The objective of this study is to assess the associative relationship between the main parameters of the infrastructure with arterial hypertension (AH) in a large industrial region (Kuzbass).Materials and methods. The study involved 1598 people (from 35 to 70 years old) living in Kemerovo region. Blood pressure was measured according to the recommendations of the Russian Society of Cardiology / the Russian Medical Society on Arterial Hypertension (2010). The assessment of the territory of the residence zone was carried out according to the subjective opinion of the respondents about the parameters of the infrastructure (questionnaire Neighborhood Environmental Walkability Scale). The format of this structure was highlighted, which was considered unfavourable according to the respondent's answer to the questionnaire.Results. In the course of this study, negative associations with a high risk of developing hypertension were identified for the following infrastructure parameters: inaccessibility of public transport (OR=1,84), remoteness of the workplace (OR=1,60), the lack of sidewalks on the streets (OR=1,66), the remoteness of the pharmacy (OR=1,64), the lack of pedestrian crossings that ensure safety when crossing streets (OR=1,48) and the absence of shadows falling on the sidewalk from the trees (OR=1,31).Conclusion. This study demonstrated the importance of studying the parameters of infrastructure and planning urban space in order to provide a healthoriented space for the population of a particular constituent entity of the Russian Federation.

The aim of the study is to identify social and economic factors associated with the development of coronary and cerebral ischemic events in urban residents based on the results of a three-year follow-up. Material and methods. The prospective non-interventional observational study included 431 patients. Data on the coronary and cerebral ischemic events in history, and social, economic and demographic data were collected at the baseline. Follow-up appointments were scheduled 3 years later to assess new cases of coronary and cerebral ischemic events. Taking into account the presence or absence of the adverse events in history at the baseline and follow-up visit, four groups of patients were formed. There were 350 (81.2 %) people without a coronary history (group 1), and 81 (18.8 %) with it (group 2). Respondents without a coronary history were divided into a subgroup with the absence of new ischemic (coronary and cerebral) events at the repeat stage, numbering 246 (57.1 %) people (1a), as well as a subgroup with their development – 104 (24.1 %) (1b). Similarly, respondents with a coronary history were divided into a subgroup with the absence of adverse events at the second stage, which included 35 (8.1 %) people (2a), as well as a subgroup with their occurrence – 46 (10.7 %) (2b). Results. At the baseline, only 18.8 % out of 431 patients had coronary events in history. At the follow-up visit, 150 (34.8 %) patients presented with new coronary or cerebral ischemic events: 10.7 % of those cases were fatal, 1.9 % – new cases of myocardial infarction, 3.5 % – cases of stroke, 13.5 % – new cases of angina pectoris, and 5.3 % – other diseases associated with coronary artery disease. One third out of 350 patients without coronary events in history and half of patients with coronary events in history presented with newly developed adverse events. Young respondents (35–49 years old) with no coronary history were 3 times more likely to have coronary and cerebral ischemic events over 3 years than people of the same age, but with previous diseases of the cardiovascular system. During the 3-year followup period, the risk of coronary and cerebral ischemic events in patients with coronary events in history was associated unemployment odds ratio (OR) 2.74 (95 % confidence interval (CI) 1.33; 5.66, p = 0.006), widowhood OR 2.98 (95 % CI 1.32; 6.74, p = 0.008), living in a rural area OR 2.30 (95 % CI 1.16; 4.55, p = 0.017) and female gender OR 2.63 (95 % CI 1.28; 5.43, p = 0.008). Conclusions. The risk of coronary and cerebral ischemic events during the 3-year follow-up period in the population of urban residents is associated with social and economic determinants such as female gender, unemployment, living in a rural area, and widowhood in the presence of a coronary history. 35–49-year-old men without a coronary history should also be considered as a group of special attention for the prevention of adverse events.

Background. Overweight and obesity significantly increase the risk of premature death and the development of chronic diseases. Many anthropometric indices have been developed to verify obesity, although the best among them still remains undetermined.The aim. To determine the sex and age specificities of the dynamics of anthropometric indicators characterizing obesity.Materials and methods. The program was implemented in the period from 2015 to 2020. It provided for the implementation of a sample research. The baseline research included 1,124 women and 476 men. The average age was 54.9 ± 9.75 years and 52.6 ± 10.0 years, respectively. To identify gender specificities, all participants were divided into three age groups: 35–49 years old, 50–59 years old, and 60–70 years old. The observation period was 3 years. To determine the level of visceral fat, the VS-532 fat mass analyzer (Tanita Health Equipment HK Ltd., Hong Kong) was used. Body mass index (BMI), waist-hip index (WV/HV), visceral obesity index (VOI) were also calculated. Statistical processing of the results was carried out using the program Statistica 6.0 (StatSoft Inc., USA).Results. New cases of obesity developed in 30.6 % of the surveyed. There was an increase in the prevalence of obesity according to the criteria of WV (by 8.9 %) and VFL (by 5.4 %) and a decrease in the number of people who are obese according to WV/HV – by 4.2 %. Of all the indicators, only VOI showed a statistically significant decrease in the mean values over the observed period, while BMI, WV and VFL showed an increase.Conclusions. It is necessary to apply various criteria for the diagnosis of obesity, since individual indices are not able to fully reflect the gender and age specificities of the distribution of fat in the body

