Repetitive quarantines and social restrictions during the coronavirus disease 2019 (COVID-19) pandemic have negatively affected the population health in general, and the control of hypertension (HTN) in particular.Aim. To evaluate the control of HTN in the Russian population during the COVID-19 period based on the results of screening for HTN May Measurement Month 2021 (MMM2021).Material and methods. During May-August 2021, 2491 participants from 11 Russian regions took part in the screening. Participation was voluntary without restrictions on sex. All participants were over 18 years of age. During the screening, blood pressure (BP) was measured three times using automatic and mechanical BP monitors. In addition, a questionnaire was filled out on behavioral risk factors, comorbidities and therapy. HTN was diagnosed with systolic BP ≥140 mmHg and/ or diastolic blood pressure ≥90 mmHg and/or taking antihypertensive therapy. The questionnaire included questions about prior COVID-19, vaccinations and their impact on the intake of antihypertensive drugs.Results. The analysis included data from 2461 respondents aged 18 to 92, of which 963 were men (39,1%). The proportion of hypertensive patients was 41,0%, while among them 59,0% took antihypertensives and 30,9% were effectively treated. In comparison with pre-pandemic period according to MMM2018-2019, the higher proportion of HTN patients in the Russian sample was revealed during MMM2021 (41,0% vs 31,3%, p<0,001) with a comparable proportion of patients receiving antihypertensive therapy (60,7% vs 59,0%, p=0,05) and treatment efficacy (28,7% vs 30,9%, p=0,36). Monotherapy was received in 44,7% of cases, while dual and triple combination therapy — in 30,9% and 14,1%, respectively. The majority of respondents (~90%) did not adjust their antihypertensive therapy during the COVID-19 pandemic.Conclusion. According to HTN screening in Russia, there is persistent ineffective control of HTN, which may be due to both the worsening pattern of behavioral risk factors, limited access to healthcare during COVID-19, and the inertia of physicians and low adherence of patients due to the asymptomatic HTN course in the majority.

Aim. To assess the association of cardiovascular risk factors with various vascular aging phenotypes using the St. Petersburg population sample as part of the Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation (ESSE-RF) study.Material and methods. The current analysis, performed within the ESSE-RF multicenter observational study, included 1600 St. Petersburg residents. The participants filled out a questionnaire to assess risk factors. In addition, blood biochemical parameters, anthropometric characteristics, and blood pressure were evaluated. Pulse wave velocity (PWV) was assessed by applanation tonometry using the SphygmoCor device (AtCor, Australia) in 524 people. For analysis, 485 participants without prior cardiovascular events were selected. PWV ≤10 percentile of PWV for healthy individuals in each age group was considered as the criterion for supernormal vascular aging (SUPERNOVA) phenotype, the PWV ≥90 percentile — early vascular aging (EVA), the PWV of 10-90 percentile — normal vascular aging (NVA).Results. The prevalence of SUPERNOVA phenotype was 9,7%, EVA — 18,8%, NVA — 71,5%. Patients with EVA phenotype were more likely to have HTN (60,4%) in comparison with those with SUPERNOVA phenotype (17%) and, less likely — high physical activity (39,6 vs 53,2%). Obesity, hyperglycemia, insulin resistance, hypercholesterolemia, dyslipoproteinemia, and excessive alcohol consumption were significantly less common in participants with SUPERNOVA phenotype compared with those with EVA phenotype.Conclusion. In addition to HTN and dyslipoproteinemia, a significant predictor of premature aging was the cumulative effect of obesity, insulin resistance and hypertriglyceridemia. Among behavioral risk factors, higher physical activity and adequate alcohol consumption were factors associated with supernormal aging.

