The EAC Guidelines represent the views of the EAC, and were produced after careful consideration of the scientific and medical knowledge, and the evidence available at the time of their publication.

Курение и гиперурикемия являются факторами риска развития сердечно-сосудистой патологии и других хронических неинфекционных заболеваний. Однако ассоциация курения с вероятностью развития гиперурикемии остается неопределенной. ЦЕЛЬ ИССЛЕДОВАНИЯ Изучить ассоциацию гиперурикемии со статусом курения, интенсивностью и продолжительностью курения у мужчин среднего возраста и факторов, ее определяющих. МАТЕРИАЛ И МЕТОДЫ Данное исследование является частью 32-летнего проспективного когортного наблюдения за лицами мужского пола, начиная с детского возраста (11—12 лет). В исследование включены 289 (28,8%) представителей исходной популяционной выборки в возрасте 41—44 лет. Обследование включало опрос по стандартной анкете с оценкой статуса, продолжительности и интенсивности курения, антропометрию, измерение уровня артериального давления, показателей липидного профиля крови и мочевой кислоты. Все участники исследования распределены по категориям статуса курения, продолжительности и интенсивности курения (пачка/лет). В группу с гиперурикемией включали мужчин с уровнем мочевой кислоты в крови более 416,5 мкмоль/л. Для изучения указанной ассоциации проведены одномерный и многомерный логистический регрессионный анализ. РЕЗУЛЬТАТЫ Статистически значимая связь гиперурикемии со статусом курения в прошлом — ОШ 2,148 (95% ДИ 1,077—4,283) обусловлена ее ковариацией с избыточной массой тела (ожирением) и избыточным употреблением алкоголя — ОШ 1,157 (95% ДИ 0,480—2,791) после коррекции на ковариаты. Обнаруженная ассоциация между продолжительностью, интенсивностью курения и гиперурикемией у куривших в прошлом мужчин — ОШ 2,676 (95% ДИ 1,114—6,431) и ОШ 4,136 (95% ДИ 1,609—10,634) соответственно обусловлена опосредованным эффектом избыточной массы тела (ожирения) и избыточного употребления алкоголя мужчинами — ОШ 0,933 (95% ДИ 0,263—3,309) и ОШ 1,231 (95% ДИ 0,302—5,021) после коррекции соответственно. Показано, что комбинация текущего курения и курения в прошлом с избыточной массой тела (ожирением) оказывает аддитивное действие на развитие гиперурикемии. ЗАКЛЮЧЕНИЕ Ассоциация гиперурикемии со статусом курения, интенсивностью и продолжительностью курения у текущих курильщиков и у куривших в прошлом обусловлена, главным образом, ее ковариацией с избыточной массой тела (ожирением) и избыточным употреблением алкоголя. Комбинация текущего курения и курения в прошлом с избыточной массой тела оказывает аддитивное действие на развитие гиперурикемии.

Aim. To evaluate a 1-year outpatient management of patients after myocardial infarction (MI) aged <75 years according to a Russian multicenter study, as well as to assess compliance with recommendations on the frequency of visiting specialists and the performance of diagnostic examinations.Material and methods. This observational study includes a representative sample of MI patients admitted to 16 clinics in 13 Russian regions. Patients with MI who were alive the next day after hospitalization aged <75 years were included in the study according to a special randomization scheme. When writing this article, the data from questionnaires of 6 and 12 months after hospitalization were analyzed: the number of visits to doctors of various specialties, hospitalizations, the number of diagnostic procedures performed (electrocardiography (ECG), echocardiography and surgical interventions (percutaneous coronary intervention, coronary artery bypass grafting (CABG)). The study included a cohort of 723 patients who participated in the survey both 6 and 12 months after hospitalization (67% — patients discharged from the hospital), of which 562 (77,7%) were men and 161 (22,3%) — women. Statistical processing was performed using IBM SPSS Statistics v.25 software for Windows.Results. In the first 6 months after MI, 218 (38,8%) men and 62 (38,5%) women visited the cardiologist the recommended number of times. However, 151 (20,9%) people were not monitored by a cardiologist in the first six months. There was a significant increase in the number of people not observed during the second 6 months up to 209 (28,9%) people (p<0,01). Of the 689 interviewed patients, 210 (30,5%) people visited the therapist the recommended number of times in the first six months, while in the second 6 months — 402 (58,4%) patients. It is also reasonable to single out patients who were not monitored by either a cardiologist or a general practitioner into a separate group. In the first 6 months, the total number of unobserved patients was 68 (7,5%), while in the second six months this number increased to 189 (25,9%). The recommended number of ECGs (4 or more times) was performed in 316 (40,4%) patients, while ECG was not performed in 35 (4,5%) patients. Echocardiography 2 or more times was performed in 194 (25,4%) patients. The procedure was not performed in 167 (21,9%) patients. During the first 6 months, 170 (22%) people were hospitalized, while 156 (20,2%) — during the second half of the year. Angioplasty during the first 12 months after discharge from the hospital was performed in 183 (23,1%) patients, CABG — in 41 (5,2%) patients without age and sex differences.Conclusion. Outpatient management of patients aged <75 years 12 months after MI characterized by low compliance with recommendations on the number of cardiologist consultations and diagnostic procedures, which may adversely affect adherence to the recommended drug treatment and lead to a worse prognosis.