Introduction. Dyslipidemia is one of the most common risk factors for cardiovascular disease (RFCVD). In coal industry workers, working conditions are considered as an additional risk factor to the well-known RFCVD. The study aims to analyze the prevalence of RFCVD in coal industry workers in comparison with the general population of the Kemerovo region. Materials and methods. The study included 2,356 male respondents, 1,656 (70.3%) coal industry workers (the main group) and 700 (29.7%) people from the population sample of participants in the multicenter epidemiological study of ESSE-RF included in the territory of Kuzbass (control group). The traditional FSSR was evaluated, including the parameters of lipid metabolism (total cholesterol (TCH), triglycerides (TC), low-density lipoproteins (LDL) and high-density lipoproteins (HDL)). Results. A comparative analysis of the FSSRP of coal industry workers and the control group showed their high prevalence in the control group: the prevalence of diabetes mellitus by 12.3 times, previous stroke by 4.8 times, myocardial infarction by 4 times, arterial hypertension by 3.8 times, obesity by 1.8 times, dyslipidemia by 1.2 times. The average values of systolic (SBP) and diastolic (DBP) blood pressure and plasma glucose levels were within the normal range in both groups, but statistically significantly higher in the control group. There were 1.3 times more smokers among coal industry workers (60.4% compared to the control group). 45.7%, p<0.001). The median of TCH and its fractions, TC were within the limits of the normative values for workers in the coal industry, whereas in the control group the LDL level was statistically significantly higher. The incidence of hypertriglyceridemia (34.2% vs. 22.4%) and low HDL (15.8% vs. 2.0%) was statistically significantly higher in miners. The researchers observed hypercholesterolemia and high LDL levels in more than half of the patients (50.6% and 65.3%, respectively) of the control group. A correlation analysis of work experience in the coal industry and the FSSR demonstrated an association with age (r=0.83, p≤0.001), body mass index (BMI) (r=0.37, p≤0.001), SBP level (r=0.33, p≤0.001) and DBP (r=0.36, p≤0.001), concentration of TCH (r=0.65, p≤0.001), LDL (r=0.51, p≤0.001) and TC (r=0.84, p≤0.001). The authors found that coal miners had an 11.5-fold increased risk of HDL reduction, 2.3-fold increased hypertriglyceridemia, and 2-fold increased risk of smoking compared to the population of the region. The proportion of people with hypertriglyceridemia and low HDL prevailed in all age groups of coal industry workers. Taking into account the work experience of more trained individuals, the risk of hypercholesterolemia and high LDL levels increases by 2 times, the risk of hypertriglyceridemia and low HDL levels is slightly lower. Limitation. The design of the study did not allow to determine the causal relationship between the profession and the RFCVD. The analysis of the nature of nutrition, intake/abuse of alcoholic beverages was not carried out and metabolic syndrome was not diagnosed as possible causes of dyslipidemia. Inclusion in the main and control groups was carried out for different periods of time. Conclusion. Smoking and dyslipidemia are among the most common RFCVD among workers in the Kuzbass coal industry. The largest proportion is hypercholesterolemia, one third has hypertriglyceridemia and elevated LDL, half as often as low HDL. The duration of work in underground conditions is associated with age, BMI, SBP, DBP, concentrations of TCH, LDL, TC. The proportion of people with hypertriglyceridemia and low HDL prevails in all age groups of coal miners. In more trained workers, the risk of hypercholesterolemia and high LDL increases by 2 times, the risk of hypertriglyceridemia and low HDL is slightly lower. Ethics. The study was performed in accordance with the standards of good clinical practice and the principles of the Helsinki Declaration. Prior to inclusion, all respondents signed an informed consent form.

Aim. To analyse clinicopathological features of smoking patients with multivessel coronary artery disease. Material and Methods. We analysed the data from the FRAILTY registry which includes patients with coronary artery disease. In addition to clinical features, we assessed echocardiography data and lipid metabolism levels (total cholesterol, triglycerides, low- and high-density lipoproteins, and high-sensitive C-reactive protein). Results. Of the 381 CAD patients, 178 (46.7%) have smoked at some point (107 (60.1%) current smokers and 71 (39.1%) smoking quitters), whereas 203 (53.3%) patients have never smoked. These groups were comparable in age and cardiovascular disease prevalence. Smokers or smoking quitters’ group had higher proportion of males (78.1 vs. 69%; p = 0.045), higher prevalence of myocardial infarction (61.8 vs. 55.2%; p = 0.047), chronic obstructive pulmonary disease (6.4 vs. 2.3%; p = 0.045), and lower extremity peripheral artery disease (47.8 vs. 31.5%; p = 0.041). There were no differences between the groups regarding the risk of death after cardiac surgery. The level of total cholesterol was 1.8-fold higher in smokers and smoking quitters as compared with patients who never smoked (5.5 (3.7; 6.7) vs. 3.0 (2.2; 4.0) mmol/L; p = 0.01). Similar pattern was discovered regarding to the level of C-reactive protein (5.1 (2.4; 5.3) vs. 3.9 (2.2; 4.2) mg/L in smokers/smoking quitters and never smokers, respectively; p = 0.041). The analysis of echocardiography parameters did not reveal statistically significant differences. Conclusion. Smoking frequently accompanies coronary artery disease. Current smokers and smoking quitters were characterized by higher frequency of myocardial infarction, chronic obstructive pulmonary disease, and lower extremity peripheral artery disease Further, current smokers and smoking quitters had higher serum total cholesterol and C-reactive protein.

