It’s time to save Latvian cardiology.
My good friend was supposed to turn 62 when he was admitted to a prestigious hospital in Riga for a complex – but quite common – heart valve replacement surgery.
The main organ of life had already failed several times, and surgical intervention was required, which was to be performed by one of the most experienced cardiologists. A date was set, but… they could not assemble the surgical team.
It was postponed to the next day. That night, the patient experienced a hurricane pulmonary edema – and the person was lost. He could have still lived and worked. And how many such cases are there across the country?
Europeans Die Several Times Less
More than 60 million Europeans suffer from heart problems. The Old World, in accordance with its name, places great importance on heart health – and over two decades, the EU has managed to reduce the number of deaths from cardiovascular diseases by 20%.
However, this does not concern us: as the Ministry of Health recently stated, the rates of "standardized mortality" (yes, there is such a term!) from cardiovascular diseases among residents of Latvia are twice as high as the EU average, with the difference for those under 64 years old being even three times higher. The main causes of mortality are ischemic heart diseases (chronic ischemic heart disease, myocardial infarction, etc.) followed by cerebrovascular diseases (strokes), hypertensive diseases, and cardiomyopathies.
The latter is not a single disease, but a whole group of myocardial diseases. All of them are associated with a disruption of the mechanical or electrical function of the heart. Either only the heart may be affected, or the manifestations in the person will be part of a generalized systemic disease. The main danger of any cardiomyopathy is progressive heart failure, which can lead to disability or death. Unfortunately, this occurs due to cardiomyopathy in a quarter of heart patients.
We Are to Blame
And the primary cause, by some estimates, accounts for up to 70%, is alcohol abuse. And the lifestyle habits of Latvians in general, which are far less healthy than they should be. Here’s what doctors have noted:
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high blood pressure was observed in 36% of the population (43% of men, 30% of women);
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elevated cholesterol levels – 63% (61% of men, 65% of women);
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elevated glucose levels – 27% (32% of men, 22% of women);
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excess weight accounted for 34%, obesity – 29% among the population aged 25-74.
Therefore, in the new Action Plan to Limit Cardiovascular Diseases by 2029, which was discussed by the government in March, combating excess body weight and measures to promote healthy eating habits and sufficient physical activity are prioritized...
As for individual indicators, everyone can verify them practically for free – throughout the year, there are various campaigns in clinics and laboratory centers, where the same blood sugar levels are measured. When was the last time you visited your local doctor?
What Abu Meri Requested 42 Million Euros For, and Where the Money Comes From
This exact amount (42,230,607 euros) is indicated in the document for government consideration for 2027 – under the Ministry of Health's activities for treating cardiovascular diseases. But even for this considerable amount, the highest achievement would be considered a 10% reduction in mortality from cardiological diagnoses compared to 2019.
By the way, even when we were all wearing masks and self-isolating at the beginning of the decade, ischemic heart disease still claimed more lives than Covid-19 and cancer.
Nevertheless, as health guardians are confident, a significant portion of cardiovascular diseases is controllable: through a healthy lifestyle and appropriate medical care at all levels: this is ensured by primary and secondary prevention, timely diagnosis, comprehensive and concomitant therapy, as well as effective monitoring of chronic diseases.
However, the geographical distribution of mortality from these diseases is very illustrative and social. The map shows a pale yellow Riga region, close to the capital, where there are fewer than 600 deaths per 100,000 people. And an intense, almost brown color in Latgale, with more than 1501. 2.5 times higher – within one country...
Smoking Harms Health
"A higher proportion of smokers, as well as unhealthier eating habits," explains the deadly disparity between Riga and Latgale, said Hosam Abu Meri from the "New Unity" party. And against this backdrop, several dozen doctors and nurses from the Daugavpils hospital are being dismissed – their citizenship, it turns out, is unsuitable.
So what has the state done to reduce the spread of electronic cigarettes? They are gaining increasing popularity among young people, "cold" smoking is so stylish, and as a result, Latvia has 43% of nicotine users among men and 16% among women, which is much higher than the EU average. There are areas where we are ahead of all of Europe! Although, of course, it would be better if this were not the case...
Alcoholics Pay for Heart Patients
As a measure against this harmful habit, a unified packaging is being considered, which is intended to indicate the danger of the product.
However, for many decades, various frightening diagnosis photos have adorned cigarette packs. But this has not stopped consumption – and the state benefits from the extra tens of millions in excise taxes, which is quite handy. Who would seriously give up the tobacco and alcohol monopoly, even if not in terms of production, at least in terms of taxes? So it turns out – one minister from "New Unity", Hosam Abu Meri, calls for quitting smoking and drinking – while another, the Minister of Finance Arvils Ašeradens, includes revenues from taxes on alcohol and tobacco in the state budget. Then part of it will also go to the Ministry of Health.
"Alcohol consumption rates in Latvia have also increased in recent years, significantly exceeding the EU average," the medical department philosophically states. The figures are quite wild – 40% of the adult population practices excessive, risky drinking habits.
Although, in general, "drinking in moderation" is a myth. "Regarding cardiovascular health," the Ministry of Health document states, "no safe level of alcohol consumption has been established: contrary to popular belief, there is no convincing evidence of the preventive influence of low or moderate alcohol consumption on the cardiovascular system."
A Life-Saving Vaccine
As readers have already realized, medical practice in Latvia is mainly focused on prevention – saving drowning people is the responsibility of the drowning themselves. No one will particularly rush to help.
But there is one nationwide initiative that goes beyond its limits and allows support for heart patients. This concerns immunization, vaccinations, including against seasonal flu.
The current spring, unstable weather promotes the spread of viral infections. Meanwhile, almost a quarter of elderly people who have suffered from severe flu lose their autonomy functions. They become bedridden.
Another three-quarters dangerously increase their blood sugar levels. So preventing the aforementioned harmful trends can be addressed – just a vaccine at the nearest clinic is enough. Although injections for heart attacks, unfortunately, have not yet been invented...
