Aim. To estimate long-term socio-economic effectiveness of broad health screening activity of adults by the results in the year 2013.

Material and methods. The study is performed with the method of mathematic modelling using the results of completed in the year 2013 health screening and with an estimate for adult productive and economically active age (up to 72) for 10-year perspective of potentially prevented deaths from the main chronic non-infectious diseases (CHID), saved years of life and economic expenses by 1 year of saved life.

Results. Through analyzed malignant tumours (MT) maximum deaths are to be prevented from breast cancer. The most significant effect of the performed screening is decrease of cardiovascular (CV) deaths — quantity of potentially saved lifes at productive age during 10 years would be 10 times higher than from MT. Screening for the studied CHID is characteristic for certain economic expediency, because expenses on 1 year of potentially saved life appeared lower than gross domestic product by one inhabitant. The most economic expediency of screening was found at the matter of CV diseases: expenses on 1 year of saved productve life (15,5^th RUR) and economically active age (11th RUR), that is significantly lower than domestic gross product by inhabitant. Return of investments into health improvement thank to earlier diagnostics of CHID and further treatment would reach 10 RUR per each invested 1 RUR by 10 years.

Conclusion. The analysis and calculations showed a significant positive effect of health screening in 2013, most of all due to earlier diagnostics and complex action against CV diseases and MT, which are included into screening and observation. Expenses on 1 year of saved life were lower than domestic gross product by inhabitant (in prices of the 2013) and return of investment by maintaining labour potential of economically active population was 10 RUR by 1 invested RUR during 10 years. Economic efficiency of health screening as a strategy to prevent premature death, preventable death and to keep health is clear.

Aim. To study interrelationship between cardiovascular risk factors and cellular and vascular aging processes. Material and methods. Totally 136 patients were included having no signs of cardiovascular diseases, diabetes 2nd type and receiving no drug therapy, but with one or several risk factors for cardiovascular diseases (smoking, arterial hypertension, obesity, dyslipidemia, fasting hyperglycemia). The telomere length and telomerase activity was measured by polymerase chain reaction. The thickness of intima-media complex (TIMC) and presence of atherosclerotic plaques (ASP) were measured by duplex scanning of right and left carotid arteries. Pulse wave velocity (PWV) was measured by applanation tonometry. Biochemical tests done by standard.

Results. PWV significantly correlated with age, body mass index, glycosilated hemoglobin level, fasting glycemia and telomere length. Presence of ASP and increased TIMC significantly correlated with age, body mass index, arterial hypertension, dyslipidemia. Conclusion. Increase of arterial wall stiffness and subclinical atherosclerotic disease have different causes. The level of PWV more linked with carbohydrate metabolism disorder, and TIMC and ASP are linked with lipid disorders.

Aim. Current study aimed to adapt and evaluate the psychometric properties of Russian versions of Patient Health Questionnaires 2 and 9 (PHQ-2 and PHQ-9) used for detection of depression in general medical practice worldwide.

Material and methods. Questionnaires were translated into Russian and adapted with regard to linguistic features of population. A study was performed on a sample of 193 patients (130 female, 63 male, mean age 34,6±11,4), who attended general practitioners in outpatient practice department of NRC for Preventive Medicine. Patients filled in PHQ-2 and –9 questionnaires in presence of clinical psychologist and then assessed for depression by a psychiatrist (using ICD-10 criteria).

Results. The optimal measures of sensitivity and specificity corresponded to cut-off scores of 3 for PHQ-2 (66,2% and 87,4% respectively) and 10 for PHQ-9 (68,9% and 93,3% respectively). Russian questionnaires were found to success in sensitivity, specificity and their positive predictive values are comparable to similar research data reported in literature. Article discusses the principles of implementation of the studied scales for depression screening in general medical practice.

Aim. To evaluate diagnostic significance of screening methodology for ischemic heart disease (CHD) and cerebrovascular disease (CD) and to adapt it to the outpatient and polyclinic conditions of primary medical care.

Material and methods. Totally 303 patients investigated, of those 143 were men of 40–70 years old and 160 were women at the age 55–70 without signs of cognitive impairment, having appointed at general practitioner office “for any reason”. The investogation was done according to standard procedure including unified questionnaire for CHD, various forms of CD, and resting ECG evaluated by Minnesota code. For diagnosis verification all patients were examined by neurologist and cardiologist, additional methods used if needed.