In modern medicine, studies devoted to the assessment of the parameters of residential infrastructure and the population’s attitude towards them have become quite large-scale. Objectives: The aim of the study was to establish associations between individually perceived parameters of residential infrastructure and the main modifiable cardiovascular risk factors (hypertension, obesity, lipid and carbohydrate metabolism disorders) in one of the subjects of the Russian Federation. Methods: The epidemiological study “Study of the influence of social factors on chronic non-communicable diseases” started in 2015 and ended in 2023. The sample was formed by using the stratification method based on the assignment to a medical organization. The study included 1598 respondents aged 35 to 70 years (491 rural residents). The study of infrastructure parameters was conducted based on the subjective opinions of respondents using the neighborhood environment walkability scale (NEWS) questionnaire, divided into eight scales. Logistic regression analysis was used to identify associations between infrastructure parameters and cardiovascular risk factors; the odds ratio (OR) and 95% confidence interval were evaluated. Results: Individually perceived infrastructure parameters of the scale B, reflecting the accessibility of infrastructure facilities, were associated with hypertension [OR = 1.33], obesity [OR = 1.40], and abdominal obesity [OR = 1.59]. Elements of the social infrastructure of the scale C, describing the streets in the residential area, increased the likelihood of developing obesity [OR = 1.42] and visceral obesity [OR = 1.43]. The characteristics of the residential area, represented by the scale D that evaluates pedestrian infrastructure, were associated with all major cardiovascular risk factors (hypertension [OR = 1.65], obesity [OR = 1.62] and abdominal obesity [OR = 1.82], and disorders of lipid [OR = 1.41] and carbohydrate metabolism [OR = 1.44]). Conclusion: Social factors represented by various aspects of infrastructure have become important criteria for determining cardiovascular health. Environmental conditions affect cardiovascular risk factors through behavioral patterns that shape the respondent’s lifestyle. Interventions in urban planning—increasing accessibility to infrastructure facilities for the population, developing a pedestrian-friendly urban environment, improving physical activity resources in areas, planning recreation areas, and landscaping—can become the most important concept for the prevention of cardiovascular diseases.

Background — Analysis of eating habits can help identify cardioprotective dietary patterns. It is necessary to qualitatively study the diet of modern inhabitants of Siberia and identify food stereotypes that contribute to effective cardiac prophylaxis. Objective — to study the diet of the inhabitants of Siberia and to identify the features of cardioprotective nutrition. Methods — A clinical and epidemiological prospective group study of the population permanently residing in Kemerovo Oblast (administrative entity of the Russian Federation) was carried out. The baseline study included 1,124 women (70.3%) and 476 men (29.7%). To identify latent factors (stereotypes of eating behavior), we used factor analysis (method of principal components). Results — Adherence to the fruit-and-vegetable stereotype was associated with an increased risk of obesity according to body mass index (BMI) (OR=1.57, CI: 1.27-1.96), waist circumference (WC) (OR=1.43, CI: 1.1-1.9), and presence of diabetes mellitus (DM) (OR=1.27, CI: 1.2-2.2). Adherence to the protein-and-carbohydrate dietary pattern was connected to a reduced risk of detecting obesity in terms of BMI criteria (OR=0.75, CI: 0.6-0.95, p=0.015), WC (OR=0.52, CI:0.41-0.66), DM (OR=0.66, CI:0.47-0.93), hypercholesterolemia (OR=0.78, CI:0.62-0.98) and hypertriglyceridemia (OR=0.66, CI:0.52-0.83). Prospective observation demonstrated the variability of stereotypes: after three years, the following five stereotypes were identified: vegetable, protein-and-carbohydrate, fruit, dairy, and mixed. Conclusion — In contrast to the protein-and-carbohydrate diet, the fruit-and-vegetable stereotype of nutrition was associated with the development of obesity and DM. Considering the obtained results, it is necessary to study the qualitative characteristics of each stereotype (the content of macro- and microelements, kcal) and the motor activity of the respondents.

