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Russian Journal Of Cardiology, 2019, 24 (6)

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Russian Journal of Cardiology. 2019;24(5):6

EDITORIAL

DIFFERENTIATED APPROACH IN DIAGNOSTICS, DIAGNOSIS FORMULATION, CASE MANAGEMENT AND STATISTICAL ACCOUNTING OF TYPE 2 MYOCARDIAL INFARCTION (UNIFIED STANCE)

Averkov O. V.1,12, Barbarash O. L.2, Boytsov S. A.3, Vasilieva E. Yu.4,13, Drapkina O. M.5, Galyavich A. S.6, Gilyarov M. Yu.1,14, Zayratiants O. V.4, Kakturskiy L. V.7, Karpov Yu. A.3, Mishnev O. D.1, Nikulina N. N.8, Orekhov O. O.9, Samorodskaya I. V.5, Soboleva G. N.3, Cherkasov S. N.10, Shakhnovich R. M.3, Shilova A. S.1.14, Shlyakhto E. V.11, Shpektor A. V.4, Yavelov I. S.5, Yakushin S. S.8

Russian Journal of Cardiology. 2019;24(6):7–21

dx.doi.org/10.15829/1560-4071-2019-6-7-21

Key words: myocardial infarction, type 2 myocardial infarction, myocardial infarction without obstructive damage of coronary arteries, diagnostics, diagnosis formulation, treatment, statistical accounting.

Conflicts of Interest: nothing to declare.

1N. I. Pirogov Russian National Research Medical University, Moscow; 2Research Institute for Complex Problems of Cardiovascular Diseases, Kemerovo; 3National Medical Research Center of Cardiology, Moscow; 4A. I. Evdokimov Moscow State University of Medicine and Dentistry, Moscow; 5National Medical Research Center for Preventive Medicine, Moscow; 6Kazan State Medical University, Kazan, Republic of Tatarstan; 7Research Institute of Human Morphology, Moscow; 8I. P. Pavlov Ryazan State Medical University, Ryazan; 9L. A. Vorokhobov City Clinical Hospital, Moscow; 10N. A. Semashko National Research Institute of Public Health, Moscow; 11V. A. Almazov National Medical Research Center, St. Petersburg; 12O. M. Filatov City Clinical Hospital, Moscow; 13I. V. Davydovskiy City Clinical Hospital, Moscow; 14N. I. Pirogov City Clinical Hospital № 1, Moscow, Russia.

Averkov O. V. ORCID: 0000-0002-3010-755Х, Barbarash O. L. ORCID: 0000-0002-4642-3610, Boytsov S. A. ORCID: 0000-0001-6998-8406, Vasilieva E. Yu. ORCID: 0000-0002-6310-7636, Drapkina O. M. ORCID: 0000-0002-4453-8430, Galyavich A. S. ORCID: 0000-0002-4510-6197, Gilyarov M. Yu. ORCID: 0000-0002-2870-3301, Zayratiants O. V. ORCID: 0000-0003-3606-3823, Kakturskiy L V. ORCID: 0000-0001-7896-2080, Karpov Yu. A. ORCID: 0000-0003-1480-0458, Mishnev O. D. ORCID: 0000-0002-6466-9147, Nikulina N. N. ORCID: 0000-0001-8593-3173, Orekhov O. O. ORCID: 0000-0001-9580-5271, Samorodskaya I. V. ORCID: 0000-0001-9320-1503, Soboleva G. N. ORCID: 0000-0002-9616-1305, Cherkasov S. N. ORCID: 0000-0003-1664-6802, Shakhnovich R. M. ORCID: 0000-0003-3248-0224, Shilova A. S. ORCID 0000-0002-4092-5222, Shlyakhto E. V. ORCID: 0000-0003-2929-0980, Shpektor A. V. ORCID: 0000-0001-6190-6808, Yavelov I. S. ORCID: 0000-0003-2816-1183, Yakushin S. S. ORCID: 0000-0002-1394-3791.

Received: 14.05.2019

Revision Received: 30.05.2019

Accepted: 06.06.2019

CLINICAL MEDICINE NEWS

Clinical medicine updates: a review of international news

Russian Journal of Cardiology. 2019;24(6):22

ORIGINAL ARTICLES

RISK FACTORS OF CORONARY ARTERY DISEASE IN 27425 OUTPATIENTS

Galyavich A. S.1, Khairullin R. N.2, Baleeva L. V.1, Sluiter P.3, Akimova S. V.3, Galimzyanov A. F.2, Aminov D. D.2, Safin D. D.2, Vafin A. Yu.4, Terpstra P.5

Abstract

Aim. To identify risk factors in outpatients without signs of coronary artery disease (CAD).

Material and methods. The Portavita computer program adapted to Russian conditions was used. Information was collected and entered into the module by district doctors and general practitioners during outpatient visits. The program involved 9 clinics, 406 district doctors and general practitioners. Individual data on sex, age, family history of CAD, smoking, physical activity, blood pressure, cholesterol level, creatinine (with the calculation of the glomerular filtration rate) and blood plasma glucose were made. Next, the system determined the risk of death from CAD according to the SCORE scale. In total, the data were entered by 27425 citizens aged 18 to 80 years old who have no obvious signs of CAD. Based on the data obtained, the program selected individual preventive measures for each patient. Then, on the basis of the initial data, the date of the next examination of each patient was planned.

Results. In the group of people without CAD (27425 people blood pressure of more than 140/90 mm Hg was detected in 66,2% of patients, body mass index more than 30 kg/m2 — in 23% of patients, the level of total blood plasma cholesterol more than 5,2 mmol/l — in 68% of patients (including more than 8 mmol/l — in 874 people), plasma glucose levels of more than 6,1 mmol/l — in 13% of patients. On the SCORE risk scale, data were calculated for 22907 people, while more than 10 points were found in 7% of the subjects.

Conclusion. In ambulatory patients with no signs of CAD, arterial hypertension (66,2%) and total blood plasma cholesterol of more than 5,2 mmol/l (68%) are the most frequently recorded risk factors. The combination of two risk factors (arterial hypertension + total blood plasma cholesterol more than 5,2 mmol/l) is recorded regardless of age (younger than 60 years and older than 60 years) — in cases of 61,8% and 64,2%, respectively.

Russian Journal of Cardiology. 2019;24(6):23–26

dx.doi.org/10.15829/1560-4071-2019-6-23-26

Key words: coronary artery disease, arterial hypertension.

Conflicts of Interest: Galyavich A. S., Khairullin R. N., Baleeva L. V., Galimzyanov A. F., Aminov D. D., Safin D. D., Vafin A. Yu. — nothing to declare. Declared: Sluiter P., Akimova S. V. — employees of PortavitaHealth, Terpstra P. — employee of Portavita B. V.

1Kazan State Medical University, Kazan, Republic of Tatarstan, Russia; 2Interregional Clinical Diagnostic Center, Kazan, Republic of Tatarstan, Russia; 3PortavitaHealth, Republic of Tatarstan, Russia; 4Medsi Group of Companies, Moscow, Russia; 5Portavita B.V., Amsterdam, Netherlands.

Galyavich A. S. ORCID: 0000-0002-4510-6197, Khairullin R. N. ORCID: 0000-0003-0788-4024, Baleeva L. V. ORCID: 0000-0002-7974-5894, Sluiter P. ORCID: 0000-0002-6063-0181, Akimova S. V. ORCID: 0000-0001-6505-1149, Galimzyanov A. F. ORCID: 0000-0003-1578-7814, Aminov D. D. ORCID: 0000-0002-1903-2120, Safin D. D. ORCID: 0000-0003-4412-9247, Vafin A. Yu. ORCID: 0000-0002-8638-3406, Terpstra P. ORCID: 0000-0003-2513-8498.

Received: 20.05.2019

Revision Received: 29.05.2019

Accepted: 06.06.2019

HEALTH SELF-ESTEEM OF 55 YEARS AND OLDER MUSCOVITES, TRADITIONAL RISK FACTORS AND THEIR PROGNOSTIC VALUE

Shalnova S. A.1, Imaeva A. E.1, Kapustina A. V.1, Muromtseva G. A.1, Balanova Yu. A.1, Shkolnikov V. M.2

Abstract

Health self-esteem is an integral parameter that reflects a person’s subjective feelings about their health and is widely used in health research. Under the tendency of population aging, health self-esteem to determine the life prognosis of the elderly is needed.