Abstract Background Modern concept of supernormal vascular aging (SUPERNOVA) can be verified in subjects with exceptionally low arterial stiffness for their age. Among subjects who were exposed to severe famine in the prenatal and early childhood period of life during Leningrad Siege 1941–1944 those who survived now reached advanced age of 75 years or more. As caliris restriction can be associated with slowing of arterial stiffening this group can be expected to have subject with SUPERNOVA phenomenon. Purpose The aim of the study was to assess predictors of SUPERNOVA phenomena in survivors of the Leningrad Siege according to different gender. Design and methods The arterial stiffness was assessed by SphygmoCor device (carotid-femoral pulse wave velocity (PWV)) in 232 survivors of Leningrad Siege in 2014. Blood pressure (BP) measurement and anthropometry (weight, height, waist circumference) were performed according to standard protocols. Fasting serum lipids and plasma glucose were measured by Hitachi-902. According to The Reference Values for Arterial Stiffness' Collaboration (2010) for Siege survivors group (over 70 years old) the median value (10–90 percentile) of the PWV is 8.0–14.6 m/s. SUPERNOVA phenomenon was determined in case of PWV ≤8.0 m/s. 35 (11,3%) participants had SUPERNOVA phenomenon: 9 males and 26 women, non-SUPERNOVA group of 50 males and 147 females was a control group. Results Comparative gender analysis revealed common and distinct predictors of SUPERNOVA presence. Conclusions Independently of gender SUPERNOVA phenomenon was observed in subjects with lower BP. In females normal triglycerides levels were associated with low arterial stiffness while in male gender lack of abdominal obesity was also important. Funding Acknowledgement Type of funding source: None

Background. Arterial stiffness, which is a marker of vascular damage and cardiovascular disease independent predictor, can be used as an indicator of vascular aging. Vascular changes may occur in some individuals earlier than it comes according to chronological age (early vascular aging syndrome) or later (healthy aging). SUPERNOVA (supernormal vascular aging) is a new protective phenotype in which very low arterial stiffness values are recorded regardless of the level of risk factors exposure.Objective. To assess the prevalence of SUPERNOVA phenomenon and risk factors in St Petersburg population-based sample.Design and methods. The survey of 1600 St Petersburg residents aged 24-65 years was performed in terms of the epidemiological observation study ESSE-RF (2012-2013). Anthropometry and fasting blood sampling for lipids and glucose detection and blood pressure measurement according to standard methods were performed. Pulse wave velocity (PWV) assessed by SphygmoCor (Australia) was performed in 524 people. 485 participants were selected without cardiovascular complications history. The participants were divided by age into 5 groups: persons under 30 years, 30-39 years, 40-49 years, 50-59 years, 60 years and older. PWV < 10th percentiles for healthy individuals PWV (Reference Values for Arterial Stability’s Collaboration, 2010) was detected as SUPERNOVA phenomenon in each age group. Mathematical and statistical data analysis was implemented using IBM SPSS Statistics 20.0.Results. SUPERNOVA phenomenon prevalence was 9,8 % (48 participants): 11,9 % women (32 participants) and 7,4 % men (16 participants). Among women systolic blood pressure (SBP) levels (p = 0,01) and body mass index (BMI) (p = 0,055) were significantly lower. Subjects with SUPERNOVA showed significantly lower SBP and diastolic blood pressure (DBP), BMI, glucose, triglycerides and lower prevalence of arterial hypertension (HTN), obesity, hypercholesterolemia and hypertriglyceridemia. In participants younger 30 years only obesity prevalence was significantly lower in respondents with SUPERNOVA, based on BMI criterion (p = 0,046). Participants aged 30-39 years showed no significant differences. In the group aged 40-49 years BMI (p = 0,02), abdominal obesity prevalence (p = 0,05), as well as SBP levels (p = 0,03) and DBP (p = 0,05) was significantly lower in individuals with SUPERNOVA. In the group aged 50-59 with SUPERNOVA significantly lower HTN prevalence (p = 0,03), glucose levels (p = 0,005) and BMI (p = 0,04) were found. In the older age group of 60-65 years subjects with SUPERNOVA have significantly lower levels of SBP (p = 0,014) and DBP (p = 0,014), as well as significantly lower prevalence of HTN (p = 0,03).Conclusions. At population level the phenomenon of supernormal vascular aging occurs in about 10 % without significant gender prevalence. HTN, obesity and metabolic factors are the determining factors of vascular aging. Ideal vascular health is associated with age-specific features.