Significance: This article is about assessing changes in selected indicators of public health against the background of the pandemic of a new coronavirus infection COVID-19 in adult population of the Siberian Federal District - a territory of the Russian Federation with a special climatic, geographical and ecological "portrait", characterized by a high prevalence of risk factors for chronic non-communicable diseases. The study of this issue creates prerequisites for a detailed analysis of the leading causes of death and peculiar features of their statistical coding in the Siberian Federal District for a given time interval, which helps to identify true mortality from diseases of the circulatory system (in particular, coronary artery disease and myocardial infarction. The purpose of the study was to assess dynamics in the indicators of total mortality and mortality from diseases of the circulatory system in adult population of the Siberian Federal District during the pandemic caused by a new coronavirus infection COVID-19. Material and methods. The study used data of the Federal State Statistics Service «Virtual statistical data mart» official website. The study analyzed non-standardized total mortality rates in adult population of the Siberian Federal District (per 100,000 population), and mortality from diseases of the circulatory system, coronary artery disease and myocardial infarction for the period from 2016 to 2021 and compared these indicators with the all-Russia data. The COVID-19 impact was assessed starting from January 2020, while the period preceding this date was conventionally designated as pre-COVID period. Ranks and econometric analysis of time series were used. Results. In the pre-COVID period, the total mortality rate in adult population was decreasing over time in the Russian Federation and most regions of the Siberian Federal District, with the exception of the Altai Republic. With the onset of the new coronavirus infection, total mortality increased in most regions of the Siberian Federal District, except for the Republic of Tyva. In the Siberian Federal District in the pre-COVID period, mortality from diseases of the circulatory system increased due to a rise in mortality from diseases of the circulatory system in the Altai Republic and Krasnoyarsk region, Irkutsk, Tomsk and Kemerovo regions; mortality from coronary artery disease increased due to a rise in mortality from diseases of the circulatory system in the Krasnoyarsk region, Altai Republic, Kemerovo, Novosibirsk and Tomsk regions; while increased mortality from myocardial infarction is associated with the increased mortality from diseases of the circulatory system in the Republic of Khakassia, Kemerovo, Novosibirsk and Irkutsk regions. With the beginning of the COVID-19 pandemic in 2020, there was an increase in mortality from diseases of the circulatory system and coronary artery disease in the Russian Federation and regions of the Siberian Federal District, including a rise in mortality from myocardial infarction, with the exception of the Altai Republic, and the Irkutsk region. In the Siberian Federal District in 2021, there was no increase in mortality from diseases of the circulatory system and coronary artery disease in the republics of Tyva and Khakassia, the Novosibirsk region and Krasnoyarsk Territory (only from coronary artery disease); mortality from myocardial infarction - in all regions of the Siberian Federal District, except the Tomsk region. Conclusion. The tendency towards lower total mortality in adult population in the pre-COVID period in the Russian Federation and the Siberian Federal District has changes towards increasing starting from official registration of COVID-19 cases. A similar trend is typical of diseases of the circulatory system (including coronary artery disease and myocardial infarction) in the Russian Federation and some regions of the Siberian Federal District. The COVID-19 pandemic is obviously associated with changes in public health indicators in the Russian Federation

Aim. To evaluate the initial concentration of calciprotein particles (CPPs), which are scavengers of excessive calcium and phosphate, in patients with cardiovascular disease and in patients with chronic kidney disease as compared with the healthy volunteers. Material and methods . The study included 308 individuals as follows: 1) 88 participants of the PURE study without hemodynamically relevant carotid athero scle rosis and symptomatic coronary atherosclerosis; 2) 88 patients with cere brovascular disease (CVD) who required carotid endarterectomy; 3) 88 pa tients with coronary artery disease (CAD) who required percutaneous coronary intervention or coronary artery bypass graft surgery; 4) 63 patients with stage 5 chronic kidney disease (CKD). We measured following mineral homeostasis parameters: total and ionized calcium, phosphate, total protein, albumin, and fetuin-A. Then, we determined a baseline serum CPP concentration by flow cytometry using a fluorescent-labeled bisphosphonate OsteoSense 680EX. Results. In comparison with other patients, healthy volunteers had the highest serum CPP concentration (249 CPPs/µL), indicating the retained ability to compensate mineral homeostasis disturbances by aggregation of excessive calcium and pho sphate with acidic proteins (mineral chaperones). Reduced serum CPP concentration in patients with CVD (170 CPPs/µL), CAD (139 CPPs/µL), and stage 5 CKD (193-203 CPPs/µL) showed impaired aggregation of excessive serum calcium and phosphate, which was also reflected by an increased level of blood ionized calcium. Conclusion. Patients with CVD, CAD, and stage 5 CKD have lower serum CPP concentration than healthy individuals. In combination with elevated ionized calcium and reduced albumin, this suggests the depletion of calcium binding buffers in the serum of patients with cardiovascular and renal diseases.