Results. The sensitivity of screening method for CHD reached 90,4%, specificity — 94,8%, for CD — 91,4% and 94,3%, respectively. In 19,8% of patients it was the first time to diagnose CD. Patients with arterial hypertension had various forms of CD in 55% cases. Also in 21% of participants chronic CD was diagnosed for the first time. Seventy six (25,1%) of hypertensives had cerbral crises in anamnesis, but this diagnosis appeared in outpatient charts only in 5,2% cases.

Conclusion. Screening is diagnostically significant for CHD and CD detecting. It made possible to find out chronic forms of CD in every fifth individual in the study for the first time. An insufficient knowledge of outpatient care practitioners is shown on symptoms of chronic CD and cerebral hypertensive crises in patients with arterial hypertension.

Aim. To carry out the population analysis of blood lipid profile trends during the period from 1985 to 2005 in Novosibirsk population.

Material and methods. The study was carried out based on the databases of two large international epidemiological projects done in Novosibirsk, WHO “MONIСA” and “HAPIEЕ”. The representative samples from nonorganized population of Novosibirsk were tested in compliance with protocol of the projects. The analysis included data of 10272 people aged from 45 to 64 years; among them 4783 were men and 5489 — women.

Results. Blood TC, non-HDL–C and LDL–С levels from the citizens of Novosibirsk aged 45–64 were significantly lower in the year 1995: 5,50±0,03 mM/l, 4,07±0,03 and 3,48±0,03 mM/l, respectively. By 2005 these values increased significantly and became higher than those initial in 1985. For women 20-year changes in TC, non-HDL–C and LDL–С levels are more prominent than for men. Trends of blood triglyceride levels are analogous to the changes of the indexes described above: average levels were the lowest in 1995 and the highest — in 2005. During a twenty years period the gradual statistically significant increase of blood HDL–C concentrations was noted: in 1985 its concentration was 1,29±0,01 mM/l, in 1995–1,42±0,01 mM/l (p<0,001), in 2005–1,53±0,004 mM/l (p<0,001). HDL–C level for the first decade (1985–1995) increased at average by 10% for the all tenyear period, and for the twenty-year period — by 18,6%, at that for men the increase was more significant (20,2%) than for women (16,4%). By 1995 the absolute values of atherogenicity coefficient decreased significantly; for women in a greater degree. By 2005 the correlation of pro-atherogenic factor to atherogenic one has slightly increased however stayed lower in relation to 1985.

Conclusion. In the year 1995 in Siberian population blood TC, non-HDL–C, LDL–С and TG levels appeared to be lower than in 1985 and 2005. Blood HDL–C content was increasing with each decade. Atherogenicity coefficient decreased during the first decade (by 1995), and during the subsequent years slightly increased for women, but did not change significantly for men.

Aim. To study gender specifics of structural and functional parameters of brachiocephal arteries with the relation to psychoemotional factors in almost healthy individuals.

Material and Methods. Overall 107 almost healthy economically active individuals included from organized population (46 male, 61 female), with the average age 43,4±10,8 y. All participants underwent psychological testing that included questionnaires: Spolberger-Khanin test, depression evaluation scale by the Center for Epidemiological Studies, visualanalogue scale (modified Dembo-Rubinstein), the social frustration level, social adaptation test by Holmes-Rey, ultrasound scanning of brachiocephal arteries with evaluation of local rigidity parameters.

Results. There were significant gender differences found for the vessel wall structural and functional parameters. Average values of systolic and diastolic diameters, total common carotid artery wall thickness were higher in males, but the rigidity index - in women. Prevalence of personal anxiety and clinically significant stress estimates by the Holmes-Rey scale was significantly higher in women, 75% and 36%, resp. In both groups the association of psycho-emotional factors and vessel parameters was found. But for men there was independent relation of reactive and personal anxiety with the thickness of “intima-media” and in women – correlation of depression and vessel wall compliance.

Conclusion. The results direct to the need for further research of novel methods for complex primary prophylaxy of stress-induced remodeling of vessels with the connection to psychoemotional and gender specifics.

Aim. To evaluate 24-week treatment by olmesartan on rigidity of arteries in different vessel areas in patients with coronary heart disease (CHD) with 1–2 grade arterial hypertension (AH).

Material and methods. Into open-label, non-randomized trial 25 patients with CHD and 1–2 grade AH were included. During 24-week treatment period patients received olmesartan medoxomil 20–40 mg daily. Baseline and final parameters of arterial wall stiffness were measured using ultrasound method with echotracking. The thickness of intima-media (TIMC) was defined. To evaluate regional vessel stiffness the volume sphygmography method was used.

