Aim. To study the prevalence of arterial hypertension (AH) in the population of Kyrgyz small towns and countryside and to analyse ethnic features of AH.

Material and methods. This cross-sectional epidemiologic study was performed as a part of the international study INTEREPID. A random sample of small town and countryside residents included 1774 people. The examination included a questionnaire survey, measurement of blood pressure, height, weight, and waist circumference, and laboratory tests. AH prevalence was age-standardised.

Results. In Kyrgyz small town and countryside residents aged 18–65 years, the prevalence of AH was 44% (33,2% in men and 46,7% in women). Among Kyrgyz participants, AH prevalence was significantly lower than in their Russian peers (36,8% vs. 46,2%, respectively). This difference was observed in women, while men did not demonstrate any marked ethnic differences in AH prevalence.

Conclusion. The results obtained suggest that AH prevalence in the Kyrgyz Republic is high (with a 40–50% increase over the past 20 years) and is characterised by marked gender and ethnic differences. Further research is required to identify whether race/ethnic group could be a risk factor for AH development. 

Aim. To assess the prevalence of overweight (OW) and obesity (O) in patients with myocardial infarction (MI) and to develop a method for monitoring the achievement of the target body weight throughout the long-term ambulatory follow-up.

Material and methods. The study included 211 patients aged 33–68 years (mean age 54,5±6,8 years), who previously had MI and experienced a stable clinical course of coronary heart disease for the 3 months before the study enrolment. By the values of body mass index (BMI), all patients were divided into 3 groups: normal body weight (BMI 18–24,9 kg/m2 ); OW (BMI 25–29,9 kg/m2 ); and O (BMI >30 kg/m2 ).

Results. In MI patients, the mean BMI value was 27,8 kg/m2 (25,0–31,1). Higher BMI levels were observed in women, compared to men (p=0,000...). No statistically significant BMI difference was observed across the age groups (p=0,64).

Aim. To study the effectiveness of the external cardiosynchronous electromyostimulation (ECSEMS) in patients with different variants of acute heart failure (AHF).

Material and methods. The study included 62 AHF patients: Group I — those receiving only standard pharmacological therapy; and Group II — those in whom standard pharmacological therapy was ineffective after 12 hours, and who were also administered ECSEMS sessions for the next 7 days. The examination included multi-frequency bio-impedance measurement and dispersion mapping.

Results. Clinical symptoms were less severe in Group I. In 64% of the Group II patients, the combination treatment was associated with a positive dynamics of the water balance parameters. The 7-day ECSEMS, as a part of the complex management of AHF patients, significantly reduced the one-month lethality, although did not change the one-year survival.

Conclusion. The ECSEMS method could be used in order to increase the effectiveness of the conservative treatment of AHF patients. 

The paper is focused on additional, or off-target, effects of angiotensinconverting enzyme inhibitors (ACEI), zofenopril in particular. This is a new area in the pharmacological research, which is also relevant to antihypertensive agents. The authors present the data on potential interaction between ACEI and acetylsalicylic acid, as well as the results of international multi-centre studies. 

The further development of preventive medicine in the 21st century may be impossible without the assessment of individual patients’ genetic data. At present, genetic methods are the gold standard in the diagnostics of monogenic diseases. Recently, genetic factors linked to complex (multifactorial) diseases, such as coronary heart disease and arterial hypertension, have been actively explored. This review focuses on the possible identification of new genetic factors of complex disease heritability, using the exome sequencing approach. 

The authors present the data on the potential of the combination of angiotensin-converting enzyme inhibitors and calcium channel antagonists in the treatment of hypertensive patients with chronic heart failure and preserved left ventricular ejection fraction. The informed choice of lisinopril, as a component of such a combination, is justified. 

The use of pharmacotherapy in prevention is aimed at the correction of already existing consequences (pathology), rather than the prevention of causes. The number of multiple known risk factors (RFs) is steadily increasing, which limits their effective control in the real-world practice. On the other hand, focusing only on a limited number of RFs (7–9) leaves plenty of room for error. Causality is a unity of multiple RFs, unique in each individual case. Determining causality with the use of mathematical modelling can facilitate a more reliable prognostic assessment in cardiovascular disease. 

Experts’ consensus on the interdisciplinary approach towards the management, diagnostics, and treatment of patients with metabolic syndrome.

Yuri P. Nikitin.

Sergey S. Yakushin.

Articles published in Cardiovascular Therapy and Prevention 2013.