

IHD diagnostics

Diagnosis of coronary artery disease is carried out by cardiologists in several stages. When questioning the patient, complaints are clarified, symptoms that may be characteristic of coronary heart disease are clarified. Examination of the patient helps to note visual changes – swelling and discoloration of the skin (cyanosis), listening to the heart reveals murmurs, rhythm disturbance.

Next, the patient passes laboratory tests for certain indicators in the blood, which may indicate a pathology. Also important is the standard biochemical analysis, as well as the determination of glucose and cholesterol levels.

But the most accurate method for diagnosing coronary disease is instrumental:

• ECG;
• ultrasound of the heart;
• stress tests with exercise or drug stimulation of the heart;
• Holter ECG monitoring;
• angiography of the coronary arteries (coronary angiography).

Timely examination helps to avoid serious consequences and the development of an irreversible form of coronary heart disease. Give your health a few hours, because this time will help preserve the quality of life in the future.

Prevention of coronary heart disease

Prevention of CVD is much easier than cure. To maintain healthy arteries and blood vessels, it is necessary to eliminate risk factors that negatively affect your health:

• Smoking cessation;
• Blood pressure monitoring
• Normalization of the level of “bad” cholesterol (low density lipoprotein)
• Combating stress and depression
• Minimizing alcohol intake;
• Refusal of smoked, fatty, fried and salty foods.

Give more time to an active lifestyle: moderate physical activity, therapeutic exercises, morning exercises, walking, swimming, dancing. Physical activity will help strengthen the walls of blood vessels and maintain normal weight, if necessary, reduce it.

The most important thing in the prevention of coronary artery disease is timely observation by a specialist. In order not to visit medical institutions several times to pass all the necessary tests and undergo research, contact our cardiology center. FSCC FMBA offers patients several programs for a comprehensive study of the heart. You can get acquainted with them here.

IHD treatment

When IHD is detected, the cardiologist determines the treatment model. Our clinic can offer you:

• drug therapy for coronary artery disease – a complex of modern medicines is prescribed, which allows you to control the symptoms and significantly improve the prognosis of the disease. The main drugs for the treatment of coronary artery disease are: antiplatelet agents (reduce the likelihood of blood clots in the coronary arteries), B-blockers, nitrates, calcium antagonists, enzyme inhibitors / angiotensin II receptor blockers (allow to prevent the development of pain, shortness of breath, edema) and statins (allow to reduce and control cholesterol). Treatment of coronary disease can take place on an outpatient basis or in the cardiology department of our center. When drug therapy for coronary artery disease does not help, they seek advice from a cardiac surgeon who will apply the following treatment methods:

  • surgical intervention aimed at myocardial revascularization (restoration of normal blood flow to the heart muscle):
  • stenting of affected arteries of the heart – intravascular surgery. Under local anesthesia, a catheter is inserted through the radial (on the forearm) or less often through the femoral (in the groin) artery, through which a special device is passed into the arteries of the heart. A special metal frame construction coated with drugs that suppress inflammation at the site of intervention is installed with the help of a balloon in the place of narrowing of the vessel. The balloon expands, as a result of which the stent presses the cholesterol plaque against the walls of the vessel and restores its patency;
  • coronary artery bypass surgery is an open heart surgery, the purpose of which is to restore a full blood supply. It is carried out by bypassing the place of narrowing of the vessel with the help of shunts (vascular prostheses), which redirect blood flow from the clogged areas of the arteries to healthy ones. The most commonly used coronary bypass grafts are the patient’s own arteries and veins. At the same time, arterial bypasses have a significant advantage in terms of long-term improvement in prognosis and pain relief as a result of surgery. In our Department of Cardiac Surgery, the operation is performed both with the help of cardiopulmonary bypass, and without (off pump).

The FSCC FMBA Cardiology Center is one of the few that performs coronary bypass surgery using mini-thoractomy. This method of surgery significantly speeds up postoperative rehabilitation and has no significant restrictions on physical activity within three months after the operation.

Our center employs highly qualified specialists who have confirmed their experience at the international level. Many years of experience and high-tech equipment allow us to achieve excellent results in surgical procedures.

In their daily practice, our doctors use the latest achievements of medical science and the most advanced medical technologies. Offering treatment to patients with coronary artery disease, our cardiologists, angiosurgeons and cardiac surgeons are always looking for the most effective, less traumatic and most appropriate way for each individual patient to carry it out.

It is important for us not only to save you from suffering, but also to ensure a long and comfortable life.

With care for you and your heart!

This article is an informational material and is not intended for self-diagnosis and self-treatment. If signs of discomfort appear, you should contact your doctor.

Causes, risk factors for CHD and social aspects

Coronary artery disease (CHD) is a common disease with severe complications. The incidence of coronary artery disease is associated with its multifactorial nature and the social characteristics of the environment in which patients are located. Why ischemia develops, who is at risk and how to assess this risk for yourself – we tell in the article.

