Aim. To study the prevalence and risk factors of hypertension (HTN), structure and effectiveness of treatment coverage, as well as disease control indicators among the male population aged 35-74 years in Novosibirsk.

Material and methods. This cross-sectional study of the Novosibirsk population was conducted in 2021-2023 at the Research Institute for Internal and Preventive Medicine — branch of the Federal Research Center Institute of Cytology and Genetics according to the ESSE-RF3 study protocol. A total of 1200 people aged 35-74 years living in Novosibirsk were examined. The analysis included 600 men. The response rate exceeded 70%. HTN was considered detected in systolic blood pressure (BP) ≥140 mm Hg and/or diastolic BP ≥90 mm Hg and/or in patients taking antihypertensive agents. Awareness was estimated as the proportion of individuals who had previously been informed by a physician about HTN. Treatment effectiveness was considered the proportion of individuals who achieved target BP values while taking antihypertensive therapy. Hypertension control was considered the proportion of individuals who achieved target values among all those examined with HTN. Statistical processing was performed using the SPSS software package (version 13.0). Associations were assessed using multiple logistic regression analysis. The critical significance level of the null hypothesis (p) was 0,05.

Results. The medians of systolic and diastolic BP among men in No­vo­sibirsk were 136,0 [126,5; 149,5] and 89,0 [82,0; 95,5] mm Hg, respectively. The prevalence of HTN among men aged 35-74 in Novo­sibirsk was 68,9%, while 81,1% of men in Novosibirsk were aware of HTN. Among men with HTN, 54,7% take antihypertensive agents. The effectiveness of treatment among men in Novosibirsk is 32,3%, while 19,6% of men control the disease. The odds of hypertension occurrence in men with hypertriglyceridemia increased by 3,5 times, with abdominal obesity — by 2 times, with an positive family history for cardiovascular diseases — by 1,6 times, and with each year of life increased by 1,1 times.

Conclusion. The prevalence of HTN among men in Novosibirsk is higher in comparison with the average Russian level. Significant risk factors for HTN include abdominal obesity, hypertriglyceridemia, and decreased physical activity. While awareness, treatment coverage, and HTN control among men aged 35-74 in Novosibirsk correspond to Russian trends, treatment effectiveness turned out to be slightly lower than in the Russian population.

Aim. To study the informativeness of sympathetic activity markers and perirenal adipose tissue (PRAT) in assessing renal function decline in patients with resistant hypertension (RH).

Material and methods. The study included 63 patients with RH of both sexes aged 40-80 years. The main group included 19 patients with chronic kidney disease (CKD). The control group consisted of 44 patients with RH without CKD. All patients were assessed for uric acid, blood lipid profile, beta-adrenergic reactivity of erythrocyte mem­branes, free metanephrine and normetanephrine in plasma and 24-hour urine. The renal function was assessed by the glomerular filtra­tion rate calculated using the CKD-EPI equation. Twenty-four hour blood pressure monitoring was performed on the brachial artery of one arm at intervals of 15 minutes during the day and 30 minutes at night. Kidney size and PRAT were calculated based on the magnetic reso­nance imaging.

Results. In both groups of patients, a significant increase in blood normetanephrine and beta-adrenergic reactivity of erythrocyte mem­branes relative to the reference values was shown. Blood and 24-hour urine metanephrine were within the reference intervals. No differences were found between the sympathetic activity indices in the main and control groups. In the main group patients, the PRAT thickness was greater (p=0,013), and the kidney diameter was smaller (p=0,046) than in the control group patients.

Conclusion. CKD in RH patients is not accompanied by additional significant changes in sympathetic regulation, assessed by the blood and 24-hour urine catecholamine levels, the degree of beta-adrenergic receptor desensitization and variability of blood pressure. PRAT increase according to magnetic resonance imaging in patients with RH is associated with a decrease in renal filtration function.

Aim. To compare clinical and hemodynamic parameters with survival of incident patients with idiopathic pulmonary arterial hypertension (IPAH) and chronic thromboembolic pulmonary hypertension (CTEPH) with a prognostically unfavorable pattern of cardiopulmonary exercise testing (CPET) parameters.

