30 pills
Composition
Crestor 5 mg
Active substance: rosuvastatin 5 mg.
Inactive substances: lactose monohydrate, microcrystalline cellulose, calcium phosphate, magnesium stearate, crospovidone, glycerol triacetate, hypromellose, iron oxide red (E 172), titanium dioxide, purified water.
Crestor 10 mg
Active substance: rosuvastatin 10 mg.
Inactive substances: lactose monohydrate, microcrystalline cellulose, calcium phosphate, magnesium stearate, crospovidone, glycerol triacetate, hypromellose, iron oxide red (E 172), titanium dioxide, purified water.
Crestor 20 mg
Active substance: rosuvastatin 20 mg.
Inactive substances: lactose monohydrate, microcrystalline cellulose, calcium phosphate, magnesium stearate, crospovidone, glycerol triacetate, hypromellose, iron oxide red (E 172), titanium dioxide, purified water.
Basic Provisions
This part of the brochure is primarily intended for those people who at a young age (ie, up to 50-55 years) suffered a myocardial infarction, suffer from angina pectoris, or who already at this age found an increase in the level of cholesterol in the blood. It deals with what was only mentioned in passing, earlier, about the hereditary and / or familial predisposition to the development of hypercholesterolemia (ie, high cholesterol in the blood) and coronary heart disease, and, accordingly, the need to examine the children of these " primedemenno "sick people. The last conclusion is based on three main provisions.
The first position.
It is known that an increase in cholesterol in the blood is often found in the next of kin. This happens due to the same living conditions, the same diet of people living together. The reason may be that people were brought up together and, even living far from each other, retain the habits of nutrition acquired in childhood.
But in some families, elevated cholesterol levels are definitely hereditary, caused by changes in one gene. In such cases, there is evidence of a monogenic disorder. One of the most serious monogenic disorders is that which leads to a condition called familial hypercholesterolemia. If one of the parents has such a violation in the genetic apparatus, a significant increase in the level of cholesterol in the blood (hypercholesterolemia) will be noted in every second child. And 90% of these children (with high cholesterol) will develop ischemic heart disease by the age of 65 years. In an average adult male with familial hypercholesterolemia, coronary heart disease develops by the age of 50.
Another inherited condition caused by a defect of one particular gene is family combined hyperlipidemia. A person with this condition has an increase in blood or cholesterol or other fatty substances - triglycerides, or both cholesterol and triglycerides at the same time.
Family and family combined hypercholesterolemia are relatively rare conditions. They show up quite early. In the most severe cases of familial hypercholesterolemia, when a child receives defective genes from both the father and the mother (such forms are called homozygous) - a significant increase in cholesterol in the blood is detected in the earliest childhood and already then can lead to the development of myocardial infarction.
The most frequent is polygenic hypercholesterolemia. It is caused by the action of several altered genes. Each of them has a small effect, which contributes to a certain increase in the level of cholesterol in the blood, but their combined effect leads to a significant increase in cholesterol (ie, hypercholesterolemia). It is especially important that the effect of these genes is manifested under the influence of environmental factors, especially in the presence in the daily diet of an excessive amount of saturated fat and cholesterol. Changing these factors (for example, by normalizing the nature of nutrition), it can be achieved that the hereditary predisposition will not manifest itself at all or will manifest only at a later age.
Most children and adolescents with elevated cholesterol have just polygenic hypercholesterolemia and lifestyle changes, in particular the nature of nutrition, can lead to the normalization of cholesterol. We can say that in most such cases there is a hereditary predisposition, but not the hereditary predetermination of hypercholesterolemia.
Second position
Early (at the age of 50-55 years) the occurrence of coronary heart disease - myocardial infarction, angina - is also very often due to a hereditary predisposition to this disease. It can be associated with the inheritance of risk factors - high cholesterol, high blood pressure, diabetes, obesity. But the early onset of the disease is sometimes traced in one family, for members of which is not typical the presence of any one of these specific factors. The origin of the disease in these cases is also probably associated with defects in several genes (polygenically). The effect of these altered genes is manifested in the presence of certain conditions (smoking, excessive intake of saturated fats, low physical activity, etc.), which can be eliminated by humans. Moreover, in order to avoid creating conditions for the early manifestation of gene defects, a particularly active influence on the identified risk factors, in particular, a significant reduction in the level of cholesterol, is necessary.
Third reference position
This provision justifies the expediency of early detection of hypercholesterolemia and other risk factors for atherosclerosis in children and adolescents. Atherosclerotic narrowing of vessels develops slowly, gradually, and the first signs of atherosclerosis appear already in childhood and adolescence.
The earliest harbingers of an atherosclerotic plaque in the vessels are the fat deposits called fat spots. It is well established that fat spots in the aorta appear already in childhood, fat spots in the coronary arteries - a little later, in adolescence. And real atherosclerotic plaques begin to form between the ages of 13 and 19 years.
