its effect can only be increased so that the stock is restored completely, but the task is there, it will be realized. ilya vasilievich, thank you very much for the conversation. thank you too. hello, in russia there is a decade of science and technology, the ntv television company and the state corporation rosatom present a program we are science, science and we are a program on how science will change our lives in the next 10 years, i am vladimir antokhin, and i am ekaterina shugaeva, in 10 years science will win atherosclerosis, well, i invited optimists who believe that in 10 years science indeed.

atherosclerosis will greatly defeat, this is oleg gulaev, doctor, angiosurgeon, good evening, and nikolai dupik, cardiologist, hello, hello, i hope we will find out what angiosurgery is, very interesting, by the way, as per tradition, i have skeptics visiting alexander karasev, doctor of clinical laboratory diagnostics, alexander vladimirovich, good afternoon, and pavel yurievich orekhov, cardiovascular surgeon, good, good evening, at the end of the program our guests are optimists. will make a forecast with what probability in 10 years science will actually will defeat atherosclerosis? our expert, professor kapustin, will tell you about the history of atherosclerosis. atherosclerosis is a disorder of lipid metabolism, which leads to drying of blood vessels, reduces blood flow and leads to thrombosis with blockage of the artery. the cause of atherosclerosis is an increase in the concentration of cholesterol derivatives. atherosclerosis is the most famous.

an analysis of mummies dating back thousands of years showed that the cause of death for many people was precisely atherosclerosis, but not so long ago , good preserved mummies. a study of the remains showed that the eskimos ate mainly fish and meat rich in omega-3 polyunsaturated acids. this diet usually prevents. sclerosis, but this did not happen in the case of greenlanders. it turned out that atherosclerosis was caused by smoke from the lesions, well, today it would be the consequences of smoking. the study of atherosclerosis began at the end of the 18th century. and the greatest contribution to the study of the disease was made by our outstanding scientist, nikolai anechkov. his work on the pathogenesis of atherosclerosis is included. listen,

in the 10 greatest discoveries in medicine, for his work he was awarded three orders of lenin and medals. our scientists are the best, this is certainly true, you see, atherosclerosis is really serious, but for now i have a question for you, come on, do you generally monitor your blood vessels, when was the last time you had an ultrasound of your blood vessels, well, when, and you? well, in order to look positive, i brought, of course, here’s a photograph, but... it’s not yours, no, but it’s from the brain, to be honest, because the ultrasound vessel, i didn’t even know what that was, nikolai vasilyevich, well but really, when people realized that there are vessels in the body, blood and some other liquid flow through these same vessels, the state of the vessels affects human health, in general i think that they always guessed about this, but in fact, the first a written source is indeed the 16th century bc, in one of... the ancient egyptian pyri

the heart and vessels coming from it were described, which were filled with blood, the first mention of the heart and vessels is considered to be then, but like the egyptians, so after them the greeks believed that in the veins, and this is a term coined by the grandson, in my opinion, of aristotle in the third century bc, there is blood, in the arteries, in fact, air, this is air, there is air, because, excuse me, during the posthumous. research, the blood was found, the arteries were empty and they looked empty, which is why, somewhere before the 17th century , complete chaos reigned, dominated, dominated by the view of galen, who in the second century ad formulated that blood is formed in the liver and the liver is the main the organ is the heart, yes, it is a pump, then it did postulate that the blood moves through cardiac activity, but the tidal movement is back and forth, back and forth.

and an anatomical study of the movement of blood in the heart of blood in animals, where he showed that the circulatory system is closed, although at that time he could not see the capillaries, there was no microscope yet, but that the circulatory system is closed and that blood circulates, that it is collected through the veins , and through the arteries it goes to the organs, and through the veins from the organs it is collected, in 1666-61, in my opinion, malpighium with the help or... with the help of a gukomgum microscope, shortly before this invention, he saw capillaries in the smallest arteries, which confirmed the prophecy, accordingly, harvey showed, well, they finally, so to speak, formed a view of the cardiovascular system , nothing has changed since then, well, by and large , this is what

is called physiology, the physiology of the circulatory system, so they realized that something was wrong and that the health of blood vessels is directly... with health and longevity, they began to guess somewhere in the 19th, from the beginning of the 19th century, when they were described cases of myocardial infarction, in fact, here, too, the priority of the russian school can be emphasized that in 1909, at the first meeting, well, in general, at one of the first meetings of the moscow society of therapists at that time, samples and strozhensk reported the described case of myocardial infarction and the connection between the development of a heart attack and... was reported