Aim. To study the role of health self-esteem in all-cause and cardiovascular disease (CVD) mortality among 55 years and older Muscovites.

Material and methods. A cohort, prospective study was conducted on a sample of 55 years and older Muscovites. The analysis included data of 1876 people, including 898 men. A standard questionnaire, that included socio-demographic data, anamnesis, behavioral habits was used. Anthropometric data, blood pressure, cholesterol levels and a highly sensitive C-reactive protein (hsCRP) were determined. Health self-esteem were defined as poor, satisfactory and good. Statistical analysis was performed using the STATA 14.0 statistical package.

Results. Only 10% of Muscovites aged 55 years and older rated their health as good. The prevalence of poor health self-esteem was 18,6%. Moreover, with age, bad health self-esteem increased not only due to “good health” decrease, but also due to a decrease in the frequency of satisfactory health self-esteem. Health self-esteem were significantly more frequently reported in women and those with low levels of education. When conducting multivariate analysis, arterial hypertension, smoking, increased hsCRP, glycated hemoglobin and obesity were significantly associated with poor health self-esteem. At the same time, an analysis of mortality has shown that poor health self-esteem is an independent predictor of death in the elderly, even with CVD, smoking and other risk factors.

Conclusion. Health self-esteem is an indicator independently and reliably associated with mortality. This suggests that health self-esteem may be useful in practice as a routinely measured indicator for screening the elderly population for making preventive interventions.

Russian Journal of Cardiology. 2019;24(6):27–33

dx.doi.org/10.15829/1560-4071-2019-6-27-33

Key words: health self-esteem, risk factors, mortality, elderly.

Conflicts of Interest: nothing to declare.

Funding. The study was conducted using the grant “Biodemography of Disease and Death in Moscow” (grant № R01 AG026786, NIA, 2006/09-2011/08).

1National Medical Research Center for Preventive Medicine, Moscow, Russia; 2Max Planck Institute for Demographic Research, Rostock, Germany.

Shalnova S. A. ORCID: 0000-0003-2087-6483, Imaeva A. E. ORCID: 0000-0002-9332-0622, Kapustina A. V. ORCID: 0000-0002-9624-9374, Muromtseva G. A. ORCID: 0000-0002-0240-3941, Balanova Yu. A. ORCID: 0000-0001-8011-2798, Shkolnikov V. M. ORCID: 0000-0003-2259-5423.

Received: 30.04.2019

Revision Received: 13.05.2019

Accepted: 20.05.2019

THE RISK OF MYOCARDIAL INFARCTION, AND SOCIAL SUPPORT AMONG THE POPULATION OF 25-64 YEARS IN RUSSIA/SIBERIA

Gafarov V. V., Gromova E. A., Gagulin I. V., Panov D. O., Krymov E. A., Suleymanov R. R., Gafarova A. V.

Abstract

Aim. To determine the impact of social support on the risk of myocardial infarction (MI) in an open population of 25-64 years in Russia/Siberia.

Material and methods. As part of the III screening of the WHO MONICApsychosocial program, a random representative sample of Novosibirsk population of both sexes aged 25-64 was examined (men: n=657, 44,3±0,4 years, response — 82,1%; women: n=689, 45,4±0,4 years, response — 72,5%). The screening survey program included: registration of socio-demographic data, definition of social support (ICC — indices of close contacts, SNI — social network index). The duration of the prospective observation of the participants was 16 years. First occurrences of MI were an endpoints of study.

Results. We revealed that 62% of men and 56,8% of women had a low ICC (χ2=22,603 df=2 P=0,0001). When distributed by age groups, the lowest ICC was observed in men in the 55-64 age group — 64,6% (χ2=14,85 df=2 P=0,0001) and in 35-44 women — 60,6% (χ2=3,917 df=2 P=0,141). Low SNI was among 43,5% of males and 33,9% of females (χ2=21,546 df=2 P=0,0001). The lowest SNI among men was among the young age group of 25-34 years old — 50% (χ2=15,894 df=3 P=0,001), for women — in the group of 35-44 years (39,4%) (χ2=0,071 df=3 P=1). Over the 16-year observation period, Cox’s regression analysis showed an increase in the MI risk among persons with a low ICC index in men 5,2 (95% confidence interval (CI) 1,947-19,383; p<0,05) and women 4,9 times (95% CI 0,108-20,762; p<0,05). The risk of MI over a 16-year observation period in the single-factor Cox regression model was higher in individuals with a low SNI index, as among men OR=3,1 (95% CI 1,138-9,247; p<0,05) and among women, RR=2,9 (95% CI 1,040-8,208; p<0,05). With the use of multivariate modeling, an increased risk of MI is found in people with low social support: among men with unfavorable family situation engaged in physical labor, and among women with a low level of education.

Conclusion. Social support is a protective risk factor for MI in both men and women.

Russian Journal of Cardiology. 2019;24(6):34–41

dx.doi.org/10,15829/1560-4071-2019-6-34-41

Key words: social support, myocardial infarction, population, risk, men, women.

Conflicts of Interest: nothing to declare.

Research Institute of Therapy and Preventive Medicine — Federal Research Center Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Novosibirsk, Russia.

Gafarov V. V. ORCID: 0000-0001-5701-7856, Gromova E. A. ORCID: 0000-0001-8313-3893, Gagulin I. V. ORCID: 0000-0001-5255-5647, Panov D. O. ORCID: 0000-0002-8101-6121, Krymov E. A. ORCID: 0000-0001-5979-5045, Suleymanov R. R. ORCID: 0000-0001-7860-6537, Gafarova A. V. ORCID: 0000-0001-5380-9434.

Received: 03.12.2018

Revision Received: 02.02.2019

Accepted: 04.03.2019

ADVERSE CARDIOVASCULAR OUTCOMES AND THEIR RELATIONSHIP WITH RISK FACTORS ACCORDING TO THE PROSPECTIVE STUDY MERIDIAN-RO

Filippov E. V., Vorobyev A. N., Dobrynina N. V., Zotova L. A., Lygina E. V., Nikulina N. N., Seleznev S. V., Yakushin S. S.

Abstract

Aim. To assess the incidence of adverse outcomes and the role of main risk factors in their development.

Material and methods. Prospective, long-term study was conducted with observation period of 36 months. The sample in the MERIDIAN-RO study was formed from the urban and rural population. It included 1622 people aged 25-64 years. The response to the study was 86,1%. Observation and screening of endpoints continued for 36 months. The endpoints were: all-cause death, ischemic stroke, myocardial infarction, coronary artery revascularization.

Results. When studying the relationship between various risk factors and outcomes, it was found that they had a significant impact on the combined endpoint (all-cause death + nonfatal ischemic stroke + nonfatal myocardial infarction): risk SCORE >5% (odds ratio (OR) 5,80, 95% confidence interval (CI) 2,31-14,58, p=0,0001, Wald — 23,040), excessive alcohol consumption (OR 7,14, 95% CI 1,41-36,31, p=0,018, Wald — 2,908), arterial hypertension (OR 4,77, 95% CI 1,91-11,90, p=0,01, Wald — 9,000), combination of coronary artery disease/myocardial infarction/stroke in history (OR 11,16, 95% CI 3,98-31,31, p=0,0001, Wald — 22,607) and an apolipoprotein B increase more than 180 mg/dL (OR 28,57, 95% CI 7,32-111,42, p=0,0001, Wald — 24,509).
Conclusion. The most significant effect on the combined endpoint (all-cause death + nonfatal myocardial infarction + nonfatal stroke) made: SCORE risk >5%, excessive alcohol consumption, hypertension, ), combination of coronary artery disease/myocardial infarction/stroke in history and an apolipoprotein B increase more than 180 mg/dL. That should be considered when choosing aims and preventive strategies.

Russian Journal of Cardiology. 2019;24(6):42–48

dx.doi.org/10.15829/1560-4071-2019-6-42-48

Key words: cardiovascular outcomes, prospective study, risk factors, MERIDIAN-RO.

Conflicts of Interest: nothing to declare.

