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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">cardiovascular</journal-id><journal-title-group><journal-title xml:lang="ru">Кардиоваскулярная терапия и профилактика</journal-title><trans-title-group xml:lang="en"><trans-title>Cardiovascular Therapy and Prevention</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1728-8800</issn><issn pub-type="epub">2619-0125</issn><publisher><publisher-name>«SILICEA-POLIGRAF» LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.15829/1728-8800-2021-2965</article-id><article-id custom-type="elpub" pub-id-type="custom">cardiovascular-2965</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>Исследование ЭССЕ-РФ</subject></subj-group></article-categories><title-group><article-title>Влияние региональных особенностей проживания на среднесрочные сердечно-сосудистые исходы: проспективный этап исследования ЭССЕ-РФ</article-title><trans-title-group xml:lang="en"><trans-title>Effect of regional living conditions on middle-term cardiovascular outcomes: data from prospective stage of the ESSE-RF study</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0545-2586</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Максимов</surname><given-names>С. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Maksimov</surname><given-names>S. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Максимов Сергей Алексеевич — доктор медицинских наук, доцент, ведущий научный сотрудник отдела эпидемиологии хронических неинфекционных заболеваний.</p><p>Москва.</p><p>Тел.: +7 (985) 333-02-61</p></bio><bio xml:lang="en"><p>Moscow.</p><p>Tel.: +7 (985) 333-02-61</p></bio><email xlink:type="simple">m1979sa@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2087-6483</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шальнова</surname><given-names>С. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Shalnova</surname><given-names>S. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Шальнова Светлана Анатольевна — доктор медицинских наук, профессор, руководитель отдела эпидемиологии хронических неинфекционных заболеваний.</p><p>Москва.</p></bio><bio xml:lang="en"><p>Moscow.</p></bio><email xlink:type="simple">sshalnova@gnicpm.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9844-3122</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Куценко</surname><given-names>В. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Kutsenko</surname><given-names>V. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Куценко Владимир Александрович — младший научный сотрудник лаборатории биостатистики отдела эпидемиологии хронических неинфекционных заболеваний.</p><p>Москва.</p></bio><bio xml:lang="en"><p>Moscow.</p></bio><email xlink:type="simple">vkutsenko@gnicpm.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8011-2798</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Баланова</surname><given-names>Ю. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Balanova</surname><given-names>Yu. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Баланова Юлия Андреевна — кандидат медицинских наук, ведущий научный сотрудник отдела эпидемиологии хронических неинфекционных заболеваний.</p><p>Москва.</p></bio><bio xml:lang="en"><p>Moscow.</p></bio><email xlink:type="simple">jbalanova@gnicpm.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0240-3941</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Муромцева</surname><given-names>Г. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Muromtseva</surname><given-names>G. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Муромцева Галина Аркадьевна — кандидат биологических наук, ведущий научный сотрудник отдела эпидемиологии хронических неинфекционных заболеваний.</p><p>Москва.</p></bio><bio xml:lang="en"><p>Moscow.</p></bio><email xlink:type="simple">gmuromtseva@gnicpm.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9624-9374</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Капустина</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Kapustina</surname><given-names>A. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Капустина Анна Владимировна — старший научный сотрудник отдела эпидемиологии хронических неинфекционных заболеваний.</p><p>Москва.</p></bio><bio xml:lang="en"><p>Moscow.</p></bio><email xlink:type="simple">akapustina@gnicpm.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7486-4667</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Евстифеева</surname><given-names>С. Е.</given-names></name><name name-style="western" xml:lang="en"><surname>Evstifeeva</surname><given-names>S. E.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Евстифеева Светлана Евгеньевна — кандидат медицинских наук, старший научный сотрудник отдела эпидемиологии хронических неинфекционных заболеваний.</p><p>Москва.</p></bio><bio xml:lang="en"><p>Moscow.</p></bio><email xlink:type="simple">sevstifeeva@gnicpm.