Aim. Research of the association of heart rate variability (HRV) with the level of psychosocial stress (PS) and other indicators of the risk of cardiovascular diseases in a sample of 41-44-year-old men living in Moscow.Material and methods. A total of 299 men aged 41-44 years were examined. The study included a clinical examination and a survey using a standard questionnaire. The categorization of risk factors (RF) for cardiovascular diseases (CVD) was carried out in accordance with generally accepted criteria The psychosocial stress was assessed using the Reeder scale. Depending on the psychosocial stress level, all surveyed men were divided into 3 groups by terciles: group 1 (3,28-4,0 points) – mild stress, group 2 (2,71-3,14) – moderate stress, group 3 (1,28-2,57) – severe stress. The analysis of HRV was performed on the basis of a short recording of an electrocardiogram using the original software package.Results. Nonparametric ANOVA showed that the mean [M (95% CI)] values of the HRV time domain (SDNN, rMSSD and the state of regulatory reserves) were lower in the group of men with high PS compared with the group with low PS [25.3 ms (20.9-29.7) versus 40.5 ms (30.7-50.3), p=0.007; 29.5 ms (24.6-34.3) versus 49.5 ms (36.7-62.3), p=0.030; and 46.7 (44.7-48.6) versus 49.7 (48.1-51.4), p=0.019; respectively]. On the contrary, the mean values [M (95% CI)] of the integral indicators of HRV (SI and IVR) were higher in the group of men with high PS [635.8 c.u. (556.2-715.4) versus 488.9 (423.8-554.1), p=0.005; 1172.6 (1045.1-1300.1) versus 904.7 (790.0-1019.4), p=0.003; respectively]. The results of correlation and multiple regression analysis confirmed that these HRV indicators are statistically significantly associated not only with PS, but also with other indicators (age, waist / hip ratio, diastolic blood pressure). However, their predictive value turned out to be low, and the proportion of the explained variance of HRV indices ranged from 2.5 to 13.1%.Conclusion. The weakening of the autonomous regulation of the heart rate with a decrease in the activity of the parasympathetic link, the activation of the central circuit of regulation with the prevalence of sympathetic influences, a decrease in the functional reserves of the heart rate regulation system are associated with an increase in the level of PS and other indicators of the risk of cardiovascular diseases.

