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THE BURDEN OF CARDIOVASCULAR DISEASES IN UZBEKISTAN: A GROWING
PUBLIC HEALTH CONCERN
Nazirova Shakhriza Bakhodirovna
Samarkand State Medical University Faculty of Pediatrics
shaxrizodanazirova62@gmail.com
(Uzbekistan)
Abstract:
Cardiovascular diseases (CVDs) have emerged as a major public health issue in
Uzbekistan, with an alarming rise in cases of myocardial infarction, chronic heart failure,
ischemic heart disease, and arterial hypertension. This article reviews the etiology, pathogenesis,
clinical presentation, complications, diagnosis, treatment, and preventive strategies associated
with these diseases in the context of Uzbekistan’s healthcare system. The paper aims to raise
awareness and propose recommendations for ...
Keywords:
Cardiovascular diseases, Uzbekistan, myocardial infarction, chronic heart failure,
ischemic heart disease, arterial hypertension, prevention, public health.
Introduction
In recent years, Uzbekistan has witnessed a significant increase in cardiovascular disease (CVD)
cases, making it a leading cause of morbidity and mortality. Rapid urbanization, changes in
dietary habits, sedentary lifestyles, and increasing rates of obesity and diabetes have collectively
contributed to this epidemiological shift. The country’s healthcare infrastructure faces challenges
in coping with the rising burden, necessitating comprehensive strategies for prevention, early
diagnosis, and treatment.
Etiology and Pathogenesis
The primary etiological factors for CVDs in Uzbekistan include genetic predisposition,
unhealthy diets rich in trans fats and salt, tobacco use, physical inactivity, obesity, diabetes, and
excessive alcohol consumption. Pathogenesis involves endothelial dysfunction, atherosclerotic
plaque formation, myocardial ischemia, and structural heart damage. Persistent arterial
hypertension accelerates vascular damage, while metabolic disorders exacerbate cardiac stress,
leading to progressive heart failure.
Myocardial Infarction (MI)
Etiology:
- Atherosclerosis of coronary arteries (primary cause)
- Coronary artery spasm
- Thrombosis or embolism
- Cocaine or amphetamine use
- Severe anemia
Pathogenesis:
MI results from an acute interruption of blood flow to a portion of the myocardium, typically due
to a thrombus formation on a ruptured atherosclerotic plaque, leading to myocardial ischemia
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and necrosis.
Clinical Presentation:
- Sudden, severe, retrosternal chest pain radiating to the left arm, neck, or jaw
- Dyspnea
- Cold sweats
- Nausea, vomiting
- Syncope
Complications:
- Arrhythmias
- Cardiogenic shock
- Pericarditis
- Left ventricular aneurysm
- Sudden cardiac death
Diagnostics:
- Electrocardiogram (ECG)
- Cardiac biomarkers: Troponin I/T, CK-MB
- Coronary angiography
- Echocardiography
Treatment:
- Immediate: oxygen, nitrates, antiplatelets (aspirin), analgesia (morphine), beta-blockers
- Reperfusion: thrombolysis or percutaneous coronary intervention (PCI)
- Long-term: ACE inhibitors, statins, lifestyle modification
Chronic Heart Failure
(CHF)
Etiology:
- Ischemic heart
disease (most
common cause)
- Hypertension
- Cardiomyopathies
- Valvular heart diseases
- Myocarditis
Pathogenesis:
CHF occurs when the heart fails to pump blood adequately, leading to neurohormonal activation
(RAAS, sympathetic nervous system) that exacerbates fluid retention, ventricular remodeling,
and progressive myocardial dysfunction.
Clinical Presentation:
- Dyspnea on exertion and at rest
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- Orthopnea, paroxysmal nocturnal dyspnea
- Peripheral edema
- Fatigue
- Ascites, hepatomegaly
Complications:
- Pulmonary edema
- Cardiorenal syndrome
- Thromboembolism
- Cachexia
Diagnostics:
- Echocardiography
- B-type natriuretic peptide (BNP) levels
- Chest X-ray
- ECG
- Blood tests: renal function, electrolytes
Treatment:
- Diuretics (furosemide, torsemide)
- ACE inhibitors/ARBs
- Beta-blockers
- Aldosterone antagonists
- Digitalis (in selected cases)
- Lifestyle modification
- Cardiac resynchronization therapy (for selected patients)
Ischemic Heart Disease (IHD)
Etiology:
- Coronary atherosclerosis
- Hypertension
- Diabetes mellitus
- Hyperlipidemia
- Smoking
- Obesity
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Pathogenesis:
Progressive narrowing of coronary arteries due to atherosclerotic plaque formation reduces
myocardial blood supply, especially during increased oxygen demand, causing angina or
infarction.
Clinical Presentation
Patients typically present with chest pain, dyspnea, palpitations, fatigue, and syncope. In
myocardial infarction, acute chest discomfort radiating to the arm or jaw, accompanied by
sweating and nausea, is common. Chronic heart failure manifests with edema, orthopnea, and
reduced exercise tolerance. Ischemic heart disease may be asymptomatic initially but can
progress to angina and acute coronary syndromes. Hypertension often remains silent until
complications develop.
Complications
Major complications include sudden cardiac death, arrhythmias, cardiogenic shock, stroke, renal
failure, and multi-organ dysfunction. Long-standing heart failure leads to pulmonary
hypertension, valvular insufficiency, and thromboembolic events. Uncontrolled hypertension
contributes to intracerebral hemorrhage and ischemic strokes.
Diagnosis
Diagnostic evaluation
involves clinical
examination, electrocardiography
(ECG),
echocardiography, cardiac biomarkers (troponins, BNP), and advanced imaging techniques like
coronary angiography and cardiac MRI. Blood pressure monitoring and lipid profile assessments
are essential for risk stratification. Stress testing aids in detecting inducible ischemia.
Treatment
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Management includes lifestyle modifications, pharmacotherapy, and interventional procedures.
Medications such as antiplatelets, beta-blockers, ACE inhibitors, statins, and diuretics are
commonly used. Revascularization techniques like percutaneous coronary intervention (PCI) and
coronary artery bypass grafting (CABG) are performed in eligible patients. Heart failure care
involves optimizing preload and afterload reduction and device therapy when indicated.
Prevention and Recommendations
Primary prevention involves promoting healthy lifestyles, smoking cessation, balanced diets,
regular physical activity, and routine health screenings. Public health policies should focus on
reducing salt and trans fat consumption, implementing tobacco control programs, and enhancing
community awareness about CVD risk factors. Secondary prevention emphasizes early detection
and management of hypertension, diabetes, and hyperlipidemia.
Conclusion
Cardiovascular diseases pose a substantial public health challenge in Uzbekistan. The growing
prevalence demands urgent action through integrated healthcare approaches, preventive
programs, and public awareness campaigns. Strengthening the healthcare system and ensuring
access to advanced diagnostic and therapeutic services are essential to mitigate the disease
burden and improve cardiovascular outcomes in the country.
References
1. World Health Organization. Cardiovascular diseases (CVDs). WHO Fact Sheets. 2023.
2. Uzbekistan Ministry
of
Health.
Annual
Health
Statistics
Report. 2024.
3. American Heart Association. 2023 Heart Disease and Stroke Statistics.
4. European Society of Cardiology. Guidelines on cardiovascular disease prevention in clinical
practice.
2021.
5. Tursunov K., et al. 'Prevalence of hypertension and risk factors in Uzbekistan: A nationwide
study.' Central Asian Journal of Medicine, 2023.