Aim:to compare various approaches to estimation of vascular age in patients from sample of citizens of Saint-Petersburg (SPB) with arterial pressure (AP) above 130 / 80 mm Hg without history of cardiovascular events.Materials and methods.Examination of a population sample of SPB citizens (n=1600) was carried out within framework of the observational epidemiological study ESSE-RF (ЭССЕ-РФ) in 2012–2013. We selected from this sample 477 women and man aged 40–65 years without history of cardiovascular events, diabetes, or chronic kidney disease, and AP >130 / 80 mm Hg. Examination included anthropometry, sampling of fasting blood for measurement of lipids, glucose, creatinine levels, urine sampling for determination of albumin excretion, and AP measurement in ac-cordance with standard methods. The SCORE scale was used of evaluation of 10-year risk of fatal stroke and fatal myocardial infarction. Volume sphygmography (VaSera device) was applied for determination of cardio-ankle vascular index (CAVI) with calculation of vascular age, and ankle-brachial index. ASCORE scale was used for determination of сalculated vascular age was determined with help of the ASCORE scale.Results.Mean age of participants (182 men [38.2 %], 295 women [61.8 %]) was 52.5±6.2 years. Calculated and instrumental methods of determination of vascular age and early vascular aging had low concordance (κ = 0.099). With elevation of cardiovascular risk early vascular aging was more frequently detected by method of its calculation ASCORE than with instrumental method (VaSera). In the absence of achievement of target AP level signs of early vascular aging were significantly more often detected by the method of vascular age calculation than by the instrumental method VaSera.Conclusion.Application of the concept of vascular age and early vascular aging syndrome might be an effective tool for stratification of cardiovascular risk by a physician and improvement of adherence of a patient. This is especially actual for young patients with burdened heredity. One can assume that estimation of virtual risk factor load on blood vessels by the ASCORE method of calculation is more sensitive to detection of premature vascular aging, while requiring less financial and organizational efforts.

AIMto compare various approaches to estimation of vascular age in patients from sample of citizens of Saint-Petersburg (SPB) with arterial pressure (AP) above 130 / 80 mm Hg without history of cardiovascular events.MATERIALS AND METHODSExamination of a population sample of SPB citizens (n=1600) was carried out within framework of the observational epidemiological study ESSE-RF (ЭССЕ-РФ) in 2012-2013. We selected from this sample 477 women and man aged 40-65 years without history of cardiovascular events, diabetes, or chronic kidney disease, and AP >130 / 80 mm Hg. Examination included anthropometry, sampling of fasting blood for measurement of lipids, glucose, creatinine levels, urine sampling for determination of albumin excretion, and AP measurement in ac-cordance with standard methods. The SCORE scale was used of evaluation of 10-year risk of fatal stroke and fatal myocardial infarction. Volume sphygmography (VaSera device) was applied for determination of cardio-ankle vascular index (CAVI) with calculation of vascular age, and ankle-brachial index. ASCORE scale was used for determination of сalculated vascular age was determined with help of the ASCORE scale.RESULTSMean age of participants (182 men [38.2 %], 295 women [61.8 %]) was 52.5±6.2 years. Calculated and instrumental methods of determination of vascular age and early vascular aging had low concordance (κ = 0.099). With elevation of cardiovascular risk early vascular aging was more frequently detected by method of its calculation ASCORE than with instrumental method (VaSera). In the absence of achievement of target AP level signs of early vascular aging were significantly more often detected by the method of vascular age calculation than by the instrumental method VaSera.CONCLUSIONApplication of the concept of vascular age and early vascular aging syndrome might be an effective tool for stratification of cardiovascular risk by a physician and improvement of adherence of a patient. This is especially actual for young patients with burdened heredity. One can assume that estimation of virtual risk factor load on blood vessels by the ASCORE method of calculation is more sensitive to detection of premature vascular aging, while requiring less financial and organizational efforts.

Objective. To determine relationship between metabolic syndrome (MS), its components and cognitive dysfunction among older adults. Design and methods. Altogether 196 subjects who did not have a history of cerebrovascular events (53 males, 143 females aged 64–86) — survivors of Leningrad Siege — were examined. IDF и АНА/NHLBI (2009) criteria for MS were used. Cognitive function was assessed applying Mini-Mental State Examination scale (MMSE). Results. MS was identifi ed in 48 % subjects. The prevailing components were hypertension, central obesity, hyperglycemia. According to MMSE results there were no participants with signs of dementia, but in 40 % cognitive dysfunction of different degree was found. Memory and attention were most impaired. Total MMSE score was associated with decreased verbal auditory working memory in women of the age group ≤ 70 years old (p < 0,05). Individual components of MS were associated with cognitive dysfunction, but only in women under or 70 years old. In this group participants with cardiometabolic disorders had the lowest scores at “Repetition” and “Sequence of actions” subscales. Hypertriglyceridemia was the component of MS most tightly associated with cognitive dysfunctions. Conclusions. Women with MS (especially with hyper-triglyceridemia) are a risk group of cognitive dysfunctions.