, which formulated the beginning of the postulate of the cholesterol theory of the development of atherosclerosis. oleg georgievich, when people actually encountered directly atherosclerosis, and how did they try to treat it? well , as my colleague already said, the first person to introduce atherosclerosis was felix marchand in 904, who, upon opening a large material in the lumen of a vessel, discovered a lipid stain that caused it. the lumen of the vessel and thereby caused myocardial infarction, then they already began to think about how to treat, but in those days they did not know and did not exist, science was not so developed, the first thing that came to mind was bloodletting, that is, when a person

blood pressure increased, bloodletting was done, thereby lowering blood pressure and improving the patient’s condition, these were the first ones like this, wait, but he didn’t connect the fact that there was no lumen in... the vessel, that he found a plaque with the fact that the person died, well, from a heart attack, so he didn’t connect, he saw a plaque, saw that blood wasn’t flowing through the vessel, well , okay, well, this, this was the first discovery of atherosclerosis, which began to be mentioned specifically as a diagnosis, not as a cause of death, because it systemic disease, there were several theories, the theory of an immune response, of an inflammatory nature, when the wall... of an artery becomes inflamed, lipid deposits are deposited, the lipid stain has already begun to grow, thereby clogging the vessel, an obstacle to blood flow, in the seventies, japanese scientists also established the immune nature of the disease, atherosclerosis, there was more work according to

monoclonal factors, which also led to atherosclerosis, but as a colleague already said, the founder of growth and lipid metabolism was anechkov, who first established the connection between lipid metabolism disorders and damage to the vessel wall and further described it in his works as atherosclerosis. let's take a break for a moment, advertising on ntv. what is it? beautiful, right? meet, this is zhenya, and just his soldiers, somehow you are younger, i imagined you differently, kuat decided to take over the entire business in the cemetery, yours too, come on, like in

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never ceases to amaze. discover your russia. on the unknown russia tv channel. the program "we are science" is on air. science and us is a program about how science will change. life for the next 10 years, in 10 years science will win atherosclerosis, but, unfortunately, our expert, professor kapustin, does not believe in this, but at present the mechanism of occurrence of atherosclerosis is unknown. atherosclerosis is a form of aging of the body and its vascular system. the older the person, the more likely the body is to be damaged. changes can be found in any person, regardless of age and gender. all attempts to dissolve, cleanse, reduce are

fantasies, and most often just quackery. atherosclerosis is generalized.

let's separate the concept, i think that many our viewers know that sclerosis, atherosclerosis , is not the same thing, but still, what science today calls atherosclerosis. atherosclerosis is a chronic artery disease, it has already been said what the causes are, uh, possible mechanisms and so on. one of the main links of this disease is that cholesterol begins to be deposited in the vessel wall, proteins begin to be deposited, and in parallel with this , connective tissue begins to grow, which again displaces active vascular cells. this is exactly what there is some commonality between sclerosis and atherosclerosis, that is, the proliferation of connective tissue. in any case , the formation of this plaque leads to deformation of the vessel wall, partial or complete blockage of the vessel lumen, but the clinical manifestations

will depend on the failure of which organ or tissue.

