cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLC10.15829/1728-8800-2018-6-77-85cardiovascular-856Research ArticleОБЗОРЫREVIEWSКакие “новые” факторы целесообразно учитывать при оценке сердечно-сосудистого риска?What “new” factors should be considered when assessing cardiovascular risk?https://orcid.org/0000-0001-6515-3882СмирноваМ. Д.SmirnovaM. D.

Смирнова Мария Дмитриевна — доктор медицинских наук, старший научный сотрудник отдела амбулаторных лечебно-диагностических технологий НИИ клинической кардиологии им. А. Л. Мясникова.

Москва, тел.: +7 (495) 414-61-66, +7 (926) 165-11-39

Moscow

naliya1@yandex.ruhttps://orcid.org/0000-0003-3753-1860БариноваИ. В.BarinovaI. V.

Баринова Ирина Владимировна — кандидат медицинских наук, младший научный сотрудник отдела.

Москва

Moscow

ndo-barinova@yandex.ruhttps://orcid.org/0000-0002-3321-2902ФофановаТ. В.FofanovaT. V.

Фофанова Татьяна Вениаминовна — доктор медицинских наук, старший научный сотрудник отдела.

Москва

Moscow

t.fofanova@yandex.ruhttps://orcid.org/0000-0002-9858-6956БланковаЗ. Н.BlankovaZ. N.

Бланкова Зоя Николаевна — кандидат медицинских наук, научный сотрудник отдела.

Москва

Moscow

blankovazoya@yandex.ruhttps://orcid.org/0000-0003-1317-036XСвиридаО. Н.SviridaO. N.

Свирида Ольга Николавна — кандидат медицинских наук, младший научный сотрудник отдела.

Москва

Moscow

olgasvirida@yandex.ruhttps://orcid.org/0000-0003-4369-1393АгеевФ. Т.AgeevF. T.

Агеев Фаиль Таипович — доктор медицинских наук, профессор, руководитель отдела.

Москва

Moscow

ftageev@gmail.comhttps://orcid.org/0000-0001-6998-8406БойцовС. А.BoytsovS. A.

Бойцов Сергей Анатольевич — доктор медицинских наук, профессор, член-корреспондент РАН, генеральный директор.

Москва

Moscow

prof.boytsov@gmail.comФГБУ “Научный медицинский исследовательский центр кардиологии” Минздрава РоссииРоссияScientific Medical Research Center of Cardiology of the Ministry of HealthRussian Federation2018201220181767785Copyright © Смирнова М.Д., Баринова И.В., Фофанова Т.В., Бланкова З.Н., Свирида О.Н., Агеев Ф.Т., Бойцов С.А., 20182018Смирнова М.Д., Баринова И.В., Фофанова Т.В., Бланкова З.Н., Свирида О.Н., Агеев Ф.Т., Бойцов С.А.Smirnova M.D., Barinova I.V., Fofanova T.V., Blankova Z.N., Svirida O.N., Ageev F.T., Boytsov S.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/856

Одна из причин высокой смертности от сердечно-сосудистых заболеваний (ССЗ) — недостаточность эффективных мер по первичной и вторичной профилактике сердечно-сосудистых осложнений (ССО), связанная с трудностью своевременного выявления и коррекции факторов риска (ФР) и лиц с высоким индивидуальным риском ССО. Особенно это актуально в отношении больных традиционно относящихся к группе низкого/умеренного риска. Группа эта неоднородна. Часто клинические проявления атеросклероза впервые возникают при отсутствии “классических” ФР. В последнее время в качестве возможных факторов, повышающих риск развития ССЗ и ССО, рассматриваются: частота сердечных сокращений, повышенное образование конечных продуктов гликации, нарушения минерального обмена костной ткани, функции щитовидной железы, низкая приверженность терапии, психосоциальные факторы, а также климатические влияния. Анализу доказательной базы влияния этих “новых” ФР ССЗ и индивидуальному прогнозу пациента посвящен этот обзор.

One of the causes of high mortality from cardiovascular diseases is the lack of effective measures for the primary and secondary prevention of cardiovascular complications (CCO), due to the difficulty of timely identification risk factors (RF) and individuals with a high individual risk of CCO. This is especially true for patients from low/mean risk. This group is heterogeneous. Often, clinical manifestations of atherosclerosis occur for the first time without “classical” RF. Possible factors that increase the risk of developing cardiovascular diseases and CCO, are: heart rate, increased formation of advanced glycation endproducts, disorders of bone mineral metabolism, thyroid function, low adherence to therapy, psychosocial factors and climatic features. This review is devoted to the analysis of the evidence base of the influence of these “new” CCO RF and the individual patient prognosis.

