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Report prepared by Associate Professor Tsioufis Konstantinos with the kind assistance of::
National CVD Prevention Coordinator for Greece:
MD, PhD, FESC, FACC
Associate Professor of Cardiology, 1st Cardiology Clinic, University of Athens, Hippocratio Hospital, Athens, Greece
President Elect of the Hellenic Society of Cardiology
Greece is located in Mediterranean Sea, in the crossroads of Europe, Asia and Africa. Greece has the 11th longest coastal in the World, and a vast number of islands – approx. 2000 – that makes communication between them sometimes very difficult. According to the 2011 census, country's population is around 10.8 million. Athens is the nation's capital and largest city, followed by Thessaloniki the second largest city, which is commonly referred to as the co-capital.
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Health care in Greece is provided through national health insurance or private health care. According to the 2011 budget, the Greek healthcare system was allocated 6.1 billion euro, or 2.8% of gross domestic product (GDP). The National Health System mainly depends on state health insurance of the inhabitants. In 2009 the hospital beds to 10,000 population ratio in the country was 48. Currently the largest hospital in the country is Attica Psychiatric Hospital "Dafni" with 1,325 beds, while the largest general hospital is Evangelismos General Hospital of Athens with 1,100 beds. Emergency, ambulance and air-ambulance services in Greece are provided by the National Centre for Direct Aid.
Regarding the frequency of the classical cardiovascular risk factors at population level from the ATTICA study in a sample of 3,051 individuals of which 51% of men and 39% of women reported smokers, 37% of men and 25% of women were defined as hypertensive, 46% of men and 40% of women had total serum cholesterol levels above 200 mg/dl and 8% of men and 6% of women had history of diabetes mellitus. Moreover, 20% of men and 15% of women were obese.
The Ministry of Health is the main actor of prevention in collaboration with medical associations, institutions and societies. The Hellenic Society of Cardiology is the leader in this field but also other scientific societies like the Hellenic Atherosclerosis Society, the Hellenic Society of Hypertension, the Hellenic Society of Lipidiology and etc. collaborate with international societies. ELIKAR - the Hellenic Foundation of Cardiology - has also contributed in the prevention of cardiovascular diseases in Greece since 1991 by editing journals, organising public campaigns etc.
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Medical education in primary and secondary prevention, press conferences and publications, tobacco control activities, collaboration between the Civil Servants’ Confederation (ADEDY), the Hellenic Labour Inspectorate (SEPE) and the Public Health doctors of the Ministry of Health and Social Solidarity (Security) aim to define laws prohibiting smoking, to implement actions for anti-tobacco initiatives and to raise awareness in both public and private sector workplaces.
The referral rates for cardiac rehabilitation (CR) are low (below 20%) as most of the centres are private. CR is mainly provided for heart failure patients and is organised as an individually patient-targeted model.
The goals for the future are: the promotion of national rehabilitation programs and heart failure clinics and widespread education on prevention among health care providers. The Hellenic Society of Cardiology has endorsed a White Paper concerning primary prevention of heart failure, education of patients and family and secondary prevention of cardiovascular risk factors.
Note: The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.
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