Important information was provided in the US study PDAY - "Pathobiological determinants (determining) atherosclerosis at a young age." People aged 15-34 who died from trauma, accidents, murders and suicides were measured in blood cholesterol and its "good" and "bad" fractions (ie low and high density lipoprotein cholesterol) and studied the state of the heart vessels (coronary arteries) and aorta. These same people made a determination of the content in the blood of thiocyanate - a substance whose presence is a sign that a person smokes (ie, a smoking marker). The results obtained from 1079 men and 364 women were published. A positive (direct) relationship was found between the degree of atherosclerotic lesion of the aorta and the coronary artery. and the content in the blood of "bad" cholesterol of low density lipoproteins. In addition, an inverse relationship between the severity of vascular changes and the level of "good" cholesterol of high-density lipoproteins has been revealed. People with a high content of "good" cholesterol, low - "bad" and no signs of smoking, had no noticeable fatty (lipid) deposits in the arteries, whereas in people with opposite indices of low HDL cholesterol, high LDL cholesterol and clearly smoked there were pronounced fatty deposition. It is especially important that the difference in the prevalence of early atherosclerotic changes in the coronary arteries in young people with a favorable and unfavorable profile of risk factors was detected at the age of 15!
Next, it is appropriate to quote from the report of the committee of experts on the level of cholesterol in children and adolescents of the National Educational Program for Cholesterol in the United States. "There are many indications that the initial atherosclerotic vascular lesions appear already in childhood and the appearance of these lesions is caused by an increased content of cholesterol in the blood."
These evidences confirm the view that efforts aimed at preventing the onset or progression of atherosclerosis should begin in childhood or in adolescence.
One can not disregard the fact that the PDAY study did not take place - among people aged 25-34 years, the severity of atherosclerotic changes in the aorta was 3 times (!) Higher than in non-smokers (according to the definition of thiocyanate).
Do all children need to determine the blood cholesterol content?
It is believed that no. Although very often children with high cholesterol become adults with hypercholesterolemia, the situation is also frequent, as the blood cholesterol grows normal.
According to the recommendations of the Committee of Experts on Cholesterol Levels in Children and Adolescents of the National Cholesterol Education Program in the United States, the cholesterol level in the blood must be determined in the following cases.
1. Those children and adolescents whose parents, grandmothers or grandfathers have (or had) any signs of coronary heart disease, cerebral vascular lesions or peripheral vascular lesions under the age of 55 years. To these signs, it is necessary first of all to carry the transferred myocardial infarction, the presence of obvious angina pectoris.
2. The cholesterol content of the child must be checked if one of his parents at a young age (up to 50-55 years) ever had elevated cholesterol (ie, exceeding 240 mg / dl or 5.2 mmol / l).
What level of cholesterol is considered "normal",
what - "increased" in childhood and adolescence?
In children over 2 years of age or in adolescents who have cholesterol in one parent, 240 mg / dL (6.2 mmol / L) or in the family there are cases of "early", i.e. developed in the father at the age of 55 years of coronary heart disease (myocardial infarction, angina pectoris)
It is necessary to identify combinations of risk factors.
As with adults, the borderline takes on special significance and requires special intervention when the child or adolescent has other risk factors for coronary heart disease - high blood pressure, diabetes, obesity or overweight, if he is physically inactive or if he has already started smoking . A particularly important risk factor, as has been repeatedly noted, is the presence of early heart disease (ie, at the age of up to 50-55 years) in one or more of the next of kin. According to the subject matter of this pamphlet, it is expressed in all of whom it refers to. And the detection of a child besides this factor and hypercholesterolemia also of the third or especially the fourth makes the situation particularly dangerous.
From what has been said it is clear that in all cases when a child or adolescent is advisable to determine blood cholesterol for the above reasons, it is necessary to conduct a thorough examination at the same time to detect high blood pressure, signs of latent diabetes or inclination to him, a tendency to obesity. Such a survey can reveal some dangerous combinations of risk factors for early development of atherosclerosis and in children without increasing the total cholesterol in the blood. So overweight is often combined with high blood pressure, signs of latent diabetes and a decrease in high-density lipoprotein cholesterol ("good" cholesterol).
When hypercholesterolemia in a child or adolescent, it is necessary to determine the levels of "good and" bad "cholesterol.
Just like in adults, if the cholesterol content is high or borderline in a child, it is necessary to determine the levels of low and high density lipoprotein cholesterol, i.e. "bad" and "good" cholesterol. Knowing these indicators is very helpful in determining further tactics. In some cases, blood cholesterol is elevated due to its "good" part, i.e. cholesterol of high density lipoproteins.
What to do if your child has high cholesterol.