“новые” факторы риска сердечно-сосудистых осложненийсердечно-сосудистый рискчастота сердечных сокращенийнарушения минерального обменагипотиреозконечные продукты гликацииприверженность терапиипсихосоциальные факторы“new” risk factors for cardiovascular complicationscardiovascular riskheart ratemineral metabolism disordershypothyroidismadvanced glycation endproductstherapy adherencepsychosocial factorsReferencesБойцов С. А., Кухарчук В. В., Уразалина С. Ж. и др. Субклинический атеросклероз как фактор риска сердечно-сосудистых осложнений. Кардиоваскулярная терапия и профилактика. 2012;11(3):82-6.Boytsov SA, Kukharchuk VV, Karpov YuA, et al. Subclinical atherosclerosis as risk factor of cardiovascular complications. Cardiovascular Therapy and Prevention. 2012;3:82-6. (In Russ.)Reil JC, Custodis F, Swedberg K, et al. Heart rate reduction in cardiovascular disease and therapy. Clin Res Cardiol. 2011;100:11-9. doi:10.1007/s00392-010-0207-x.Reil JC, Custodis F, Swedberg K, et al. Heart rate reduction in cardiovascular disease and therapy. Clin Res Cardiol. 2011;100:11-9. doi:10.1007/s00392-010-0207-x.Шальнова С. А., Деев Д. А., Бойцов С. А. и др. от имени участников исследования ЭССЕ-РФ. Частота сердечных сокращений и ее ассоциации с основными факторами риска в популяции мужчин и женщин трудоспособного возраста. Рациональная Фармакотерапия в Кардиологии. 2017;13(6):819-26. doi:10.20996/1819-6446-2017-13-6-819-826.Shalnova SA, Deev AD, Boytsov SA, et al. on behalf of the participants of the ESSE-RF study. Heart Rate and its Association with the Main Risk Factors in the Population of Men and Women of Working Age. Rational Pharmacotherapy in Cardiology. 2017;13(6):819-26. (In Russ).doi:10.20996/1819-6446-2017-13-6-819-826.Nakanishi K, Jin Zh, Homma Sh, Elkind MSV, et al. DISCLOSURES|Association Between Heart Rate and Subclinical Cerebrovascular Disease in the Elderly Stroke. 2018;49(2):319-24. doi:10.1161/STROKEAHA.117019355.Nakanishi K, Jin Zh, Homma Sh, Elkind MSV, et al. DISCLOSURES|Association Between Heart Rate and Subclinical Cerebrovascular Disease in the Elderly Stroke. 2018;49(2):319-24. doi:10.1161/STROKEAHA.117019355.Monnier VM. Nonenzymatic glycosylation, the Maillard reaction and the aging process. J Gerontol. 1990;45(4)В:105-11. PMID: 2195101.Monnier VM. Nonenzymatic glycosylation, the Maillard reaction and the aging process. J Gerontol. 1990;45(4)В:105-11. PMID: 2195101.Титов В. Н., Хохлова Н. В., Ширяева Ю. К. Глюкоза, гликотоксины и продукты гликирования протеинов: роль в патогенезе. Клиническая медицина. 2013;3:15-24. PMID: 23789446.Titov VN, Khokhlova NV, Shiryaeva YuK. Glucose, glycotoxins and protein glycation products: the role in pathogensis. Klinicheskaya Meditsina. 2013;3:15-24. (In Russ.)Den Engelsen C, van den Donk M, Gorter KJPL, et al. Advanced glycation end products measured by skin autofluorescence in a population with central obesity. Dermatoendocrinol. 2012;4:33-8. doi:10.4161/derm.17999.Den Engelsen C, van den Donk M, Gorter KJPL, et al. Advanced glycation end products measured by skin autofluorescence in a population with central obesity. Dermatoendocrinol. 2012;4:33-8. doi:10.4161/derm.17999.Lutgers HL, Gerrits EG, Graaff R, et al. Skin autofluorescence provides additional information to the UK Prospective Diabetes Study (UKPDS) risk score for the estimation of cardiovascular prognosis in type 2 diabetes mellitus. Diabetologia. 2009;52:789-97. doi:10.1007/s00125-009-1308-9.Lutgers HL, Gerrits EG, Graaff R, et al. Skin autofluorescence provides additional information to the UK Prospective Diabetes Study (UKPDS) risk score for the estimation of cardiovascular prognosis in type 2 diabetes mellitus. Diabetologia. 2009;52:789-97. doi:10.1007/s00125-009-1308-9.McIntyre NJ, Fluck RJ, McIntyre CW, et al. Skin autofluorescence and all-cause mortality in stage 3 CKD. Clin J Am Soc Nephrol. 2014;9(8):1361-8. doi:10.2215/CJN.09510913.McIntyre NJ, Fluck RJ, McIntyre CW, et al. Skin autofluorescence and all-cause mortality in stage 3 CKD. Clin J Am Soc Nephrol. 2014;9(8):1361-8. doi:10.2215/CJN.09510913.McNulty M, Mahmud A, Feely J. Advanced glycation end-products and arterial stiffness in hypertension. Am J Hypertens. 2007;20:242-7. doi: 10.1016/j.amjhyper.2006.08.009.McNulty M, Mahmud A, Feely J. Advanced glycation end-products and arterial stiffness in hypertension. Am J Hypertens. 2007;20:242-7. doi: 10.1016/j.amjhyper.2006.08.009.De Vos LC, Mulder DJ, Smit AJ, et al. Skin Autofluorescence Is Associated With 5-Year Mortality and Cardiovascular Events in Patients With Peripheral Artery Disease. Arterioscler Thromb Vasc Biol. 2014;34(4):933-8. doi:10.1161/ATVBAHA.113.302731.De Vos LC, Mulder DJ, Smit AJ, et al. Skin Autofluorescence Is Associated With 5-Year Mortality and Cardiovascular Events in Patients With Peripheral Artery Disease. Arterioscler Thromb Vasc Biol. 2014;34(4):933-8. doi:10.1161/ATVBAHA.113.302731.Ueno H, Koyama H, Tanaka S. Skin autofluorescence, a marker for advanced glycation end product accumulation, is associated with arterial stiffness in patients with end-stage renal disease. Metab Clin Exper. 