Material and methods. The study included 48 incident cases with a verified diagnosis of IPAH (n=18) and CTEPH (n=30). All patients were examined in accordance with the European Society of Cardiology and the European Respiratory Society guidelines (2015). The inclusion criterion was the ventilatory equivalent for carbon dioxide (CO₂) according to the CPET (VE/VCO₂) >44, indicating an unfavorable prognosis for patients.

Results. VE/VCO₂ in the examined patients with IPAH and CTEPH averaged 70,6±0,8 and did not differ in the study groups. Hemodynamic parameters of patients with IPAH and CTEPH also indicated a high risk of adverse events as follows: cardiac index — 1,9±0,1 and 1,8±0,1 l/min/m², respectively (p=0,3). Peak oxygen consumption, anaerobic threshold level, oxygen delivery to work performed were reduced in both groups. However, patients with IPAH did not have a decrease in dead space ventilation and desaturation severity during exercise was greater than in patients with CTEPH. Patients with CTEPH had better survival compared to patients with IPAH: 1 year — 89 vs 83%, 3 years — 84 vs 65%, 5 years — 73 vs 35%, 7 years — 55 vs 36%.

Conclusion. Among patients with IPAH and CTEPH who have an unfavorable prognosis, patients with IPAH demonstrate a more pronounced decrease in cardiovascular and respiratory reserves, which negatively affects patient survival. CPET may be a valuable non-invasive method for death risk stratification in patients with IPAH and CTEPH.

Aim. To study factors associated with carotid artery calcification as an atherosclerotic marker in the general working-age population.

Material and methods. The data of a representative ESSE-RF sample aged 25-64 years (n=1412) were studied. They underwent standard cardiology screening and assessment of carotid plaque (CP) characteristics using ultrasound. All respondents signed an informed consent to participate in the study. The association analysis included socio-demographic, anamnestic, laboratory, and ultrasound characteristics. Univariate and multivariate statistics were used.

Results. The prevalence of detection of calcified CP (cCP) was 5,4% — 7,8% in men and 3,7% in women (odds ratio (OR)=2,2; p=0,001). The probability of cCP detection was associated with following factors: male sex (OR=3,9; p<0,001), age (OR=1,2; p<0,001), total cholesterol (women, OR=1,7; p=0,001), history of thyrotoxicosis (OR=2,1; p=0,034), osteoporosis (OR=2,6; p=0,009), and smoking (OR=1,8; p=0,046). The odds that the detected plaque would be calcified were higher in individuals in the 4th quartile of mean plaque size distribution (OR=3,8; p<0,001) and in the presence of the following factors: male sex (OR=1,9; p=0,031), age ≥55 years (OR=4,3; p<0,001), osteoporosis (OR=3,2; p=0,007), high-density lipoprotein cholesterol level ≥1,3 mmol/l (OR=2,0; p=0,025).

Conclusion. The obtained data indicate an association of carotid calcification with both traditional cardiovascular risk factors and systemic diseases associated with impaired calcium and phosphorus metabolism (thyrotoxicosis, osteoporosis). The study results can be useful in practical healthcare, research, and developing preventive technologies.

Aim. To study the possible relationship between personal anxiety and polymorphic variants of genes associated with eating disorders (rs17782313 MC4R, rs1800497 DRD2, rs9939609 FTO) in women aged 45-64 in Novosibirsk.

Material and methods. A random representative sample of women aged 45-64 years (n=1074, mean age, 54,27±0,2 years) was examined in 2003-2005 at the Research Institute of Internal and Preventive Medicine, a branch of the Institute of Cytology and Genetics, within the Health, Alcohol and Psychosocial Factors In Eastern Europe (HAPIEE) project. Personal anxiety was assessed using the Spielberger self-assessment questionnaire included in the protocol of the Multinational Monitoring of Trends and Determinants of Cardiovascular Disease — Optional Psychosocial Study (MONICA-MOPSY), tested at screenings of the World Health Organization (WHO) MONICA program in 1983-1995. The sample for the HAPIEE program was formed at the program data processing center in Prague for each of the collaborating centers in such a way that each respondent was random. From the sample, every second woman (n=537) was selected for genotyping of the FTO rs9939609 variant (n=384); every third woman (n=358) — for genotyping the MC4R rs17782313 (n=279) and DRD2 rs1800497 variants (n=327). Genotyping was performed in the laboratory of molecular genetic studies by the polymerase chain reaction with the analysis of restriction fragment length polymorphism.