Acknowledgements. Authors expresses profound gratitude to the staff of the National Medical Research Center for Preventive Medicine for their methodological guideline and assistance in collecting, analyzing and systematizing the data.

I. P. Pavlov Ryazan State Medical University, Ryazan, Russia.

Filippov E. V. ORCID: 0000-0002-7688-7176, Vorobyev A. N. ORCID: 0000-0003-2077-1243, Dobrynina N. V. ORCID: 0000-0003-2200-1592, Zotova L. A. ORCID: 0000-0001-7658-7846, Lygina E. V. ORCID: 0000-0001-6746-6743, Nikulina N. N. ORCID: 0000-0001-8593-3173, Seleznev S. V. ORCID: 0000-0002-0260-4305, Yakushin S. S. ORCID: 0000-0002-1394-3791.

Received: 13.05.2019

Revision Received: 27.05.2019

Accepted: 03.06.2019

ARTERIAL HYPERTENSION IN RYAZAN REGION: DATA OF THE THIRD SECTION OF THE EPOHA STUDY

Smirnova E. А.1,2, Terekhovskaya Yu. V.1, Molodtsova A. A.2, Yakushin S. S.1

Abstract

Aim. To study the nine-year dynamics of prevalence, risk factors, approaches to the treatment of arterial hypertension (AH) in the Ryazan region according to a representative sample survey, to assess the impact of risk factors and cardiovascular diseases on achieving blood pressure (BP) control.

Material and methods. A representative sample of the population of the Ryazan region, created in 2002 by the method of step-by-step randomization, was reexamined in 2007 and 2016. The group of AH included people with blood pressure ≥140/90 mm Hg. with double measurement or normal blood pressure, receiving antihypertensive therapy. The role of risk factors (age, smoking, alcohol abuse, salt, obesity, burdened heredity, low physical activity) and cardiovascular diseases was analyzed.

Results. In 2016, the prevalence of AH was 43,9%, the number of people receiving antihypertensive drugs — 89,5%, those who are treated effectively — 37,3%, which is higher than in 2007 (39,3%, 799% and 16,6%, respectively). Smoking (RR 1,23; 1,11-1,37, p=0,005), salt abuse (RR 1,11; 1,01-1,23, p=0,04) and obesity (RR 1,16; 1,06-1,27, p=0,003) negatively effect on the effectiveness of AH treatment. Treatment of AH is more effective in the absence of cardiovascular diseases (35,0% vs. 26,8%), signs of chronic heart failure (24,9% vs. 34,9%) and intermittent claudication (8,3% vs. 31,7%), p <0,001.

Conclusion. Over nine years, the standardized by age prevalence of AH has increased significantly, the number of individuals taking antihypertensive drugs and the treatment effectively, the structure of the drugs taken has changed positively. Smoking, obesity, salt abuse and the presence of diseases of the cardiovascular system adversely affect the effectiveness of therapy.

Russian Journal of Cardiology. 2019;24(6):49–53

dx.doi.org/10.15829/1560-4071-2019-6-49-53

Key words: arterial hypertension, prevalence dynamics, treatment effectiveness, risk factors of cardiovascular diseases.

Conflicts of Interest: nothing to declare.

1I. P. Pavlov Ryazan State Medical University, Ryazan; 2Regional Clinical Cardiology Dispensary, Ryazan, Russia.

Study participants: Yepikhina E. A., Biryukova Zh. A., Larina T. A., Ivushkina L. I., Kozakova Yu. V., Motsnaya O. A., Surova A. I., Skorobogatova S. Yu., Tolmacheva E. A., Golubeva I. V., Smagina E. V., Kiseleva E. A., Bulavchenkova O. N., Shvykova T. A., Bashmakova G. N., Soloveva N. N., Davydkina S. A., Gorbunova L. A., Khoteenkova N. V., Dukova E. V., Varlamova L. A., Vorobyova G. A., Korzhevskaya A. A., Tabolkina A. A., Nechaeva G. P., Vybornova E. Z., Kashapova L. M., Tarasova A. I., Ryazantseva L. L., Yakovleva N. S., Semenets A. A., Chikova N. A., Muravyova G. V., Chizhikova M. I. Smirnova E. А. ORCID: 0000-0003-0334-6237, Terekhovskaya Yu. V. ORCID: 0000-0002-9537-1618, Molodtsova A. A. ORCID: 0000-0002-3775-5250, Yakushin S. S. ORCID: 0000-0002-1394-3791.

Received: 13.05.2019

Revision Received: 27.05.2019

Accepted: 03.06.2019

ARTERIAL HYPERTENSION SPECIFIC PATIENT-REPORTED OUTCOME MEASURE. PART I: DEVELOPMENT AND PRIMARY EVALUATION

Ionov M. V.1,2, Zvartau N. E.1,2, Dubinina E. A.3,4, Konradi A. O.1,2

Abstract

Aim. While essential hypertension (HT) is highly prevalent and health-care is on its way to be value-based, there still no Russian-language tools to assess healthrelated quality of life (HRQoL) exclusively in hypertensive patients. The aim of this first part of the study was to develop and primarily evaluate a new core HT-specific patient-reported outcome measure (PROM).

Material and methods. HT-specific PROM was established in several steps. As a first step conceptual framework was developed and quantity of domains and subdomains was determined. Psychometrics were also instituted for the whole scale. Next, the primary item pool was built via selection from open-access Russian-language generic and English-language specific PROMs (the latter proceeded with double-translation). Moreover some newly developed HT-specific items were introduced into scale. Finally the item pool was revised according to small pilot survey with subsequent experts’ scrutiny.

Results. Four experts, three in HT, one in clinical psychology constituted the expert panel. After an iterative process of literature searches 14 relevant questionnaires were selected to build 264-item pool with five-point Likert response scales (poor to better HRQoL) with a global score. Based on conceptual framework 4 key domains (physiology, psychology, social, treatment) and 24 subdomains were drafted. On the basis of onsite and extra-mural interviews with 30 hypertensive patients (18 females, mean age 62,1±10,5 years old, 1-3 severity grades) extra questions on symptoms, psychological and social burden were developed and incorporated into corresponding domains. PROM draft underwent small pilot survey (n=50, 32 females, mean age 58,3±9,6 years old, 1-3 severity grades) and then was further revised, simplified by expert panelists. The initial PROM consisted of 163 items of which 36 were HT-specific.

Conclusion. The forming HT-specific PROM is intended to measure basic HRQoL, elicit the differences between hypertensives with any stage and assess HRQoL dynamics in response to treatment. Further work will be focused on conducting a large-scale survey with PROM’ primary version.

Key words: hypertension, patient-reported outcome measures, health-related quality of life, questionnaire.

Russian Journal of Cardiology. 2019;24(6):54–60

dx.doi.org/10.15829/1560-4071-2019-6-54-60

Conflicts of Interest: nothing to declare.

Funding. The study was carried out by Russian Science Foundation grant (project № 17-15-01177).

1V. A. Almazov National Medical Research Center, St. Petersburg; 2St. Petersburg National Research University of Information Technologies, Mechanics and Optics (ITMO University), St. Petersburg; 3A. I. Herzen State Pedagogical University of Russia, St. Petersburg; 4V. M. Bekhterev National Research Medical Center for psychiatry and neurology, St. Petersburg, Russia. Ionov M. V. ORCID: 0000-0002-3664-5383, Zvartau N. E. ORCID: 0000-0001-6533-5950, Dubinina E. A. ORCID: 0000-0003-1740-6659, Konradi A. O. ORCID: 0000-0001-8169-7812.

Received: 10.02.2019

Revision Received: 25.03.2019

Accepted: 01.04.2019

ROLE OF COGNITIVE IMPAIRMENTS AND DECREASED MUSCLE STRENGTH IN CARDIOVASCULAR MORTALITY OF 55 YEARS AND OLDER POPULATION

Imaeva A. E.1, Kapustina A. V.1, Shalnova S. A.1, Balanova Yu. A.1, Shkolnikov V. M.2

Abstract

Aim. To assess possible associations of impaired cognitive function (CF) with muscle strength, determined using handgrip test, as well as their role in cardiovascular mortality (CVM) in a population of 55 years and older.

