Aim . To determine the role of cardio-ankle vascular index (CAVI) in predicting cardiovascular events (CVEs) in adult Russian population using model of the Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation (ESSE-RF) study (Tomsk). Material and methods . We analyzed the data of 1342 people aged 25-64 (4,3±11,6) years, in whom arterial stiffness was assessed as part of the ESSE-RF study using the vascular screening system VaSeraVS-1500, followed by phone contacts, on average, 4,7 years later. We studied the prognostic role of CAVI in relation to primary composite (cardiovascular death, nonfatal myocardial infarction (MI) or stroke) and secondary composite (all CVEs) endpoints. Results . We revealed that prior myocardial infarction or stroke (n=52) is associated with an increase in CVE incidence from 2,3 to 11,5% (p=0,0003) and from 5% to 23% (p 7,8 (relative risk (RR): 5,06; 95% confidence interval (CI): 2,32-11,06) (p<0,001) and (RR: 3,95; 95% CI: 2,37-6,58) (p<0,001), which retains its predictive value when adjusted for conventional risk factors (RR: 3,13; 95% CI: 1,26-7,75) (p=0,014) and (RR: 2,16; 95% CI: 1,18-3,98) (p=0,013) — primary and secondary composite endpoints, respectively. Conclusion . CAVI has a significant independent value in predicting CVEs in Tomsk adult urban population aged 25-64 years. To clarify the cardiovascular risk, vascular screening with identifying CAVI should be carried out during preventive and screening examinations for men over 35 and women over 45.

Aim . To study the relationship between carotid plaque burden and conventional, behavioral, and social cardiovascular risk factors. Material and methods . The object of the study was 469 people (women, 49%) from a representative sample of the general population aged 25-64 years (crosssectional ESSE-RF study) with the presence of one or more atherosclerotic plaques in the carotid arteries. The study participants underwent cardiac screening and carotid ultrasound. All respondents signed informed consent. The number of involved segments and the average plaque height were studied. The associative analysis included blocks of conventional, social, and behavioral risk factors for cardiovascular diseases. The study of relationships was carried out using linear and log-linear models. An error probability <5% was considered significant. Results . According to multivariate analysis, age (in men), male sex, smoking, systolic blood pressure (SBP), total cholesterol, heart rate, alcohol abuse, statin and β-blocker therapy were interrelated with the number of involved segments. In turn, the average plaque size was associated with age (in men), male sex, higher education, alcohol abuse, smoking, and high-sensitivity C-reactive protein. Conclusion . The results obtained confirm the leading role of age (in men), smoking, SBP, total cholesterol, β-blockers as indicators of the number of involved segments. Alcohol abuse and heart rate have shown associations between the ages of 40-50 years and thus may contribute to premature atherosclerosis. Key role of age (in men), sex (among those ≥50 years old), and educational status in average plaque height in this study was confirmed. A significant contribution was also made by alcohol abuse, smoking, high-sensitivity C-reactive protein. The obtained data do not confirm the hypothesis about the contribution of atherogenic lipoproteins and SBP to average plaque height. The study results can be useful for studying the plaque burden role in risk stratification and further development of cardiovascular prevention.

Aim . To analyze factors associated with the probability of antihypertensive drugs (AHD) receiving in the population of patients with arterial hypertension (AH). Material and methods . 334 hypertensive men and 436 women of 25-64 years old from the representative sample of general population were examined. The associative analysis included socioeconomic, psychosocial, behavioral and biological variables. Univariable and multivariable (logistic regression) statistics were applied. The error probability <5% was considered statistically significant. Results . Over 60% of the low/moderate cardiovascular risk (CVR) hypertensive women were taking medications. The highest medication rate was found at very high CVR. Men with high CVR have showed lower medication rate than expected. There is a reserve for more complete treatment coverage among those with very high CVR. Factors of nontaking medications in both genders included: being non-informed of elevated blood pressure (BP), lack of knowledge of own BP, AH absence in the relatives, higher education. Younger age, intensive smoking (in those without chronical heart disease), non-attendance of a doctor over the past year correlated with lower odds of medication in men whereas SCORE 10 and above, and occupational physical activity pattern “walking mostly” were associated with lower odds of medications in women. Conclusion . We emphasize several factors, associated with lower odds of taking medication in the hypertensive population. These factors should be considered when developing tools to help motivate obviously healthy people to participate in screening programs and to explain risks and potential benefits of a conscious attitude to hypertension problem.