Objective. To determine the prognostic role of the polymorphism of candidate genes for hypertension (HTN) in the effectiveness of antihypertensive therapy in the population of Mountain Shoria, taking into account the ethnic factor. Design and methods. The material for the study was the population of indigenous (Shors) and nonindigenous inhabitants of Mountain Shoria. In the first stage of the study (2013–2017), 901 indigenous people and 508 non-indigenous people were included in the continuous method. A group of patients with HTN was identified — 367 (40,7 %) shors and 230 (45,3 %) representatives of non-indigenous ethnic group. The second stage of the study involved 525 patients with HTN (317 shors, 208 non-indigenous representatives). According to the recommendations of National Guidelines of the Russian Society of Cardiology/the Russian Medical Society on Arterial Hypertension (2010), antihypertensive therapy was prescribed by a cardiologist. A re-examination of patients with HTN included in the prospective stage of the study was carried out after a month, 3 months and 6 months by a paramedic of the local feldsher-obstetric center and after 12 months by a cardiologist. Gene polymorphism ACE (I/D, rs 4340), AGT (c. 803T > C, rs699), AGTR 1 (А1166С, rs5186), ADRB 1 (с. 145A > G, Ser49Gly, rs1801252), ADRA2B (I/D, rs28365031), MTHFR (c. 677C > T, Ala222Val, rs1801133) and NOS 3 (VNTR, 4b/4a) were tested using polymerase chain reaction. Results. In the Shors cohort, the minor allele D of the ACE gene and the favorable allele A of the AGTR 1 gene were associated with a significant decrease in blood pressure (BP) with the 2-component therapy for HTN using blockers of the renin-angiotensin-aldosterone system (RAAS) with a diuretic (odds ratio (OR) = 5,01 and OR = 6,28). The carriage of the mutant allele D of the ACE gene in subjects with the 3-component therapy (RAAS blocker, calcium channel blocker (CCB), diuretic) also determined the achievement of the target BP level (OR = 3,11). In the cohort of non-indigenous nationality, allele A of the AGTR 1 gene was associated with positive dynamics of BP with the use of another combination therapy with a RAAS blocker and CCB (OR = 5,38). Conclusions. Taking into account the ethnicity, genetic characteristics of the patient when choosing drugs is a key point in the effectiveness of therapy in HTN patients. The possibility of using pharmacogenetics in the practice of a cardiologist opens up promising areas and has a great future.

Over the past few decades, heavy smoking and alcohol use have been shown to results in serious health consequences and are associated with the increased risk of death. Alcohol and tobacco have an individual effect on the human body, but in combination they act synergistically, and the neurochemical processes that occur during their use seem to reinforce each other. The combined impact of tobacco and alcohol consumption on public health is still poorly understood, despite the fact that these two behavioral risk factors for cardiovascular diseases (CVD) often complement each other. The purpose of the study is to analyze prevalence of traditional risk factors for diseases of the circulatory system (DCS) depending on the combination of the behavioral risk factors (smoking and alcohol consumption). Material and methods - 1124 females and 476 males were included in the clinical and epidemiological prospective cohort study. The average age equaled to 54.9 ± 9.75 and 52.6 ± 10.0 years, respectively, p <0.001. Statistical data processing was carried out using the Statistica 6.0 software package. Results - the group of people who never used alcohol and tobacco was associated with the development of significant DCS (OR = 2.2, CI: 1.2-4.1, p = 0.010) and DCS resulting in hospitalization (OR = 1.7 , CI: 1.1-2.7, p = 0.015). The group of people who “smoke but quitted alcohol” was associated with a lower risk of significant DCS resulting in hospitalization (OR = 0.1, CI: 0.01-1.0, p = 0.050) and higher risk of death from all causes (OR = 23.9, CI: 1.0-587.5, p = 0.049). The group of people who “do not use tobacco, but drink alcohol” was associated with a lower risk of significant DCS resulting in hospitalization (OR = 0.3, CI: 0.2-0.7, p = 0.002), significant DCS resulting in hospitalization (OR = 0.5, CI: 0.3-0.8, p = 0.007). The group of people who “quitted tobacco and alcohol” was associated with a higher risk of death from all causes (OR=28.0, CI:1.0-769.8, p=0.047). The group of people who “quitted tobacco but continued to drink alcohol” was also associated with higher risk of death from all causes (OR=7.9, CI: 1.4-43.9, p=0.017). Also, the respondents who smoked but never consumed alcohol had a risk of developing obesity (OR=6.0, CI:1.2-30.0, p=0.027). Conclusion - a complete absence of behavioral risk factors was associated with the risk of developing significant DCS, including those resulted in hospitalization. The risk of death from all causes was higher in individuals who “smoke but quitted alcohol,” “quitted tobacco and alcohol,” and “quitted tobacco, but drink alcohol”.

Objective to evaluate the dynamics and identify the relationship between empirically obtained dietary stereotypes and the presence of arterial hypertension (AH) according to a prospective study among the population of a large region of Siberia.Design and methods. A clinical and epidemiological prospective group study of the population aged 35 to 70 years was carried out. The baseline study included 1124 women (70,3%) and 476 men (29,7%). The mean age was 54,9 ± 9,75 years and 52,6 ± 10,0 years, respectively, p < 0,001. The followup period was 3 years from the first visit of the respondent. An adapted questionnaire (Questionnaire Food Frequency (FFQ)) was used to assess the frequency of food consumption. To identify latent factors (stereotypes of eating behavior), we used factor analysis (method of principal components). The association of eating habits with the presence of AH was assessed using logistic regression analysis. The critical level of significance when testing statistical hypotheses in the study was taken to be ≤ 0,05.Results. In men, the prevalence of AH was the highest among those who adhered to the fruit and vegetable dietary stereotype (75,0%), the minimum was in men who followed the mixed stereotype (60,1 %, p = 0,034). Among women, as well as among men, the maximum prevalence of AH was observed in people with a fruit and vegetable diet (71,1 %), and the minimum was observed in those with a protein-carbohydrate diet (63,2 %, p = 0,049). Among those who followed the fruit and vegetable stereotype, new cases of AH were identified in 30,9 %, protein-carbohydrate — 33,3 %, mixed — 35,7 % (p = 0,846). The structure of nutrition of the population has undergone changes during the observation period. So, 5 main stereotypes of eating behavior were determined: vegetable, protein-carbohydrate, fruit, dairy and mixed. The prevalence of AH did not differ statistically significantly among individuals with different nutritional stereotypes at the prospective stage (p = 0,337): the maximum prevalence of AH was observed among individuals who followed the vegetable stereotype (77,6%), and the minimum — fruit (67,6%). When conducting a logistic regression analysis, after leveling the influence of gender and age, no statistically significant associations were found between nutritional stereotypes and the development of AH.Conclusions. 1. Over three years of observation, the prevalence of AH among residents of a large industrial region of Siberia increased from 66,4% to 72,0%. 2. With the help of factor analysis, three nutrition stereotypes were identified: fruit and vegetable, protein and carbohydrate, and mixed. During the three-year period of observation, the diet of the inhabitants of Siberia has changed: 5 main stereotypes of eating behavior have been identified — vegetable, protein-carbohydrate, fruit, dairy and mixed. 3. At the basic stage, AH was more common among people who followed the fruit and vegetable diet, especially among young men. During the prospective phase of the study — in individuals who preferred the vegetable stereotype.

