Bolile netransmisibile (BNT) sunt boli cronice, cu evolutie in general lunga, dependente de factori genetici, fiziologici, de mediu si comportamentali. Principalele afectiuni ce fac parte din BNT sunt bolile cardiovasculare (BCV), cancerul, bolile cronice respiratorii si diabetul zaharat. BNT sunt responsabile de 70{3c0ae28f7ba2fee7d97cbf644c0d9d2a617e65985b4cd9b4c81a694deadcb233} din decesele anuale la nivel mondial (40 milioane). BCV sunt raspunzatoare de 17,7 mil (44,25{3c0ae28f7ba2fee7d97cbf644c0d9d2a617e65985b4cd9b4c81a694deadcb233}) din decesele prin BNT, fiind urmate de cancere (8,8 mil- 22{3c0ae28f7ba2fee7d97cbf644c0d9d2a617e65985b4cd9b4c81a694deadcb233}), bolile cronice respiratorii (3,9 mil-9,75{3c0ae28f7ba2fee7d97cbf644c0d9d2a617e65985b4cd9b4c81a694deadcb233}) si diabet (1,6 mil-4{3c0ae28f7ba2fee7d97cbf644c0d9d2a617e65985b4cd9b4c81a694deadcb233}), insumand 81{3c0ae28f7ba2fee7d97cbf644c0d9d2a617e65985b4cd9b4c81a694deadcb233} din decese prin BNT. In fiecare an, se inregistreaza 17 mil de “morti premature” (la varste sub 70 ani) prin BNT, avand ca si leader, de departe, decesele de cauza cardiovasculara, in special prin accidente vasculare coronariene si cerebrale.
Aceste date obiective fac din BNT o problema de sanatate mondiala, devenind una din prioritatile de actiune ale Organizatiei Mondiale a Sanatatii (OMS) in perioada actuala. Programul OMS vizeaza atat diagnosticul precoce si tratamentul curativ, cat si prevenirea si monitorizarea. Acest program a dus la dezvoltarea de strategii globale de scadere a incidentei, morbiditatii si mortalitatii BNT, prin reducerea efectiva a factorilor de risc, dezvoltarea de strategii cost eficiente pentru managementul BNT si monitorizarea trendurilor BNT si a factorilor lor de risc.
Urbanizarea neplanificata si globalizarea unui stil de viata nesanatos au dus la cresterea incidentei BNT, in special in tarile subdezvoltate si in curs de dezvoltare. Pe de alta parte, speranta de viata in crestere in tarile dezvoltate a dus la imbatranirea populatiei si la cresterea duratei expunerii la factorii de risc. Fumatul, sedentarismul, consumul excesiv de alcool si dieta nesanatoasa (factori de risc comportamentali, modificabili) favorizeaza aparitia hipertensiunii arteriale, a diabetului, a dislipidemiei si obezitatii (factori de risc metabolic, tratabili). Factorii de risc comportamentali si metabolici (factori de risc ce pot fi corectabili), alaturi de cei necorectabili (varsta si bagaj genetic) conduc la BCV. Toate grupele de varsta (copii, adulti, varstnici) sunt vulnerabile. OMS trage un semnal de alarma in ceea ce priveste cresterea obezitatii la copil, in 2017. Se estimeaza ca intreruperea fumatului, activitatea fizica cel putin 30 minute zilnic, dieta sanatoasa (cu scaderea aportului de sare, de dulciuri hiperconcentrate si de grasimi de origine animala, concomitent cu consumul de fructe si legume proaspete si carne de peste) alaturi de tratamentul hipertensiunii arteriale, a dislipidemiei si a diabetului zaharat, pot duce la reducerea mortalitatii “premature”, care este in special de cauza cardiovasculara, cu 80{3c0ae28f7ba2fee7d97cbf644c0d9d2a617e65985b4cd9b4c81a694deadcb233}. Necorectabili raman varsta si incarcatura genetica.