he thought how good it was, the horse plays sports all the time, every day, i don’t know, runs around the arena, walks, but it turned out that horses are the most susceptible animals to atherosclerosis, i even told you about it demonstrated, he now doesn’t allow her to run around the arena, makes the horse sleep all day long, yes, now he ’s at a loss, wait, even to be honest, he didn’t want to let me ride her. one time is possible, well, one time is possible, he said, but not very quickly, so that she doesn’t have any extra physical activity, let’s go, she won’t get injured, you’ll forgive alexander vladimirov that i’m on top here, let’s go, let’s go, let’s go, let’s go, let’s go , don’t be afraid, tell us what the main causes of atherosclerosis are, we’re very

you need to know in order to cure a person, well , if not a horse, then at least a person, yes. and we cannot say that there are vessels and there is a separate human body, no, really the problem is complex throughout our entire dear body, we also said that there are vessels in which this problem exists, and nearby... we will write out some points , about which we already know for sure, we know maybe as the reasons, and maybe how - just the knowledge that we have received under a microscope, let's look at the vessels. so we have the outer one here. the wall of blood vessels, as we talked, we have a growth of plaque that begins here, and here it looks like a huge, thick

otrosclerotic plaque, there is fat on the inner wall, this is all that was seen historically, and the first thing about we thought that people who eat fat are most susceptible to atherosclerosis, and now we still have this theory, this... everything is fat, and cholesterol is its separate chemical component. let's eat cholesterol-free foods. vegetable oil does not contain cholesterol in principle, therefore yes, we have cholesterol. forget that there is good cholesterol and there is bad, it was later, we realized that cholesterol consists of many fractions in the body, it is

actually formed by a certain organ called the liver, and here those early theorists were right, yes golen, who said that yes , it is formed there, but not blood, but just the same cholesterol, we have here a small gall bladder and a bile duct, which gradually removes all this through the intestines. so low that they in fact, from the liver they fly into the vessels , these plaques are made up of bad cholesterol, there is this one here, what is this x, this is cholesterol, here it really has fatty components, then we looked, listen, people with such plaques live quite a long time they don’t die for a long time, what is the cause of death from atherosclerosis, we saw on the x-ray that there is calcium in the vessels in this plaque, there is a shadow there that clearly indicates that this plaque contains the whole metal calcium, which should be in the bones, and for some reason he is in

vessel, when this stage had already begun, calcium became to blame for everything, and now we know for sure that just any person should not take calcium supplements, because tell all mothers this, you can write this in pharmacies, which for some reason they buy huge amounts of calcium for their children, but why is calcium contained in dairy products... this is a good food for children, but not very good for people who already have atherosclerosis. now we remember, listen, but in all people the plaque grows so quickly and so it calcifies quickly, what else is the problem? the problem is that the plaque gradually becomes rough, and this is where a blood clot forms. blood in a normal vessel flows laminarly, a calm flow, absolutely not disturbing these formed elements inside, red blood cells, platelets and many blood cells. when there are plaques, then turbulence begins, collision of cells begins, thrombus formation immediately begins, so now yes, prevention is there, well, that’s not all, now we know that sometimes this form becomes

genetically determined, especially in early age, we have genetics, we know that some people have a little more of these cells, that is, they are predisposed to osteal formation, and now we are talking about the inner layer of cells, the endothelium of these same ones... which suddenly for some reason attract athersclerotic plaques, some are a little better, some are a little worse, there is personalization in this, we now know hereditary forms of atherosclerosis that require immediate prevention, but that’s not all, it turned out that if we remove fat, cholesterol, let's prevent the formation of the wrong form of lipoproteins, we remove calcium and have also identified a genetic factor, then it turns out that there is a huge layer that forms in our liver, and what does diabetes mellitus have to do with it, and despite the fact that almost all cholesterol and its irregular form, as we now know in xx century, it is formed from fast carbohydrates, i said from the very beginning, eat up, yes,

it turns out that excess glucose, which we form for a reason, because we suddenly overate it, is formed for a reason cholesterol, because we overate it, by the way, shrimp is one of the interesting sources of large amounts of cholesterol, pork is in second place, veal is in third, but it turns out that irregular forms of carbon... sugar, lactose, fructose, milk sugar, fructose are to blame, it seems that this product is for diabetics for diabetics, it really is a product for diabetics and for atherosclerotic people, now we will definitely write, and excess fructose, we now know for sure that it is a bad product for us, it turns out that if our diet is rich in fiber, these are long form of carbohydrates and does not contain fast carbohydrates, glucose, fructose and... analogues, then this is the best diet for the prevention of atherosclerosis, and also, and this is definitely the end, wait, you know, so people came, science went on, there may be a whole list here,

