{"id":1104,"date":"2022-10-19T08:59:37","date_gmt":"2022-10-19T06:59:37","guid":{"rendered":"https:\/\/www.olejnadzlato.cz\/?p=1104"},"modified":"2022-10-19T09:57:07","modified_gmt":"2022-10-19T07:57:07","slug":"jak-udrzet-cholesterol-na-uzde%ef%bf%bc","status":"publish","type":"post","link":"https:\/\/www.olejnadzlato.cz\/?p=1104","title":{"rendered":"Jak udr\u017eet cholesterol na uzd\u011b"},"content":{"rendered":"\n

V \u010dl\u00e1nku na na\u0161em webu<\/a>  jsme informovali o d\u016fle\u017eitosti hl\u00eddat si svoji hladinu cholesterolu. \u010cl\u00e1nek reagoval na rozhovor s prof. Vrabl\u00edkem<\/a> z III. Intern\u00ed kliniky 1. LF UK a VFN v Praze, p\u0159edsedou \u010cesk\u00e9 spole\u010dnosti pro ateroskler\u00f3zu v r\u00e1mci podcastu Radia M.  <\/p>\n\n\n\n

V z\u00e1\u0159\u00ed 2022 byl zve\u0159ejn\u011bn na webu Radia M navazuj\u00edc\u00ed podcast<\/a>. Rozhovor tentokr\u00e1te poskytla prof. Rosolov\u00e1 z Centra preventivn\u00ed kardiologie FN v Plzni. V podcastu se dozv\u00edme, co d\u011blat, aby nedoch\u00e1zelo ke zvy\u0161ov\u00e1n\u00ed hladiny cholesterolu a abychom se vyhnuli infarktu myokardu.<\/p>\n\n\n\n

V \u010cesk\u00e9 republice um\u00edr\u00e1 na onemocn\u011bn\u00ed srdce a c\u00e9v v\u00edce obyvatel ne\u017e v Z\u00e1padn\u00ed Evrop\u011b<\/strong><\/p>\n\n\n\n

Podle rizika \u00famrtnosti na kardiovaskul\u00e1rn\u00ed onemocn\u011bn\u00ed d\u011bl\u00edme zem\u011b do 4 kategori\u00ed. Mezi zem\u011b s n\u00edzk\u00fdm rizikem pat\u0159\u00ed nap\u0159. Norsko, \u0160v\u00fdcarsko, Benelux, D\u00e1nsko \u010di Velk\u00e1 Brit\u00e1nie, do kategorie zem\u00ed s m\u00edrn\u00fdm\/st\u0159edn\u00edm rizikem pat\u0159\u00ed mimo jin\u00e9 N\u011bmecko, Francie, \u0160pan\u011blsko, It\u00e1lie. \u010cesk\u00e1 republika se \u0159ad\u00ed spolu se Slovenskem, Ma\u010farskem, Tureckem \u010di Estonskem mezi zem\u011b s vysok\u00fdm rizikem. \u010ctvrtou kategori\u00ed tvo\u0159\u00ed zem\u011b s velmi vysok\u00fdm rizikem, kter\u00e9 se nach\u00e1zej\u00ed na v\u00fdchod od Slovenska a Polska. V roce 2019 zem\u0159elo v \u010cesk\u00e9 republice na kardiovaskul\u00e1rn\u00ed choroby v\u00edce ne\u017e 64 000 osob, co\u017e je v\u00edce ne\u017e polovina z celkov\u00e9ho po\u010dtu \u00famrt\u00ed a v p\u0159epo\u010dtu na po\u010det obyvatel 3 x v\u00edce ne\u017e ve Francii.<\/p>\n\n\n\n

Rizika jako na houpa\u010dce<\/strong><\/p>\n\n\n\n

Po roce 1989 u n\u00e1s \u00famrtnost na nemoci srdce a c\u00e9v poklesla o v\u00edce ne\u017e 50 %, z \u010d\u00e1sti to bylo zp\u016fsobeno nov\u00fdmi l\u00e9\u010debn\u00fdmi postupy (asi 43 %) a 58 % \u0161lo na vrub preventivn\u00ed kardiologie. Po roce 1989 se zm\u011bnilo stravov\u00e1n\u00ed, za\u010dala se l\u00e9\u010dit hypertenze a hypercholesterolemie. Ale stravov\u00e1n\u00ed m\u011blo asi nejv\u00fdrazn\u011bj\u0161\u00ed vliv na pokles hladiny cholesterolu v populaci. V sou\u010dasn\u00e9 dob\u011b se situace sp\u00ed\u0161e zhor\u0161uje. Podle posledn\u00edch dostupn\u00fdch dat z roku 2018 a 2019 doch\u00e1z\u00ed op\u011bt k m\u00edrn\u00e9mu n\u00e1r\u016fstu \u00famrtnosti. Roste po\u010det diabetik\u016f 2. typu ve spole\u010dnosti, zvy\u0161uje se obezita, hlavn\u011b u mu\u017e\u016f. K n\u00e1r\u016fstu \u00famrtnosti na kardiovaskul\u00e1rn\u00ed onemocn\u011bn\u00ed (asi o 10 %) p\u0159isp\u011bl i Covid-19. Zat\u00edm nen\u00ed jasn\u00e9, jestli to byl p\u0159\u00edm\u00fd vliv, nebo zprost\u0159edkovan\u00fd, kdy do\u0161lo k zanedb\u00e1n\u00ed p\u00e9\u010de. Kardiologov\u00e9 bij\u00ed na poplach. Co s t\u00edm? Hlavn\u00ed d\u016fraz v r\u00e1mci prevence je kladen na zdrav\u00fd \u017eivotn\u00ed styl.<\/p>\n\n\n\n