Dietary pattern usually changes with age; however, certain dietary habits may remain constant. The goal of this study was to analyze dynamic changes in the dietary pattern of males from adolescence to adulthood during a 28-year prospective follow-up. Material and methods. Initially, a representative population sample of 1,005 boys aged 11 to 12 years (mean age 11.9±0.1 years) was examined. Four visits were performed at the ages of 15, 17, 22 and 43. Assessment of actual dietary pattern was carried out by the 24-hour dietary recall method. Results. It was discovered that dietary pattern was changing with age as follows: proportions (Δ%) of meats [M (95% confidence interval)] 2.4 (-0.5-5.3), fish and seafood 1.5 (0.4-2.7), eggs 0.8 (0.1-1.5), and vegetable oils 0.3 (0.1-0.5) were increasing with age, whereas the proportions of animal fats -1.0 [-1.4…-0.6], bread and bakery -2.8 [-5.5…-0.1], sweets and confectionery -2.6 [-4.8…-0.5] were decreasing. We also observed a trend of increased consumption of fruits and fruit juices [Δ=4.9 (1.5-8.4)%]. The magnitudes of the tracking coefficients (correlation coefficients) between the initial (at the age of 15 years) values of the contributions of the main food groups to the total weight of the daily diet and their values at subsequent stages of prospective study showed that eating habits, as a certain dietary pattern, are relatively stable only in adolescence. Conclusion. Over 28 years of prospective observation of males, from adolescence to adulthood, their eating patterns underwent significant changes, which must be taken into account when developing preventive measures aimed at correcting unhealthy dietary patterns in children and adolescents, and at transition to a balanced diet.

Увеличение распространенности избыточной массы тела (избМТ) и ожирения, относящихся к основным причинам потери здоровых лет жизни в Российской Федерации, делает данную проблему актуальной и свидетельствует о необходимости поиска новых подходов к диагностике и лечению. ЦЕЛЬ ИССЛЕДОВАНИЯ Изучить особенности компонентного состава тела, физического и психического здоровья у лиц женского пола с избМТ различной степени. МАТЕРИАЛ И МЕТОДЫ В исследование включена 251 женщина (средний возраст 47,2 года). Всем женщинам проведено стандартное антропометрическое обследование, а также выполнена оценка состава тела. Биоимпедансные измерения проводили на анализаторе АВС-01 «Медасс». Показатели физического и психического здоровья оценивали с помощью опросника Short Form Medical Outcomes Study (SF-36). РЕЗУЛЬТАТЫ ИзбМТ и ожирение выявлены у 67,6% женщин, из них ожирение — у 34,7%. Объем жировой массы составил 27,6% у женщин с нормальной МТ, 35,5% — с избМТ и 42,4% — с ожирением. Индекс жировой ткани при ожирении составил 15,1 (14,6—15,6), а при нормальной МТ — 6,2 (5,7—6,8); индекс безжировой МТ — 20,1 (19,8—20,4) и 15,9 (15,6—16,2) соответственно. У женщин с нормальной МТ соотношение внеклеточной и клеточной жидкости составило 0,715 (0,710—0,721), что статистически значимо меньше по сравнению с женщинами с избМТ (0,727 (0,722—0,732), p<0,01) и ожирением (0,759 (0,752—0,766), p<0,001). При нормальной МТ вероятность развития метаболического синдрома (ОШ метаболического синдрома по%жировой массы тела) составляла 1,6 (1,3—1,9), при избМТ — 5,7 (4,9—6,5), при ожирении — 20,9 (17,3—24,6), что статистически значимо выше по сравнению как с нормальной МТ, так и с избМТ (p<0,001 во всех случаях). ЗАКЛЮЧЕНИЕ Анализ состава тела дает возможность определить изменения, повышающие кардиометаболический риск, связанный с накоплением жировой ткани. Полученные данные о риске развития сердечно-сосудистых заболеваний и метаболического синдрома позволят рекомендовать профилактические мероприятия (коррекцию диеты и образа жизни) для улучшения состояния здоровья женщин с ИзбМТ и ожирением.

