Recently, medical community and mass media actively discuss the need for broad screening programs, criteria of those, investigation methods, frequency of start-up, etc. The article focuses on the main screening programs for adult citizens ofGreat Britain,USA,Australia,JapanandRussia. 

Aim. To compare the influence of monoand combined with antidepressant antihypertension therapy (AHT) on the parameters of 24-hour blood pressure (BP) profile, severity of depression and life quality of patients with non-controlled arterial hypertension (AH) and depression.

Material and methods. 71 patients, aged 48,7±5,2 y.o., 37 females, were randomized to two groups. Each group during a year consequently received two types of pharmacotherapy for 6 months twice: mono AHT and AHT with antidepressant fluvoxamine (AHT+A). Group 1 (n=35) for the first half-year received AHT, then AHT+A; group 2 (n=36) in reversed order. At the end of each half-year, we compared 24-hour blood pressure, and severity of depression by Beck score, with life quality. Same comparisons were done in the group by endings of two periods.

Results. Starting with combination AHT led to faster achievement of relatively low values of mean day and mean night systolic and diastolic BP, lower BP variability. Combination AHT made to reach significantly higher level of the value and velocity of morning BP raise. Only combination therapy showed adequate reduction of depression symptomathics. Combination, as monotherapy in 6 month led to significant improvement of life quality; however, combination therapy was significantly better.

Conclusion. Efficacy of antidepressant-combined AHT with fluvoxamine in AH patients with depression better than mono AHT. 

Aim. To study the efficacy of rosuvastatin and ezetimibe combination in patients with moderate clinical signs of chronic heart failure.

Material and methods. We incllded outpatients (n=70) >40 y.o. with clinical picture of moderate heart failure (functional class by NYHA II), with comorbid diabetes 2 type, carotid atherosclerosis and hypercholesterolemia. Patients were randomized to 2 groups, 35 persons in each. In the 1st group threatment was performed with rosuvastatin 20 mg daily, with ezetimibe 20 mg daily, in the 2nd — only rosuvastatin 20 mg daily. During one year of study we collected primary endpoints: death, myocardial infarction, stroke, hospitalizations; and secondary endpoints: the amount of those reached target level of low density lipoproteides cholesterol (LDL), changes of lipidogram, C-reactive protein (CRP), intima-media thickness of internal carotid artery.

Results. Significant decrease of LDL comparing to baseline, occured in both groups by the end of the first month and remained until the end of study. The most significant LDL decrease (mediana >50%) occured in 1st group by 12 months of the study. Also, since the 3 month, we observed the decrease of LDL more than 45%. In the 2nd group this parameter was not more than 40%. The decrease of CRP by 12 months of the study was found only in the 1st group: mediana of baseline value 3,2 mg/L, end of study mediana 2,2 mg/L, mediana of changes 31,25% (p=0,028). Hospitalizations related to cardiovascular diseases were at level 14,3% in 1 group, and 40% in the 2nd st (р=0,032).

Conclusion. Prescription of combination hypolipidemic therapy by rosuvastatin and ezetimibe at dose 20 mg/daily leads to more prominent decrease of LDL in blood, decrease of CRP, number of hospitalizations for cardiovascular diseases comparing to single use of rosuvastatin 20 mg/daily. 

Aim. To study molecular effects of tiotriazoline in 30 patients with stable angina I-III functional class.

Material and methods. Comparison of molecular effects of cardioprotection is done based on dynamics of exercise tolerance dynamics, and via proteomic methods of investigation, questionnaires assessment of life quality in patients with ischemic heart disease (IHD).

Results. It was found, that tiotriazoline improves exercise tolerance, shows strong cardioprotective effect that includes antioxidant and cytoprotection effects in IHD patients.

Conclusion. Tiotriazoline helps to reduce the mean number of angina attacks in IHD patients, as to improve mean functional class. 

Aim. The analysis of relationship between coronary arteries lesion, patients’ age, type of acute coronary syndrome (ACS) and risk level by GRACE.

Material and methods. Totally, 179 patients included at the age 24-65 y.o. (mean age 51,2±7,0), hospitalized for ACS. All patients underwent coronary angiography during hospitalization.

Results. In ST elevation ACS two-vessel disease was more common (28,6%), comparing to those with non-ST ACS (15,1%), р=0,031. Regardless the correlation of GRACE risk with age, there was no relation of coronary lesion with age in our study. Mean calculated points by GRACE in non-ST ACS were 95,9±3,3, low risk patients predominated (66,2%). Also, among those with low risk by GRACE, in 48,9% coronary arteriogram showed high risk coronary anatomy.

Conclusion. Low calculated risk by GRACE in young patients has low predicting ability for severe coronary lesion, which is important to note in management of non-ST elevation ACS. 

Aim. To study gender specifics of risk factors and to assess their relation with myocardial infarction development (MI) in patients of various age subgroups.

 Material and methods. Totally, we included 188 men and women with Qand non-Q MI at the age 45-74 y.o., selected to 4 groups depending on age and gender. For all patients we evaluated clinical and anamnestic data, lipid profile, carbohydrate metabolism markers, sex hormones, C-reactive protein; we assessed hypodynamia level, depression and anxiety using questionnaires. To findout a relation of risk factors (RF) with MI development, statistically, we invented mathematical models of assessment of odds ratio for non-fatal MI cases for male and female population of patients.