Z\u00e1kladem je nekou\u0159it<\/strong><\/p>\n\n\n\n

Pro n\u011bkoho je t\u011b\u017ek\u00e9 p\u0159estat kou\u0159it. Z\u00e1vislost na nikotinu se p\u0159ipodob\u0148uje k z\u00e1vislosti na kokain. \u00dasp\u011b\u0161nost osobn\u00edho rozhodnut\u00ed p\u0159estat kou\u0159it je \u00fasp\u011b\u0161n\u00e1 asi z 5 %. Vy\u0161\u0161\u00ed \u00fasp\u011b\u0161nost maj\u00ed n\u00e1v\u0161t\u011bvy pracovi\u0161\u0165 zam\u011b\u0159en\u00fdch na odvyk\u00e1n\u00ed kou\u0159en\u00ed.<\/p>\n\n\n\n

Nezapom\u00ednejte na pohyb<\/strong><\/p>\n\n\n\n

Nedostatek pohybu je jedn\u00edm z 10 rizikov\u00fdch faktor\u016f s vlivem nejen na kardiovaskul\u00e1rn\u00ed onemocn\u011bn\u00ed, ale i na celkovou \u00famrtnost. Sedav\u00fd zp\u016fsob \u017eivota, kter\u00fd p\u0159in\u00e1\u0161\u00ed dne\u0161n\u00ed doba, je velmi nebezpe\u010dn\u00fd. Vede k n\u00e1r\u016fstu obezity a dal\u0161\u00edch onemocn\u011bn\u00ed.<\/p>\n\n\n\n

Zdrav\u00e1 strava <\/strong><\/p>\n\n\n\n

V\u0161em pacient\u016fm je doporu\u010dov\u00e1no dodr\u017eov\u00e1n\u00ed z\u00e1sad zdrav\u00e9ho stravov\u00e1n\u00ed. Jednoduch\u00fdch cukr\u016f by m\u011blo b\u00fdt ve strav\u011b co nejm\u00e9n\u011b. Polysacharidy (zelenina, p\u0159\u00edlohy) by m\u011bly tvo\u0159it asi 60 % energetick\u00e9ho p\u0159\u00edjmu. P\u0159\u00edjem b\u00edlkovin spl\u0148uje doporu\u010dovan\u00fdch 15-20 %. Velk\u00fdm probl\u00e9mem jsou ale tuky. Probl\u00e9m spo\u010d\u00edv\u00e1 hlavn\u011b v jejich skladb\u011b. P\u0159eva\u017eovat by m\u011bly hlavn\u011b takzvan\u00e9 zdrav\u00e9 tuky p\u0159edev\u0161\u00edm rostlinn\u00e9ho a ryb\u00edho p\u016fvodu. Tyto tuky obsahuj\u00ed omega 3 a omega 6 polynenasycen\u00e9 mastn\u00e9 kyseliny nebo mononenasycen\u00e9 mastn\u00e9 kyseliny zastoupen\u00e9 nap\u0159. v olivov\u00e9m oleji. Tyto tuky jsou pro n\u00e1s v\u00fdhodn\u00e9, nevedou k nadm\u011brn\u00e9 tvorb\u011b cholesterolu. Naopak tuky obsahuj\u00edc\u00ed nasycen\u00e9 mastn\u00e9 kyseliny (hlavn\u011b tuky \u017eivo\u010di\u0161n\u00e9) n\u00e1m neprosp\u00edvaj\u00ed, proto\u017ee vedou k nadm\u011brn\u00e9 tvorb\u011b cholesterolu. Mus\u00edme d\u00e1vat pacient\u016fm p\u0159\u00edklady, hlavn\u011b kde jsou omega 3 mastn\u00e9 kyseliny. Omega 6 mastn\u00fdch kyselin m\u00e1me ve strav\u011b v\u00edce. Pom\u011br omega 3 a 6 mastn\u00fdch kyselin by m\u011bl b\u00fdt ve strav\u011b vyv\u00e1\u017een\u00fd.<\/p>\n\n\n\n