Material and methods. This work was carried out in the framework of the prospective cohort study “Stress, aging and health”. During the study 1876 men and women aged 55 and older were examined. CF was estimated on the Mini-Mental State Examination (MMSE) scale, the decrease of CF was recorded with scores of less than 24 points (overall 30 points). Muscle strength was estimated according to handgrip test. To assess the role of muscle strength in CVM, handgrip test values, corresponding to the first quintile, were used — less than 19 kg for women, and less than 32 kg for men. Mortality was estimated on the basis of death register using standard methods. During the observation, 247 deaths from cardiovascular diseases were recorded.

Results. The study included 1876 participants aged 55 years and older (48% of men and 52% of women). CF parameters according to the MMSE questionnaire were within the normal range of more than 80% of those examined. According to the results of the regression analysis, only low values of handgrip test (at the level of 1 quintile) were reliably associated with cognitive impairments (p<0,05). These associations were more pronounced in women (odds ratio (OR): 3,17; 95% CI 1,31-7,69), compared with men (OR: 2,41; 95% CI 1,05-5,54). In 55 years and older men, cognitive impairments were significantly associated with CVM (OR: 1,97; 95% CI 1,40-2,78) and reduced muscle strength (OR: 1,63; 95% CI 1,18-2,25). Among women, only reduced muscle strength significantly increased the risk of CVM (OR: 1,77; 95% CI 1,19-2,61). The simultaneous presence of these pathologies was reliably associated with CVM.

Conclusion. The presented study revealed significant associations of cognitive impairments with reduced muscle strength. The presence of both pathological disorders is prognostically unfavorable for cardiovascular death in a population of 55 years and older (both among men and women). Thus, it is recommended to consider the possibility of including of muscle strength and cognitive functioning assessment in prognostic scales.

Russian Journal of Cardiology. 2019;24(6):61–65

dx.doi.org/10.15829/1560-4071-2019-6-61-65

Key words: cognitive function, muscular strength, mortality, cardiovascular diseases, population 55 years and older.

Conflicts of Interest: nothing to declare.

1National Medical Research Center for Preventive Medicine, Moscow, Russia; 2Max Planck Institute for Demographic Research, Rostock, Germany.

Imaeva A. E. ORCID: 0000-0002-9332-0622, Kapustina A. V. ORCID: 0000-0002-9624-9374, Shalnova S. A. ORCID: 0000-0003-2087-6483, Balanova Yu. A. ORCID: 0000-0001-8011-2798, Shkolnikov V. M. ORCID: 0000-0003-2259-5423.

Received: 10.04.2019

Revision Received: 25.04.2019

Accepted: 20.05.2019

GENDER DIFFERENCES IN THE NUTRITIONAL PATTERN OF THE ADULT POPULATION OF THE RUSSIAN FEDERATION. THE RESULTS OF ESSE-RF EPIDEMIOLOGICAL STUDY

Karamnova N. S., Shalnova S. A., Tarasov V. I., Deev A. D., Balanova Yu. A., Imaeva A. E., Muromtseva G. A., Kapustina A. V., Evstifeeva S. E., Drapkina O. M. on behalf of the participants of the ESSE-RF study#

Abstract

Many nutritional studies have noted that men and women form their diets from various food sources, preferring different dishes.

Aim. To study the sex differences in the nutritional pattern of the adult population of the Russian Federation according to the epidemiological study.

Material and methods. The analysis was performed on representative data from male and female population aged 25-64 years (22,258 people, of whom 8,519 men and 13,698 women) from 13 regions of the Russian Federation. The response was about 80%. The nutritional pattern was estimated by the frequency of food consumption with individual quantitative assessment.

Results. The most pronounced differences in men and women diets were observed in the consumption of fresh vegetables and fruits, dairy products, meat, and confectionery products. Women more often than men include in their diet (odds ratio, 95% CI): raw vegetables and fruits 1,45 [1,33-1,59], sweets and pastries 1,22 [1,33-1,59] , dairy products 1,57 [1,39-1,76], in particular, cottage cheese 1,69 [1,60-1,79], milk 1,46 [1,36-1,56] and cheese 1,31 [1,23-1,40]. The number of daily consumption of fruits and vegetables is more significant in the diet of women — 207,6 g/day versus 165,8 g/day for men, p<0,0001. Women are less likely to consume men; red meat 0,43 [0,39-0,46], sausage products — 0,63 [0,59-0,67], cereals and pasta — 0,79 [0,74-0,86], pickles and marinades — 0,79 [0,75-084], fish and seafood — 0,79 [074-0,86]. There were no gender differences in the level of consumption of leguminous products. Among men, the habit of adding more salt to food is more common — 47,0% against 34,7%, p<0,0001.

Conclusion. Women more often than men include in the diet vegetables and fruits, dairy products and confectionery, less often — products of animal origin (meat, sausages, fish and seafood).

Russian Journal of Cardiology. 2019;24(6):66–72

dx.doi.org/10.15829/1560-4071-2019-6-66-72

Key words: nutritional pattern, gender characteristics of nutrition, dietary habits, differences in the diet of men and women.

Conflicts of Interest: nothing to declare.

National Medical Research Center for Preventive Medicine, Moscow, Russia.

#Participants of the ESSE-RF study and co-authors of the article: Moscow: Zhernakova Yu. V., Boytsov S. A., Saint-Petersburg: Rotar O. P., Vladivostok: Kulakova N. V., Nevzorova V. A., Vladikavkaz: Astakhova Z. T., Vologda: Shabunova A. A., Volgograd: Nedogoda S. V., Voronezh: Chernykh T. M., Ivanovo: Belova O. A., Kemerovo: Artamonova G. V., Indukayeva E. V., Krasnoyarsk: Grinshtein Yu. I., Petrova M. M., Orenburg: Libis R. A., Samara: Duplyakov D. V., Tomsk: Trubacheva I. A., Kaveshnikov V. S., Serebryakova V. N., Tyumen: Efanov A. Yu., Medvedeva I. V., Shalaev S. V.

Karamnova N. S. ORCID: 0000-0002-8604-712Х, Shalnova S. A. ORCID: 0000-0003-2087-6483, Tarasov V. I. ORCID: 0000-0003-3757-676X, Deev A. D. ORCID: 0000-0002-7669-9714, Balanova Yu. A. ORCID: 0000-0001-8011-2798, Imaeva A. E. ORCID: 0000-0002-9332-0622, Muromtseva G. A. ORCID: 0000-0002-0240-3941, Kapustina A. V. ORCID: 0000-0002-9624-9374, Evstifeeva S. E. ORCID: 0000-0002-7486-4667, Drapkina O. M. ORCID: 0000-0002-4453-8430.

Received: 19.02.2019

Revision Received: 05.04.2019

Accepted: 17.04.2019

ANALYSIS OF FACTORS, ASSOCIATED WITH THE PROBABILITY OF ANTIHYPERTENSIVE MEDICATION IN THE POPULATION OF PATIENTS WITH ARTERIAL HYPERTENSION

Kaveshnikov V. S., Serebryakova V. N., Trubacheva I. A.

Abstract

Aim. To analyze factors associated with the probability of antihypertensive drugs (AHD) receiving in the population of patients with arterial hypertension (AH).

Material and methods. 334 hypertensive men and 436 women of 25-64 years old from the representative sample of general population were examined. The associative analysis included socioeconomic, psychosocial, behavioral and biological variables. Univariable and multivariable (logistic regression) statistics were applied. The error probability <5% was considered statistically significant.

Results. Over 60% of the low/moderate cardiovascular risk (CVR) hypertensive women were taking medications. The highest medication rate was found at very high CVR. Men with high CVR have showed lower medication rate than expected. There is a reserve for more complete treatment coverage among those with very high CVR. Factors of nontaking medications in both genders included: being non-informed of elevated blood pressure (BP), lack of knowledge of own BP, AH absence in the relatives, higher education. Younger age, intensive smoking (in those without chronical heart disease), non-attendance of a doctor over the past year correlated with lower odds of medication in men whereas SCORE 10 and above, and occupational physical activity pattern “walking mostly” were associated with lower odds of medications in women.

Conclusion. We emphasize several factors, associated with lower odds of taking medication in the hypertensive population. These factors should be considered when developing tools to help motivate obviously healthy people to participate in screening programs and to explain risks and potential benefits of a conscious attitude to hypertension problem.