Results. Among women aged 45-64, anxiety was detected in 58,3%, and in 15,9% of women the anxiety level was high. The homozygous genotype C/C rs17782313 of the MC4R gene was more common among women with high anxiety levels (17,5%) than among women with low and moderate anxiety levels (1,8 and 0,8%, respectively; p=0,001). There were no significant differences in the detection rate of the rs1800497 genotypes of the DRD2 gene among women with different levels of anxiety (p>0,05). The frequency of the A/A rs9939609 genotype of the FTO gene was highest among women with high anxiety levels — 29,5%, compared to participants with low and moderate anxiety levels (15 and 15,3%, respectively; p=0,048). The probability of anxiety among carriers of the C/C+C/T genotypes of the MC4R gene was 1,29 times higher than among carriers of the T/T genotype (p=0,001). Among carriers of the A/A rs9939609 genotype of the FTO gene, the anxiety probability was 2,34 times higher than among carriers of the A/T+T/T genotypes (p=0,008).

Conclusion. The association between anxiety and genes of eating disorders dictates the need for diagnosis and subsequent treatment of anxiety and its associated consequences.

Dietary habits affect the risk of all-cause mortality (ACM) in the adult population according to prospective studies.

Aim. To assess the effect of dietary habits on the ACM risk in the Rus­sian population.

Material and methods. The prospective cohort included represen­ta­tive samples of 10 Russian regions (n=17175, 6767 men and 10408 wo­men aged 25-64 years), examined in 2012-2014 as part of the ESSE-RF study. Dietary habits were studied based on the consumption rate of the main food groups. The vital status of the cohort was updated every 2 years. The follow-up period was 6 years. Kaplan-Meier curves were used to analyze overall survival (OS). Cox proportional hazards model was used to assess the ACM risk.

Results. In the Russian population, an increase in OS is associated with daily consumption of vegetables/fruits, dairy products (milk, kefir, yogurt, cottage cheese, and cheese), and the presence of the Heal­thy Eating Model (HEM) in the diet. A decrease in OS is associated with excess salt intake (ESI) in the diet, the habit of adding salt to pre­pared foods, and daily consumption of pickles (p<0,05). Among men, an increase in OS is observed with daily consumption of fruits/ve­ge­tables, cheese, and HEM, while a decrease is observed with daily consumption of pickles, general ESI, and the habit of adding salt to foods (p<0,05). In women, daily consumption of red meat, liquid dairy products, cheese, and sweets is associated with an increase in OS (p<0,05). The risk of ACM in the general population and among men increases with ESI — relative risk (RR)=1,31 [1,06-1,61] (p=0,012) and 1,41 [1,06-1,87] (p=0,017), respectively, adding salt to food — RR=1,34 [1,09-1,65] (p=0,006) and 1,5 [1,13-1,98] (p=0,005) and daily consumption of pickles — RR=1,48 [1,02-2,14] (p=0,039) and 1,5 [1,01-2,54] (p=0,045). In women, regular consumption of red meat — RR=0,7 [0,49-0,99] (p=0,043), liquid dairy products — RR=0,68 [0,5-0,93] (p=0,015) and cheese — RR=0,64 [0,46-0,9] (p=0,011) were associated with an ACM decrease.

Conclusion. An ACM risk increase in the general population and among men is associated with excess salt intake, and a decrease in ACM risk in women is associated with the regular inclusion of red meat and dairy products in the diet.

Aim. To determine the effect of dapagliflozin on cardiac remodeling parameters and left ventricular mass according to cardiac magnetic resonance imaging in patients with heart failure (HF) with reduced ejection fraction (EF) and atrial fibrillation (AF).

Material and methods. The study included 60 patients with HF and AF receiving triple therapy for heart failure for at least 3 months, which were divided into two groups. Patients in the first group (1) were prescribed dapagliflozin, while patients in the second group (2) formed the comparison group. The study analyzed the following cardiac remodeling parameters and left ventricular (LV) mass measured using cardiac magnetic resonance imaging at baseline and after 6 months.