In ceea ce priveste Romania, principalele cauze de deces (din datele statistice OMSin 2012 ) sunt: boala coronariana ischemica (21,4{3c0ae28f7ba2fee7d97cbf644c0d9d2a617e65985b4cd9b4c81a694deadcb233} din decesele totale), accidentul vascular cerebral (17,8{3c0ae28f7ba2fee7d97cbf644c0d9d2a617e65985b4cd9b4c81a694deadcb233}), boala cardiaca hipertensiva (11,3{3c0ae28f7ba2fee7d97cbf644c0d9d2a617e65985b4cd9b4c81a694deadcb233}), urmate de ciroza hepatica (4,3{3c0ae28f7ba2fee7d97cbf644c0d9d2a617e65985b4cd9b4c81a694deadcb233}), cancere bronhopulmonare (4,1{3c0ae28f7ba2fee7d97cbf644c0d9d2a617e65985b4cd9b4c81a694deadcb233}), cancere colorectale (2,4{3c0ae28f7ba2fee7d97cbf644c0d9d2a617e65985b4cd9b4c81a694deadcb233}), infectiile de cai respiratorii inferioare (2,2{3c0ae28f7ba2fee7d97cbf644c0d9d2a617e65985b4cd9b4c81a694deadcb233}) si boala pulmonara obstructiva cronica (2,1{3c0ae28f7ba2fee7d97cbf644c0d9d2a617e65985b4cd9b4c81a694deadcb233}), cardiomipatii/miocardite (1,6{3c0ae28f7ba2fee7d97cbf644c0d9d2a617e65985b4cd9b4c81a694deadcb233}) si cancerul de stomac (3,7{3c0ae28f7ba2fee7d97cbf644c0d9d2a617e65985b4cd9b4c81a694deadcb233}). Se constata ca 50.5{3c0ae28f7ba2fee7d97cbf644c0d9d2a617e65985b4cd9b4c81a694deadcb233} din cauzele de deces annual, in Romania, sunt de cauza cardiovasculara (BCI , AVC, HTA). Este interesant de comparat, din datele statistice disponibile OMS, impactul factorilor de risc, distribuita pe sexe (barbati/femei) in Romania comparativ cu media europeana din regiune: hipertensiunea arteriala- 39{3c0ae28f7ba2fee7d97cbf644c0d9d2a617e65985b4cd9b4c81a694deadcb233} si respectiv 32,9{3c0ae28f7ba2fee7d97cbf644c0d9d2a617e65985b4cd9b4c81a694deadcb233} versus 33,1{3c0ae28f7ba2fee7d97cbf644c0d9d2a617e65985b4cd9b4c81a694deadcb233} si 25,6{3c0ae28f7ba2fee7d97cbf644c0d9d2a617e65985b4cd9b4c81a694deadcb233}; diabetul zaharat- 10{3c0ae28f7ba2fee7d97cbf644c0d9d2a617e65985b4cd9b4c81a694deadcb233} si respectiv 8,9{3c0ae28f7ba2fee7d97cbf644c0d9d2a617e65985b4cd9b4c81a694deadcb233} versus 9,6{3c0ae28f7ba2fee7d97cbf644c0d9d2a617e65985b4cd9b4c81a694deadcb233} si 8{3c0ae28f7ba2fee7d97cbf644c0d9d2a617e65985b4cd9b4c81a694deadcb233}; obezitatea – 16,3 {3c0ae28f7ba2fee7d97cbf644c0d9d2a617e65985b4cd9b4c81a694deadcb233} si 19{3c0ae28f7ba2fee7d97cbf644c0d9d2a617e65985b4cd9b4c81a694deadcb233} versus 20,4{3c0ae28f7ba2fee7d97cbf644c0d9d2a617e65985b4cd9b4c81a694deadcb233} si 23,1{3c0ae28f7ba2fee7d97cbf644c0d9d2a617e65985b4cd9b4c81a694deadcb233}; fumatul- 38{3c0ae28f7ba2fee7d97cbf644c0d9d2a617e65985b4cd9b4c81a694deadcb233} si 18{3c0ae28f7ba2fee7d97cbf644c0d9d2a617e65985b4cd9b4c81a694deadcb233} versus 38{3c0ae28f7ba2fee7d97cbf644c0d9d2a617e65985b4cd9b4c81a694deadcb233} si 19{3c0ae28f7ba2fee7d97cbf644c0d9d2a617e65985b4cd9b4c81a694deadcb233}.
Aceste date fac necesara intensificarea masurilor de preventie (avand ca viza factorii de risc corectabili, prin educatie, media, medic de famiie), de depistare precoce (prin screening) si tratament al afectiunilor cardiovasculare (prin programe nationale). Dreptul la sanatate este un drept constitutional. Pe de alta parte, este mai eficient sa previi decat sa tratezi.
