1. Badtieva Viktoria professor, doctor of medicine The Russian Scientific Centre of Restorative and Resort Medicine, Moscow, Russia Physiobalneotherapy methods in the prevention, treatment and rehabilitation programs of cardiovascular diseases

2. Deaths by cause in the Europe

3. Cardiovascular disease mortality and mortality rate are falling in most Western European countries, reaching in some countries 50-60%, that became possible by the wide use of primary and secondary preventive maintenance and rehabilitation programs

4. The goal of the cardiac rehabilitation is to stabilize, slow or reverse the progression of cardiovascular disease, thereby reducing the risk of heart disease, another cardiac event or death

5. According to the meta-analysis data which include 48 trials with 8940 patients, it has been revealed that the application of rehabilitation programs has led to decrease in mortality rate from all causes by 20% p=0.005 cardiovascular mortality by 26 % p=0.002 Taylor et al. Am.J.Med. 2004; 116:682-697

6. physical trainings educational programs «School for patients and their relatives» consultations with a psychologist a suitable work placement

7. - not limited by the physical trainings; - aimed at reducing modified risk factors. Circulation. 2005; 111:369-376

8. In Russia the methods of Physiobalneotherapy have been successfully applied for a long time. It is explained by the fact that we have a lot of sanatoriums (a resort and a health centre).

9. In sanatoriums we use a combination of physiobalneotherapy methods and a wide range of medical services.

10. Since 1978 there has been a state cardiac rehabilitation system for patients after an acute cardiovascular diseases.

11. - the hospital stage - the recovery stage when the physiobalneotherapy methods are applied in a sanatorium - the supporting rehabilitation stage in an outpatient clinic and a sanatorium

12. Patient Psycholo gist Social worker Cardiol ogist Physio therapist Doctor of physioth erapy exercises Nurse

13. The Russian Scientific Centre of Restorative and Resort Medicine - a central institute in Russia on balneology

14. The mechanism of cardiovascular effects: the impact on the nervous and neuro-humoral regulation mechanisms for the circulation the restoration of the function of the central and autonomic nervous system the impact on the neuroendocrine processes

15. The mechanism of cardiovascular effects: improved tissue oxygenation increased oxygen- transport function of the blood the effect on extra cardiac mechanisms of the circulation the arterial vasodilation improved microcirculation the venous vasodilation reduced systemic vascular resistance

16. The mechanism of cardiovascular effects: increased contractility the restoration of bioelectric activity of the heart the restoration of the central section of the blood circulation - increased cardiac output improved myocardial metabolism the normalization of the oxygen consumption by the myocardium improved coronary circulation the decrease in the β-adrenaline acceptors sensitivity

17. Physiobalneotherapy methods in the prevention, treatment and rehabilitation programs of cardiovascular diseases Prevention of cardiovascular disease Reduction of cardiovascular risk factors Treatment of patients with diagnosed CVD Rehabilitation after a surgical intervention

18. We can rank the programs of physiobalneotherapy treatment and rehabilitation depending on the degree of their effectiveness. They can be applied in different ways according to the major clinical syndromes, the dominant risk factors and associated conditions

19. -Laserotherapy -Air-carbonic baths - The general contrast baths -Laserotherapy -Gas carbonic baths -Underwater shower-massage -Laserotherapy -Gas carbonic baths -The general jodo-bromic baths -Laserotherapy -Air-carbonic baths -AG III st +IHD, aIII f. cl -AG III st +IHD, angina pectoris III f. cl -Laserotherapy -Air-radonic baths -AG III st + IHD, aIII f. cl+ Heart failure I – II -AG III st + IHD, angina pectoris III f. cl+ Heart failure I – II -IHD, aIII f. cl. -IHD, angina pectoris III f. cl. - AG III st+ IHD, aIII f. cl+ Heart failure I – II - AG III st+ IHD, angina pectoris III f. cl+ Heart failure I – II

20. According to our research, the efficiency of rehabilitation programs increases by 10-40% in case methods of physiobalneotherapy are applied Sorokina E.I. (1970-1995) Knyazeva T.A. (1985-2009) Badtieva V.A. (1996-2009)

21. The result of the use of physiobalneotherapy methods: increased cardiac output the strengthening of the compensatory mechanisms the increase of the reserve capacity (myocardial, coronary and aerobic reserves) the increase of the physical capacity of an organism.

22. We are ready to cooperate!

23. The Russian Scientific Centre of Restorative and Resort Medicine, Moscow, Russia