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9332-0622</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Имаева</surname><given-names>А. Э.</given-names></name><name name-style="western" xml:lang="en"><surname>Imaeva</surname><given-names>A. E.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Имаева Асия Эмверовна — кандидат медицинских наук, старший научный сотрудник отдела эпидемиологии хронических неинфекционных заболеваний.</p><p>Москва.</p></bio><bio xml:lang="en"><p>Moscow.</p></bio><email xlink:type="simple">aimaeva@gnicpm.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8604-712X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Карамнова</surname><given-names>Н. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Karamnova</surname><given-names>N. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Карамнова Наталья Станиславовна — кандидат медицинских наук, руководитель лаборатории эпидемиологии питания отдела эпидемиологии хронических неинфекционных заболеваний.</p><p>Москва.</p></bio><bio xml:lang="en"><p>Moscow.</p></bio><email xlink:type="simple">nkaramnova@gnicpm.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4453-8430</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Драпкина</surname><given-names>О. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Drapkina</surname><given-names>O. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Драпкина Оксана Михайловна — доктор медицинских наук, профессор, член-корреспондент РАН, директор.</p><p>Москва.</p></bio><bio xml:lang="en"><p>Moscow.</p></bio><email xlink:type="simple">odrapkina@gnicpm.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Национальный медицинский исследовательский центр терапии и профилактической медицины Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>National Medical Research Center for Therapy and Preventive Medicine</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2021</year></pub-date><pub-date pub-type="epub"><day>16</day><month>07</month><year>2021</year></pub-date><volume>20</volume><issue>5</issue><fpage>2965</fpage><lpage>2965</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Максимов С.А., Шальнова С.А., Куценко В.А., Баланова Ю.А., Муромцева Г.А., Капустина А.В., Евстифеева С.Е., Имаева А.Э., Карамнова Н.С., Драпкина О.М., 2021</copyright-statement><copyright-year>2021</copyright-year><copyright-holder xml:lang="ru">Максимов С.А., Шальнова С.А., Куценко В.А., Баланова Ю.А., Муромцева Г.А., Капустина А.В., Евстифеева С.Е., Имаева А.Э., Карамнова Н.С., Драпкина О.М.</copyright-holder><copyright-holder xml:lang="en">Maksimov S.A., Shalnova S.A., Kutsenko V.A., Balanova Y.A., Muromtseva G.A., Kapustina A.V., Evstifeeva S.E., Imaeva A.E., Karamnova N.S., Drapkina O.M.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://cardiovascular.elpub.ru/jour/article/view/2965">https://cardiovascular.elpub.ru/jour/article/view/2965</self-uri><abstract><sec><title>Цель</title><p>Цель. Оценка ассоциаций характеристик регионов проживания с развитием сердечно-сосудистых исходов по результатам проспективного этапа исследования ЭССЕ-РФ (Эпидемиология сердечно-сосудистых заболеваний и их факторов риска в регионах Российской Федерации).</p></sec><sec><title>Материал и методы</title><p>Материал и методы. Использовались данные 3- и 5-летнего проспективного этапа исследования ЭССЕ-РФ, проводившегося в 2012-2013гг. Итоговая выборка составила 16210 человек 25-64 лет на момент первичного скрининга. Для характеристики регионов проживания использовались 5 выделенных региональных индексов (РИ). Рассматривались конечные точки (КТ): смерть от болезней системы кровообращения (БСК), развитие инфаркта миокарда, инсульта, комбинированная КТ — смерть от БСК + инфаркт миокарда + инсульт. Для оценки зависимостей применялись обобщенные оценочные уравнения с учетом вложенной структуры данных (индивиды в регионах). Исследуемые ассоциации корректировались на широкий круг возможных модификаторов эффекта.</p></sec><sec><title>Результаты</title><p>Результаты. Наблюдаются множественные прямые ассоциации РИ с вероятностью развития всех КТ. Исключение составила обратная ассоциация РИ “Промышленный” со смертью от БСК. Наиболее устойчивые ассоциации демонстрирует РИ “Смешанный”, РИ “Промышленный” и РИ “Социально-географический”, с высокой значимостью данных РИ в развитии КТ, по сравнению с хорошо известными индивидуальными факторами сердечно-сосудистого риска. Отдельные ассоциации отмечаются по РИ “Экономический” и РИ “Демографический”.</p></sec><sec><title>Заключение</title><p>Заключение. Результаты проведенного исследования свидетельствуют о существенном вкладе ряда региональных условий проживания населения на индивидуальный риск фатальных и нефатальных сердечно-сосудистых исходов.</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Aim</title><p>Aim. To assess regional living conditions with cardiovascular outcomes based on prospective stage of the Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation (ESSE-RF) study.