2008;57:1452-7. doi: 10.1016/j.metabol.2008.05.016.Ueno H, Koyama H, Tanaka S. Skin autofluorescence, a marker for advanced glycation end product accumulation, is associated with arterial stiffness in patients with end-stage renal disease. Metab Clin Exper. 2008;57:1452-7. doi: 10.1016/j.metabol.2008.05.016.Meerwaldt R, Graaff R, Oomen PH, et al. Simple non-invasive assessment of advanced glycation endproducts accumulation Diabetologia. 2004;47:1324-30. doi:10.1007/s00125-004-1451-2.Meerwaldt R, Graaff R, Oomen PH, et al. Simple non-invasive assessment of advanced glycation endproducts accumulation Diabetologia. 2004;47:1324-30. doi:10.1007/s00125-004-1451-2.Meerwaldt R, Hartog JW, Graaff R, et al. Skin autofluorescence, a measure of cumulative metabolic stress and advanced glycation endproducts, predicts mortality in hemodialysis patients. J Am Soc Nephrol. 2005;16:3687-93. doi: 101681/ASN.2005020144.Meerwaldt R, Hartog JW, Graaff R, et al. Skin autofluorescence, a measure of cumulative metabolic stress and advanced glycation endproducts, predicts mortality in hemodialysis patients. J Am Soc Nephrol. 2005;16:3687-93. doi: 101681/ASN.2005020144.Mulder D, van Haelst PL, Graaff R, et al. Skin autofluorescence is elevated in acute myocardial infarction and is associated with the one-year incidence of major adverse cardiac events. Neth Heart J. 2009;17:162-8. PMID: 19421362.Mulder D, van Haelst PL, Graaff R, et al. Skin autofluorescence is elevated in acute myocardial infarction and is associated with the one-year incidence of major adverse cardiac events. Neth Heart J. 2009;17:162-8. PMID: 19421362.Watfa G, Soulis G, Tartagni EA, et al. Relationship between tissue glycation measured by autofluorescence and pulse wave velocity in young and elderly non-diabetic populations. Diabetes Metab. 2012;38:413-9. doi:10.1016/j.diabet.2012.04.004.Watfa G, Soulis G, Tartagni EA, et al. Relationship between tissue glycation measured by autofluorescence and pulse wave velocity in young and elderly non-diabetic populations. Diabetes Metab. 2012;38:413-9. doi:10.1016/j.diabet.2012.04.004.Агеев Ф. Т., Виценя М. В., Смирнова М. Д. и др. Взаимосвязь между уровнем тканевых конечных продуктов гликации и скоростью распространения пульсовой волны у больных сердечно — сосудистыми заболеваниями без сахарного диабета. Кардиология. 2015;55(6):63-7 PMID:26625521.Ageev FT, Vitsenia MV, Smirnova MD, et al. The Relationship Between Level of End-Products of Tissue Glycation and Pulse Wave Velocity in Non-diabetic Patients With Cardiovascular Disease. Kardiologiia. 2015;55(6):63-7. (In Russ.)Dehghan M, Mente A, Yusuf S, et al., on behalf of the Prospective Urban Rural Epidemiology (PURE) study investigators Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study. The Lancet. 2017;390(10107):2050-62. doi:10.1016/S0140-6736(17)32252-3.Dehghan M, Mente A, Yusuf S, et al., on behalf of the Prospective Urban Rural Epidemiology (PURE) study investigators Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study. The Lancet. 2017;390(10107):2050-62. doi:10.1016/S0140-6736(17)32252-3.Troshina EA. Inadequate diagnosis of hypothyroidism. Orientation to therapists. Poliklinika. 2012;5:11-3. (In Russ.) Трошина Е.А. “Недодиагностика” гипотиреоза. Ориентация на терапевтов. Поликлиника. 2012;5:11-3.Troshina EA. Inadequate diagnosis of hypothyroidism. Orientation to therapists. Poliklinika. 2012;5:11-3. (In Russ.) Трошина Е.А. “Недодиагностика” гипотиреоза. Ориентация на терапевтов. Поликлиника. 2012;5:11-3.Chaker L, Baumgartner C, den Elzen WP, et al. Thyroid Function Within the Reference Range and the Risk of Stroke: An Individual Participant Data Analysis. J Clin Endocrinol Metab. 2016;101(11):4270-82. doi:101210/jc.2016-2255.Chaker L, Baumgartner C, den Elzen WP, et al. Thyroid Function Within the Reference Range and the Risk of Stroke: An Individual Participant Data Analysis. J Clin Endocrinol Metab. 2016;101(11):4270-82. doi:101210/jc.2016-2255.Collet TH, Gussekloo J, Bauer DC, et al. Subclinical hyperthyroidism and the risk of coronary heart disease and mortality. Clin Endocrinol Metab. 2012;87:4662-6. doi:10.1161/CIRCULATIONAHA.112.096024.Collet TH, Gussekloo J, Bauer DC, et al. Subclinical hyperthyroidism and the risk 43. of coronary heart disease and mortality. Clin Endocrinol Metab. 2012;87:4662-6. doi:10.1161/CIRCULATIONAHA.112.096024.Hernandez-Mijares A, Jover A, Bellod L, et al. Relation between lipoprotein subfractions and TSH levels in the cardiovascular risk among women with subclinical hypothyroidism. Clin Endocrinol (Oxf). 