Russian Journal of Cardiology. 2019;24(6):73–77

dx.doi.org/10.15829/1560-4071-2019-6-73-77

Key words: arterial hypertension, population, treatment, drugs, risk factors, probability.

Conflicts of Interest: nothing to declare.

RI of Cardiology, Tomsk National Research Medical Center, Tomsk, Russia.

Kaveshnikov V. S. ORCID: 0000-0002-0211-4525, Serebryakova V. N. ORCID: 0000-0002-9265-708X, Trubacheva I. A. ORCID: 0000-0003-1063-7382.

Received: 13.05.2019

Revision Received: 27.05.2019

Accepted: 03.06.2019

PREVALENCE OF CORONARY HEART DISEASE (BY EPIDEMIOLOGICAL CRITERIA) AND ITS ASSOCIATION WITH LIPID AND NON-LIPID RISK FACTORS IN THE NOVOSIBIRSK POPULATION OF 25-45 YEARS

Ragino Yu. I., Kuzminykh N. A., Shcherbakova L. V., Denisova D. V., Shramko V. S., Voevoda M. I.

Abstract

Aim. To study the prevalence of coronary artery disease (CAD) according to epidemiological criteria in the Novosibirsk population of 25-45 years, to identify its associations with lipid and non-lipid risk factors.

Material and methods. Cross-sectional survey of the Novosibirsk population aged 25-45 was carried out. The study included 650 people (268 men and 382 women). The epidemiological diagnosis of CAD (“Certain CAD” — CCAD, “Possible CHD” — PCAD) was made according to epidemiological (according to Rose questionnaire) and clinical functional (ECG recording with the Minnesota code) criteria. Blood levels of total cholesterol, triglycerides, cholesterol of low and high density lipoproteins (LDL-Ch, HDL-Ch) were determined. Blood pressure were measured (SBP, DBP), the presence of arterial hypertension (AH), body mass index and the smoking status were assessed.

Results. CCAD was detected in 3,8% people, including in 2,6% men and in 4,7% women. PCAD was detected in 6,1% people, including 7,8% men and 5,0% women. The results of univariate analysis showed that the relative risk of PCAD in the population is higher in people with low HDL-Ch (OR 2,136), in smokers (OR 1,925) and in AH subjects (OR 2,235). The results of logistic regression analysis showed that the relative risk of PCHD in the population, independently of other factors, is associated with lower level of HDL-Ch (OR 0,180) and higher SBP (OR 1,026). The relative risk of CCAD developing in the female population is higher in women with low HDL-Ch (OR 3,800) and in AH women (OR 4,572).

Conclusion. In the Novosibirsk population of 25-45 years, CAD, determined by epidemiological criteria, independently of lipid and non-lipid risk factors, is associated with AH presence and reduced HDL-Ch.

Russian Journal of Cardiology. 2019;24(6):78–84

dx.doi.org/10.15829/1560-4071-2019-6-78-84

Key words: epidemiological study, certain coronary artery disease, possible coronary artery disease, prevalence, population of 25-45 years, risk factors.

Conflicts of Interest: nothing to declare.

Funding. The work was carried out within the framework of State task № 0324-2018-0001.

Research Institute of Therapy and Preventive Medicine — Federal Research Center Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Novosibirsk, Russia.

Ragino Yu. I. ORCID: 0000-0002-4936-8362, Kuzminykh N. A. ORCID: 0000-0001-8649-1979, Shcherbakova L. V. ORCID: 0000-0001-9270-9188, Denisova D. V. ORCID: 0000-0002-2470-2133, Shramko V. S. ORCID: 0000-0002-0436-2549, Voevoda M. I. ORCID: 0000-0001-9425-413X.

Received: 14.03.2019

Revision Received: 19.04.2019

Accepted: 30.04.2019

FEATURES OF GLYCEMIC STATUS AND RISK FACTORS IN PATIENTS WITH CORONARY ARTERY DISEASE AND TYPE 2 DIABETES IN AZERBAIJAN POPULATION

Mehdiev S. Kh.1, Mustafaev I. I.1, Mamedov M. N.2

Abstract

Aim. To study the associations of glycemic control with risk factors of cardiovascular diseases and parameters of life quality in patients with coronary artery disease (CAD) and type 2 diabetes (T2D).

Material and methods. In single-step cross-sectional clinical-epidemiology cohort study were involved 142 patients with CAD and T2D between the ages of 35 and 69. The patients answered the questions of “ARİC” questioner about their socio-demographic

status, behavioral risk factors and quality of life. We measured anthropometric indicators, determined level of glucose and glycated hemoglobin in venous plasma.

Results. It was determined no statistically significant relationship between level of glycemic status and patients ages, education level, occupation and family status, physical activities, body mass index, smoking habit, feeding disorder, anxiety, stress conditions. Such life quality parameters as moving, taking care of oneself, daily activities, pain or feeling discomfort also didn’t have associations with glycemic status. In the background of abdominal obesity (p=0,034), using alcohol (p=0,045), depressive conditions (p=0,036) and such life quality parameters as anxiety or depression (p=0,039) control of glycaemia was disturbed. As a result, in 28,7% of patients with poor glycemic control compared with previous years, there was no change in the condition of patients, and 55,7%, on the contrary, worsened. An increase in the duration of diabetes and chronic hyperglycemia adversely affected the course of the disease (F=4,3, p=0,041 and F=18,3, p<0,001, respectively), and insufficient control of the glycemic status was accompanied by tachycardia.

Conclusion. In patients with CHD and T2D, alcohol intake, depressive conditions, abdominal obesity and an increase in the duration of diabetes were accompanied by worsening of glycemic control, which led to deterioration in the life quality parameters.

Timely screening and adequate correction of these risk factors will prevent complications, mortality and disability, as well as reduce healthcare costs associated with these diseases.

Russian Journal of Cardiology. 2019;24(6):85–91

dx.doi.org/10.15829/1560-4071-2019-6-85-91

Key words: coronary artery disease, type 2 diabetes, glycemic control, risk factors, quality of life.

Conflicts of Interest: nothing to declare.

1A. Aliyev Azerbaijan State Advanced Training Institute for Doctors, Baku, Azerbaijan; 2National Medical Research Center for Preventive Medicine, Moscow, Russia.

Mehdiev S. Kh. ORCID: 0000-0001-5970-0456, Mustafaev I. I. ORCID: 0000-0002-7356-5470, Mamedov M. N. ORCID: 0000-0001-7131-8049.

Received: 22.04.2019

Revision Received: 21.05.2019

Accepted: 03.06.2019

THE PREVALENCE OF HYPERGLYCEMIA, AS A COMPONENT OF THE METABOLIC SYNDROME, IN MEN OF AN OPEN POPULATION OF SIBERIAN CITY (EPIDEMIOLOGICAL STUDY)

Akimova E. V.1, Akimov M. Yu.2, Frolova E. Yu.1, Gafarov V. V.3, Kuznetsov V. A.1

Abstract

Aim. To determine glucose levels and the prevalence of hyperglycemia, as a component of metabolic syndrome (MS), among men of an open population of 25-64 years of Siberian city.

Material and methods. The study of the prevalence of MS and its components was carried out following a cardiological screening of men aged 25-64 years of Western Siberia city (Tyumen). In order to conduct a single-step epidemiological study using the “random numbers” method, a representative sample of 1000 people was formed among men 25-34, 35-44, 45-54, 55-64 years of Tyumen, the response was 85,2%. Hyperglycemia was taken into account according to the criteria of the metabolic syndrome by NCEPATPIII (2004), IDF (2005), Russian Society of Cardiology (RSC) (2009). The distribution of quantitative parameters in the population was assessed using a percentile analysis.

Results. An average glucose level was established for men of 25-64 years old in Tyumen (4,9±0,8 mmol/l). In participants of 35-44 and 55-64 years, a significant increase in glucose levels was determined. The prevalence of hyperglycemia was 17,4% according to the same NCEPATP, IDF assessment criteria, 7,7% — according to the RSC criteria. A consistent age-related trend in the prevalence of hyperglycemia was formed in 3 decades of 25-54 years diapason.

Conclusion. The presented regional features of glucose levels and the prevalence of hyperglycemia should be taken into account when developing a strategy for the prevention of cardiovascular and other non-infectious diseases in Siberian cities.