The aim of the research. To study clinical and genetic factors predisposing to progression of carotid artery atherosclerosis among the Shor people based on a 5-year dynamic follow-up of hypertensive patients. Material and methods. A prospective clinical and epidemiological study of the indigenous population of the Mountain Shoria was carried out including patients with arterial hypertension (367 subjects). The dynamics of the intima-media complex thickness and atherosclerotic plaque thickness was assessed 5 years later by repeat ultrasound examination of carotid arteries. Polymorphisms of ACE (I/D, rs 4340), AGT (c.803T>C, rs699), AGTR1 (A1166C, rs5186), ADRB1 (c.145A>G, Ser49Gly, rs1801252), ADRA2B (I/D, rs28365031), MTHFR (C677T, rs1801133) and eNOS (VNTR 4b/4a) genes were tested using polymerase chain reaction. Results. The 5-year observation of the indigenous population of the Mountain Shoria has shown that such factors as the age (p=0.011) and the course of arterial hypertension (3rd-degree AH, duration of the disease for over 10 years, failure to achieve the target level of arterial pressure during treatment) play a significant role in the frequent unfavourable dynamics of the intima-media complex thickness. Th e study has also established association between the development of the atherosclerotic process in carotid arteries and smoking (OR=1.52), abdominal obesity (OR=2.87) and impaired glucose tolerance (OR=2.94). The increased level of low-density lipoprotein cholesterol also determines the negative dynamics as manifested by the growth of the atherosclerotic plaque in brachiocephalic arteries (OR=1.93). A high risk of atherosclerosis in the Shor cohort is associated with carriership of the prognostically unfavourable D alleles of the ACE gene (OR=8.29), C of the AGTR1 gene (OR=7.04) and T of the MTHFR gene (OR=3.25). Conclusion. The 5-year prospective observation of the small indigenous population of the Shors has revealed certain clinical and genetic factors for patients with arterial hypertension that are associated with the carotid artery atherosclerosis. The polymorphism of certain candidate genes is an important strategic biomarker that can be used in the future for early diagnostics of diseases associated with atherosclerosis.