</p></sec><sec><title>Material and methods</title><p>Material and methods. We used data from a 3- and 5-year prospective stage of the ESSE-RF study (2012-2013). For initial screening, 16210 people aged 25-64 were included. To characterize the regions of residence, 5 regional indices (RIs) were used. The following endpoints were considered: cardiovascular death, myocardial infarction, stroke, composite endpoint (cardiovascular death + myocardial infarction + stroke). To assess the correlations, generalized estimating equations with nested data structure (individuals in the regions) were used. The studied associations were adjusted for a wide range of potential effect modifiers.</p></sec><sec><title>Results</title><p>Results. There are multiple direct associations of RIs with the likelihood of all endpoints. The exception was the reverse association of Industrial RI with cardiovascular death. The most stable associations regarded Mixed RI, Industrial RI and Socio-geographical RI, with a high RI significance in endpoint development, compared with well-known individual cardiovascular risk factors. Separate associations were noted for Economic RI and Demographic RI.</p></sec><sec><title>Conclusion</title><p>Conclusion. The results indicate a significant contribution of a number of regional living conditions to individual risk of fatal and non-fatal cardiovascular outcomes.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>окружающая среда</kwd><kwd>география здоровья</kwd><kwd>сердечно-сосудистые заболевания</kwd><kwd>инфаркт миокарда</kwd><kwd>инсульт</kwd></kwd-group><kwd-group xml:lang="en"><kwd>environment</kwd><kwd>health geography</kwd><kwd>cardiovascular diseases</kwd><kwd>myocardial infarction</kwd><kwd>stroke</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Авторы статьи выражают глубокую благодарность участникам исследования ЭССЕ-РФ, внесшим большой вклад в получение данных: Москва: Бойцов С. А., Жернакова Ю. В., Константинов В. В., Мамедов М. Н., Оганов Р. Г., Суворова Е. И., Худяков М. Б., Ощепкова Е. В.; Санкт-Петербург: Баранова Е. И., Конради А. О.; Владивосток: Кулакова Н. В., Невзорова В. А., Шестакова Н. В., Мокшина М. В., Родионова Л. В.; Владикавказ: Толпаров Г. В.; Вологда: Ильин В. А., Шабунова А. А., Калашников К. Н., Калачикова О. Н., Попов А. В.; Волгоград: Недогода С. В., Чумачек Е. В., Ледяева А. А.; Воронеж: Фурменко Г. И., Черных Т. М., Овсянникова В. В., Бондарцов Л. В.; Иваново: Белова О. А., Романчук С. В., Назарова О. А., Шу-темова О. А.; Кемерово: Барбараш О. Л., Артамонова Г. В., Индукаева Е. В., Мулерова Т. А., Скрипченко А. Е., Черкасс Н. В., Табакаев М. В., Данильченко Я. В.; Красноярск: Гринштейн Ю. И., Петрова М. М., Данилова Л. К., Евсюков А. А., Шабалин В. В., Руф Р. Р., Косинова А. А., Филоненко И. В., Байкова О. А.; Оренбург: Либис Р. А., Лопина Е. А., Басырова И. Р.; Самара: Дупляков Д. В., Гудкова С. А., Черепанова Н. А.; Томск: Трубачева И. А., Кавешников В. С., Карпов Р. С., Серебрякова В. Н.; Тюмень: Ефанов А. Ю., Медведева И. В., Сторожок М. А., Шалаев С. В.</funding-statement><funding-statement xml:lang="en">The authors express deep gratitude to following participants of the ESSE-RF study: Moscow: Boytsov S. A., Zhernakova Yu. V., Konstantinov V. V., Mamedov M. N., Oganov R. G., Suvorova E. I., Khudyakov M. B., Oshchepkova E. V.; St. Petersburg: Baranova E. I., Konradi A. O.; Vladivostok: Kulakova N. V., Nevzorova V. A., Shestakova N. V., Mokshina M. V., Rodionova L. V.; Vladikavkaz: Tolparov G. V.; Vologda: Ilyin V. A., Shabunova A. A., Kalashnikov K. N., Kalachikova O. N., Popov A. V.; Volgograd: Nedogoda S. V., Chumachek E. V., Ledyaeva A. A.; Voronezh: Furmenko G. I., Chernykh T. M., Ovsyannikova V. V., Bondartsov L. V.; Ivanovo: Belova O. A., Romanchuk S. V., Nazarova O. A., Shutemova O. A.; Kemerovo: Barbarash O.L., Artamonova G. V., Indukaeva E. V., Mulerova T. A., Skripchenko A. E., Cherkass N. V., Tabakaev M. V., Danilchenko Ya. V.; Krasnoyarsk: Grinstein Yu. I., Petrova M. M., Danilova L. K., Evsyukov A. A., Shabalin V. V., Ruf R. R., Kosinova A. A., Filonenko I. V., Baikova O. A.; Orenburg: Libis R. A., Lopina E. A., Basyrova I. R.; Samara: Duplyakov D. V., Gudkova S. A., Cherepanova N. A.; Tomsk: Trubacheva I. A., Kaveshnikov V. S., Karpov R. S., Serebryakova V. N.; Tyumen: Efanov A. Yu., Medvedeva I.V., Storozhok M. A., Shalaev S. V.</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Naik Y, Baker P, Ismail SA, et al. Going upstream — an umbrella review of the macroeconomic determinants of health and health inequalities. BMC Public Health. 2019;19(1):1678. doi:10.1186/s12889-019-7895-6.</mixed-citation><mixed-citation xml:lang="en">Naik Y, Baker P, Ismail SA, et al. Going upstream — an umbrella review of the macroeconomic determinants of health and health inequalities. 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