The issues on prevention of non-communicable diseases (NCD) with the goal of premature mortality decrease and, respectively, of people lives saving, is being discussed actively in the countries of Northern Dimension Partnership in Public Health and Social Well-being (NDPHS). Comparative analysis of NCD in the NDP countries showed serious, approximately 3 times, differences in the parameters of premature mortality from NCD within the countries, and direct relationship of premature mortality from NCD with smoking prevalence in men, as with alcohol consumption in both sexes. Negative correlation is found in premature NCD mortality indices and amount of money spent on public health per person per year; such difference is as high as 10-15 times among the countries. The discussion of priorities and effective methods of NCD prevention by the members of NDPHS is significant for experience exchange and facilitates implementation of three strategies on NCD prevention and their promotion in all political and strategic events in the countries.

Aim. Evaluation of the severity of inflammation at systemic level and its relation with clinical picture, lipid parameters, lipid peroxidation and antioxidant system (LP-AS) in bronchial asthma (BA) patients with comorbid arterial hypertension (AH).

Material and methods. Totally, 77 BA and AH patients included. Comparison groups included 53 BA and 52 AH monovariants. Clinical state assessed, biochemical and immunological parameters characterizing the activeness of inflammation, lipid metabolism, LP-AS system.

Results. The severity of systemic inflammation is closely related to local bronchial inflammation, especially with comorbid AH. The relation of systemic inflammatory reaction is proved with the control ability of BA, as with lipid metabolism disorders and LP-AS system.

Conclusion. The assessed comorbid pathology is characterized by the existence of local and systemic inflammation forming a “vicious circle” of the antioxidation activity, lipid disorders and endothelial dysfunction. 

Aim. The assessment of cardiac hemodynamics in the test with reactive hyperemia in young females with idiopathic arterial hypotension.

Material and methods. The comparative analysis was done, of echocardiography in the standard test with reactive hyperemia within brachial area among 72 women with idiopathic arterial hypotension — systolic blood pressure 94-98 mmHg, and in 37 females normotensive — systolic BP 120-123 mmHg. In both groups the age was 19 (18-22) y.o.

Results. Reactive hyperemia in hypotension is followed by a significant increase of maximum velocities relation of the early (peak E) and delayed (peak A) diastolic filling of the left ventricle by 18%. In normotensive women there was no such change of the relation.

Conclusion. In young females with idiopathic arterial hypotension the test with reactive hyperemia, as a model of acute hypoxia, is followed by isolated diastolic dysfunction of myocardium. Probably, it is related to the increase of the rate of already existing hypernitricoxidemia, which is a key factors for arterial hypotension pathogenesis. 

Aim. Analysis of psychosocial risk factors in coronary heart disease (CHD) patients among Russian centers of the EUROASPIRE IV study, comparing to overall study population.

Material and methods. In the cross-sectional study, 24 European countries participated, including Russian Federation (3 centers). In the study, patients were included of the age 18-80 y.o., who, during the period ≥6 months to <3 years before the inclusion, had been hospitalized with myocardial infarction (MI) or other acute coronary syndromes (ACS) or for myocardial revascularization. To the study protocol, the analysis of medical charts was included, with following visit and structured interview. During the study, long-term results were evaluated, presence and level of the risk factors, including psychosocial, life quality parameters, adequacy of the acquired by patients recommendations and the grade of adherence. Prevalence of anxiety and depression symptoms was assessed with the Hospital Anxiety and Depression Scale (HADS).

Results. Overall, in the Russian centers, 746 patients were included, of those to the interview visit 424 admitted (mean age 63,4±9,0 y.o., 25,2% females). Educational level of the Russian cohort was higher than of overall study population (higher education in 44,3% and 22,3%, respectively). Prevalence of the anxiety symptoms in Russian patients and in overall population almost matched: 8-10 points by HADS-A in Russia and overall had 15,7% and 15,0% of participants, respectively, the ≥11 points — 12,4% and 11,3%, respectively. Contrary, the prevalence of depression symptoms in Russia was slightly higher: 8-10 by HADS had 16,4% and 14,6%, and ≥11 — 10,9% and 7,8%, respectively. Both anxiety and depression symptoms were more common among women; depression symptoms were more common for post-MI/ ACS patients than in the re-vascularized.

Conclusion. By the data from European monitoring center of EUROASPIRE IV, in Russian cohort of CHD post MI/ACS, and revascularized patients there are specific differences in comparison with overall study population in psychosocial risk factors. Prevalence of clinically significant anxiety and depression symptoms in Russian cohort of EUROASPIRE IV was significantly lower than in earlier trials, including EUROASPIRE III, and was just slightly higher than in overall study population. 

