The cardiovascular disease prevention programme in Lithuania

Who the programme is for

The cardiovascular disease prevention programme (Širdies ir kraujagyslių ligų prevencinė programa) covers men and women aged 40 to 60 inclusive. It is one of the prevention programmes of the National Health Insurance Fund (Valstybinė ligonių kasa, VLK — the Lithuanian agency that administers compulsory health insurance), and for people in that age group the tests it lists are free of charge when arranged by your family doctor (šeimos gydytojas — the general practitioner you are registered with, and the first point of contact in the Lithuanian health system).

What the programme covers

• Assessment of risk factors by the family doctor (šeimos gydytojas)
• A blood glucose (blood sugar) test (gliukozė)
• A total cholesterol test (bendras cholesterolis)
• A triglyceride test (trigliceridai)
• An ECG (electrocardiogram; in Lithuanian elektrokardiograma, EKG)
• Other tests that help establish whether you are in the high-risk group
• If risk is high — a referral to specialised centres for further investigation; the further decisions are made by the doctor

How to get it

• Contact your own family doctor (šeimos gydytojas) once you reach the relevant age group — 40 to 60 years inclusive
• If you do not fall within that age group but feel unwell, contact your family doctor anyway: they will carry out the necessary tests and, if needed, issue a referral to a specialist

Why these particular tests

Cardiovascular disease often develops over years without any symptoms — neither raised cholesterol nor a slightly elevated glucose level usually causes any discomfort. The tests are therefore done not because of complaints, but to notice risk factors before they cause a heart attack or a stroke. Each test on its own has limits, which is why the programme combines several of them: together they let the doctor form a more general picture of risk and, if needed, draw up an individual prevention plan or refer the patient on to a specialist.

• Glucose (gliukozė) helps assess whether the body is regulating blood sugar properly. A raised value can point to prediabetes or diabetes, which are additional cardiovascular risk factors, but a single measurement does not confirm a diagnosis — repeat tests and a doctor's assessment are needed.
• Total cholesterol (bendras cholesterolis), together with the LDL and HDL fractions, shows how much fat is circulating in the blood and how it may affect the walls of the blood vessels over time. These numbers alone do not diagnose heart disease: they are always assessed together with age, family history, lifestyle and other risk factors.
• Triglycerides (trigliceridai) complete that picture. A high triglyceride level together with high LDL or low HDL raises risk more than each indicator does on its own, which is why they are tested alongside the cholesterol fractions.
• The electrocardiogram (EKG) records the heart's electrical activity and can show rhythm disturbances or signs of a heart muscle problem that has already occurred. A normal ECG result does not by itself show narrowing of the blood vessels.
• Risk factor assessment covers age, family history, smoking habits, blood pressure and other factors. Raised blood pressure is one of the main cardiovascular risk factors and often causes no symptoms at all, so it is assessed at every visit.

If your risk is assessed as high

If the family doctor assesses your risk as high, they refer you to a specialised centre for further investigation and, if needed, prescribe treatment. The further decisions are always made by the doctor, after weighing all the findings together.

Situations that need medical attention straight away

If you have any of the following, call 112 — the emergency number in Lithuania — straight away:

• Sudden chest pain or pressure, particularly when it spreads to the arm, jaw or back
• Sudden shortness of breath, profuse sweating or nausea together with chest discomfort
• Sudden weakness on one side of the body, facial drooping or slurred speech
• An unusual or irregular heartbeat, frequent dizziness or loss of consciousness

How often the programme is repeated

The National Health Insurance Fund states that the family doctor assesses risk factors at a set interval and, if needed, draws up an individual prevention plan. The timing of your next visit is worth agreeing with your own family doctor, based on your individual situation.