Th e aim of the research. To analyse the relation between gender and age characteristics and various anthropometric parameters of obesity with impaired lipid metabolism among residents of the industrial region of Siberia. Material and methods. A total of 1,600 subjects aged 35-70 were enrolled. Th e mean age was 54.9±9.75 years and 52.6±10.0 years. Th e study was carried out in accordance with Good Clinical Practice and Declaration of Helsinki principles. Prior to inclusion, all respondents signed an informed consent form approved by the institution’s local ethics committee. Th e studied indices of lipid blood spectrum were evaluated using standard tests by Th ermo Fisher Scientifi c, Finland. Th e change in lipid level was assessed according to the “Diagnosis and correction of lipid metabolism disorders for the prevention and treatment of atherosclerosis recommendations, revision 5, 2012. Obesity was assessed based on fi ve anthropometric parameters: body mass index (BMI), waist-to-hip ratio (W/H), waist circumference (WC), skeletal muscle mass-to-visceral fat area ratio (SVR), and visceral adiposity index (VAI). Statistical processing was carried out using Statistica 6.0. Quantitative variables are presented as a median (Me), percentiles (25 %; 75 %) were used as scattering measurements; frequencies (percentages) were used to describe qualitative characteristics. Th eir comparison was carried out using Mann Whitney and Pearson’s Chi-squared test. As an indicator of the contribution of the risk factor (obesity, assessed according to various criteria) to the prevalence of dyslipidemia variants, the values of the predictor signifi cance ranking was used (when using classifi cation trees, discriminant univariate branching was selected and the signifi cance of the predictors was evaluated during the classifi cation process). Results. Hypercholesterolemia was detected in 66.2% of the subjects, hypertriglyceridemia – in 36.3 %. A high level of LDL was found in 75.6 %, and a low level of HDL – in 38.7 % of the respondents. Among men aged 35-49 years, total cholesterol, TG and LDL were higher than in women (p <0.001). At the age of 50-59 years, total cholesterol and LDL cholesterol were higher in women (p <0.001). At the age of 60-70 years, the mean level of total cholesterol and TG was also higher in women than in men (p <0.001). Th e frequency of detection of dyslipidemia, depending on the presence of obesity, diff ered when using all the studied obesity criteria, especially for WC. According to such criteria as BMI, WC, VAI, the prevalence of obesity was higher among women and in men when using the criterion of the area of visceral fat. Th e presence of obesity according to the criteria of WC, W/H and VAI demonstrated the presence of associations with indicators of the entire lipid spectrum. Th e highest values were demonstrated by the presence of obesity according to VAI: it was associated with an increase in TG by 1.23 mmol / l and with a decrease in HDL cholesterol by 0.49 mmol / l (p <0.001). At a younger age, indicators characterising a poorer lipid profi le (high values of TC and LDL, low HDL) were found in males, while with increasing age, these changes in lipid metabolism were observed in the female patients. When performing linear regression analysis, the greatest infl uence was demonstrated by age (rank 100 for hypercholesterolemia and high LDL cholesterol) and VAI (rank 100 for hypertriglyceridemia and low HDL). Th e rest of the studied obesity criteria demonstrated approximately the same value of the ranks for all studied parameters characterising lipid metabolism. It should be noted that the sex showed the lowest values for all the studied parameters of the lipid spectrum. Conclusion. When analysing the relationship between gender and age characteristics and various anthropometric parameters of obesity with impaired lipid metabolism, the following patterns were revealed among the inhabitants of a large industrial region of Siberia, according to the data of this epidemiological study. Th us, such parameters as VAI, WC, W/H, which characterise obesity, are more reliable while assessing the risk associations for development of dyslipidaemia, in contrast to the classical assessment of obesity by BMI. It should be noted that VAI was a more signifi cant criterion in assessing the risk of hypertriglyceridemia and low HDL levels. Considering the gender and age of the surveyed respondents, the following diff erences were revealed. Male subjects of younger age were characterised by higher results of LDL, total cholesterol and HDL. With increasing age, this trend changed and a more unfavourable course of dyslipidaemia was observed in females. Th is study proves the need to take into account the extended parameters of obesity when assessing dyslipidaemia. Th e use of extended criteria for assessing obesity will provide additional information in the management of patients with dyslipidaemia. However, further research is needed to fi nd out whether the identifi ed patterns are regional features or may be projected on all residents of our state.

19 НАРУШЕНИЯ УГЛЕВОДНОГО ОБМЕНА АССОЦИИРОВАНЫ С ГИПЕРУРИКЕМИЕЙ, ОЖИРЕНИЕМ И ПОВЫШЕНИЕМ АРТЕРИАЛЬНОЙ ЖЕСТКОСТИ ПО ДАННЫМ ИССЛЕДОВАНИЯ ЭССЕ-РФ В КУЗБАССЕБезденежных Н .А

Introduction. A special position among the structural changes of the heart is occupied by left ventricular myocardial hypertrophy (LVH), which refers to the subclinical signs of heart damage in arterial hypertension (AH). Currently, the role of not only demographic, neuroendocrine, but also genetic factors in the development and progression of LVH is no longer in doubt.Aim. To assess the role of clinical and genetic factors in the progression of LVH in patients with hypertension based on the results of a dynamic 5-year follow-up of a cohort of Shors.Materials and methods. The survey of the indigenous population in Gornaya Shoria was carried out in two time periods: onetime (from 2013 to 2017) and prospective (from 2018 to 2020). The study included the adult population (18 years and older) – a total of 901 people – by continuous method. A group of patients with hypertension was identified – 367 people (40.7%). LVH was assessed by electrocardiography and/or echocardiography. The prospective stage of the study included patients with hypertension who had not previously received antihypertensive therapy (263 people). The control and correction of blood pressure numbers was carried out annually, the dynamics of LVH was assessed after five years.Results. Clinical predictors of negative dynamics of LVH were established: obesity (OR = 3.61), abdominal obesity (OR = 4.11), impaired carbohydrate metabolism (OR = 2.83), low high-density lipoprotein cholesterol (OR = 2.05). Genetic markers also demonstrated their involvement in the progression of LVH: allele D of the ACE gene, allele C of the AGTR1 gene, and 4a of the eNOS gene (OR = 9.69; OR = 6.72; OR = 6.37, respectively).Conclusion. The associations of clinical and genetic factors with LVH identified in the Shor cohort can be considered as predictors of myocardial remodeling in hypertension. The data obtained support the hypothesis that polymorphisms of the renin-angiotensin-aldosterone system and endothelial function can influence the phenotype, creating new approaches to the possible prediction of unfavorable outcomes.