2013;78(5):777-82. doi:10.1111/cen.12064.Hernandez-Mijares A, Jover A, Bellod L, et al. Relation between lipoprotein subfractions and TSH levels in the cardiovascular risk among women with subclinical hypothyroidism. Clin Endocrinol (Oxf). 2013;78(5):777-82. 44. doi:10.1111/cen.12064.Ochs N, Auer R, Bauer DC, et al. Meta-analysis: subclinical thyroid dysfunction and the risk for coronary heart disease and mortality. Clin Endocrinol Metab. 2008;93:4749-54. PMID: 18490668.Ochs N, Auer R, Bauer DC, et al. Meta-analysis: subclinical thyroid dysfunction and the risk for coronary heart disease and mortality. Clin Endocrinol Metab. 45. 2008;93:4749-54. PMID: 18490668.Biondi B, Cooper DS. The clinical significance of subclinical thyroid dysfunction. Endocr Rev. 2008;29(1):76-131. doi:10.1210/er.2006-0043.Biondi B, Cooper DS. The clinical significance of subclinical thyroid dysfunction. Endocr Rev. 2008;29(1):76-131. doi:10.1210/er.2006-0043. 46.Лесняк О. М., Баранова И. А., Белова К. Ю. и др. Остеопороз в Российской Федерации: эпидемиология, медико-социальные и экономические аспекты проблемы (обзор литературы). Травматология и ортопедия России. 2018; 24(1):155-68. doi:10.21823/2311-2905-2018-24-1-155-168. 48.Lesnyak OM, Baranova IA, Belova KYu, et al. Osteoporosis in Russian Federation: Epidemiology, Socio-Medical and Economical Aspects (Review). Travmatologiya i ortopediya Rossii. [Traumatology and orthopedics of russia]. 2018;24(1):155-68. (In Russ.) doi:10.21823/2311-2905-2018-24-1-155-168. 48.Tanko LB, Christiansen C, Cox DA, et al. Relationship between osteoporosis and cardiovascular disease in postmenopausal women. J Bone Miner Res. 2005;20(11):1912-20. doi:10.1359/JBMR.050711.Tanko LB, Christiansen C, Cox DA, et al. Relationship between osteoporosis and cardiovascular disease in postmenopausal women. J Bone Miner 49. Res. 2005;20(11):1912-20. doi:10.1359/JBMR.050711.Szulc P, Samelson EJ, Kiel DP, et al. Increased bone resorption is associated with increased risk of cardiovascular events in men: the MINOS study. J Bone Miner Res. 2009;24(12):2023-31. doi:10.1359/jbmr.090531.Szulc P, Samelson EJ, Kiel DP, et al. Increased bone resorption is associated with increased risk of cardiovascular events in men: the MINOS study. J Bone Miner Res. 50. 2009;24(12):2023-31. doi:10.1359/jbmr.090531.Shen C, Deng J, Zhou R, et al. Relation between bone mineral density, bone loss and the risk of cardiovascular disease in a Chinese cohort. Am J Cardiol. 2012;15;110(8):1138-42. doi:10.1016/j.amjcard.2012.05.053.Shen C, Deng J, Zhou R, et al. Relation between bone mineral density, bone loss and the risk of cardiovascular disease in a Chinese cohort. Am J Cardiol. 2012;15;110(8):1138-42. doi:10.1016/j.amjcard.2012.05.053.Wiklund P, Nordstrom A, Jansson JH, et al. Low bone mineral density is associated with increased risk for myocardial infarction in men and women. Osteoporos Int. 2012;23(3):963-70. doi:10.1007/s00198-011-1631-0.Wiklund P, Nordstrom A, Jansson JH, et al. Low bone mineral density is associated with increased risk for myocardial infarction in men and women. Osteoporos Int. 2012;23(3):963-70. doi:10.1007/s00198-011-1631-0.Chiang CH, Liu CJ, Chen PJ, et al. Hip fracture and risk of acute myocardial infarction: a nationwide study. J Bone Miner Res. 2013;28(2):404-11. doi:10.1002/jbmr.1714.Chiang CH, Liu CJ, Chen PJ, et al. Hip fracture and risk of acute myocardial infarction: a nationwide study. J Bone Miner Res. 2013;28(2):404-11. doi:10.1002/jbmr.1714.Chen SJ, Lin CS, Lin CL, et al. Osteoporosis Is Associated With High Risk for Coronary Heart Disease: A Population-Based Cohort Study. Medicine (Baltimore). 2015;94(27):e1146. doi:10.1097/MD.0000000000001146.Chen SJ, Lin CS, Lin CL, et al. Osteoporosis Is Associated With High Risk for Coronary Heart Disease: A Population-Based Cohort Study. Medicine (Baltimore). 2015;94(27):e1146. doi:10.1097/MD.0000000000001146.Chen YC, Wu JC, Liu L, et al. Hospitalized osteoporotic vertebral fracture increases the risk of stroke: a population-based cohort study. J Bone Miner Res. 2013;28(3):516-23. doi:10.1002/jbmr.1722.Chen YC, Wu JC, Liu L, et al. Hospitalized osteoporotic vertebral fracture increases the risk of stroke: a population-based cohort study. J Bone Miner Res. 2013;28(3):516-23. doi:10.1002/jbmr.1722.Pfister R, Michels G, Sharp SJ, et al. Low bone mineral density predicts incident heart failure in men and women: the EPIC (European Prospective Investigation into Cancer and Nutrition)-Norfolk prospective study. JACC Heart Fail. 2014;2(4):380-9. doi:10.1016/j.jchf.2014.03.010.Pfister R, Michels G, Sharp SJ, et al. Low bone mineral density predicts incident heart failure in men and women: the EPIC (European Prospective Investigation into Cancer and Nutrition)-Norfolk prospective study. JACC Heart Fail. 2014;2(4):380-9. doi:10.1016/j.jchf.2014.03.010.Veronese