When it is established that a child who has relatives with premature (early) ischemic heart disease, other atherosclerotic vascular diseases, or hypercholesterolemia, has elevated cholesterol, one must first assess the nature of his nutrition and change it. The main principle of this change is the same as in the detection of hypercholesterolemia in an adult. It is necessary to limit the intake of saturated fat, replacing it with unsaturated, and cholesterol (for more details, see the first section).
The diet of children of any age must necessarily contain the amount of calories, carbohydrates, proteins, fats, vitamins and minerals that corresponds to the needs of the growing organism. The diet recommended for the normalization of blood cholesterol and the prevention of atherosclerosis, fully meets this condition. What is required of a child is simply the normal proper nutrition of a healthy person.
But still, when planning a diet for children and adolescents, one should always remember the need to ensure sufficient intake of calories (energy), protein and minerals. However, a diet with a reduced content of saturated fat is not poor in protein, nor in calories, nor in minerals.
The high calorie of food required by a growing body is provided by carbohydrates.
In low-fat meat, in skim milk milk protein is the same as in fatty. The protein is rich in protein and fish. A lot of it in carbohydrate food - bread, cereals, pasta, rice, dried beans and peas.
Many minerals, in particular, necessary for calcium growth, in milk and dairy products. Therefore, it is very early to teach a child to consume skimmed milk and products from it. A lot of iron in low-fat "red" meat.
The National Cholesterol Education Program in the US does not recommend a dramatic change in the nutrition of a child or adolescent and immediately deprive him of fat-rich and cholesterol-rich foods. It is considered expedient to replace one or two "harmful" dishes on a daily diet that meets the requirements.
The nature of nutrition and lifestyle are in the family
It is necessary to realize well that the nature of the nutrition of parents affects the eating habits of children and even determines them. Therefore, adults who surround a child or teenager in the family should constantly think about the example they are giving. Habits are formed very early. That is why it is so important to create common family eating habits - for example, the habits of consuming some raw vegetables, a little salted food, the use of vegetable oil, cereal cereals, skimmed milk products. Already in the earliest childhood a child can learn and love the taste of fatty foods and sweets and it will be extremely difficult to overcome this. Therefore, parents should do everything to make him fall in love with vegetables and fruits at this age. It is necessary that he would prefer, for example, an ice cream - an orange, a "trendy" western sweet - a banana, etc. (the cost of fruit in these cases is less).
If a child is forced to adhere to a diet, in some way restrict himself, then unwanted products for him simply should not be in the house.
You can not require the child or adolescent to follow some kind of dietary rules or behavior, if you do not observe them yourself (for example, continue to smoke).
Stop smoking - if you have not already done this for yourself,
they must do it for the sake of his son's health
(or sons). Your duty is to do everything to make it
never started smoking.
Parents' example is especially important because their children will have to overcome many extraneous influences - friends and acquaintances, radio and television, newspapers and magazines, cigarette advertisements, sweets containing a lot of saturated fatty acids, etc.
The most important condition for the normalization of blood lipids is the expansion of motor activity. It is advisable to sport with a fairly long physical effort - running, cycling, various sports games (football, basketball, handball, badminton or others with similar energy expenditure). A teenager must perform such physical exercises at least 3 times a week. In this case, the active participation of parents is also very helpful.
On the use of lipid-lowering drugs in children and adolescents.
When should the idea arise about the need for special drugs that lower blood cholesterol (the so-called hypocholesterolemic or hypolipidemic drugs)? I must say that the use of such medicines in children is extremely undesirable and should be used only if the diet is clearly ineffective.
The Committee of Experts on Cholesterol in Children and Adolescents in the United States developed the following recommendations. The use of drugs can be discussed in children only from the age of 10 (with the possible exception of rare cases of homozygous forms of familial hypercholesterolemia) after a diet for at least 6 months has not allowed to achieve the desired result (ie did not lead to a decrease in the level low-density lipoprotein cholesterol less than 160 mg / dL or total cholesterol less than 235-240 mg / dL).
In what cases should you determine the blood cholesterol
in children older than 2 years
·
- When one parent, grandparent is under 55 years of age there is obvious (proven) ischemic heart disease
- When one parent, grandparent is under 55 years of age there is an obvious (proven) disease of peripheral vessels or vessels of the brain
- When one of the parents, grandparents or younger is younger 55 years of serum cholesterol exceed 240 mg / dL
- When the child has other risk factors for ischemic(coronary heart disease) - increased arterial pressure, diabetes, obesity
Attention!
Description of the preparation "Krestor" on this page is a simplified and supplemented version of the official instructions for use. Before purchasing or using the drug, you should consult with your doctor and read the annotation approved by the manufacturer. Information about the drug is provided solely for informational purposes and should not be used as a guide to self-treatment. Only the doctor can decide on the appointment of the drug, as well as determine the dose and methods of its use.