Aim. To study the relations of polymorphic variants of the genes: АРОЕ, MTHFR, IL8, IL6, TNF-а, VEGFA, ADIPOQ, ADIROR, APOB, APOА-V, APOC-IV, LPL, LP(a), BDNF, GRM1, GRM3 and development of the first ischemic stroke (IS).

Material and methods. The alleles frequencies and genotypes assessed for 20 mono-nucleotide polymorphic gene variants in 435 patients, who had first IS, and 229 persons with no stroke, comparable with age, gender, place of living and ethnicity. Genotyping of polymorphisms was done with the prepared TaqMan probes.

Results. For polymorphisms АРОВ (rs676210) and IL8 (rs1803205) there was significant difference between groups in the variety of minor alleles and genotypes.

Conclusion. There is significant relation of mononucleotide polymorphisms of the genes АРОВ (rs676210) and IL8 (rs1803205) with the development of first IS in the studied groups. 

Aim. To study the dynamics of metabolic syndrome markers: insulin, glucose, uric acid, triglycerides, low and high density lipoproteides; of food addiction (ghrelin-leptin) in both genders, of 18-25-year-old patients with normal and extensive body fat tissue amount.

Material and methods. Totally, 76 persons participated. At first stage, participants underwent survey on their food related behavior and physical activity. For the evaluation of fat tissue amount OMRON BF 506 devices were used, and the analizator of the balance of water-containing body sectors ABC-01 “Medass”. At the concluding stage of the study all participants underwent biochemical and hormonal blood tests.

Results. Excessive amount of body fat by bioimpedance is common in normal body mass index. Nevertheless, the correlation data on leptin, insulin, lipids and uric acid with gender and amount of fat tissue makes it to suspect subclinical metabolism disorder in the presence of minimal excess of fat tissue.

Conclusion. For the on time more effective prevention of obesity and its consequences as type 2 diabetes, arterial hypertension, etc., it is aimful to use the results of body fat tissue amount measurements, but not empirical calculations. 

Aim. To assess the all-cause and cardiovascular mortality by the results from prospective cohort study of non-organized inhabitants of Tomsk city depending on behavioral risk factors — smoking, alcohol consumption, in 25 years observation.

Material and methods. The study was done on the model of nonorganized Tomsk city population. Totally, 1546 persons studied, of the age 20-59 y.o., 630 males, 916 females. The parameters of all-cause and cardiovascular mortality studied, as the prognostic significance of behavioral risk factors — smoking, alcohol consumption, in the all-cause mortality origin, as the mortality from cardiovascular diseases.

Results. The data acquired, on the increase of all-cause mortality risk in smokers 2,34 times, 1,93 times in men and 1,99 in women. Among those having quit smoking, mortality risk was also higher comparing to nonsmokers — 1,86 in general population; 1,83 in men. Cardiovascular mortality risk is also significantly higher in those influenced by tobacco smoking: relative mortality risk 1,58, females — 1,93; no significant data for males. Relative risk increases in those consuming alcohol frequently, 2,55 times comparing to those non-drinking, especially in younger age strata. Gender analysis showed remaining of all relations for whole population in men, and in women there were significant results only for frequent alcohol intake.

Conclusion. It was shown that smoking significantly increases the risk of all-cause mortality among persons of both ages; among those quit smoking risk of death is still higher as in current smokers, comparing to non-smokers. Frequent alcohol consumption increases the risk of alcohol intake 2.6 times comparing to non-drinkers. Moderate and rare alcohol intake also increases the risk of all-cause mortality. 

Aim. To assess the influence of sex, type of settlement on the dynamics of risk factors (RF) and treatment adherence in arterial hypertension (AH).

Material and methods. Randomly, 1704 AH patients selected and investigated in 3 outpatient institutions of Tyumenskaya oblast. Mean patients age 62±7,5 y.o., 31,5% — males, 18,7% — rural inhabitants. The prevalence of RF evaluated for cardiovascular diseases, as treatment adherence to antihypertension therapy (AHT). Patients were selected to the groups of active observation and control. Active observation group received SMS and e-mail with preventional kind content. General practitioners were educated on the specifics of dispensary follow-up of AH patients. In 12±3,2 months patients were assessed second time. The efficacy of RF correction was evaluated, as AHT adherence, according to sex and settlement type.