Russian Journal of Cardiology. 2019;24(6):92–96

dx.doi.org/10.15829/1560-4071-2019-6-92-96

Key words: glucose level, hyperglycemia, criteria for metabolic syndrome, open population, men.

Conflicts of Interest: nothing to declare.

1Tyumen Cardiology Research Center, Tomsk; 2Tyumen Industrial University, Tyumen; 3Research Institute of Therapy and Preventive Medicine, branch of Federal Research Center Institute of Cytology and Genetics, Novosibirsk, Russia.

Akimova E. V. ORCID: 0000-0002-9961-5616, Akimov M. Yu. ORCID: 0000-0003-1016-7560, Frolova E. Yu. ORCID: 0000-0003-3631-4362, Gafarov V. V. ORCID: 0000-0001-5701-7856, Kuznetsov V. A. ORCID: 0000-0002-1970-2606.

Received: 14.05.2019

Revision Received: 28.05.2019

Accepted: 03.06.2019

FEATURES OF INFECTIVE ENDOCARDITIS IN INJECTION DRUG USERS

Demko I. V.1, Pelinovskaya L. I.1, Mankhayeva M. V.1, Ishchenko O. P.1, Mosina V. A.1, Kraposhina A. Yu.1, Ivanitskaya E. E.2

Abstract

Aim. To reveal the peculiarities of clinical manifestations of infectious endocarditis in injection drug addicts.

Material and methods. Clinical, laboratory, echocardiographic manifestations of infectious endocarditis in 40 injecting drug addicts and in 21 patients of control group were analysed. Among injection drug users there were 22 men aged 40,0±2,9 years and 18 women aged 29,5±2,3 years. The history of the disease, clinical manifestations, laboratory markers of inflammation, the results of bacteriological blood tests, and the dynamics of the state during therapy were analyzed. Echocardiography at admission to hospital and at the end of treatment was carried out on a Vivid E-9 apparatus using transthoracic and transesophageal probes. The

electrocardiogram was recorded in 12 standard leads. All patients underwent an x-ray examination of thoracic organs or multispiral pulmonary tomography, ultrasound of the liver and spleen. Statistical analysis of the research results was conducted using Statistica 7.0, Microsoft Office Excel.

Results. We determined significantly younger age of patients in the group of injection drug users (p<0,05). The most frequently detected manifestation of infective endocarditis in both groups was fever. According to echocardiography data, tricuspid valve isolated localization of endocarditis was found in 90%. Radiographically, 8,2% of drug-dependent patients had signs of pneumonia

(often bilateral multisegmental), regarded as a manifestation of the thromboembolic syndrome by vegetation particles. Splenomegaly (75%) was detected in the majority of drug addicts, less often — hepatomegaly (47,5%). Manifestations of chronic heart failure were detected only in 12,5% of patients who use drugs, the kidneys were less involved in the process. An association of infective endocarditis with HIV infection (72,5%) and hepatitis C was detected in 97,5% of patients.

Conclusion. Knowing of the infective endocarditis features in drug addicts makes it possible to improve the approaches to the diagnostics in earlier periods of its progression and thus makes the treatment of these patients more promising.

Russian Journal of Cardiology. 2019;24(6):97–102

dx.doi.org/10.15829/1560-4071-2019-6-97-102

Key words: infective endocarditis, injection drug users, clinical presentation, diagnosis, treatment.

Conflicts of Interest: nothing to declare.

1V. F. Voyno-Yasenetsky Krasnoyarsk state medical University, Krasnoyarsk; 2Regional Clinical Hospital, Krasnoyarsk, Russia.

Demko I. V. ORCID: 0000-0001-8982-5292, Pelinovskaya L. I. ORCID: 0000-0002-2528-9037, Mankhayeva M. V. ORCID: 0000-0002-4804-2694, Ishchenko O. P. ORCID: 0000-0002-1784-9356, Mosina V. A. ORCID: 0000-0002-7298-8965, Kraposhina A. Yu. ORCID: 0000-0001-6896-877X, Ivanitskaya E. E. ORCID: 0000-0003-0162-9233.

Received: 25.11.2018

Revision Received: 19.01.2019

Accepted: 12.03.2019

SUPPORTING A PRACTITIONER

EPIDEMIOLOGY OF PULMONARY EMBOLISM IN TODAY’S CONTEXT: ANALYSIS OF INCIDENCE, MORTALITY AND PROBLEMS OF THEIR STUDY

Nikulina N. N., Terekhovskaya Yu. V.

Abstract

Pulmonary embolism (PE) is the third most common cardiovascular disease (estimated incidence in Europe and the United States is at least 250000-300000 per year), as well as one of the main causes of death. At the same time, over the past two decades, there has been a steady increase in the incidence of PE with a relatively stable prevalence of deep vein thrombosis. Obtaining objective epidemiological and statistical information on PE is difficult due to the difficulties of diagnostics (non-specificity of clinical symptoms, late seeking medical attention, limited diagnostic capabilities, frequency of autopsies, insufficient alertness of doctors) and the peculiarities of statistical recording (being a complication of other diseases, PE is subject to accounting only for multicausal statistical analysis of the diagnosis, which is not a widespread practice; in the International Statistical Classification of Diseases and Related Health Problems, the 10th revision, of the code I26 “Pulmonary embolism” also includes other conditions and excludes PE due to obstetric and gynecological pathology, so it is not possible to “isolate” PE as a single nosology in the official statistical reports under the existing coding system).

Key words: pulmonary embolism, PE, venous thromboembolism, epidemiology, statistics, International Statistical Classification of Diseases and Related Health Problems.

Russian Journal of Cardiology. 2019;24(6):103–108

dx.doi.org/10.15829/1560-4071-2019-6-103-108

Conflicts of Interest: nothing to declare.

I. P. Pavlov Ryazan State Medical University, Ryazan, Russia.

Nikulina N. N. ORCID: 0000-0001-8593-3173, ResearcherID: A-8594-2017, Terekhovskaya Yu. V. ORCID: 0000-0002-9537-1618, ResearcherID: U-7160-2018.

Received: 23.03.2019

Revision Received: 06.05.2019

Accepted: 20.05.2019

OBESITY PHENOTYPES AND THE RISK OF MYOCARDIAL INFARCTION: A PROSPECTIVE COHORT STUDY

Mustafina S. V.1, Winter D. A.1, Rymar O. D.1, Shcherbakova L. V.1, Gafarov V. V.1, Panov D. O.1, Gromova E. A.1, Gafarova A. V.1, Verevkin E. G.1, Nikitenko T. I.1, Bobak M.2, Malyutina S. K.1

Abstract

Aim. To study the dynamics of obesity phenotypes and risk of myocardial infarction (MI) during 13-year follow-up period.

Material and methods. The study was performed based on the material of the international project HAPIEE (population sample of men and women 45-69 years old, n=9360, basic survey 2003-2005). The analysis included persons with a body mass index (BMI) ≥30 kg/m2: 3197 people; 857 men (26,8%) and 2340 women (73,2%). To analyze the incidence of MI, a sample of 3008 subjects free from baseline history of MI was selected (752 men and 2256 women). New cases of myocardial infarction have been collected according to the data of the WHO “Register of Acute Myocardial Infarction” program, held at the Research Institute of Therapy and Preventive Medicine; the results of two repeated examinations (2006-2008 and 2015-2017) and repeated postal interview of cohort during 13-year follow-up. The analysis was carried out in individuals with a metabolically phenotype of healthy obesity (MHO). The MHO is defined according to various classifications: NCEPATPIII 2001 — in the presence of 2 and/or less components of the metabolic syndrome; IDF 2005 — waist circumference (WC) ≥94 cm in men and ≥80 cm in women and one or no risk factor; Russian Society of Cardiology (RSC) — the index of waist circumference/hip circumference (WC/HC) ≤0,9 in men and ≤0,85 in women. Statistical analysis was performed using the SPSS (V. 13.0) package.

