What screening studies are needed for general prevention? If we talk about mass prophylaxis, then, first, you need to regularly measure blood pressure. There are no strict regularity criteria: if the pressure is normal and does not bother - you can measure it from time to time, if the pressure fluctuates - then, naturally, more often. Now these devices - tonometers - are sold freely. The second is the heart rate (pulse). In a healthy person, the pulse should not exceed 70-75 beats per minute (at rest). If this indicator is higher, you need to understand, determine the cause. It is also important that the heart rate be uniform. If there are interruptions, this is an occasion for a visit to the doctor. The third is the level of cholesterol. The simplest study allows you to determine the level of total cholesterol. If simplified - it consists of two fractions. The first is low-density lipoproteins, the so-called "bad" cholesterol. The second is high-density lipoproteins ("good" cholesterol).
Since the indicator of "good" cholesterol is fairly stable, if total cholesterol is raised, it is most likely due to "bad" cholesterol. A more accurate study helps determine the so-called "triple": both cholesterol fractions and triglycerides. In addition, it is important to control body weight and measure the waist circumference. Here these indicators in principle for the formation of a general picture of the state of health is enough. As for the level of glucose in the blood, first of all, people who are at risk for diabetes mellitus: with weighed heredity, with overweight or obesity, should follow it. And also in the case of manifestations of cardiovascular disorders - since cardiovascular diseases (CVD) are often combined with a violation of carbohydrate metabolism. And, in general, it is necessary to distinguish the types of preventive examinations: there is a general program of medical examination and the types of screening that must be carried out for certain indications. In addition, women need to be examined regularly by a gynecologist, to check the condition of the mammary glands. The main problem of medical examination, in my opinion, is that if any changes in the body are detected, but there is no obvious disease, then there is no clearly defined program of further actions. And, of course, the position of the person is very important - if he does not show interest, does not take care of his health, then no doctors will help.
Many of the necessary types of examination people "from the street" often can not get in the polyclinic at the place of residence (there are not enough specialists, diagnostic equipment to sign up for a free reception to a number of specialists, for example, you need to tune in for a month of waiting) ... What if there is no way to buy a VHI policy? Those studies can be done in a regular clinic, it's easy and affordable. And if you refuse a free high-tech examination (ultrasound or MRI)? Why, as practice shows, for a fee you can pass the examination at least now, but for free ... on record, after many weeks of waiting? The types of necessary research should be determined by the doctor. You can not simply demand that you have an ultrasound or a tomography for free - these are very expensive types of research. But in case the doctor discovered any changes, pathology, then, according to the law, you should get such a survey for free, another thing is that, most likely, it will not be done right away ... Everywhere in different ways - everything depends on equipment and conditions in a medical institution. Now the Ministry of Health is trying to solve such problems - for this purpose Health Centers have been created and continue to be created. Their purpose is preventive screening, identifying risks to prevent the development of diseases. Such centers of health are created on a functional basis in medical institutions - with clinics, prevention centers, sports dispensaries, etc. The idea is good - to pay attention to people who are not sick yet, but there are already risk factors. With people sick all is clear - they should be treated. But if a person is at risk, there are a lot of such people, they will be engaged in health centers.
How to convince people of young, working age in the need for prevention? There are two necessary conditions: first, education, awareness and, of course, the desire of the person himself. And secondly, creating the necessary conditions to lead a healthy lifestyle was easy. In order not to have to fight for a healthy lifestyle, as we struggle for the harvest. And that useful tips, for example, go to work on a bicycle, were realizable - in European cities there are special paths for this, and where and where in Moscow you can ride a bicycle? Prior to the Sklifosovsky Institute, unless ... But we must understand that prevention requires a long time and the return will not be soon. For example, Americans have actively taken up prophylaxis since the early 1950s, and the mortality rate of the population has declined only after 20 years. Therefore, we hope that thanks to the health centers we will change something tomorrow, it will not work. But a lot - very much! - depends on ourselves, on our way of life.
So, is it true that the way of life affects our health significantly more than heredity? Of course, heredity certainly plays a role, but nevertheless, the large prevalence of cardiovascular diseases, which has become a scourge of our time, depends on the way of life. As an example, we can cite the following facts: the Japanese have a low mortality from cardiovascular diseases, since they eat mostly fish, seafood, etc. But when the Japanese move to the US, after a while they begin to get sick - and die, as Americans. Or Italians - those who live on the coast and adhere to the Mediterranean diet, mortality from CVD is very low. But the Italians who moved to the United States are catching up with the aboriginal population in these indicators. And even in people with a hereditary predisposition to these or other diseases, if they lead, as we say, a healthy lifestyle, the probability that the hereditary program is implemented is very small. Human health in general is based on three pillars. The first is a rational diet, that is, calorie content, corresponding to energy costs. How to determine if you eat well?
You need to take a centimeter and measure the waist circumference. If it increases - a man has reached 102 cm, a woman has 88 cm, then this is a sign of so-called abdominal obesity, when fat is stored in the abdomen, and this is the most unfavorable situation, a risk factor for CVD and diabetes. In this case, you need to either reduce the caloric content or increase the activity. In addition, the diet should be dominated by products of vegetable origin, and you need to eat more vegetables and fruits. WHO recommends at least 400 g per day. Very useful fish, you can consume vegetable oil, but do not forget that this is also fat. The second "whale" is a reasonable physical activity. What do I mean by the word "reasonable"? It does not matter what kind of physical activity it is to maintain and maintain health. It can be running, digging in the garden, it can be swimming, simulators - the main thing is that a person is physically active, but in moderation.
In general, it is believed that to preserve the health of a person must take place on the day of 10 thousand steps - from 3 to 5 km. In jest I sometimes advise, answering the question "how to increase physical activity?", - get a dog, it's better big. Twice a day you have to run several kilometers - it will make it do. And more, speaking about physical exertion, it is necessary to observe the principle of gradualness. How to determine that the load is good for you? The main criterion is well-being? Yes, and the second criterion is the heart rate. For each age there is a maximum heart rate. This is calculated, if you do not go into details, as follows: from 220 age is subtracted. If a person is 50 years old: 220 - 50 - his maximum load is obtained - 170 beats per minute. But do not stress at the peak - the optimal load is 60-70% of the maximum heart rate. And in this rhythm you need to practice for 20-30 minutes 3 times a week, but you can at least every day. And the third "whale" is a complete refusal to smoke. If we sometimes say about alcohol that small doses - a glass of wine - hamper the development of atherosclerosis, then there are no such indicators for smoking. Here are three basic principles that an ordinary person must observe in order to maintain health. And it does not require special expenses - only the will and desire of the person himself.
Get regular medical check-ups
Preventive examination can pass all working, as well as pensioners and adolescents who have a MHI (mandatory health insurance) policy.