Objective. To estimate the association between metabolic syndrome (MS) and its components with markers of subclinical target organ damage (TOD) in otherwise healthy bank employees. Design and methods. A sample of 383 participants with at least 1 component of MS and without cardiovascular complications was randomly selected from a cohort of bank employees (n = 1600). Mean age of participants was 46,6 ± 9,0 years, 66,3 % were females (n = 254). Anthropometry, fasting lipids, creatinine (estimated glomerular filtration rate calculation, eGFR), and fasting glucose were performed according to standard procedures. In all patients echocardiography (left ventricular myocardial mass index assessment, LVMMI), carotid ultrasound (atherosclerotic plaques and intima-media thickness evaluation, IMT), arterial stiffness (pulse wave velocity measurement, PWV), ankle-brachial index, and urine albumin were assessed. Results. Patients with MS (n = 229; 50,9 %) had significantly higher prevalence of atherosclerotic plaques (n = 29; 12,7 % vs. n = 9; 5,7 %; p = 0,03) and low eGFR (81,3 ± 13,1 vs. 84,3 ± 13,7 ml/min/m 3; р = 0,03) compared to patients without MS. All markers of subclinical TOD were associated with age based on multiple linear regression. Blood pressure correlated with LVMMI and PWV, hypercholesterolemia — with increased IMT, hypertriglyceridemia — with PWV, and LVMMI — with waist circumference. There was no association between MS and TOD markers. Conclusions. Left ventricular hypertrophy was detected more often in females (probably due to higher prevalence of abdominal obesity), while carotid atherosclerotic lesions were more frequently found in males (possibly due to higher prevalence of hypertriglyceridemia). TOD was more profound with the higher number of MS components, in particular, atherosclerotic plaques and decreased eGFR. Individual components of MS (hypertension, obesity, dyslipidemia) and age were the main factors associated with structural changes of cardiovascular system, but no effect was found for MS as a cluster.

Obesity is one of the most important public health challenges of the XXI century. Currently, the adipose tissue is considered as an active endocrine organ producing hormones — adipokines. Adipokines are the regulators of insulin sensitivity, oxidative stress, energy metabolism, coagulation and inflammatory reactions. That’s why adipokines may be retailers of mechanism of negative actions of obesity on the cardiovascular system. The study of their pathophysiological role will unveil the potential of adipokines as a therapeutic target in the treatment of obesity and associated conditions.

Objective. To estimate the prevalence of subclinical organ damage by basic existing screening methods, and correlation with traditional risk factors in a sample of St Petersburg inhabitants. Design and methods . The study was carried out as a part of ESSE-RF study. Totally, 1592 St Petersburg inhabitants (567 men and 1025 women) were examined. Anthropometry, blood pressure measurement and biochemistry were performed according to standard protocols. During instrumental investigation intima-media thickness (IMT) by My Sono U6; carotid-femoral pulse wave velocity (cfPWV), cardio-ankle vascular index (CAVI) and ankle brachial index (ABI) by VaSera VS‑1500 were assessed. Сardiovascular risk was assessed by SCORE-scale. Results . There is no subclinical vascular damage found in the majority of participants (n = 955, 76,7 %). The highest prevalence of subclinical organ damage is detected in patients with low and intermediate SCORE risk. Increasing of IMT more than 0,9 mm is the most prevalent marker (n = 212, 24,7 %) and ABI lower than 0,9 (n = 18, 2,1 %) was the less prevalent marker comparing with other methods. IMT correlates with waist circumference and BMI; besides this, a correlation with systolic BP is found only in women. Cardiovascular risk score correlated with CAVI, ABI and IMT. СfPWV and CAVI mean values, prevalence of IMT > 0,9 mm are significantly higher in males comparing with females. Only association between cfPWV and IMT is significant (β = 0,43, p < 0,0001). Conclusion . Low prevalence of subclinical organ damage is revealed according to different diagnostic methods. Evaluation of subclinical organ damage is reasonable for patients with low and intermediate risk; the risk level according to SCORE correlates with CAVI, ABI and IMT data. The prevalence of high CAVI and IMT is higher among men with hypertension, hypertriglyceridemia and hyperglycemia. Increased CAVI is associated with high blood pressure, larger prevalence of hypertension and older age; among women with hypertriglyceridemia and hyperglycemia also.