Results. For the assessed males the most significant risk factors were smoking, lipid disorders, overweight; for older males additionally RF were carbohydrate metabolism disorders with insulin resistance development, and mostly abdominal obesity. For women, main RF were carbohydrate metabolism disorders due to 2 type diabetes, arterial hypertension, obesity with its abdominal type, and lipid disorders.

Conclusion. The invented mathematical models of evaluation of odds ratios make it to estimate the probability of non-fatal MI in men and women using their age and collection of RF. 

Aim. To assess leptin level in blood serum of patients with metabolic syndrome (MS), including comorbidity with ischemic heart disease (IHD), to reveal possible predictive value of this marker for IHD development in MS.

 Material and methods. Totally, 43 MS patients studied, of those 36 with IHD, and 33 non-MS, among those had been diagnosed with IHD 18. Mean age of the MS patients at baseline was 62,7±10,3 y.o. Controls (non-MS) were 60±14,7 y.o. Leptin level in serum was measured via immune-enzyme assay “Platinum ELISA”.

Results. Mean level of leptin in MS groups was significantly higher — 41,89±33,28 ng/mL comparing to non-MS — 17,64±16,87 ng/mL (р<0,001). Women had higher leptin level — 38,65±29,23 ng/mL, comparing to men — 19,54±27,23 ng/mL (р=0,006). A direct correlation of leptin and IHD was found (r=0,258, p=0,024).

Conclusion. Leptin level in MS patients is higher than non-MS. Leptin plasma level in MS and IHD is higher than MS non-IHD. Further study and understanding of possible leptin mechanisms of action might be applied in improvement of effectiveness of earlier IHD diagnostics in MS.

Usual practice of a physician quite oftenly shows difficulties in differentiation of ischemic heart disease and so called “stressor” myocardium changes, occuring in persons participating in sports. 

Telomere length (TL) is a recognized marker of replicative cellular ageing, and related to the ageing of cardiovascular system with the risk of cardiovascular diseases development (CVD). Chronic inflammation and oxidative stress significantly determine the velocity of telomeres shortening, and most of CVD risk factors (RF) closely related to these proceses; and it is possible to suggest that relationship of TL and RF determine CVD risk. However, clinical studies on this processes elaboration are lacking.

Aim. To study relation of TL with traditional and some “new” RF in persons of different age without clinical signs of CVD, related to atherosclerosis.

Material and methods. Totally, 303 patients included, of the age 25-91 y.o., without signs of CVD and other chronic diseases, not taking regularly and medications. All patients underwent traditional and some “novel” RF. TL was measured via real time polymerase chain reaction.

Results. According to the regression model, TL is independently related to age, C-reactive protein (marker of inflammation), urea (oxidative stress maker), and metabolic status markers as waist circumference, insulin resistance index HOMA, fasting glucose level; the most significant predictor is HOMA (p=0,0001). Risk of having shortened telomeres increases 12 times with increased urea, 2,4 times with insulin resistance, 2 times in fasting hyperglycemia.

Conclusion. Revealing of the factors that are related to cellular ageing makes it to define the most potentially benefit targets for interventions towards early and effective CVD prevention. 

Since the end of the 20th century, as by the results of epidemiological studies, there is broadly known concept of risk factors (RF), having become the fundamentals of cardiovascular prevention. Traditionally, there is distinction of conventional and non-conventional, or psychosocial, RF, among those emotional factors and chronic stressors. The impact of non-conventional RF on the diseases development, and primarily cardiovascular, is questionned, but is the most actual due to high mortality from cardiovascular diseases, and one of the most complicated as well. The article focuses on a review of known studies of the influence of non-conventional RF on the ischemic heart disease development, and an attempt is done to evaluate the influence of these factors on the development of acute coronary syndrome. 

Genetics of arterial hypertension is broadly discussed as of one of multifactorial diseases. Invention of an algoritm for risk stratification based upon genetic parameters, gives chance to select groups of higher essential hypertension (EH) risk with the aim of primary prevention. One of such prototypes was assessed, that inculdes 11 genetic markers, in 30 patients with known clinical parameters; 19 of those were with EH and 11 normotonics. Individual impact is assessed of each marker and comparison done for total risk in patients. As a result, there were no differences found in individual risk for patients with and without EH by 11 markers, between subgroups. There was protective effect found for the allele С rs1799998 of gene CYP11B2 (OR 0,247; CI=[0,081-0,754], p=0,01). 

Close relation of cardiovascular (CVD) diseases and chronic obstructive pulmonary disease (COPD) gains attention during last years as one of the aspects of systemic COPD signs. High prevalence of CVD in COPD patients can be explained by a concept of persisting systemic lowintensive inflammation. Current review regards COPD as risk factor for CVD that demands respective multidisciplinary diagnostic and management approaches. 

The review focuses on the results of epidemiological and clinical trials, which witness high prevalence of risk factors for chronic noncommunicable diseases in student population, their common combination and potentiating negative impact on the health and academic success of students. The results of literature data analysis underlies an aim for further long-term population epidemiologic studies, trends and age tracking of the main risk factors for chronic noncommunicable diseases in student population, with properly organized interinstitutional system of medical-social follow-up of the studying and research for differentiated prevention technologies.