Why ischemia occurs in the myocardium

The heart muscle is supplied with blood by the coronary, or coronary, vessels, which bring oxygenated (oxygenated) blood to the myocardium and carry away oxygen-deprived blood. If this process is disturbed and the inflow of oxygenated blood to the myocardium does not cover the oxygen demand of the heart muscle, ischemia develops in the heart.

The blood supply to the myocardium can be disturbed both slowly and quickly – from several years to hours or even minutes. With prolonged chronic oxygen starvation, stable or progressive forms of angina pectoris develop. Postinfarction cardiosclerosis also belongs to the chronic form of coronary artery disease. In situations of rapid disruption of blood supply, acute forms of ischemic disease occur – sudden coronary death, unstable angina, or myocardial infarction.

The causes of insufficient myocardial oxygenation are divided into non-coronary – if the problem is located outside the vessels (a sharp jump in pressure, tachycardia or hypertrophy of the heart muscle) and coronarogenic, when the coronary vessels are to blame for oxygen starvation of the heart, in which the lumen narrows or spasm occurs.

Coronary causes of myocardial ischemia

• Atherosclerosis is a narrowing of the lumen of blood vessels due to the deposition of cholesterol in the form of plaques or uniform impregnation of the wall with lipid compounds. Without diet and other aspects of disease prevention, the lumen of the vessels will progressively narrow, annually increasing the risk of developing acute forms of coronary artery disease.

• Anatomical malformations of the coronary vessels (formed in utero, that is, during the development of the fetus during pregnancy).

• Coronaritis is an inflammatory process in the coronary vessels, caused by systemic pathologies of the connective tissue, autoimmune or general infectious diseases. Inflammatory processes in the walls of the coronary arteries lead to edema, a change in their structure and a decrease in the lumen, which leads to a deterioration in the blood supply to the myocardium.

• Dissection of an aortic aneurysm – tearing of the aorta is accompanied by blood flow into the space between the layers of its wall, which leads to progressive dissection of the latter and narrowing of its lumen.

• Coronary embolism of various origins is a complete or partial blockage of the lumen of the coronary arteries by foreign bodies, gases, tissue particles, including fatty tissue, and also by a thrombus. As a result, the blood supply to the heart is stopped, which causes a sharp oxygen starvation and subsequent necrosis of the myocardium.

Prolonged oxygen starvation of the myocardium can lead to the development of chronic forms of coronary artery disease, and a sharp one – to myocardial infarction.

IHD risk factors

Factors in the development of coronary heart disease are divided into two groups – deterministic, which cannot be influenced, and non-deterministic, amenable to adjustment.

Deterministic factors

Genetic:

• age – although coronary artery disease often develops in the elderly, at present this disease is “getting younger”;

• gender – men are more likely to suffer from myocardial ischemia, since the female body synthesizes estrogens that have a beneficial effect on blood vessels and the heart, however, during menopause, the vessels lose “estrogen protection”, which increases the incidence of coronary artery disease in women;

• obesity, diabetes mellitus, dyslipidemia and arterial hypertension in a family history.

Anatomical, physiological and biochemical:

• hypertonic disease;

• obesity;

• dyslipidemia;

• diabetes.

Non-deterministic (controllable) factors

• Low physical activity. The lack of regular exercise slows down blood flow, which creates conditions for thrombosis, and weak contractions of an untrained heart reduce myocardial oxygenation.

• Arterial hypertension. Vessels that are in tension for a long time pass less blood, leading to oxygen starvation of the heart muscle.

• Overweight (including metabolic syndrome). Obesity is accompanied by lipid degeneration of the heart, the deposition of fatty complexes in the walls of blood vessels and an increased content of lipids in the blood. All this together impedes the movement of blood and normal oxygenation of the myocardium.

• Dyslipidemia is a general group of diseases characterized by improper absorption of lipids and an abnormal ratio of their fractions. As a result of these violations, “bad” fats are deposited in the vessels, starting the process of their narrowing.

• Smoking. Increases the risk of atherosclerosis by increasing the concentration of low-density lipoproteins in the blood, which are the basis of cholesterol plaques. In addition, this bad habit provokes an increase in the level of fibrinogen, a protein that is the basis of blood clots.

• Diabetes. A persistent increase in blood glucose levels damages blood vessels, leading to the development of changes similar to those in atherosclerosis. Arteries and capillaries become rigid (stiff), narrow and lose their ability to expand.

Daily half-hour exercise normalizes myocardial oxygenation and body weight

Social aspects of coronary heart disease

Low awareness of the population about the causes of the disease, the mechanisms of its development and consequences, as well as a sedentary lifestyle and bad habits, lead to the fact that the disease “gets younger” and reaches middle age.

The above risk factors for the development of coronary artery disease are adjustable, they are also called behavioral, or behavioral.