The potential of cardiovascular diseases’ prevention according to the results of dispensary examinations of the adult population

Aim. To examine the relationship between early detection of cardiovascular diseases (CVD) during dispensary examinations of theadult population with cardiovascular mortality and assess the possibilityand feasibility of periodic examinations for prevention of CVD.

Material and methods. During comparative statistical and analytical research we studied standardized CVD mortality rate, prevalence of newly diagnosed CVD and risk factors (RF) among subjects of different ages (smoking, risk of detrimental alcohol consumption, poor nutrition, low physical activity, increased body weight with a BMI >25,0 kg/m², hypercholesterolemia >5 mmol/l, hyperglycemia >6,1 mmol/l). Statistical analysis was conducted by descriptive statistics methods, Pearson correlation analysis with Student’s t-test.

Results. In the subjects of the Central Federal District, compared with the Russian Federation, the frequency of newly diagnosed cases of CVD was less. However, the correlation of this indicator with the age structure of patients was not observed (r=0,17, p>0,05), what means low quality of medical examination. The incidence of newly diagnosed CVD was lower in regions with a higher rate of CVD mortality and there was a tendency to lower coverage of these patients with dispensary observation (r=-0,28, p>0,05). The RF prevalence in dispensary examinations is lower than during epidemiological studies, which also confirms the need to improve the completeness and quality of dispensary surveys, starting with questionnaires. At young age correlation of newly diagnosed CVD with factors of unhealthy lifestyle is more often recorded, and at the age of >40 years, metabolic RF (increased body weight, dyslipidemia, hyperglycemia) are added.

Conclusion. We identified interregional differences and insufficient dispensary quality regarding early diagnostics of CVD and RF. It allowed determining priority areas for the regions of the Central Federal District — disease intelligence, the coverage of dispensary examinations, and multifactorial preventive counseling. While ensuring the completeness and quality, the results of dispensary examinations can be proposed for CVD prevention. Abidance by multifactor approach to recommendations for reducing the risk of CVD and their complications is important.

1. Boytsov SA, Samorodskaya IV, Semenov VY, et al. Lost years of potential life, living conditions, health system resource indicators and economic indicators: comparative assessment of regions. Problems of social hygiene, health care and history of medicine. 2017;25(30):132­8. (In Russ.)

2. Oganov RG, Koncevaya AV, Kalinina AM. Economic burden of cardiovascular disease in the Russian Federation. Cardiovascular Therapy and Prevention. 2011;10(4):4­9. (In Russ.)

3. Order of the Ministry of health of the Russian Federation 03.02.2015 № 36an “On approval of the medical examination of certain groups of adults”. (In Russ.)

4. Order of the Ministry of health of the Russian Federation 06.03.2015 № 87n “On the unified form of medical documentation and form of statistical reporting used in the conduct of clinical examination of certain groups of the adult population and preventive medical examinations, orders for filling them out”. (In Russ.)

5. Order of the Ministry of health of the Russian Federation 26.10.2017 № 869n “On the statement of the order of carrying out medical examination of certain groups of the adult population”. (In Russ.)

6. Kalinina AM, Ipatov PV, Kaminskaya AK, et al. Identification of circulatory diseases and their risk during medical examination of an adult population: Methodological aspects. Therapeutic archive. 2015;87(1):31-7 (In Russ.)

7. Order of the Ministry of health of the Russian Federation 2112.2013 № 1344н “On the statement of the order of carrying out dispensary supervision” (In Russ)

8. Kalinina AM, Kushunina DV, Gorny'j BE'. The tasks of improving the quality of medical examination of the adult population as an important tool to prevent cardiovascular diseases in primary health care. Preventive medicine. 2018;21(5):22-7. (In Russ.)

9. Medical and demographic indicators of the Russian Federation.2017. Statistical materials. M.2018: 264p. (In Russ.)

10. Conroy R. Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J. 2003;24(11):987-1003.

11. Eganyan RA, Kalinina AM, Karamnova NS, et al. Comparative analysis of the rate of nutrition-related risk factors for noncommunicable diseases detected during health surveys among certain adult population groups of Russia in 2013 and 2016. Preventive medicine. 2018;21(4):38-43. (In Russ.)

12. Kalinina AM, Ipatov PV, Kushunina DV, et al. Results of detection of diseases of the circulatory system in the clinical examination of the adult population: the experience of the first 2 years. Therapeutic archive. 2016;1(88):146-52. (In Russ.)

13. Boytsov SA, Drapkina OM, Kalinina AM, et al. Organization of medical examination of certain groups of the adult population. Guidelines for the practical implementation of the order of the Ministry of health of the Russian Federation of October 26, 2017, № 869n “on approval of the procedure for medical examination of certain groups of the adult population.” M. 2017. 162 p. (In Russ.)