Aim. Evaluation of the association of smoking (status, intensity and duration) with indicators of the structure and function of the left ventricle of the heart in a sample of middle-aged men.Material and methods. This study is part of a 32-year prospective cohort observation of men from childhood (11-12 years). 301 (30.0%) representatives of the original population sample aged 41-44 years were included in the study. The examination included a survey on intensity of smoking, anthropometry, measuring blood pressure, pulse rate, echocardiography, and blood lipid analysis.Results. 301 men aged 41-44 included 92 (30.6%) men who had never smoked, 73 (24.3%) men smoked in the past and 136 (45.2%) men currently smoke. 75% of current smokers started smoking before age 19, of which 32.3% started smoking before age 15. The duration of smoking cessation among former smokers was 14.4 (12.5; 16.2) years. The average duration of smoking [average (95% confidence interval)] among former smokers was 14.4 (12.5; 16.2), for current smokers – 25.3 (24.6; 26.0) years. Current smoking was statistically significantly associated with higher mean values of the left ventricular myocardium mass (LVMM), the left ventricular myocardial mass index (LVMMI), the end-systolic and end-diastolic interventricular septum thickness (IVSTs/IVSTd), the end-systolic left ventricular posterior wall thickness (LVPWs), and the intensity and duration of current smoking were associated with higher values of the relative wall thickness of the left ventricle, the end-diastolic interventricular septum thickness, the end-systolic interventricular septum thickness, and with low values of the left ventricular stroke volume index (LV SVI). Multiple regression analysis showed that current smoking has an independent effect on the left ventricular myocardium mass, the left ventricular myocardial mass index and the end-diastolic interventricular septum thickness, and the duration and intensity of smoking has an effect on the index of the left ventricular stroke volume index.Conclusion. Current smoking, duration and intensity in middle-aged men is associated with unfavorable changes in indicators of the structure and function of the left ventricle of the heart. Efforts for primary prevention of smoking should begin as early as childhood and continue into adolescence and young adulthood.

(1) Background: Vital exhaustion (VE) is no less of an important risk factor (RF) for cardiovascular diseases (CVD) and cardiovascular events than the well-known RFs. Insufficient knowledge of the relationship between VE and CVD RF, quality of life, and lifestyle was the rationale for this study. (2) Methods: We examined 301 Muscovite men 41–44 years of age. The categorization of RFs for CVD was carried out in accordance with conventionally considered criteria. In order to evaluate the lifestyle and quality of life in study participants, we were offering them a self-filling questionnaire developed by I.A. Gundarov. The presence of VE signs was assessed using a 14-item short version of the Maastricht Vital Exhaustion Questionnaire scale (MVEQ). All study subjects were classified into three ordered groups depending on the distribution of VE indicators by tertiles: Group 1 consisted of men with a low VE (0–2 points), Group 2 included males with a medium VE score (3–5 points), and Group 3 comprised subjects with high VE scores (6–14 points). To analyze the obtained data, we used one-way analysis of variance (ANOVA), Pearson’s chi-squaredtest (χ2), Goodman and Kruskal’s gamma, and linear regression analysis. (3) Results: We established that every third male (36.8%) had VE signs, while 10.6% of men had high VE levels. With an increase of VE in men, the frequency of arterial hypertension (AH) was increasing as well, and it was significantly higher in men with a high VE compared to their peers with a low VE (48.4% versus 33%; p = 0.03). A significant linear relationship was discovered between VE levels and excessive alcohol consumption (p = 0.001). The strongest linear associations were found between the VE level, and both psychosocial stress indicator and the amount of consumed ethanol. Self-assessment of personal happiness, job and sleep satisfaction, residential living conditions, and spiritual needs, as well as psychosocial stress indicator, total amount of consumed ethanol, and muscle strength (hand-grip dynamometry), were independent determinants of the VE level, and, collectively, they explained 46.6% of its variability. The greatest contribution to VE was made by the personal happiness level, explaining 25.5% of its variability. The proportions of the VE variance uniquely explained by various factors were as follows: 9.3% by the psychosocial stress, 4.9% by job satisfaction, 2.8% by sleep satisfaction, 2.3% by total consumption of ethanol, 1.6% by muscle strength, 1.1% by living conditions in the residential neighborhood, and just 0.8% by spiritual needs. (4) Conclusion: High VE levels in 41–44-year-old men are associated with AH, sedentary behavior, excessive alcohol consumption, and lower values of most indicators of both lifestyle and quality of life.