Objective. We aimed to estimate allele frequency and association of the genetic marker TCF7L2 gene (T-risk allele of rs1225537 SNP of TCF7L2 gene) with hyperglycemia, lipids and abdominal obesity in Saint-Petersburg residents. Materials and Methods. As a part of all-Russian epidemiology survey ESSE-RF, random sampling of 1600 Saint-Petersburg inhabitants stratified by age and sex was involved. All subjects signed informed consent and filled in questionnaire regarding lifestyle risk factors. Anthropometry (weight, height with body mass index (BMI) calculation, waist circumference), blood pressure (BP) and heart rate measurement and fasting blood-tests (lipids, glucose (Abbott Architect 8000, Roche Diagnostics) were performed. Genomic DNA was extracted from blood samples using magnetic bead technology. The TCF7L2 polymorphism rs1225537 was determined using real time PCR method by allele-specific probes (Applied Biosystems). Results: Female carriers of T allele (TT + GT genotypes) had tendency to have higher cholesterol level (5,6 ± 1,3 mmol/l; 5,4 ± 1,3 mmol/l; p = 0,04) compared to females with GG genotype. Among females carriers of T allele only hyperglycemia was observed more frequently compared with female carriers of G allele. The frequency of T- risk allele was 22,6 %. Conclusions: The TCF7L2 genetic variant rs1225537 is associated only with hyperglycemia in Saint-Petersburg residents. The frequency of T allele in Saint-Petersburg residents is the same as in general population (20 %).

Objective. Difference in cardiovascular diseases (CVD) prevalence between Russia and European Union may be caused by life style risk factors. Long period of common history and close geographic position allows to compare the nutrition behavior in North-West region of Russia and Estonia. Design and methods. As a part of collaborative study between Almazov FMRC and DIfE (IDAMES project), 131 inhabitants from St. Petersburg and 70 from Estonia randomly selected 18-65 y/o were interviewed by European food propensity questionnaire (EPFQ), translated and adapted to Russian and Estonian languages. It contained questions about frequency of main food groups consumption during last year. Informed consent and data regarding smoking status and anthropometry (height, weight with body mass index (BMI) calculation) were obtained from all participants. Results. Between Russia and Estonia no difference in smoking status and BMI were revealed (28,57 % and 24,81 % of current smokers; 26,32 kg/m 2 and 26,28 kg/m 2 for BMI respectively). Estonians take meat 2 times more frequent compared to Russian inhabitants. Estonian women consume 1,5 times more bread and fish than Russian, drink 2 to 5 times more alcohol. Russian men take more fruits and vegetables, 5 times more strong drinks, but 2 time less beer compared to Estonian men. Consumption levels of milk, semi-processed products, eggs, rice, pasta and sweets were comparable between groups. conclusion. Obtained data show differs in Estonia and in St. Petersburg eating behavior in spite of close geographical position and common history as well as comparable prevalence of smoking and obesity. Estonians have higher meat intake. Gender analysis surprisingly showed that Estonian females take more alcohol than Russian females. Russian males keep superiority in strong drinks consumption but have better level of fruits/vegetable intake and drink less beer.

Objective. To study personal characteristics affecting health behavior in individuals with different risk of metabolic syndrome (MS).Design and methods. We examined 138 respondents (aged 20–62 years) with the use of the medical examination, interview, observation and personality questionnaires (coping style, locus of control, alexithymia), and personality and behavioral characteristics of patients with different risk of MS were identiied. Results. Subjects with MS and single components of MS are characterized by emotional eating behavior, lack of sleep, lack of exercise, alexithymia, more external locus of control, avoidant coping strategies. The study showed a signiicant role of internal attitudes in the formation of health-promoting eating behavior, and the correlation between coping style and characteristics of eating behavior and smoking. Conclusion. The data support the importance of corrective measures aimed at changing not only the lifestyle, but also personal attitudes, and behavioral patterns that have an impact on health.