Results. At the baseline, the prevalence of RF was as following: current smokers 24,1%, hypodynamic 64,0%, salt overconsuming 47,0%, insufficient vegetables and fruits intake 38,0%, elevated total cholesterol (TC) and low density lipoproteides (LDL) in 89,0% and 90,7%, respectively, body mass index (BMI) ≥30 kg/m2 in 49,5%, visceral obesity in 39,0%. Regularly received treatment 39,9%, of those effectively — 39,0%. In one year of follow-up, patients were investigated second time. In the active follow-up group there was 6% decrease of smoking rate (p<0,01); by 20,2% and 15,9% increased the number of those achieved target TC level (p<0,01) and LDL (p<0,01). There was significant number of BMI decrease and target waist circumference — 7,4% (p<0,01) and 6,1% (p<0,05), resp. By 14,3% the number of adherent to AHT increased (p<0,01) and by 10,9% — of those with effective treatment (p<0,01). Males quit smoking more frequently, and females reached target LDL levels, regularly took therapy and were more effective. Citizens more commonly reached target levels of TC, LDL, BMI, and took AHT more frequently.

Conclusion. The proposed model of active follow-up of AH patients makes it to improve the control of dyslipidemia, obesity, smoking, and to increase treatment adherence. 

Aim. To evaluate the specifics and dynamics of acute coronary pathology in the period of the year with anomaly hot weather.

Material and methods. The study is based upon integration of clinical and epidemiological data from the “Registry of acute myocardial infarction” with meteorological data by Tomsk city for last 25 years. Taken the weather report data, summer months of 2012 were taken for further assessment on myocardial infarction (MI) course in extreme weather heat. Into the study, all patients included that had MI in summer of 2012 and registered in the “Acute MI Registry” (n=241). Comparison group consisted of MI patients in the 2010 summer (n=198).

Results. The part of females increased, as of senile and older age persons, among the cohort of MI patients during the heat. The increase of the number found, of atypical acute coronary pathology course at extreme weather conditions. In 2012, MI developed more frequently in those drunk or at the next day, comparing to 2010. All-cause mortality among all MI patients was registered in several days of the heat wave beginning. During anomaly hot period mortality rate was comparable with the time frames of similar mean temperatures, and after the end of the heat wave, mortality tended to decline, mostly by reduction of sudden cardiac deaths.

Conclusion. Adverse tendencies in mortality and morbidity of MI are being registered in several days before the onset of anomalous heat. Taken that on-time healthcare influence is depended on the correctness of weather forecast, it is impossible to perform situational prevention events in response to the onset of extreme weather conditions, which demands for the long-term type organizational activities. Development of MI in alcohol intoxication or after this, as the high number of atypical clinical forms of MI demands for the improvement of information in general population.

Aim. To assess the attitudes toward smoking in economically active men and women in Tyumen city within various education and family status.

Material and methods. A single-point epidemiological study conducted, under the cardiological screening of open city population aged 25-64 y.o., males 850 (respond 85,0%), females 704 (respond 70,4%). The attitudes toward smoking were assessed by the coverage method of self-completion of the WHO questionnaire “Knowledge and attitude of the one’s health” with the pre-formulated points. Social status was assessed by educational level — elementary, general, graduate, and family status — with or none partner. Statistics was done with the software SPSS (11.5), Statistica 7.0 and Microsoft Excel. Values of p<0,05 were taken as significant.

Results. The prevalence of smoking was higher in women having partner — 17,0%, and in men with no partner — 63,4%. Men with general education and partner significantly more frequently quit smoking than single men — 23,7% and 13,6% (p<0,05; χ2 =4,28, df=1, p=0,04). Same tendency was found in graduate women (p=0,07). Men with partner and general education significantly more commonly did not smoke during the year (p<0,05), and such tendency was found in graduate men. In women with general education and partner, during the year, less number smoked (p=0,08), χ2 =2,91, df=1), but the intensity of smoking decreased (p=0,02, χ2 =4,93, df=1) compared to single females.

Conclusion. By the data from open city population, there are significant differences in attitudes of men and women toward tobacco smoking; there are different vectors of smoking tendency in relation with family status and education level.

Aim. To evaluate the 32-year dynamics and prognostic significance of the baseline levels of arterial pressure (BP) in teenage boys.

Material and methods. Thirty-two-year prospective cohort follow-up of males, beginning from the age 11-12 y.o. In 32 years, among 1005 participants, 303 (30,1%) assessed, and the cohort consisted of 290. The investigation included: standard questionnaires; three-time BP measurement; pulse rate; anthropometry; triceps, scapula and abdominal skin folds measurement, waist and hip circumference; total cholesterol measurement, as high density lipoproteides and triglycerides.