Aim. This study determined the level of public satisfaction with neighborhood design features in Kemerovo Oblast and their connection to cardiovascular disease risk factors.Subjects and methods. The study population included 1,598 respondents aged between 35 and 70, with 491 living in rural areas and others living in Kemerovo (1,221 women and 477 men). The assessment of neighborhood environment was done according to residents' subjective opinions about infrastructural features (the Neighborhood Environmental Walkability Scale). Depending on how participants responded to the questionnaire, some of these parameters were identified as adverse.Results. The residents of Kemerovo and rural areas of Kemerovo Oblast identified the following neighborhood design features as adverse: the lack of interesting places in neighborhood environment, the remote location of parks and restaurants, the absence of pavement, busy traffic, and a long distance between home and workplace. In the city, arterial hypertension prevalence was high among men, when grocery, fruit and clothing stores were distant, and among women, when banks, public transport stops were distant and the traffic was heavy. Lipid metabolism disorders were more common among women in urban areas, when there were no interesting places around. Obesity prevalence was high among urban female population, when the following adverse factors were present: the remote location of grocery stores, fruit stores, bank, pharmacy and public transport stops and the absence of pavement. Among rural male population, this risk factor was common when there were no pavements. The highest rate of carbohydrate metabolism disorders was found among women living in villages where the traffic is heavy and public transport stops are far away. Conclusion. The impact of infrastructure on the health status of the living population is a new direction of scientific research. Epidemiological studies in different geographic areas and population groups show significant differences in health status, morbidity and mortality from chronic noncommunicable diseases. To reduce the risks of developing diseases of the cardiovascular system, the formation of a socially comfortable health-saving environment is of great importance.

Aim of the study was to analyze the socio-economic determinants and prevalence of possibly presence CHD in residents of a large industrial region.Material and methods. The study sample included residents of rural settlements of the Kemerovo region and districts of the city of Kemerovo. The study involved 1600 respondents aged 35-70 years. The determinants of socio-economic status (SES) were assessed: the level of education and income, professional affiliation, marital status / family composition, place of living.Results. The majority residents of rural settlements (50.9 %) had a secondary vocational education, compared with urban residents (46 %). A high level of income (over 20 000 rubles) was observed 1.53 times more often among the urban population than rural population. It was revealed that one third (29.3 %) of the rural population is employed in agriculture, and about 40.4 % do work that does not require vocational qualification. Among residents of rural settlements, there are statistically significant more those marriage/living with a partner, than among urban residents (75.6 % versus 62.9 %, respectively). The SES analysis of the study participants with possibly presence CHD indicates a predominant share (50.9 %) of vocational secondary education and medium income level (48.9 %). It was revealed that among the lonely rural residents possibly presence CHD occurred 10.0 % more often (urban 26.7 %, rural 36.7 %, p = 0.035) than among those living in the city.Conclusion. In the Kemerovo Oblast CHD possibly presence is more common in women, depending on socio-economic determinants it is more often observed in persons with a secondary vocational education and medium income level, equally among both skilled and low/ unskilled workers living with partner in urban settings.

Aim. To analyze prevalence of cardiovascular risk factors in the Kemerovo region based on the results of epidemiological studies (2013 and 2016). Material and methods . The study was based on two large epidemiological studies of the Kemerovo region: on 2013, «The epidemiology of cardiovascular diseases and their risk factors in the Russian Federation» and on 2016, «The prospective study of urban and rural epidemiology: study of the influence of social factors on chronic non-infectious diseases in low, middle and high income countries». In the study we analyzed cardiovascular risk factors using identical questionnaires, functional, anthropometric, biochemical means and measured on identical scales. As a result, we analyzed the prevalence of smoking, diabetes mellitus, overweight and obesity, abdominal obesity, hypercholesterolemia and hypertriglyceridemia, high levels of low-density lipoprotein (LDL). Results. Univariate analysis indicates that in the sample of 2016, compared to the sample of 2013, the prevalence of smoking is statistically significantly lower, as well as the proportion of participants with high cholesterol levels, but not taking lipid-lowering drugs. In contrast, the prevalence of diabetes, hypercholesterolemia and hypertriglyceridemia is higher. In women, the frequency of abdominal obesity on 2016 is lower than on 2013: at 35-44 age group odds ratio (OR) =0.67 with 95% confidence interval (CI) 0.44-1.03, at 45-54 age group OR =0.47 with 95% CI 0.31-0.72, 55-65 age group OR =0.49 with 95% CI 0.30-0.79. A high incidence of diabetes, hypercholesterolemia and hypertriglyceridemia is characteristic mainly of older women (55-65 age group): accordingly, OR =1.96 with 95% CI 1.19-3.22, OR =1.42 with 95% CI 1,02-1.97, OR =1.51 at 95% CI 1.08-2.12. In the 45-54 age group of men, they smoked statistically significantly less often on 2016 compared to 2013, OR =0.59 with 95% CI 0.36-0.96. The prevalence of overweight and obesity in both samples is the same: for women, the OR for overweight in different age groups is within 0.74-0.87, for men - within 0.95-1.78; for obesity OR in women is from 0.70 to 0.79, in men - from 1.03 to 1.34. Conclusion. A significant advantage of the study is the analysis of changes in prevalence in age and gender groups, which showed significant differences in the dynamics of men and women in different age categories for a number of risk factors. Analysis of the dynamics of the prevalence of cardiovascular risk factors makes it possible to assess the effectiveness of state and regional policies in the field of health protection and, first of all, "risk groups” that require closer attention, development and implementation of targeted health-saving technologies.