N, Stubbs B, Crepaldi G, et al. Relationship Between Low Bone Mineral Density and Fractures With Incident Cardiovascular Disease: A Systematic Review and Meta-Analysis. J Bone Miner Res. 2017;32(5):1126-35. doi:10.1002/jbmr.3089.Veronese N, Stubbs B, Crepaldi G, et al. Relationship Between Low Bone Mineral Density and Fractures With Incident Cardiovascular Disease: A Systematic Review and Meta-Analysis. J Bone Miner Res. 2017;32(5):1126-35. doi:10.1002/jbmr.3089.Demer LL, Tintut Y. Inflammatory, metabolic, and genetic mechanisms of vascular calcification. Arterioscler Thromb Vasc Biol. 2014;34(4):715-23. doi: 101161/ATVBAHA.113.302070.Demer LL, Tintut Y. Inflammatory, metabolic, and genetic mechanisms of vascular calcification. Arterioscler Thromb Vasc Biol. 2014;34(4):715-23. doi: 101161/ATVBAHA.113.302070.Dao HH, Essalihi R, Bouvet C, et al. Evolution and modulation of age-related medial elastocalcinosis: impact on large artery stiffness and isolated systolic hypertension. Cardiovasc Res. 2005;1;66(2):307-17. doi:10.1016/j.cardiores.2005.01.012.Dao HH, Essalihi R, Bouvet C, et al. Evolution and modulation of age-related medial elastocalcinosis: impact on large artery stiffness and isolated systolic hypertension. Cardiovasc Res. 2005;1;66(2):307-17. doi:10.1016/j.cardiores.2005.01.012.Safar ME, London GM. The arterial system in human hypertension. In Textbook of Hypertension, (ed. J. D. Swales), Blackwell Scientific, London, 1994, p. 85-102. ISBNSafar ME, London GM. The arterial system in human hypertension. In Textbook of Hypertension, (ed. J. D. Swales), Blackwell Scientific, London, 1994, p. 85-102. ISBNFolsom AR, Kronmal RA, Detrano RC, et al. Coronary artery calcification compared with carotid intima-media thickness in the prediction of cardiovascular disease incidence: the Multi-Ethnic Study of Atherosclerosis (MESA). Arch Intern Med. 2008;23;168(12):1333-9. doi:10.1001/archinte.168.12.1333.Folsom AR, Kronmal RA, Detrano RC, et al. Coronary artery calcification compared with carotid intima-media thickness in the prediction of cardiovascular disease incidence: the Multi-Ethnic Study of Atherosclerosis (MESA). Arch Intern Med. 2008;23;168(12):1333-9. doi:10.1001/archinte.168.12.1333.Pletcher MJ, Tice JA, Pignone M, et al. Using the coronary artery calcium score to predict coronary heart disease events: a systematic review and meta-analysis. Arch Intern Med. 2004;28;164(12):1285-92. doi:10.1001/archinte.164.12.1285.Pletcher MJ, Tice JA, Pignone M, et al. Using the coronary artery calcium score to predict coronary heart disease events: a systematic review and meta-analysis. Arch Intern Med. 2004;28;164(12):1285-92. doi:10.1001/archinte.164.12.1285.Naghavi M, Falk E, Hecht HS, et al. From vulnerable plaque to vulnerable patient-Part III: Executive summary of the Screening for Heart Attack Prevention and Education (SHAPE) Task Force report. Am J Cardiol. 2006;17;98(2A):2H-5. doi:101016/j.amjcard.2006.03.002.Naghavi M, Falk E, Hecht HS, et al. From vulnerable plaque to vulnerable patient-Part III: Executive summary of the Screening for Heart Attack Prevention and Education (SHAPE) Task Force report. Am J Cardiol. 2006;17;98(2A):2H-5. doi:101016/j.amjcard.2006.03.002.Ternovoj SK, Fedotenkov IS. MSCT of the heart: guidance. M.: GEHOTAR-Media, 2011. 112 p. (In Russ.) Терновой С. К., Федотенков И. С. МСКТ сердца: руководство. М.: ГЭОТАР-Медиа, 2011. 112 с. ISBN: 978-5-9704-1689-1.Ternovoj SK, Fedotenkov IS. MSCT of the heart: guidance. M.: GEHOTAR-Media, 2011. 112 p. (In Russ.) ISBN: 978-5-9704-1689-1.Долженко А., Рихтер Т., Сагаловски С. Кальцификация сосудов, атеросклероз и потеря костной массы (остеопороз): новые патофизиологические механизмы и перспективы развития медикаментозной терапии. Альманах клинической медицины. 2016; 44 (4): 513-34. doi:1018786/2072-0505-2016-44-4-513-34.Dolzhenko A, Richter T, Sagalovsky S. Vascular calcification, atherosclerosis and bone loss (osteoporosis): new pathophysiological mechanisms and future perspectives for pharmacological therapy. Almanac of Clinical Medicine. 2016;44(4):513-34. (In Russ.) doi:1018786/2072-0505-2016-44-4-513-34.Вербовой А. Ф., Митрошкина Е. В., Пашенцева А. В. Взаимосвязь патогенеза атеросклероза и остеопороза. Ожирение и метаболизм. 2016; 13 (4):8-14. doi:10.14341/omet201648-14.Verbovoj AF, Mitroshkina EV, Pashenceva AV. Interrelation of the pathogenesis of atherosclerosis and osteoporosis. Ozhirenie i metabolizm. 2016; 13 (4):8-14. (In Russ.) Вербовой А. Ф., Митрошкина Е. В., Пашенцева А. В. Взаимосвязь патогенеза атеросклероза и остеопороза. Ожирение и метаболизм. 