Aim. To assess the influence of sex, age and length of service on scientific productivity (h-index in the RSCI, Scopus and Web of Science) of researchers of the National Medical Research Center for Therapy and Preventive Medicine.Material and methods. The study sample was formed from the staff of the National Medical Research Center for Therapy and Preventive Medicine and consisted of scientists of various ranks. The study included 147 people (women, 103; men, 44); Information was collected on their age, education, length of service, academic degree, the position held and author-level metrics — the h-index, obtained from three abstract and citation databases — RSCI, Scopus and Web of Science. All study participants were divided into groups by sex and age categories — young (≤39 years), middle-aged (men, 40-60 years; women, 40-55 years) and older (men >60 years old; women >55 years).Results. Analysis showed that 70,1% of the research team consists of women; 60% — young and middle-aged scientists, and 40% — older people. Among male researchers, compared with women, there are more doctors of science and high h-index values in the RSCI, Scopus and Web of Science. H-index value in the RSCI among male researchers is 47,3% due to the age and work duration at the National Medical Research Center for Therapy and Preventive Medicine, and among female researchers, 42,8% due to academic degree and length of service. The h-index in Scopus in men is influenced by age, in women — by the presence of an academic degree, which explain, respectively, 19,7 and 18,1% of its variability. H-index value in the Web of Science in men is associated with the work duration, while in women, with an academic degree and length of service, which explain, respectively, 24,4 and 21,1% of its variance.Conclusion. Women and young and middle-aged scientists prevail in research team pattern of the National Medical Research Center for Therapy and Preventive Medicine. However, male researchers make a more significant contribution to scientific productivity, assessed by the h-index in the RSCI, Scopus and Web of Science. Age and length of service have the greatest influence on scientific productivity for male researchers, while for women — presence of academic degree and length of service. It is necessary to continue research on the study of individual, motivational and institutional factors affecting the scientific productivity.

Aim. To study the relationship of psychosocial stress with the social environment, lifestyle and risk factors for cardiovascular diseases (CVDs) in middle-aged men.Material and methods. A total of 301 men aged 41-44 years were examined. The study included a clinical examination and a survey using a standard questionnaire. The categorization of CVD risk factors (RF) was carried out in accordance with generally accepted criteria. The psychosocial stress was assessed using the Reeder scale. Depending on the psychosocial stress level, all surveyed men were divided into 3 groups by tertiles: group 1 (3,28-4,0 points) — mild stress, group 2 (2,71-3,14) — moderate stress, group 3 (1,28-2,57) — severe stress.Results. More than half (53,5%) of males had manifestations of psychosocial stress, while 9% had a mild stress. With an increase in stress severity, the prevalence of hypertension increased and was significantly higher in men with a severe stress compared with their peers with mild stress (45,7% vs 31,7%; p=0,045). A significant linear trend was revealed between the levels of PSS and indicators of sedentary behavior. The strongest linear relationship was found between the psychosocial stress level and vital exhaustion (VE). The level of VE, stress at work, satisfaction with government performance and the level of family happiness are independent determinants of psychosocial stress level, and explain 33,1% of its variability. The proportion of the variance of psychosocial stress, uniquely explained by VE, is 20,8%, the absence of stress at work — 8,0%, satisfaction with government performance — 3,5% and the level of family happiness — 2,0%.Conclusion. A high level of psychosocial stress in middle-aged men is associated with hypertension, sedentary lifestyle and lower values of most indicators of the social environment, lifestyle and quality of life. This must be taken into account along with other behavioral and psychosocial risk factors for noncommunicable diseases when developing population-based programs.

