February, the month of the heart.. American month of the heart

February, the month of the heart

The 'American Heart Month' (American month of the heart) is an event supported by the federal government of the United States, which takes place every year in this country and is carried out with the purpose of remembering and focusing American citizens on heart care, including families, friends, and community (American Heart Association, 2019).

According to the same source, this event took place for the first time in February 1964 and was driven by the high mortality from cardiovascular diseases, including heart disease and stroke, being at that time the leading cause of death in the world, with more 17.9 million deaths each year.

Currently, this initiative seeks to generate an impact beyond borders and promote heart health and the necessary care to enhance quality of life in other countries and settings.

Cardiovascular diseases:

According to the World Health Organization (2019), cardiovascular diseases (CVD) are the leading cause of death worldwide.

These are a series of abnormalities of the heart and blood vessels and are the leading cause of death worldwide, mainly affecting low-income countries, since more than 80% of deaths occur in these places.

The same organization estimates that 17.5 million people died in 2012 from this cause, and it is estimated that between now and 2030, around 23.6 million will die from cardiovascular disease, especially heart disease and stroke.

Risk factors – cardiovascular diseases:

According to Alcedo & Angulo (2015), the risk factors for cardiovascular diseases (CVD) are divided into two groups:

a) Non-modifiable, which are those that, due to their characteristics, establish a relationship with the appearance or not of the disease, among which are age, sex and socioeconomic level.

- Age:

This is a factor that has a direct relationship with the onset of cardiovascular disease, because the older the age, the greater the risk of suffering from this condition, and CVDs are more common in older people, due to the loss of functions in the homeostatic systems of the human body.

- Gender:

Apart from age, gender is another non-modifiable factor linked to cardiovascular diseases. According to Cuevas; Segura et al. (as cited in Alcedo & Angulo, 2015) statistics indicate that men under 50 years of age are more likely to suffer from these pathologies than women of the same age, which may be related to the presence of estrogens in blood vessels and the characteristics of the cardiovascular system of women.

However, other studies conducted by Alfonzo, Bermejo & Segovia (as cited in Alcedo & Angulo, 2015) indicate that from the age of 55 women suffer more frequent heart attacks, heart failure and cardiovascular death, which may be associated, for example, , to menopause.

- Socioeconomic level:

This is a factor that is related to cardiovascular disease in terms of access to health services, economic resources for it and health conditions to which people may be exposed.

b) Modifiable, which can be smoking, diabetes, high blood pressure, obesity, dyslipidemia, sedentary lifestyle, among others.

How to prevent cardiovascular diseases?

Taking into account Bejarano & Cuixart (2011), for the prevention of cardiovascular diseases, it is necessary:

• Modify lifestyles and isolation from harmful habits, such as smoking or excessive alcohol consumption.
• Acquisition of healthy habits and self-care, such as healthy eating, physical activity and weight control.
• Adhere to pharmacological treatments for the indicated cases (hypertension, hypercholesterolemia, etc), taking into account that they cannot always provide clinical results and therefore it is necessary to act on the other CVRFs to reduce the risk.

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February 28, World Rare Disease Day

What are rare diseases?

A disease is considered rare when it affects a certain number of people within a population, affecting 5 individuals per 10,000 inhabitants. The qualifier 'rare' has to do with it being infrequent or uncommon (Arcos, 2013).

These are diseases with a high mortality rate, but low prevalence, with a severe chronic evolution and with different motor, sensory and cognitive defects.

Their treatment and clinical care are highly complex, which makes diagnosis and recognition difficult, and most of them are genetic, although others are strongly influenced by the environment (Posada et al., 2008).

Prevalence of rare diseases:

According to the European Medicines Agency (as cited in World Health Organization, 2012), the number of rare diseases is between 5,000 and 8,000 in the European Union, affecting between 27 and 36 million people.

In Colombia, the Comprehensive Social Protection Information System (SISPRO) carried out a census in 2013 and found a total of 13,173 patients with rare diseases for 2013. Of this total, 53.96% (7,132) were women and 46.03% were men, most of them over the age of 28, the most common pathologies being congenital deficiency of factor VIII, myasthenia gravis, von Willebrand disease, short stature due to growth hormone abnormality and bronchopulmonary dysplasia. The five departments with the highest prevalence are Cundinamarca Caldas, Risaralda, Antioquia and Santander (Arcila, 2017).

therapeutic treatments:

Therapeutic treatments are limited and, in general terms, there is no remedy to cure rare diseases, although there are drugs aimed at managing the symptoms and controlling the evolution of the disease, as well as physical therapies (massage therapy, therapeutic exercise, magnetotherapy or electrotherapy) that they prevent and improve the quality of life of those affected, especially in patients with neuromuscular, postural, neouromotor, congenital or morphological alterations (Puente, Barahona & Fernández, 2013).

Colombian Federation of Rare Diseases (FECOER):

Rare diseases (RD) are represented by the Colombian Federation of Rare Diseases (FECOER), which emerged in 2011 as a response to the need to unify all associations and existing rare diseases and to be diagnosed in Colombia. This implies involving other actors such as the government, scientists, academics, service providers and the pharmaceutical system to solve common problems related to these pathologies, and generate clinical consensus around the diagnosis and the required care (Colombian Federation of Rare Diseases, 2019).

Law 1392 of 2010 – recognition of rare diseases in Colombia:

Rare diseases (RD) are backed by Law 1392 of 2010, which includes these pathologies within the Government's social protection scheme and through which orphan diseases are recognized and regulations are included to ensure social protection by of the Colombian State to people with these conditions and their families and/or caregivers (Ministry of Health and Social Protection, 2010).

According to the same source, the law includes aspects such as the financing of orphan diseases, the duties and obligations of the Colombian State with these pathologies (which includes the creation of a national registry of patients suffering from these diseases, medicines, care, training or dissemination of knowledge and strategies for research and social insertion) and the inspection, surveillance and control of actors linked to the care system.

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