2016; 13 (4):8-14. doi:10.14341/omet201648-14.Claxton AJ, Cramer J, Pierce C. A systematic review of the associations between dose regimens and medication compliance. Clin Ther. 2001; 23:1296-310. PMID: 11558866.Claxton AJ, Cramer J, Pierce C. A systematic review of the associations between dose regimens and medication compliance. Clin Ther. 2001; 23:1296-310. PMID: 11558866.Krousel-Wood M, Thomas S, Munter P, et al. Medication adherence: a key factor in achieving blood pressure control and good clinical outcomes in hypertensive patients. Curr Opin Cardiol. 2004;19(4):357-62. PMID: 15218396.Krousel-Wood M, Thomas S, Munter P, et al. Medication adherence: a key factor in achieving blood pressure control and good clinical outcomes in hypertensive patients. Curr Opin Cardiol. 2004;19(4):357-62. PMID: 15218396.Mazzaglia G, Ambrosioni E, Alacqua M, et al. Adherence to antihypertensive medications and cardiovascular morbidity among newly diagnosed hypertensive patients. Circulation. 2009;120(16):1598-605. doi:0.1161/CIRCULATIONAHA.108.830299.Mazzaglia G, Ambrosioni E, Alacqua M, et al. Adherence to antihypertensive medications and cardiovascular morbidity among newly diagnosed hypertensive patients. Circulation. 2009;120(16):1598-605. doi:0.1161/CIRCULATIONAHA.108.830299.Claxton AJ, Sokol MG, McGuigan KA, et al. Impact of medication adherence on hospitalization risk and healthcare cost. Med Care. 2005;43(6):521-30. PMID:15908846.Claxton AJ, Sokol MG, McGuigan KA, et al. Impact of medication adherence on hospitalization risk and healthcare cost. Med Care. 2005;43(6):521-30. PMID:15908846.Munger MA, Van Tassell BW, LaFleur J. Medication nonadherence: an unrecognized cardiovascular risk factor. Med Gen Med. 2007;19;9(3):58. PMID: 18092064.Munger MA, Van Tassell BW, LaFleur J. Medication nonadherence: an unrecognized cardiovascular risk factor. Med Gen Med. 2007;19;9(3):58. PMID: 18092064.Mann DM, Allegrante JP, Natarajan S, et al. Predictors of adherence to statins for primary prevention. Cardiovasc Drugs Ther. 2007;21(4):311-6. doi:101007/s10557-007-6040-4.Mann DM, Allegrante JP, Natarajan S, et al. Predictors of adherence to statins for primary prevention. Cardiovasc Drugs Ther. 2007;21(4):311-6. doi:101007/s10557-007-6040-4.Агеев Ф. Т., Фофанова Т. В., Деев А. Д. Применение фелодипина в амбулаторной практике: оценка клинической эффективности и приверженности к лечению у больных с артериальной гипертонией. Кардиология. 2009;1(49):30-3.Ageev FT, Fofanova TV, Deev AD. The Use of Felodipine in Ambulatory Practice: Assessment of Clinical Efficacy and Compliance in Patients With Arterial Hy-pertension. Kardiologiia. 2009;1(49):30-3. (In Russ.)Sorokin, MY, Lutova NB, Wied VD. Neurosci Behav Physi. 2017;47:890. doi:10.1007/s11055-017-0486-zSorokin, MY, Lutova NB, Wied VD. Neurosci Behav Physi. 2017;47:890. doi:10.1007/s11055-017-0486-zКардиоваскулярная профилактика 2017. Российские национальные рекомендации. Российский кардиологический журнал. 2018;23(6):7-122. doi:10.15829/1560-4071-2018-6-7-122.Cardiovascular prevention 2017. National guidelines. Russian Journal of Cardiology. 2018;23(6):7-122. (In Russ.) Кардиоваскулярная профилактика 2017. Российские национальные рекомендации. Российский кардиологический журнал. 2018;23(6):7-122. doi:10.15829/1560-4071-2018-6-7-122.Piepoli MF, Hoes AW, Agewall S, et al. European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts). Eur Heart J. 2016;37(29):2315-81. doi:10.1016/j.rec.2016.09.009.Piepoli MF, Hoes AW, Agewall S, et al. European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts). Eur Heart J. 2016;37(29):2315-81. doi:10.1016/j.rec.2016.09.009.Yusuf S, Hawken S, Ounpuu S, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004;(9):11-17; 364(9438):937-52. doi:10.1016/S0140-6736(04)17018-978.Yusuf S, Hawken S, Ounpuu S, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004;(9):11-17; 364(9438):937-52. doi:10.1016/S0140-6736(04)17018-978.Погосова Г. В. Депрессия — фактор риска развития ИБС. Кардиология. 2012;12: 4-11. PMID:23237434.Pogosova GV. Depression is a risk factor for development CHD. Kardiologiia. 2012;12:4-11. (In Russ.) Погосова Г. В. Депрессия — фактор риска развития ИБС. Кардиология. 2012;12: 4-11. PMID:23237434.Ariyo AA, Haan M, Tangen CM, et al. Depressive symptoms and risks of coronary heart disease and mortality in elderly Americans Cardiovascular Health Study Collaborative Research Group. Circulation. 2000;102:1773-9. PMID: 11023931.Ariyo AA, Haan M, Tangen CM, et al. Depressive symptoms and risks of coronary heart disease and mortality in elderly Americans Cardiovascular Health Study Collaborative Research Group. Circulation. 2000;102:1773-9. PMID: 11023931.Brown JM, Stewart JC, Stump TE, et al. Risk of Coronary Heart Disease Events Over 15 Years among Older Adults with Depressive Symptoms. Am J Geriatr Psychiatry. 2011;19:721-9. doi:10.1097/JGP.0b013e3181faee19.Brown JM, Stewart JC, Stump TE, et al. Risk of Coronary Heart Disease Events Over 15 Years among Older Adults with Depressive Symptoms. Am J Geriatr Psychiatry. 