the latest achievements. concern small substances that are formed in the intestines, which are formed in the intestines, bacteria, exactly, and there are bacteria that stimulate inflammation, the immune system flies in to remove this plaque instead of cleaning it, it triggers even more attracting thrombosis cells, and accordingly , inflammation appears here. bacteria and viruses are to blame, bacteria use excess food that we have not digested, excess meat, we returned to the animal, yes, the source of fat and so on, when we overeat a lot of meat in one serving, bacteria save us a little, form quite toxic compounds , which damage endothelial cells, endothelial cells already attract cholesterol and then plaque formation begins if a person he also eats quite large

quantities... in his supplements in particular, he accelerates the calcification process, it will be normal for bacteria to test, yes, if there is an excess in general, then soon everything will end, the less you eat, as usual, excess protein and animal products is not very good, so we came to the mediterranean diet, which is balanced, not very many simple carbohydrates, there are vegetable fats, like the base and a large amount of fiber, which helps us remove excess cholesterol through the bile ducts, thank you big. so he’s sitting in ryazania, he says, the mediterranean diet, that ’s the very thing, yes, the very thing, oleg georgievich, but seriously, how is atherosclerosis diagnosed today, the diagnosis of atherosclerosis is made from an initial appointment in the doctor’s office, when a specialist, based on complaints, anamnesis, checks with the patient whether any of

his relatives have? father, mother, grandmother, stroke, heart attack, that is, this is also a risk factor. then he begins to examine the patient, our body is designed in such a way that we have points that come as close as possible to skin, where we can palpate the pulse, feel the pulse on the hips, listen to the heart with a fondoscope, hear characteristic noises above the heart, above the carotid arteries, which will give us indirect signs that yes this... vessel is sick, it needs further examination, then eat without seeing the vessels, we can diagnose with our hands that his vessels are affected by atherosclerosis, it happens that by placing a finger on the thigh or in the popliteal area, we do not find pulsation, which means this area of ​​tissue, the muscles are affected, they lack oxygen, they begin to experience ischemia, and the main complaint of such patients is pain

when walking. they can’t walk, they came, and how very often such complaints are confused there, they come to a neurologist, a traumatologist, well, everyone first goes to a therapist, and to a therapist, the direct route is to a vascular surgeon, already in the office, when the specialist understands that the area is affected, say on the leg, he sends it to the ultrasound diagnostic room, where under ultrasound we can...

the characteristic calcium behind which it is hiding atherosclerotic plaque, narrowing of a vessel that leads to the affected area, well , this also happens, sometimes surgeons are not enough, we can see the lumen of the vessel in real time, the so-called coronary angiography, when the patient is on the table, we visualize the hearts, visualize the plaque that impedes blood flow to this area and... immediately make a diagnosis and cure it, put a stand, but sometimes this happens, it’s not enough for us specialists, we can insert a thin catheter into the lumen of the vessel, called intravascular ultrasound, so that there is 99% certainty to determine whether this vessel needs a stent or not, because there is such a problem, if there is atherosclerosis, most likely this is a problem in more than one vessel, you put a stand in one vessel,

and the same in others. this is a systemic disease, so we examine it comprehensively, starting with the heart, blood vessels, neck, lower limbs, kidneys, because deposits are also deposited in the renal vessels. i understand that you have to put stands wherever possible, because, in principle , today a person can be trained from atherosclerosis impossible, vasilievich, but how is atherosclerosis treated today? great, katya, you’re doing great, it’s just really, a systemic disease, a systemic process, a stent - this only kind of removes the tip of the iceberg, something that directly threatens life or interferes with a person’s life, in fact, the process itself remains, professor kapustin said, alexander vladimirovich he said that everything is written exactly on the task. we don’t know the reasons, we know the risk factors and the impact on these risk factors, firstly, the impact on these factors risk, we can reduce or prevent the development or slow down the development of atherosclerosis, do not smoke, move more, control sugar levels, control blood pressure levels, this is what is called