Results. Dapagliflozin led to a significant increase in LVEF from 29±6 (27-31) to 37±9 (33-40)% (p<0,001), and a decrease in the volumetric and linear dimensions of the LV and left atrium as follows: end-diastolic dimension from 70 (64-73) to 63 (60-70) mm (p<0,001), end-systolic dimension from 55±7 (52-58) to 50±7 (47-52) mm (p<0,003), end-diastolic volume from 239±50 (220-258) to 207±43 ml/m² (191-223) (p<0,001), end-systolic volume from 170±40 (155-185) to 140±33 ml/m² (p<0,001), left atrium from 48±5 (46-49) to 44±6 (42-46) mm (p<0,001), and a decrease in LV mass from 156,5 (130-180) to 109 (98-145) g (p=0,001).

Conclusion. In patients with HF with reduced LVEF and AF, dapagli­flozin therapy promotes reverse myocardial remodeling processes and increases cardiac contractility.

Implantation of a drug-eluting stent into the area of hemodynamically significant coronary artery lesion is a generally accepted and widespread method of coronary artery disease (CAD) treatment. However, rigid metallic frame in artery is associated with disrupted vascular biomechanics and neointimal proliferation in response to foreign material. These processes can lead to restenosis and/or late thrombosis of the implanted stent and, as a consequence, to the recurrence of CAD symptoms, as well as to adverse cardiovascular events. One of the options for solving the above problems is the implantation of bioresorbable stents. This technique already has an evidence base and is increasingly being introduced into routine clinical practice in certain groups of patients. The article presents a case of successful balloon angioplasty and stenting of the right coronary artery with a new-generation bioresorbable stent in a young patient with CAD.

Aim. To summarize the published data on the nomenclature of ambu­latory care sensitive diseases/conditions (ACSCs) in adult patients as one of the tools for a comprehensive assessment of the effectiveness of primary health care (PHC) measures implemented.

Material and methods. The study was implemented in 4 following stages: 1 — search for articles by keywords in electronic bibliographic databases; 2 — duplicate elimination; 3 — review of abstracts with an as­sessment for compliance with the inclusion/exclusion criteria, fol­lowed by a search for full-text versions and final selection of pub­lications; 4 — systematization and analysis of data on the ACSCs. Articles published in the period from January 1, 2012 to December 31, 2022 and containing information on ACSC nomenclature were searched in 4 domestic and foreign electronic bibliographic databases (Elibrary, NLM (PubMed), MEDLINE, PreMEDLINE). The PRISMA (Preferred Re­porting Items for Systematic reviews and Meta-Analyses) system was used in the preparation of the systematic review. Systematization of information on the obtained results was carried out in Microsoft Office Excel 2016 spreadsheets.

Results. In total, out of 10898 initially found publications, 11 full-text pa­pers describing studies that fully met the inclusion/exclusion criteria we­re admitted to stage 4 and were included in the final analysis. In none of the 11 publications was ACSC nomenclature identical to any other pub­lication included in stage 4 of the analysis. Variability in the total num­ber of ACSCs was noted in each of the assessed papers. In 100% of the analyzed publications, the NCAs included chronic obstructive pul­monary disease/chronic bronchitis, heart failure, diabetes, and hypertension. In 91% (10 publications), the ACSCs included angina pectoris, asthma, iron deficiency anemia, dental and oral diseases, urinary tract infections, acute skin infections, and gastroenteritis.

Conclusion. The nomenclature of the ACSCs in different countries is characterized by variability due to demographic, epidemiological, organizational, and other features. The conducted systematic review showed that the nomenclature of the ACSCs has not been defined in the Russian Federation. The data obtained in this work can serve as a basis for initiating a project aimed at developing a domestic nomenclature of ACSCs as one of the tools for a comprehensive assessment of the effectiveness of PHC measures implemented.

Aim. To compare clinical and anamnestic characteristics of patients with atrial fibrillation (AF) included in three large international stu­dies assessing the efficacy and safety of therapy with direct oral anti­coagu­lants, with the profile of a typical Russian patient with AF in clinical practi­ce, established by medical registries in the Russian Federation (RF).