Aim. To assess the association of smoking status and smoking intensity with general and abdominal obesity in a sample of middle-a ged men.Material and methods. This study was conducted as a part of the 32-year prospective cohort observation of males from childhood (11-12 years of age). The study included 301 (30,0%) representatives of the initial population sample aged 41-44 years. Age, anthropometric parameters, relationship of smoking status and smoking intensity with general (overweight/obesity) and abdominal obesity were analyzed.Results. Overweight/obesity were more common in former smokers (78,1%) compared with non-smokers (58,7%; p<0,01). Abdominal obesity, estimated by the waist circumference (WC), was detected more often among former (57,5%) and current smokers (50,7%), and abdominal obesity, estimated by the waist-to-hip ratio, was more common among current smokers, compared with non-smokers (37,0%; p<0,01, p<0,05 and p<0,05 respectively). A direct linear relationship was found between the intensity of current smoking and indicators of abdominal obesity in terms of waist-to-hip ratio (P for trend=0,004) and a direct linear relationship between intensity of former smoking and general obesity estimated by BMI (P for trend = 0,001), and abdominal obesity estimated by waist-tohip ratio (P for trend=0,004). The probability of developing abdominal obesity in current smokers with WC≥94,0 cm and with waist-to-hip ratio ≥0,9 was 1,8 and 2 times higher, respectively, than in non-smokers, but lower compared to former smokers. The risk of overweight/obesity and abdominal obesity in former smokers was 2,5 and 2,3 times higher, respectively, than in non-smokers. The 10-year risk of fatal CVD in nonsmokers and former smokers was lower than in current smokers (0,8% and 0,9% vs 1,8%; p<0,001 and p<0,001, respectively).Conclusion. High intensity of smoking among current smokers is associated with a higher probability of developing abdominal obesity, and in former smokers — with a higher probability of developing general and abdominal obesity. Former smokers, compared to current smokers, are at a lower risk of developing fatal cardiovascular diseases. Smoking cessation activities should be aimed at minimizing weight gain after quitting smoking and developing tobacco control programs.

Aim. Estimation of the correlation of self-perceived health (SPH) with social and psychological environment, lifestyle and cardiovascular risk markers in middle-aged men.Material and methods. A total of 301 men aged 41-44 years were examined. The study included clinical examination and interrogation using a standard form. Physical activity was estimated with the help of the International Physical Activity Questionnaires, the level of psychosocial stress – with the Reeder scale, signs of vital exhaustion with the Maastricht Questionnaire Vital Exhaustion Scale. To evaluate the mode and quality of life the questionnaire developed by I.A. Gundarev was used. All the examined people were divided in three groups according to the distribution of SPH rates by tertiles: the group 1 (from 7 to 60 scores) – bad health, the group 2 (61-79 scores) – satisfactory and the group 3 (80-100 scores) – good health.Results. Parameters of the social and psychological environment of middle-aged men were the basic determinates of their health self-perception, at that majority of the indices of the quality and mode of life were independent of family material well-being. Bad SPH in middle-aged men was determined by such parameters as: increased blood pressure (BP), abdominal obesity, excessive alcohol consumption, psychosocial stress, vital exhaustion, low physical activity. Material wealth influenced systolic BP level, the waist/hips circumference ratio, a number of cigarettes per day and thus the SPH status. The most significant determinants of SPH were the level of personal happiness, nervous stress at work, support by family, sports activities, working conditions, total cholesterol level, satisfaction with own work.Conclusion. When working on programs focused on public health improvement the social, psychological and behavioral determinants of health selfperception must be considered.

ВВЕДЕНИЕ Курение взрослых в семье, и особенно в присутствии детей, является особо значимым показателем негативного влияния не только на их здоровье, но и поведение в настоящем и будущем. ЦЕЛЬ ИССЛЕДОВАНИЯ Оценить ассоциации курения в семьях с самооценкой здоровья, образом и качеством жизни детей школьного возраста. МАТЕРИАЛ И МЕТОДЫ Обследованы 624 учащихся 6—7 и 8—10 классов общеобразовательных школ Москвы и Мурманска (321 мальчик и 303 девочки) и их родители. Обследование включало: опрос родителей по структурированной анкете (социально-экономический статус семьи, данные о курении родителей и других членов семьи) и анкетирование школьников (самооценка здоровья, образ жизни, поведенческие и пищевые привычки, психосоциальные факторы). РЕЗУЛЬТАТЫ В 280 (45%) семьях школьников курили проживающие с ними родственники, а также 197 (46%) отцов и каждая 5-я мать. Матери чаще курили дома, отцы — вне дома. Девочки, проживающие в семье с курильщиками, чаще отмечали наличие проблем со здоровьем, чем в некурящих семьях, — 60 (60,6%) против 62 (45,9%) (p=0,026). Школьники, проживающие в семьях с курящими родителями и другими родственниками, чаще имели проблемы со здоровьем, дольше проводили время за компьютером, имели менее разнообразный досуг, реже придерживались принципов ЗОЖ, а также отмечали проблемы в отношениях с близкими в эмоциональном плане. Курение родителей негативно влияло на пищевое поведение детей, формируя характер питания с более высоким потреблением консервов и копченостей, сладких газированных напитков, меньшим содержанием в рационе питания фруктов и овощей и более редкими ежедневными завтраками. ЗАКЛЮЧЕНИЕ Курение в семье оказывает негативное влияние на образ и качество жизни школьников, их здоровье, психоэмоциональное состояние, поведение, формирование навыков ЗОЖ. Профилактические мероприятия должны быть направлены на прекращение курения в семье и предотвращение начала курения детей и подростков.