Results. The frequency of MHO in studied sample was 20% (by IDF); 45% (by NCEPATPIII); — 31% (by RSC criteria). During 13-year prospective follow-up among participants with MHO 51-59% of subjects developed metabolically unhealthy obesity phenotype (MUH). Women were more likely to retain MHO according to NCEP ATP III and RSC criteria, and more frequently transited, to MUH, according to IDF and RSC criteria than men during 13 years. The relative risk of MI in subjects with MHO was 2,5 times lower than in those with MUO: OR=1,9 (95% CI: 1,2; 2,9) by NCEPATP III; OR=3,2 (95% CI: 1,7; 6,1) by RSC; no significant difference was found in the incidence of MI by IDF criteria, p>0,05.

Conclusion. MHO is unstable condition accompanied by transition to the MUH among more than half of men and women during 13 years of observation. In studied population cohort the 13-years risk of incident MI in subjects with MUO was higher compared to MHO: OR=1,9 (95% CI: 1,2; 2,9) by NCEPATP III; OR=3,2 (95% CI: 1,7; 6,1) by RSC criteria.

Russian Journal of Cardiology. 2019;24(6):109–114

dx.doi.org/10.15829/1560-4071-2019-6-109-114

Key words: metabolic healthy obesity, metabolic syndrome, myocardial infarction.

Conflicts of Interest: nothing to declare.

Funding: HAPIEE project supported by Wellcome Trust grants, UK064947/Z/01/Z; 081081/Z/06/Z; National Institute of Aging, USA (1R01 AG23522), research 2015- 2018 supported by the RSF № 14-45-00030. The present analysis was carried out within the framework of budget of the Research Institute of Therapy and Preventive Medicine № 0324-2018-0001, Reg. № AAAA-A17-117112850280-2.

1Research Institute of Therapy and Preventive Medicine — a branch of Federal Research Center Institute of Cytology and Genetics, Novosibirsk, Russia; 2Department of Epidemiology and Public Health, University College London, London, UK.

Mustafina S. V. ORCID: 0000-0003-4716-876X, Winter D. A. ORCID: 0000-0001-7977-2705, Rymar O. D. ORCID: 0000-0003-4095-016, Shcherbakova L. V. ORCID: 0000-0001-9270-9188, Gafarov V. V. ORCID: 0000-0001-5701-7856, Panov D. O. ORCID: 0000-0002-8101-6121, Gromova E. A. ORCID: 0000-0001-8313-3893, Gafarova A. V. ORCID: 0000-0001-5380-9434, Verevkin E. G. ORCID: 0000-0003-2877-1846, Nikitenko T. I. ORCID: 0000-0002-3967-6126, Bobak M. ORCID: 0000-0002-2633-6851, Malyutina S. K. ORCID: 0000-0001-6539-0466.

Received: 08.05.2019

Revision Received: 27.05.2019

Accepted: 03.06.2019

ASSOCIATIONS OF POLYPHENOLIC COMPOUNDS CONSUMPTION AND THE RISK OF ARTERIAL HYPERTENSION IN THE POPULATION

Denisova D. V., Berezovikova I. P., Batluk T. I., Shcherbakova L. V., Voyevoda M. I.

Abstract

Aim. To identify associations of polyphenolic compounds consumption in general, as well as their particular classes with the risk of arterial hypertension (AH) in the population of Novosibirsk residents of the 45-69 age group.

Material and methods. In 2003-2005, an epidemiological survey of the population of 45-69 years of Novosibirsk was conducted (HAPIEE international project “Determinants of cardiovascular diseases in Eastern Europe: a multicenter cohort study”). 9360 people were examined, including 4266 men and 5094 women. The average age of the surveyed was 57,6 years A nutrition assessment was performed using Food Frequency Questionnaire (FFQ) questionnaire. The European base Phenol-Explorer 3,6 was used to estimate the content of polyphenolic compounds and their subclasses. In the structure of each product group, food habits of the Siberian population, typically used products were taken into account. AH was diagnosed in case of systolic blood pressure (SBP) levels ≥140 mm Hg. and/or diastolic blood pressure (DBP) ≥90 mm Hg, as well as in individuals with normal blood pressure values while taking antihypertensive drugs in the last two weeks prior to this survey.

Results. The risk of AH developing in the quartile with the highest total consumption of polyphenolic compounds in men is 33% less than in the quartile with the lowest consumption (odds ratio (OR) 0,67, confidence interval (CI) 0,56-0,79, P=0.004), and in women, respectively, — 37% less ( OR 0,63, CI 0,54-0,74, P<0,001). For certain classes of polyphenolic compounds: the highest level of consumption of flavonoids associates with a reduction of AH risk in men by 33% (OR 0,67, CI 0,57-0,80, P<0,001) and in women — by 39% (OR 0,61, CI 0,57-0,71, P=0,002). For both men and women, the probability of AH developing in the quartile with consumption of phenolic acids is 21% lower (OR 0,79, CI 0,66-0,94, P=0,002) and 16% (OR 0,84, CI 0,72-0,99, P<0,001), respectively. In men, the consumption of other polyphenols is also significant (the risk with maximum use is reduced by 18%, OR 0,84, CI 0,69-0,98, P=0,018).

Conclusion. In the population of Novosibirsk (age group 45-69 years), high levels of consumption of polyphenols in general, as well as such subclasses as flavonoids and phenolic acids, are associated with a decrease of AH risk.

Russian Journal of Cardiology. 2019; 24 (6):115–120

dx.doi.org/10.15829/1560-4071-2019-6-115-120

Key words: arterial hypertension, polyphenolic compounds, population.

Conflicts of Interest: nothing to declare.

Funding. This work was partially supported by the grant of the Russian Foundation for Basic Research № 19-013-00800.

Research Institute of Therapy and Preventive Medicine — a branch of Federal Research Center Institute of Cytology and Genetics, Novosibirsk, Russia.

Denisova D. V. ORCID: 0000-0002-2470-2133, Berezovikova I. P. ORCID: 0000-0001-5897-7699, Batluk T. I. ORCID: 0000-0002-0210-2321, Shcherbakova L. V. ORCID: 0000-0001-9270-9188, Voyevoda M. I. ORCID: 0000-0001-9425-413X.

Received: 12.05.2019

Revision Received: 27.05.2019

Accepted: 03.06.2019

CLINIC AND PHARMACOTHERAPY

COMPARATIVE ANALYSIS OF ANTIHYPERTENSIVE EFFECTS OF CHLORTHALIDONE AND INDAPAMIDE-RETARD IN COMBINATION WITH AZILSARTAN MEDOXOMIL IN PATIENTS WITH ARTERIAL HYPERTENSION

Kobalava Zh. D.1, Kulakov V. V.2, Goreva L. A.1, Villevalde S. V.2

Abstract

Achievement of target blood pressure (BP) is one of the key strategies of primary prevention of cardiovascular complications in patients with arterial hypertension (AH).

Aim. To assess and compare antihypertensive effects of azilsartan medoxomil (AZM) with chlorthalidone or indapamide-retard combination in patients with AH in real clinical setting.

Material and methods. The open randomized comparative study included 50 patients with uncontrolled AH who were randomized to the starting therapy with combination of AZM with chlorthalidone (Edarbi Clo 40/12,5 mg) (group 1) or indapamide-retard 1,5 mg (group 2) for 4 weeks. After 4 weeks, up-titration of one of the drugs was done in the patients who didn’t achieve target BP level (<140/<90 mm Hg): chlorthalidone from 12,5 mg to 25 mg in G1 and AZM from 40 to 80 mg in group 2. Duration of the study was 12 weeks. Treatment efficacy was assessed by the target office BP achievement and changes in 24-h peripheral and central BP. Results were considered statistically significant at p<0,05.

Results. At the end of the 12-week period target BP was achieved in 88% of group 1 and 72% of group 2 patients. According to 24-h blood pressure monitoring (ABPM) mean peripheral BP decline was 19,3/11,1 vs 17,1/9,1 mm Hg for 24h, 20,1/11,4 vs 19,1/9,9 mm Hg for daytime, 19,5/9,1 vs 17,6/8,9 mmHg for nighttime (p<0,05 for trend). Target 24-h BP levels <130/<80 mm Hg were achieved in 40 vs 32% of patients respectively (р<0,05). Increase of the portion of dippers was observed from 60 to 64% and from 58 to 62% respectively (p<0,05).

Conclusion. In patients with uncontrolled AH combination of AZM with chlorthalidone compared has led to more pronounced antihypertensive effect compared to combination of AZM with indapamide-retard.