2011;19:721-9. doi:10.1097/JGP.0b013e3181faee19.Ahto M, Isoaho R, Puolijoki H, et al. Stronger symptoms of depression predict high coronary heart disease mortality in older men and women. Int. J Geriatr Psychiatry. 2007;22:757-63. PMID: 17133654.Ahto M, Isoaho R, Puolijoki H, et al. Stronger symptoms of depression predict high coronary heart disease mortality in older men and women. Int. J Geriatr Psychiatry. 2007;22:757-63. PMID: 17133654.Albus C, Ladwig KH, Herrmann-Lingen C. Psychocardiology: clinically relevant recommendations regarding selected cardiovascular diseases. Dtsch Med Wochenschr. 2014;139:596-601. doi:10.1055/s-0033-1360102.Albus C, Ladwig KH, Herrmann-Lingen C. Psychocardiology: clinically relevant recommendations regarding selected cardiovascular diseases. Dtsch Med Wochenschr. 2014;139:596-601. doi:10.1055/s-0033-1360102.Ladwig KH, Baumert J, Marten-Mittag B, et al. Room for depressed and exhausted mood as a risk predictor for allcause and cardiovascular mortality beyond the contribution of the classical somatic risk factors in men. Atherosclerosis. 2017;(2);257:224-31. doi:10.1016/j.atherosclerosis.2016.12.003.Ladwig KH, Baumert J, Marten-Mittag B, et al. Room for depressed and exhausted mood as a risk predictor for allcause and cardiovascular mortality beyond the contribution of the classical somatic risk factors in men. Atherosclerosis. 2017;(2);257:224-31. doi:10.1016/j.atherosclerosis.2016.12.003.Eaker ED, Sullivan LM, Kelly-Hayes M, et al. Tension and anxiety and the prediction of the 10-year incidence of coronary heart disease, atrial fibrillation, and total mortality: The Framingham Offspring Study. Psychosom Med. 2005;67:692. PMID: 16204425.Eaker ED, Sullivan LM, Kelly-Hayes M, et al. Tension and anxiety and the prediction of the 10-year incidence of coronary heart disease, atrial fibrillation, and total mortality: The Framingham Offspring Study. Psychosom Med. 2005;67:692. PMID: 16204425.Roest AM, Martens EJ, de Jone P, et al. Anxiety and risk of incident coronary heart disease. A meta-analysis. JACC. 2010;56:38-46. doi:10.1016/j.jacc.2010.03.034.Roest AM, Martens EJ, de Jone P, et al. Anxiety and risk of incident coronary heart disease. A meta-analysis. JACC. 2010;56:38-46. doi:10.1016/j.jacc.2010.03.034.Janszky I, Ahnve S, Lundberg I, et al. Early-onset depression, anxiety and risk of subsequent coronary heart disease. 37-year follow-up of 49,321young Swedish men. JACC. 2010;56:31-7. doi:10.1016/j.jacc.2010.03.033.Janszky I, Ahnve S, Lundberg I, et al. Early-onset depression, anxiety and risk of subsequent coronary heart disease. 37-year follow-up of 49,321young Swedish men. JACC. 2010;56:31-7. doi:10.1016/j.jacc.2010.03.033.Scherrer JF, Chrusciel T, Angelique Zeringue A, et al. Anxiety Disorders Increase Risk for Incident Myocardial Infarction in Depressed and Nondepressed Veterans Administration Patients. Am Heart J. 2010;159:772-9. doi:10.1016/j.ahj.2010.02.033.Scherrer JF, Chrusciel T, Angelique Zeringue A, et al. Anxiety Disorders Increase Risk for Incident Myocardial Infarction in Depressed and Nondepressed Veterans Administration Patients. Am Heart J. 2010;159:772-9. doi:10.1016/j.ahj.2010.02.033.Smoller JW, Pollack MH, Wassertheil-Smoller S, et al. Panic attacks and risk of 79. incident cardiovascular events among postmenopausal women in the Women's Health Initiative Observational Study. Arch Gen Psychiatry. 2007;64:1153-60. PMID: 17909127.Smoller JW, Pollack MH, Wassertheil-Smoller S, et al. Panic attacks and risk of 79. incident cardiovascular events among postmenopausal women in the Women's Health Initiative Observational Study. Arch Gen Psychiatry. 2007;64:1153-60. PMID: 17909127.Довженко А. В., Васюк Ю. А., Семиглазова М. В. Клиническая картина и лечение расстройств депрессивного спектра у больных сердечно-сосудистыми заболеваниями. Терапевтический архив. 2009;81(12):30-4. PMID:20481045.Dovzhenko TV, Vasiuk IuA, Semiglazova MV. The clinical picture and treatment of depression spectrum disorders in patients with cardiovascular disease. Ter Arkh. 2009;81(12):30-4. (In Russ.)Albert CM, Chae CU, Rexrode KM, et al. Phobic anxiety and risk of coronary heart disease and sudden cardiac death among women. Circulation. 2005;111:480. PMID: 15687137.Albert CM, Chae CU, Rexrode KM, et al. Phobic anxiety and risk of coronary heart disease and sudden cardiac death among women. Circulation. 2005;111:480. PMID: 15687137.Meyer T, Buss U, Herrmann-Lingen C. Role of cardiac disease severity in the predictive value of anxiety for all-cause mortality. Psychosom Med. 2010;72:9-15. doi:10.1097/PSY.0b013e3181c64fc0Meyer T, Buss U, Herrmann-Lingen C. Role of cardiac disease severity in the predictive value of anxiety for all-cause mortality. Psychosom Med. 2010;72:9-15. doi:10.1097/PSY.0b013e3181c64fc0Фофанова Т. В., Агеев Ф. Т., Смирнова М. Д., Деев А.