Aim. To study the relationship of early smoking initiation (adolescence) with changes in body weight, blood pressure (BP), and lipid profile in males within a prospective study.Material and methods. This paper presents the results of a 26-year follow-up of two groups: group 1 — males who began to smoke up to 17 years; group 2 — males who have not smoked until 17 years of age. The examination included a standard questionnaire, anthropometry, blood pressure measurement, determination of lipids and apolipoproteins (apo).Results. In males with an early smoking initiation, its prevalence by the age of 22 was 64,8%, and by the age of 43 it decreased to 41,7%. At 43, 60% of the original number of smokers continued to smoke. The relative risk for adolescents who started smoking before 17 years of age to be every day smoker at the age of 22, 33 and 43, respectively, was 2,2, 1,7 and 2,1 times higher than their peers who did not smoke before 17 years. With age, the prevalence of smoking decreased and its intensity increased (number of cigarettes smoked per day). At 33-43, in the group of early smoking initiation, compared with nonsmokers, there were higher values of body mass index, waist circumference, waist-to-hip ratio, systolic and diastolic blood pressure, triglycerides, low-density lipoprotein cholesterol, apo B, and apo B/apo AI ratio.Conclusion. Smoking initiation in adolescence is associated with an early adherence to smoking, higher prevalence in young adulthood and a high probability of continuation in adulthood. It also contributes to the general and abdominal obesity in adulthood and increases the atherogenicity of lipoprotein profile.

Aim. To study the association of smoking with indicators of the structure and function of blood vessels in a sample of middle-aged men.Material and methods. This study is part of a 32-year prospective cohort observation of males starting in childhood (11-12 years). The study included 301 (30.0%) representatives of the original population sample aged 41-44 years. The examination included a survey on a standard questionnaire with an assessment of the status and intensity of smoking, of anthropometric indicators, blood pressure (BP), and determination of the blood lipid spectrum. The stiffness of the arterial wall and central pressure were measured by the method of applanation tonometry. The carotid intima-media thickness of the common carotid artery (C-IMT) was estimated by the method of ultrasonic duplex scanning of the main vessels of the neck.Results. Of the 301 men examined, aged 41-44 years, 92 (30.6%) people never smoked, 73 (24.3%) smoked in the past and 136 (45.2%) people currently smoke. Former smokers were divided by the intensity of smoking in the past as follows: less than 20 cigarettes/day were smoked by 41 (56.0%) people, and ≥20 cigarettes/day - 32 (44.0%) people. Among current smokers, less than 20 cigarettes/day were smoked by 63 (46.0%) people, and ≥20 cigarettes - 73 (54.0%) people. Current smokers have a statistically significantly higher level of triglycerides and lower cholesterol of high density lipoproteins in the blood, augmentation index (AIx), augmentation blood pressure and C-IMT thicker than non-smokers. The thickness of the C-IMT and AIx was statistically significantly greater among current smokers who smoked 20 or more cigarettes daily. Men who smoked in the past had significantly greater body weight, waist circumference and pulse wave velocity. 12.4% of AIx variability was attributable to current smoking combined with variability in alcohol consumption, blood glucose, and heart rate. The body mass index (BMI) and ethanol consumption are independent determinants of peripheral and central systolic pressure, and account for 17.8% and 18.6% of their variance, respectively. The combined contribution of current smoking, age, BMI, low-density lipoprotein cholesterol and plasma glucose to the thickness variability of C-IMT was 13.7%. Among men with a smoking duration in the past >10 years, the levels of total cholesterol, triglycerides and arterial stiffness indicators - AIx, pulse pressure amplification were higher compared to peers with a shorter smoking duration.Conclusion. Current smoking is associated with atherogenic changes in the blood lipid spectrum, impaired structure and function of the main arteries. Moreover, the severity of structural and functional disorders of the arteries is associated with the intensity of current smoking. If you give up smoking, there is a potential possibility of reversibility of these vascular disorders.