Aim. To assess rate of familiarity and specifics of treatment with statins among the citizens of economically active age with various cardiovascular risk by the data from epidemiological study ESSE-RF (Epidemiology of Cardiovascular Diseases in Different Russian Federation Regions). Material and methods. In the work the data from ESSE-RF study was used,  of representative  selection  of non-organized  male and  female inhabitants aged 25-64 y.o. from 13 regions, investigated during 2012-2014. Responded ~80%. The study included questionning by standard scale that included data on the anamnesis, etc. Lipid profile, including total cholesterol  (TC), cholesterol  of lipoproteids low and high density were measured at SSRCPM and RSPCC. Results. Analysis of the whole selection showed that 20% of men and 32% of women knew their TC, and 13,6% and 18,2% were even familiar having increased  level of TC. Part of those with high and very high risk was 31,3%, incl. men — 42,2%, women — 30,9%. Statins took ~7,0% of patients from this risk category. Effectiveness of treatment (target levels reached  of low density cholesterol) in these groups of men and women was 14,4% and 4,8%, respectively. Conclusion. The data obtained in populational study points on insufficient knowledge and low rate of statin treatment  of the persons with high and very high cardiovascular  risk in RF, which confirms the anxiety provoking data of registries and other studies. The data dictates necessity  of development  and implementation of specific educational programs for citizens, of physician improvement and availability of cheap but effective lipid-lowering medications.

Life quality (LQ) is an integrated parameter of the health, applied for integral characterization of population health, and as the parameter of healthcare interventions effectiveness. Aim. To assess LQ in Russian population at the age 25-64 y. o. in general and in various socio-economical groups using EQ-5D, by the results of ESSE-RF (2012-2013) study. Material and methods. LQ was assessed on representative selections of inhabitants of 13 Russian Federation regions, aged 25-64 (males 8327, females 13497) with response 80%. LQ was assessed via international questionnaire EUROQOL — EQ-5D: 1) no decline; 2) mild decline; 3) significant decline; scoring also performed with visualanalogue scale (VAS). Integral LQ by EUROQOL performed with Shaw JW et al. method (ranging from 0,0 (death) to 1,0 (perfect health)). Result. EQ-5D index of Russian population was 0,87 with no  gender difference. By the increase of the age LQ declines. Educational gradient of LQ was significant only in VAS (p<0,05). Wealth level negatively associated with LQ. Most common (p<0,0005) were disorders by the components pain/discomfort and anxiety/depression. Part of those with lower LQ among males is lesser than in females, by all 5 factors of the LQ, and in all educational states. Regional specifics of LQ by EQ-5D index: from 0,82 in Vladikcaucas to 0,95 in Orenburg (p<0,0005). There was significant correlation of EQ-5D index with unemployment level (0,4) and consumer prices index (0,29) in regions. Conclusion. Monitoring of LQ is necessary condition for assessment of efficacy of population health improvement interventions, and the LQ values obtained will be useful as populational norms for health condition assessment in addition to morbidity and mortality factors.

The aim of the study was to investigate the multifactorial associations between the traditional cardiovascular risk factors and prevalence of carotid atherosclerosis in general population of Tomsk. Cross-sectional epidemiologic study of general Tomsk population aged 25-64 years (n=1600) consisted in screening examination of extracranial carotid vascular bed to detect the presence of atherosclerotic plaques by ultrasonography. We examined age, gender, smoking exposure duration, total cholesterol, high density cholesterol, abdominal obesity, low educational status, systolic blood pressure, hsCRP, fasting plasma glucose, diabetes mellitus, antihypertensive treatment, and cholesterol-lowering treatment as potential determinants of carotid atherosclerosis. To study associations, we used logistic regression analysis. Error probability <5% was considered as statistically significant. Single-factor analysis showed that all factors were significantly associated with carotid plaque prevalence. After adjustment for age and gender, only three factors, namely: total cholesterol, smoking exposure duration, and low education were significantly associated with carotid plaques. Multiple regression analysis showed that eight factors correlated with carotid plaque prevalence in an independent manner. Among these factors, the most influential determinants of carotid plaques were age, total cholesterol, smoking exposure duration, high density cholesterol, and gender. Results of the study provide rationale for more efficacious control of target lipid profile parameters, first of all, of total cholesterol, as well as for prevention of smoking exposure to reduce prevalence of atherosclerosis in the adult urban population of Siberian region.