such a modification, there is a horse moving, and at the same time it is susceptible to atherosclerosis, genetics, we are now we will come to this, this is nevertheless, nevertheless, a kind of modification of lifestyle and implementation of healthy lifestyle measures. no matter how trite it may sound, it is extremely important, and it works, and it works, and we are that the so-called is not a medicinal level of correction for the prevention of atherosclerosis, but of course the basis for the treatment of atherosclerosis and the prevention of atherosclerosis in people who are prone to its development, we can now calculate the probability of development, but not 100%, but nevertheless predict the estimate, not even seeing the vessels of a particular patient, even without seeing the patient himself, we can... say that he has atherosclerosis and its severity, yes approximately, but nevertheless, and of course, the basis of treatment of atherosclerosis is drug treatment, we have several classes of drugs, and what makes me an optimist is that we are now experiencing a boom in education, the emergence of new

classes of treatment drugs, including genetics, we are now trying to influence, and this is not so far away, we have now now there are already at least three or four high classes... so, statins are the most, most effective, well, one of the most effective preventive measures, this is not for the treatment of prevention, and for treatment as well. atherosclerosis, what causes death, complications atherosclerosis, from heart attack from stroke,

isatin, inhibiting the development of plaques, and stabilizing the development of plaques, by the way, when we see calcium in a plaque, we actually see calcified plaques, we are not afraid of them, we are afraid of young plaques, 80%. non-calcified plaques, which have a soft covering, which crack on which a blood clot forms, statins prevent this process; in addition to their direct cholesterol-lowering properties, they also have a lot of polyotropic effects, anti-ischemic, antithrombotic, antifibrillatory, improving the function of the vascular endothelium, that is, a statin is really a root, root. stone for the treatment and prevention of atherosclerosis, and besides this, there are several other drugs, when we cannot prescribe a statin, by the way, this happens extremely rarely, complications, side effects, yes, they do happen, this is a real medicine, but this happens quite

rarely if it doesn’t work out on statins to achieve target values, now there is no general norm, it is very important to convey to our viewers that there is no general norm, there is the norm is specific, tied to a specific person in order... you just need to follow it, at the delization they will do a screening, they will tell you your predisposition, your cholesterol level will be determined, your blood pressure will be measured, maybe it’s so high, i don’t know, it’s normal for me, special algorithms have been developed that,

depending on the presence of risk factors specifically for you, will calculate the required level, the target level of cholesterol specifically for you, and if necessary, conduct additional research methods that will allow the issue to be resolved sufficiently. why didn’t you start wandering earlier? yes, i had this music, ruzil minikaev, although there will be a war soon, leon kemstach, i see in the area, i’ll bury you, nikita kologrivy, don’t you understand that they will now catch us all one by one, anna peresilt, help, anton vasiliev, we now we are creating a new administration, the power is now behind us, we will hand over all of you in 2 weeks. sergei burunov, why

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transsip will not work, it is not a large highway, it is many, many small, small, small vessels, but the totality of a huge number of these small vessels, in some cases it allows you to compensate for the blood circulation of borgani or in tissues to such a level that they do not die.