Russian Journal of Cardiology. 2019;24(6):122–130

dx.doi.org/10.15829/1560-4071-2019-6-122-130

Key words: azilsartan medoxomil, chlorthalidone, indapamide-retard, 24-h blood pressure monitoring, antihypertensive efficacy.

Conflicts of Interest: nothing to declare.

1Peoples’ Friendship University of Russia, Moscow; 2Almazov National Medical Research Center, St. Petersburg, Russia.

Kobalava Zh. D. ORCID: 0000-0002-5873-1768, Kulakov V. V. ORCID: 0000-0001-8633-1852, Goreva L. A. ORCID: 0000-0002-5456-8545, Villevalde S. V. ORCID: 0000-0001-7652-2962.

Received: 15.05.2019

Revision Received: 24.05.2019

Accepted: 07.06.2019

OPINION ON A PROBLEM

MANAGEMENT OF EPIDEMIOLOGICAL RESEARCH IN A PARTICULAR REGION (BASED ON ESSE-RF2

IN THE RYAZAN REGION)

Dobrynina N. V., Moseychuk K. A., Nikulina N. N., Pereverzeva K. G., Filippov E. V.

Abstract

Despite the decline in cardiovascular mortality in Russia over the past 15 years, it remains relevant to study the possibilities of its further reducing. And preventive measures of risk factors reducing play the main role. However, before developing preventive measures, it is necessary to study the prevalence and structure of risk factors in a particular region, since Russia is a huge country and each region is different from another. The study of this issue needs large-scale epidemiological studies, the conduct of which is very difficult in organizational terms. This article presents our own experience in successfully organizing a regional phase of

epidemiological research.

Russian Journal of Cardiology. 2019;24(6):131–134

dx.doi.org/10.15829/1560-4071-2019-6-131-134

Key words: cardiovascular diseases, risk factors, prevention, epidemiological studies, organization.

Conflicts of Interest: nothing to declare.

Acknowledgments. Authors expresses profound gratitude to the staff of the National Medical Research Center for Preventive Medicine for their methodological guideline and assistance in planning, organizing and conducting the study.

I. P. Pavlov Ryazan State Medical University, Ryazan, Russia.

Dobrynina N. V. ORCID: 0000-0003-2200-1592, ResearcherID: U-9725-2018, Moseychuk K. A. ORCID: 0000-0002-4444-2439, ResearcherID: I-2294-2018, Nikulina N. N. ORCID: 0000-0001-8593-3173, ResearcherID: A-8594-2017, Pereverzeva K. G. ORCID: 0000-0001-8393-3273, ResearcherID: I-3658-2018, Filippov E. V. ORCID: 0000-0002-7688-7176, ResearcherID: О-1490-2016.

Received: 13.05.2019

Revision Received: 27.05.2019

Accepted: 03.06.2019

HEREDITARY SYSTEMIC TRANSTHYRETIN AMYLOIDOSIS: A CLINICAL CASE AND AN OPINION ON THE PROBLEM

Draganova A. S.1,2, Soboleva A. V.1,2, Ertman A. E.1,2, Galanskaya T. A.2, Nikolaychuk E. I.1,2, Ryzhkova D. V.2, Polyakova E. А.1,2, Shlyakhto E. V.1,2

Abstract

This article presents a clinical case of a patient with hereditary systemic hereditary transthyretin amyloidosis. Difficulties of diagnostics and differential diagnostics of this disease are shown in a patient with arterial hypertension, a clinic of angina, coronary artery disease, cardiac rhythm and conduction disturbances, cardiomegaly, heart failure and renal dysfunction. It required a comprehensive approach using the methods of routine clinical and laboratory examination, as well as nuclear cardiology, morphological studies and molecular DNA diagnostics.

Russian Journal of Cardiology. 2019;24(6):136–142

dx.doi.org/10.15829/1560-4071-2019-6-136-142

Key words: transthyretin amyloidosis, hereditary amyloidosis, systemic amyloidosis, heart failure.

Conflicts of Interest: nothing to declare.

1I. P. Pavlov First State Medical University of St. Petersburg, St. Petersburg; 2V. A. Almazov National Medical Research Center, St. Petersburg, Russia.

Draganova A. S. ORCID: 0000-0002-9541-0947, Soboleva A. V. ORCID: 0000-0002-2165-1027, Ertman A. E. ORCID: 0000-0001-6066-7008, Galanskaya T. A. ORCID: 0000-0003-1768-0842, Nikolaychuk E. I. ORCID: 0000-0002-8055-9087, Ryzhkova D. V. ORCID: 0000-0002-7086-9153, Polyakova E. А. ORCID: 0000-0002-3231-6152, Shlyakhto E. V. ORCID: 0000-0003-2929-0980.

Received: 16.03.2019

Revision Received: 23.04.2019

Accepted: 20.05.2019

LITERATURE REVIEWS

EPIDEMIOLOGY AND COMORBIDITY OF ARTERIAL HYPERTENSION AND GALLSTONE DISEASE

Grigorieva I. N.1,2, Ragino Yu. I.1, Romanova T. I.1

Abstract

The review presents current data on the Arterial Hypertension (AH) and Gallstone Disease (GSD) prevalence. The heterogeneity of the relationship between cardiovascular diseases, AH and GSD was shown. According to our data, in Novosibirsk, in the population sample of women 25-64 years with/without GSD (n=870) prevalence of AH (criteria blood pressure (BP) ≥160/95, WHO MONICA project, 1994-1995) was 41,6% and 31,3%, p<0,05. In this female population as a whole (n=1663) prevalence of AH was 30,8%. But with the criteria of BP ≥140/90, the corresponding indicators of prevalence of AH were similar: 55,4%, 47,1% and 49,0%. The evidence of the association between the GSD and the carotid arteries intima-media thickness, as atherosclerosis marker, is presented, and the main mechanisms of development of AH in GSD are highlighted. Gastroenterological symptoms, BP, blood lipids, quality of life were compared, which were worse in comorbid patients with GSD and AH than in GSD or AH. The expediency of an active approach to the detection of GSD and AH in terms of their contribution to cardiovascular prognosis is shown.

Russian Journal of Cardiology. 2019;24(6):143–148

dx.doi.org/10.15829/1560-4071-2019-6-143-148

Key words: arterial hypertension, gallstone Disease, cardiovascular diseases, prevalence, comorbidity.

Conflicts of Interest: nothing to declare.

Funding. “Epidemiological monitoring of the state of public health and the study of molecular genetic and biological mechanisms for the development of common therapeutic diseases in Siberia to improve approaches to their diagnostics, prevention and treatment” state task № 0324-2018-0001, Reg. № AAAAA17-17112850280-2.

1Scientific Research Institute of Therapy and Preventive Medicine — a branch of Federal Research Center Institute of Cytology and Genetics, Novosibirsk; 2Novosibirsk National Research State University, Novosibirsk, Russia.

Grigorieva I. N. ORCID: 0000-0003-0069-7744, Ragino Yu. I. ORCID: 0000-0002-4936-8362, Romanova T. I. ORCID: 0000-0001-8514-2304.

Received: 07.05.2019

Revision Received: 20.05.2019

Accepted: 03.06.2019

JUBILEE

Eugeny I. Chazov

Russian Journal of Cardiology. 2019;24(6):149-150

CLINICAL GUIDELINES

2018 ESC GUIDELINES FOR THE MANAGEMENT OF CARDIOVASCULAR DISEASES DURING PREGNANCY

The Task Force for the Management of Cardiovascular Diseases during Pregnancy of the European Society of Cardiology (ESC)

Endorsed by: the International Society of Gender Medicine (IGM), the German Institute of Gender in Medicine (DGesGM), the European Society of Anaesthesiology (ESA), and the European Society of Gynecology (ESG).

Russian Journal of Cardiology. 2019;24(6):151–228

dx.doi.org/10.15829/1560-4071-2019-6-151-228

Key words: guidelines, pregnancy, cardiovascular disease, risk assessment, management, congenital heart disease, valvular heart disease, hypertension, heart failure, arrhythmia, pulmonary hypertension, aortic pathology, cardiomyopathy, drug therapy, pharmacology.

APENDIX

(text is available in electronic version

doi:10.15829/1560-4071-2019-6-229-261)

9 июля 2019 г.

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