Results. Acorrding to the data of volume sphygmography terapy by olmesartan significantly decrease PWVao by 19,4%, R-PWV b L-PWV — by 11,9% and 11,6% (p<0,05). CAVI1 decreased by 9,3%; L–CAVI1 — by 13,7%, CAVI2 — на 14,9% (p<0,05). В-PWV did not change significantly. During 24-week medication treatment the regress of carotid atherosclerosis was marked: decrease of TIMC from 773,6±155,7 μm to 736,3±124,1 μm (p<0,05). The values loc P sys and loc P dia significantly decreased by 13,5% and 11% (p<0,05); rigidity index β by 19,1% (p<0,05). Also we marked the increase of transverse pliability by 3,3% (p<0,05) and decrease of loc PWV by 17% (p<0,05). The coefficient of transverse pliability, locAix and DOCA did not show significant changes.

Conclusion. Addition of olmesartan to the standard treatment of CHD and AH showed significant improvement of local and regional stiffness.

Aim. To study associations of deletional polymorphism of genes GSTM1 and GSTT1 with myocardial infarction (MI) development on the background of metabolic syndrome (MS).

Material and methods. Totally 86 patients with STEMI were included (from those 45 had signs of MS) and 30 healthy persons as control. By polymerase chain reaction the data on deletional polymorphism was obtained on the genes coding glutathiontransferase GSTM1 and GSTT1 in both groups.

Results. The significant increase of prevalence of genotype GSTT10/0 is ascertained in patients with MI and without MS; presence of the “null” genotype increases relative risk of infarction in both patients with and without MS. In the first group (without MS) presence of genotype GSTT10/0 leads to increase of MI risk irrespective of smoking status, though in MS patients — only in those who smokes.

Conclusion. Diagnostic of homozygous deletional mutation GSTT1 can be used for individual prognosis of MI risk in patients with MI risk factors — smoking and MS.

Aim. To explore the association between Metabolic Syndrome (MS) and risk of stroke in Novosibirsk citizens aged 45–69 years.

Material and methods. As a part of an international prospective cohort HAPIEE study the population sample of 9363 residents of Novosibirsk aged 45–69 years were surveyed by screening method.

Results. A high prevalence of metabolic disorders in the population was revealed; the levels and distribution of cardiometabolic factors in first-ever stroke examined. It was found by the “case-control” study, that the combination of hypertension and abdominal obesity (AO) increases the odds ratio (OR) for stroke in the population studied.

Conclusion. It was shown to 2-fold increase in the risk of stroke in people with MS by 9-year prospective observation. Prognostic models of combining components of MS affecting the OR of stroke were identified in an urban population of Siberia.

Brief episodes of myocardial ischemia initiate a cascade of endogenous mechanisms which protect the heart during further ischemic attack. This phenomenon is called an ischemic preconditioning. Preinfarction angina is a clinical model of this phenomenon. Clinical studies have demonstrated that preinfarction angina is associated with: lower incidence of cardiogenic shock, pulmonary edema, ventricular tachycardia and ventricular fibrillation, reduced infarct size, less severe left ventricular dysfunction, better results of thrombolytic therapy, less severe myocardial reperfusion injury, better hospital and long-term prognosis. There is evidence that elderly age, presence of diabetes mellitus, left ventricular hypertrophy and hypercholesterolemia do reduce the cardioprotective effect of preinfarction angina. Preinfarction angina may be an additional criterion of risk stratification in myocardial infarction patients. This review summarizes data from the literature on the most important aspects of preinfarction angina.

The article provides general requirements to the organization of investigation by a register type, what kind of results can be obtained, their relevance for evaluation of care at all levels (pre-hospital, hospital, rehabilitational) of medical care. Existence of the one harmonized program makes possible to compare data from different regions and to evaluate in dynamic the results of interventions. Also the actions to improve pre-hospital urgent care are summarized, which are now being taken in various countries.

In contemporary medicine anemia is not just a decrease of hemoglobin level, but risk factor for worse outcome in vascular patients. At the same time anemia usually is not stated in the diagnosis and is not registered in statistic reports. Anemia – is always a complication that is why it always requires diagnostic algorithm to explore the underlying reason. Low hemoglobin level must be always marked by general physician. However in practice this happens just in 25% cases. Due to time deficiency at outpatient visits there is a demand for algorithm to provide GP with. This article concerns such algorithms to investigate the patients with found low hemoglobin level.