Omezte alkohol<\/strong><\/p>\n\n\n\n

V posledn\u00edch doporu\u010den\u00fdch postupech pro prevenci kardiovaskul\u00e1rn\u00edch onemocn\u011bn\u00ed se sni\u017euj\u00ed tolerovan\u00e9 d\u00e1vky alkoholu. D\u0159\u00edve platila tolerance 3 drink\u016f pro mu\u017ee (pivo, 2 dcl v\u00edna, sklenka destil\u00e1tu), 2 pro \u017eenu. V sou\u010dasnosti plat\u00ed omezen\u00ed na 100 g \u010dist\u00e9ho alkoholu (nap\u0159. 1 litr v\u00edna nebo 7 desetistup\u0148ov\u00fdch piv) za t\u00fdden, nerozli\u0161uje se limit pro mu\u017ee a \u017eeny. <\/p>\n\n\n\n

Posouzen\u00ed rizikovosti pacienta <\/strong><\/p>\n\n\n\n

Celkov\u00e9 riziko pacienta se posuzuje podle pohlav\u00ed, v\u011bku, zda se jedn\u00e1 o ku\u0159\u00e1ka, jak\u00fd je systolick\u00fd krevn\u00ed tlak, jak\u00e1 je hladina non-HDL cholesterolu (celkov\u00fd cholesterol \u2013 HDL cholesterol). Pokud m\u00e1 n\u011bkdo hladinu LDL cholesterolu nad 3 mmol na litr, je t\u0159eba posoudit ostatn\u00ed v\u00fd\u0161e uveden\u00e9 faktory a za\u0159adit pacienta do ur\u010dit\u00e9 rizikov\u00e9 skupiny. U pacient\u016f s vysok\u00fdm a velmi vysok\u00fdm rizikem se doporu\u010duje zah\u00e1jit farmakologickou l\u00e9\u010dbu. Pokud zah\u00e1j\u00edme l\u00e9\u010dbu v\u010das, m\u016f\u017eeme odd\u00e1lit vliv progrese ateroskler\u00f3zy. U rizikov\u00fdch pacient\u016f chceme doc\u00edlit hladiny LDL cholesterolu pod 1,8 a u pacient\u016f s velmi vysok\u00fdm rizikem pod 1,4 mmol na litr. To jsou hodnoty, kdy ji\u017e zdrav\u00fd \u017eivotn\u00ed styl nesta\u010d\u00ed na dosa\u017een\u00ed t\u011bchto hodnot.<\/p>\n\n\n\n

Nepodce\u0148ujme proto vy\u0161\u0161\u00ed hladinu cholesterolu a zdrav\u00fd \u017eivotn\u00ed styl jako sou\u010d\u00e1st prevence. S v\u00fdb\u011brem spr\u00e1vn\u00fdch tuk\u016f m\u016f\u017ee pomoci bro\u017eura<\/a>. <\/p>\n","protected":false},"excerpt":{"rendered":"

V \u010dl\u00e1nku na na\u0161em webu  jsme informovali o d\u016fle\u017eitosti hl\u00eddat si svoji hladinu cholesterolu. \u010cl\u00e1nek reagoval na rozhovor s prof. Vrabl\u00edkem z III. Intern\u00ed kliniky 1. LF UK a VFN v Praze, p\u0159edsedou \u010cesk\u00e9 spole\u010dnosti pro ateroskler\u00f3zu v r\u00e1mci podcastu Radia M.   V z\u00e1\u0159\u00ed 2022 byl zve\u0159ejn\u011bn na webu Radia M navazuj\u00edc\u00ed podcast. Rozhovor tentokr\u00e1te poskytla prof. Rosolov\u00e1 z Centra preventivn\u00ed kardiologie FN […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"2880"},"categories":[3],"tags":[],"_links":{"self":[{"href":"https:\/\/www.olejnadzlato.cz\/index.php?rest_route=\/wp\/v2\/posts\/1104"}],"collection":[{"href":"https:\/\/www.olejnadzlato.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.olejnadzlato.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.olejnadzlato.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.olejnadzlato.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1104"}],"version-history":[{"count":3,"href":"https:\/\/www.olejnadzlato.cz\/index.php?rest_route=\/wp\/v2\/posts\/1104\/revisions"}],"predecessor-version":[{"id":1117,"href":"https:\/\/www.olejnadzlato.cz\/index.php?rest_route=\/wp\/v2\/posts\/1104\/revisions\/1117"}],"wp:attachment":[{"href":"https:\/\/www.olejnadzlato.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1104"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.olejnadzlato.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1104"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.olejnadzlato.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1104"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}