Aim. Metabolic syndrome (MS) is a combination of the key cardiovascular risk factors, namely obesity, carbohydrate metabolism disturbances, arterial hypertension (AH), and dyslipidemia. MS prevalence varies, depending on the MS definition used. The aim of this study was to assess the prevalence of MS and its components in large Russian cities (St. Petersburg, Kursk, Orenburg, and Kaliningrad), using international MS criteria. Material and methods. In total, 1046 individuals were screened in 4 cities: 309 in St. Petersburg, 170 in Kursk, 279 in Orenburg, and 288 in Kaliningrad. All participants underwent a questionnaire survey on demographics, risk factors, lifestyle, family history, comorbidities and treatment. Blood pressure measurement (3 measurements on the right arm) and anthropometry were also performed. Lipid profile and fasting glucose levels were measured with the use of Hitachi-902 analyser (Roche Diagnostics). MS was diagnosed based on the criteria by ATP III (2001–2005), IDF (2005), and JIS (2009). Results. High prevalence of MS was observed regardless of the criteria used; the highest prevalence was registered for the JIS-2009 criteria. For all MS criteria, no significant difference in MS prevalence was registered across the cities, or between men and women in each city. The majority of the patients (over 80%, regardless of the criteria used) had at least one MS component, with the highest prevalence observed in Kursk (94% for IDF-2005 and JIS-2009 criteria). Conclusion. In each region, the prevalence of MS was high, which might be related to high levels of cardiovascular morbidity and mortality in Russia. The IDF-2005 criteria agreed with the JIS-2009 ones to a greater extent than with the ATP III definition. However, prospective studies are needed to establish the national normal values of waist circumference, for reliable diagnostics of abdominal obesity in the Russian population.

Aim. To assess the influence of starvation on the prevalence of cardiovascular risk factors and diseases in survivors of Leningrad Siege, depending on the starvation occurrence. Material and methods. Leningrad Siege survivors from Primorsky district of Saint-Petersburg were invited and examined during December 2009 to January 2012. All participants were interviewed by a questionnaire regarding lifestyle, risk factors, cardiovascular disease, comorbidities and medication. Blood pressure (BP) measurements and anthropometry (weight, height, waist and neck circumference) were performed according to standard procedures. Fasting serum lipids and plasma glucose were measured on Hitachi-902. Echocardiography (Vivid 7) and electrocardiography (MAC1200ST) were performed. 305 survivors of Leningrad Siege (224 (73%) females and 81 (27%) males) were examined, the mean age was 70,5 yrs. In the control group were 46 patients with similar gender and age pattern — 31 (67%) females and 15 (33%) males, mean age was 71,3 years. All people were divided in two groups: who was born during the Leningrad Siege (45 (14,7%)) and before the Leningrad Siege (260 (85,3%) subjects) in the period from 1928 to 1941. Results. Siege survivors had lower anthropometric indexes but higher HDL level comparing with control group. There were no significant differences in the prevalence of cardiovascular disease in 2 groups: only chronic CHD was more often (48,9% vs 33,3%, р=0,04) and prevalence of atrial fibrillation was slightly lower (17% vs 8.5%, p=0,05) in siege survivors comparing with the controls. Survivors who were undergone the starvation during childhood and adolescent period more often had hypertriglyceridemia comparing with subjects after intrauterine starvation. Diagnosis of myocardial infarction (16 (19,8%) vs 16 (7,2%), p=0,002) and AF (13 (16%) vs 12 (5,35%), respectively, p=0,02) were detected more often in men comparing with women. Males less often had hypercholesterolemia (39 (48,1%) vs 170 (75,8%), р<0,0001) and abdominal obesity (43 (53,0%) vs 162 (72,3%), р=0,001) than females. Conclusions. No significant influence of starvation during Leningrad Siege on cardiovascular risk factors and diseases was revealed. Delayed consequences of starvation appeared to be less important than other risk factors and heredity predisposition.