Material and methods. A systematic review of scientific publications was con­ducted. The search was conducted in the E-library and Google Scholar databases. Publications from 8 registries of patients with AF, con­ducted in the Russian Federation from 2012 to 2023, were found, which present the clinical and anamnestic characteristics of patients. All studies included in the analysis meet the generally accepted require­ments for medical registries. The systematic review protocol was pre­viously recorded in the PROSPERO electronic database (CRD42024512425).

Results. A Russian patient with AF is a patient with a large number of cardiovascular pathologies and a high risk of thromboembolic events. According to the analysis, Russian patient with AF has an average age of ~70 years. Most patients have a diagnosis of hypertension, heart failure, while from one third to half of patients have a diagnosis of chronic kidney disease. From 20 to 30% of patients have a history of myocardial infarction and every fifth patient has type 2 diabetes.

Conclusion. In all countries around the world, including the Russian Fe­deration, for many years, medical registries have been one of the main sources of information on the characteristics of patients with AF and the disease course. They can supplement the available data from randomized clinical trials with real-world data. Comparison of clinical and anamnestic characteristics of patients in randomized clinical trials of direct oral anticoagulants with characteristics of patients in the Russian registries shows that patients included in the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K An­tagonism for Prevention of Stroke and Embolism Trial in Atrial Fib­rillation (ROCKET AF trial) were most similar to Russian patients with AF.

Cardio-oncology is a new medical direction which is responsible for the prevention of development, diagnosis and treatment of cardiovascular disease (CVD) in patients with cancer. The prevalence of cardiac pathology in cancer patients turned out to be unexpectedly high, while only half of the patients with pathology of two systems are referred to a cardiologist for consultation and receive optimal therapy. The coincidence of risk fa­ctors for CVD and cancer suggests that these diseases have common underlying biological and molecular mechanisms. Antitumor therapy and radiation therapy can also contribute to the onset and progression of CVD. Diagnosis of coronary artery disease (CAD) in patients with cancer is difficult, since this group of patients often lacks typical angina pain, and the most common complaint is dyspnea. Endovascular surgery for CAD and severe aortic valve stenosis can be an effective and safe method for treating patients with concomitant cancer. However, given the heterogeneity of cancer diseases and the fact that these patients were not included in most randomized trials studying the CVD treatment, further research is required in this area.

Aim. To analyze the literature on the etiopathogenesis of CVD in cancer patients, as well as the clinical features of CAD and aortic valve stenosis in cancer patients and the potential of innovative endovascular technologies.

Conclusion. For management and treatment of such severe comorbid patients, the participation of a multidisciplinary team and a personalized approach to each patient are necessary.

Endothelial dysfunction (ED) is a pathogenetic link in many cardio­vas­cular diseases. One of the promising approaches to non-invasi­ve diagnostics and assessment of the ED severity may be the deter­mi­nation of specific blood biomarkers. This review is devoted to the patho­genetic role of some biochemical and molecular factors associated with ED, as potential biomarkers of noncommunicable diseases.

The article presents data on the high relevance of studying a renal tubular injury in heart failure with preserved ejection fraction (HFpEF). The available research data and prerequisites for HFpEF development and renal tubular injury in detail. Markers of tubulopathy are presented. The main paradigm of cardiorenal syndrome in HFpEF with renal tubular injury is discussed — the unity of risk factors and pathogenetic mechanisms (low-intensity chronic inflammation, endothelial dysfunction, profibrotic hyperactivity). The need to identify markers of tubular dysfunction is due to expanding preventive capabilities to slow down the cardiorenal continuum stages — a decrease in filtration function and further remodeling of the myocardium and vascular bed. The review presents the analysis of available Russian and foreign data and analytical portals.

The oscillometric method, which is gradually replacing the traditional auscultatory method, is attractive to practitioner due to the possibility of automating blood pressure (BP) measurements. However, there is little literature information about its limitations. The purpose of this review is to address such issues. For this purpose, the main modern information on the maximum amplitude algorithm for BP measurement and location features, in which it is possible to obtain an oscillometric waveform, are preliminarily considered. In addition, the limitations and disadvantages of the method associated with both the equipment and the characteristics of various population groups are analyzed. The list of groups in which blood pressure measuring devices may be inaccurate has expanded significantly in the 2020s compared to the previous decade. This suggests that the reliability of the interpretation of data obtained by the oscillometric method in a certain part of patients is limited.