what is this you have lying around? and i ’ll tell you this, when you ask me about surgical methods of treatment, let me tell you what surgical methods of treatment are. let's do everything we did for you. let's do. well, first of all, i would like to say that it is a very correct remark that atherosclerosis is a systemic disease, but it has its favorite places. and first of all, uh, most often the places where the blood vessels divide are affected, or the beginning of the vessel, which is called the ustim. here most often plaques develop there. many theories have been proposed as to why athersclerotic plaques most often break out in places where blood vessels divide. it is believed that most likely due to the fact that some kind of blood flow turbulence occurs in these places, which triggers a whole cascade of subsequent processes. there is no 100% proof yet, but in any case this is an obvious fact. i would also like to say that

the term itself is surgical treatment of atherosclerosis, it requires a small, small correction, because we do not surgically treat atherosclerosis. this circulatory failure will manifest itself in a person depending on where the trouble happened, if say, there is a blockage in the vessels of the legs, then the person will limp, the so-called intermittent claudication, by the way, intermittent claudication was first described in a horse, yes, then it passed to a person, it’s really true, yes, if the disease is in a more severe stage, then there may already be a threat of organ loss, for example, in the same leg, severe vascular damage no longer just leads to intermittent chromate, to gangrene and the threat of amputation, critical narrowing of the renal artery can lead to loss of kidney function as an organ, there are

vascular diseases that do not manifest themselves clinically, well, for example, a person may not feel the narrowing of the carotid artery until a stroke develops, or , for example, aortic aneurysm. many people even find out about this by accident, like for the first time when they undergo an ultrasound in the abdominal cavity, i don’t feel anything, but the rupture of an aortic aneurysm leads to fatal bleeding. therefore, indications for surgical treatment of complications of atherosclerosis is performed when there are already obvious manifestations. sufficiency of blood supply, and conservative therapy is no longer able to compensate for this blood flow or somehow prevent it, we do, well, what is the main goal of treating complications - is to improve blood flow to a starving organ

or tissue, for this you need to restore blood flow, how can this be restored, can it be restored or open operations, probably in development, this technique is what is now a priority, is that a puncture is made in the skin that is subject to the tissue, through this puncture the instrumentation is inserted into the lumen of the vessel, but can you show demonstration materials to make it easier to explain? yeah, well, they showed us something a little different, with this method we can remove blood clots. the blood clot turns out to be so big, it’s not some kind of ball, it’s not a ball, it’s.

using a can, we try to expand this lumen of the vessel, sometimes even this manipulation is enough, but if this is not enough, then they come to our aid stents are a metal structure that is delivered to a place on a plastic tube catheter, and to a narrowed place, then this delivery device is removed, the stand remains in place. a stand is, in theory, a wire that will expand, it is a braided, yes, well, a braided cylinder, in fact this is a very complex

technology, most stents are made of an alloy of nickel and titanium, they have thermal memory, they have radial stability, and they are flexible for in order to repeat the shape of the vessel, stents can be to fasten vessels together already in the lumen in order to lengthen them, modern technologies: now they are making very complex stands, called endoprostheses, which can, for example, isolate an aneurysm, the aorta, just through a puncture, without any incisions, and where previously it was required anesthesia, a multi-hour operation, intensive care, a long postoperative period, after such endoprosthetics, a person, well, literally a day later can go home, wow, that is, no incisions, just through a puncture or something like this, a modern clinic should have everything. these treatment methods. here ’s a short question, but now a person here wants to go to advertising, but what if science defeats atherosclerosis?

how much will human life expectancy increase? now estimates converge to approximately 15-20 years, that is, really plus 15-20 years. yes, this is very decent, yes, that is, if we start in advance, not like at 40 years old, at 40 years old prevention is already a little late, because there are already changes in blood vessels, there are already theatersleotic plaques and this process has already started. it’s good to have good habits a little earlier, when we start managing these risk factors that we can control earlier, by the age of 45-50 we will already approach 45-50 years old in a cheerful state of mind, able to cope with physical activity, with good vascular elasticity, this is also important and it can be trained, of course, any physical activity, it trains not only the muscles, but it also trains the blood vessels, plus this stress that we constantly experience when we exercise physically, give it to the vessels, it gives an incentive for the growth of new ones.

contractor, you should know this. when you enlist in military service, you receive a number of benefits and guarantees. but there is also something that has no price. to be shoulder to shoulder with comrades, to defend your family and homeland, to fight for a just cause, to gain new knowledge and skills, to become stronger. join us. to your own, serve under a contract.