Results. The prevalence of arterial hypertension slightly declines in 12 to 15 years, and then increases at 17-22 years with high increase at 33 years, with further stabilization. All tracking coefficients (Pearson correlation) for systolic BP (sBP) were statistically significant, but decreased from the age 33 to 43 (from 0,35 to 0,17). For the diastolic BP-5 (dBP5) statistic significance was found only by 22 years, dBP4 — by 33 years. There was significant correlation of sBP and dBP with body mass index and anthropometry. In 30 years, the stabilized increase (fifth quintile) remains by sBP and dBP for every fifth. From the first to the fifth, every tenth switched by sBP and every fifth by dBP.

Conclusion. Measurement of BP in childhood and teenage is worthful, as there is significant relation of sBP and dBP in teenage with its adult level. Every fifth teenager with increased BP at childhood remain it in 30 years. Also, every tenth with low BP shows its increase in 30 years. The special attention should be paid for primary prevention of arterial hypertension in obese children and those with raised BP. It is important to search for new markers of prognosis.

Aim. To evaluate the impact of traditional risk factors (RF) to overall and cardiovascular mortality of the population ≥75 year old.

Material and methods. The results are acquired in the prospective cohort study “Stress, ageing and health”. Totally, 455 Moscovites assessed, age ≥75 y.o. The traditional RF were evaluated: arterial hypertension, smoking, obesity and dyslipidemia. The follow up on mortality lasted for 8 years. Totally, 239 deaths registered, of those 169 cardiovascular. Statistics was done with STATA 14.1.

Results. After stratification by sex and age, with the mortality from all cases in the 75-79 y.o. cohort, only current smoking status associated significantly (p=0,0001), and with cardiovascular mortality — current smoking and abdominal obesity, with relative risks 2,91 and 1,92, respectively. Also, in the ≥80 y.o. group, there were no RF influencing significantly the mortality.

Conclusion. Among all traditional RF, in the age strata 75-79 y.o., only current smoking associated significantly with the all-cause mortality, and with cardiovascular — also abdominal obesity. Among the persons of ≥80 y.o., traditional RF lose their impact for both all-cause and cardiovascular mortality. 

High prevalence of anxiety and depression disorders, as the increase of cardiovascular pathology prevalence make the problem of on time diagnostics and correction actual and important, as of the differential pharmacotherapy in internal disease practice. The article points on the data of relations in psychoemotional disorders and cardiovascular risks, as on the issues of pharmacotherapy. Based on the data presented, the conclusion done on the necessity of a specific tactics of such patients management.

There are many methods of the body composition assessment, but the most relevant are computed tomography and magnete-resonance tomography. Composition of the body shows the rate of fat amount and distribution in metabolic syndrome (MS) patients. It is known that MS increases the risk of atherosclerosis, arterial hypertension, type 2 diabetes, with further significant increase of cardiovascular morbidity and mortality. MS is associated with subclinical damage of internal organs; and the role of abdominal obesity is high. However, till recently there is no unified understanding of the role of visceral and subcutaneous fat.

Aim. To assess the influence of sleep disorders (SD) on the risk of arterial hypertension (AH) and stroke during 16 years follow-up in open population of females 25-64 y.o.

Material and methods. Under the framework of WHO program “MONICA-psychosocial” (Multinational Monitoring of Trends in cardiovascular disease — psychosocial study) in 1994, the random representative cohort was assessed, of women (n=870) at the age 25-64 y.o., living in the district of Novosibirsk city. SD were studied by Jenkins C.D. test. During 16-year follow-up (1994-2010) in the cohort, all new cases of AH/stroke were assessed. Cox-proportional regression was implemented for the development risk of AH/stroke.

Results. The prevalence of SD in open female population of 25-64 y.o. was 5,3%. Risk of development of AH was 4,3 times and 2,7 times higher for the first 5 and 10 years of follow-up, respectively, in females with SD, comparing to normal sleep. Stroke development risk was 1,95 times in SD women comparing to normal sleep, for 16 years follow-up.

Conclusion. Prevalence of SD in open female population 25-64 y.o. is significant, and impact the risk of AH/stroke onset in 16 years. 

Recently, high prevalence of atherosclerotic lesion of the vascular walls and further development of cardiovascular pathology attracts the specialists from different fields. The main attention is paid to the risk factors of atherosclerosis and its clinical complications with the aim of prevention and treatment methods development. New knowledge from fundamental research of atherosclerosis at cellular and molecular levels facilitates the development of novel methods for prevention and treatment of the pathology. The article points on the review of the main modern laboratory tests for atherosclerotic plaques assessment. The opportunities discussed for the study of cellular contents of the plaques, as functional evaluation of the cells in plaques.