Д. Приверженность к терапии в амбулаторных условиях: возможность выявления и оценка эффективности терапии. Кардиология. 2017;57(7):35-42. doi:10.18087/cardio.2017.7.10004.Fofanova TV, Ageev FT, Smirnova MD, Deev AD. Adherence to therapy in outpatient settings: the ability to identify and evaluate the effectiveness of therapy. Kardiologiia. 2017;57(7):35-42. (In Russ.) doi:10.18087/cardio.2017.7.10004.Denollet J, Schiffer AA, Spek V. A general propensity to psychological distress affects cardiovascular outcomes: Evidence from research on the Type-D (distressed) personality profile. Circulation: Cardiovascular Quality and Outcomes. 2010;3:546-57. doi:10.1161/CIRCOUTCOMES.109.934406.Denollet J, Schiffer AA, Spek V. A general propensity to psychological distress affects cardiovascular outcomes: Evidence from research on the Type-D (distressed) personality profile. Circulation: Cardiovascular Quality and Outcomes. 2010;3:546-57. doi:10.1161/CIRCOUTCOMES.109.934406.Kupper N, Denollet J. Type-D personality as a prognostic factor in heart disease: Assessment and mediating mechanisms. Journal of Personality Assessment. 2007;89:265-76. doi:10.1080/00223890701629797.Kupper N, Denollet J. Type-D personality as a prognostic factor in heart disease: Assessment and mediating mechanisms. Journal of Personality Assessment. 2007;89:265-76. doi:10.1080/00223890701629797.Fouillet A, Rey G, Laurent F, et al. Excess mortality related to the August 2003 heat wave in France. Int Arch Occup Environ Health. 2006;80(1): 16-24. doi: 10.1007/s00420-006-0089-4.Fouillet A, Rey G, Laurent F, et al. Excess mortality related to the August 2003 heat wave in France. Int Arch Occup Environ Health. 2006;80(1): 16-24. doi: 10.1007/s00420-006-0089-4.Revich BA, Shaposhnikov DA, Podol'naya MA, et al. Heat waves in southern cities of European Russia as a risk factor for premature mortality. Studies on Russian Economic Development. 2015;26(2):142-50. doi:10.1134/S1075700715020100.Revich BA, Shaposhnikov DA, Podol'naya MA, et al. Heat waves in southern cities of European Russia as a risk factor for premature mortality. Studies on Russian Economic Development. 2015;26(2):142-50. doi:10.1134/S1075700715020100.O'Riordan M, Barclay L. Traffic Exposure, Air Pollution Biggest Population-Level Triggers for MI. From Heartwire. Published online. 2011 ;25(2). www.medscape.com/viewarticle/738001 (18.07.18).O'Riordan M, Barclay L. Traffic Exposure, Air Pollution Biggest Population-Level Triggers for MI. From Heartwire. Published online. 2011 ;25(2). www.medscape.com/viewarticle/738001 (18.07.18).Hoffman B, Hertel S, Boes T. Increased Cause-Specific Mortality Associated with 2003 Heat Wave in Essen, Germany. Journal of Toxicology and Envi-ronmental Health. 2008; 71, part A:759-65. doi:10.1080/15287390801985539.Hoffman B, Hertel S, Boes T. Increased Cause-Specific Mortality Associated with 2003 Heat Wave in Essen, Germany. Journal of Toxicology and Envi-ronmental Health. 2008; 71, part A:759-65. doi:10.1080/15287390801985539.Braga AL, Zanobetti A, Schwartz J. The effect of weather on respiratory and cardiovascular deaths in 12 U.S. cities. Environmental Health Perspectives. 2002;110(9):859-63. doi:10.1289/ehp.02110859.Braga AL, Zanobetti A, Schwartz J. The effect of weather on respiratory and cardiovascular deaths in 12 U.S. cities. Environmental Health Perspectives. 2002;110(9):859-63. doi:10.1289/ehp.02110859.Huang C, Barnett AG, Wang X, et al. Effects of extreme temperatures on years of life lost for cardiovascular deaths: a time series study in brisbane, Аustralia. Circ Cardiovasc Qual Outcomes. 2012;1;5(5):609-14. doi:10.1161/CIRCOUTCOMES.112.965707.Huang C, Barnett AG, Wang X, et al. Effects of extreme temperatures on years of life lost for cardiovascular deaths: a time series study in brisbane, Аustralia. Circ Cardiovasc Qual Outcomes. 2012;1;5(5):609-14. doi:10.1161/CIRCOUTCOMES.112.965707.Смирнова М. Д., Фофанова Т. В., Агеев Ф. Т. и др. Прогностические факторы развития сердечнососудистых осложнений во время аномальной жары 2010 г. (когортное наблюдательное исследование). Кардиологический вестник. 2016;XI(1):43-51.Smirnova MD, Fofanova TV, Аgeev FT, et al. Prognostic factors of cardio vascular complications during the heatwave of 2010. Cohort observational study. Kardiologicheskij vestnik. 2016;XI(1):43-51. (In Russ.)Huntley AL, Johnson R, Purdy S, et al. Measures of Multimorbidity and Morbidity Burden for Use in Primary Care and Community Settings: A Systematic Review and Guide Annals of Family Medicine. 2012;10(2):134-41. doi:10.1370/afm.1363.Huntley AL, Johnson R, Purdy S, et al. Measures of Multimorbidity and Morbidity Burden for Use in Primary Care and Community Settings: A Systematic Review and Guide Annals of Family Medicine. 2012;10(2):134-41. doi:10.1370/afm.1363.

The authors declare that there are no conflicts of interest present.