Aim. To evaluate the prevalence of smoking in 41-43-year-old men living in Moscow and its association with other chronic non-communicable diseases risk factors.Material and methods. People of male sex were prospectively followed up during 32 years since childhood (11-12 years). Only 301 (30%) representatives of 1005 initially enrolled people were examined after 32 years. The examination included: survey by a standard questionnaire (the passport data, the level of physical activity, bad habits – smoking, alcohol consumption); three-time blood pressure measurement; assessment of heart rate; measurement of weight and height, thickness of skin folds (over the triceps, under the scapula and on the abdomen); waist circumference.Results. Almost 50% of 41-44-year-old males smoked every day; less than a third of the study participants had never smoked. Every fifth of the smokers smoked less than 10 cigarettes per day while more than a half of them – a pack and more. The vast majority of the past smokers (85.2%) had stopped smoking at their own will and only very few (1.2%) by doctor’s advice. The intensity of smoking according to the pack/year index was >10 in almost 81.9% of the current smokers. The past smokers had abdominal obesity significantly more often than the non-smokers and the current smokers (57.5% vs 37% and 50.7%, respectively). The current smokers revealed the significantly higher risk of hypertension. The past smokers had 2.5 times higher risk of general obesity and 2.3 times higher one – of abdominal obesity as compared to the non-smokers. The intensity of smoking at the present time correlated with heart rate (HR). The past smokers (who smoked ≥20 cigarettes/day) as compared to the non-smokers had significantly higher HR, the Quetelet index, thickness of skin fold over the triceps and on the abdomen. The currents smokers revealed correlation of the status of smoking with HR, while the past smokers – with such parameters as the Quetelet index, waist circumference, thickness of skin fold under the scapula and over the triceps and no correlation with HR. The current smokers had significantly higher the 10-year risk of death as compared to thepast smokers and the non-smokers. Conclusion. Smoking is one of the most important risk factors of development of chronic non-communicable diseases. The struggle against smoking must be promoted, while close attention should be paid to people who had stopped smoking as a group of risk of cardiovascular disease onset.

Material and methods. A 32-year prospective cohort follow-up of males from childhood (11-12 years) was carried out. After 32 years of 1005 participants 301 (30.0%) were examined. The survey included: a survey on a standard questionnaire (passport data, the presence of bad habits [smoking, alcohol consumption]), a three-time measurement of blood pressure. The levels of total cholesterol, high and low density lipoprotein cholesterol, triglycerides were determined.Results. There is no established relationship between the average level of total cholesterol and hypercholesterolemia with smoking status and smoking intensity. It is shown that the level of triglycerides is statistically significantly higher in smokers as compared to non-smokers. Hypertriglyceridemia was not associated with smoking status, but was associated with the smoking index in current smokers, and only with the highest values of this index in past smokers. The probability of being in a group with dyslipidemia was more than 2 times higher in smokers as compared to non-smokers. The differences in the chances of getting into a group with dyslipidemia between smokers and nonsmokers in the past were statistically insignificant. The linear dependence of the frequency of dyslipidemia on the intensity of smoking at the present time, i.e. with increasing intensity of smoking increases the frequency of dyslipidemia. Such a dependence between smoking in the past and the frequency of dyslipidemia was not revealed. The probability of being in a group with a high atherogenic risk is 2 times higher in both smokers at present and smokers in the past as compared to non-smokers. The linear dependence of the frequency of high atherogenic risk on the intensity of smoking both now and in the past is established, i.e. with the increase in the intensity of smoking the frequency of high atherogenic risk increases in both smokers at present and smokers in the past as compared to non-smokers.Conclusion. Close association of smoking with dyslipidemia was confirmed. The high probability of being in a group with a high atherogenic risk not only in smokers at present, but also smokers in the past indicates the importance of not only secondary, but also primary prevention of smoking.