Целью исследования был анализ распределения полиморфизмов I/D, Т786С, T1565C и H1/H2 генов ACE, NOS3, ITGB3, P2RY12 и их ассоциации с уровнем глюкозы и общего холестерина у женщин трудоспособного возраста, проживающих на территории Западной Сибири. В исследование включены 138 женщин в возрасте 51,6±7,5 лет, постоянно проживающих на территории г. Томска. Содержание глюкозы определяли с помощью ферментативного колориметрического теста (Biocon ®Diagnostik, Германия), основанного на реакции Триндера, а содержание ОХС - на биохимическом анализаторе Clima MC- 15 (Испания). ДНК выделяли из лейкоцитов венозной крови с помощью «Wizard Genomic DNA Purification Kit» («Promega», USA). Полиморфизмы генов определяли путем аллель-специфичной полимеразной цепной реакции с использованием наборов «SNP-Express» («ЛИТЕХ», Россия) и электрофоретической детекцией продуктов реакции. В выборке женщин трудоспособного возраста, проживающих в г. Томске, частота аллелей D, 786С, 1565С и гаплотипа H2 генов ACE, NOS3, ITGB3, P2RY12 составила 49 %, 31 %, 12 % и 16 %, соответственно. Распределение генотипов соответствует равновесию Харди-Вайнберга. Уровень ОХС составил 6,1±1,20 ммоль/л, а уровень глюкозы в крови - 4,9 (4,3; 5,4) ммоль/л. У носителей аллеля 1565С гена ITGB3 содержание ОХС выше, чем у носителей генотипа TT (p<0,05). Уровень ОХС не зависел от полиморфизмов других генов. Ни один из рассматриваемых полиморфизмов не влиял на содержание глюкозы. В выборке женщин Западной Сибири частоты полиморфизмов I/D, Т786С, T1565C и H1/H2 генов ACE, NOS3, ITGB3, P2RY12 близки к таковым в европейских популяциях. Носительство аллеля 1565C гена ITGB3 ассоциировано с повышенным уровнем ОХС.

Aim. To study the association of high-sensitivity C-reactive protein (hsCRP) level with socio-demographic, behavioral and traditional risk factors in different regions of the Russian Federation (RF). Material and methods. Data of the multicenter epidemiological study of cardiovascular disease in different regions of the Russian Federation (ESSE-RF) were used. Representative sample of the unorganized male and female population aged 25-64 from 6 regions of the Russian Federation was drown. 3407 men and 6354 women (n=9761) were included into the study. Standard questionnaire was applied in all subjects. Gender, age, level of education, place of residence and region of residence, traditional risk factors and diseases were analyzed. HsCRP level (level ≥3.0 mg/l was defined as elevated one) was evaluated to detect of indolent inflammation. Results. HsCRP levels in women was significantly higher compared to males (p<0.005). The average prevalence of elevated hsCRP in the regions was 24.2%, for men - 21.4%, and for women - 25.7% (p<0.005). Significant age-related dynamics of hsCRP (p<0.0001) was found. The average level of hsCRP was significantly lower (p<0.0001) in a cohort of persons with higher education against these with lower level of education. Level of hsCRP as well as prevalence of elevated hsCRP level were higher in villagers than this in the urban population (p<0.05). Prevalence of elevated hsCRP in patients with traditional risk factors after adjustment for sex, age, and region of residence showed that the elevated hsCRP was mostly associated with metabolic factors and diseases that were characterized by systemic inflammation. Conclusion. Elevated level of hsCRP (≥3.0 mg/l) was significantly associated with female gender, with an older, less educated, and smoking population of Russians. After the multivariate adjustment there remained significant associations (p<0.0001) of elevated hsCRP level with obesity, including abdominal obesity, hyperglycemia and hypertriglyceridemia, low levels of low density cholesterol, rheumatoid arthritis, chronic bronchitis and Parkinson's disease.

Aim. To analyze spread of alleles and genotypes of ACE gene in CHD patients of different gender and age and to study their realtion with MI risk. Material and methods. Totally 326 individuals of both age, Tomsk city inhabitants, aged 34-79 y. o., included into the study. Of those 173 CHD patients having MI anamnesis and 153 healthy individuals. For the entire group the I/D polymorphism of ACE gene with PCR method using primers by AmpliKit Company (Saint-Petersburg). For the analysis of frequency spread of alleles and genotypes the χ2 criteria used, precise Fischer test and relative risk estimation. Results. By the results of statistic analysis there were no difference between control and patient groups by the prevalence of ACE genes and alleles. While studying women separately there were no siginificant differences between patients and controls in genotypes and alleles. In men with MI in anamesis there was increase of DD genes prevalence comparing to healthy individuals (p=0,038). The analysis of MI prevalence and I/D polymorphism in men and women was performed with relation to age. It is shown that in men younger than 50 y.o. homozygotes there are moreprevalent II and DD genotypes, than in men older than 50 y.o., whom ID genotype is more prevalent (p=0,031). In women group the difference between those younger and older than 55 y.o. the spread of genotypes was similar, but there were more prevalent MIs in older group (p=0,020). Conclusion. The important points of I/D polymorphism of ACE genes influence on MI risk was shown. Among women, sick and healthy, and of various age, there were no significant differences in genitypes prevalence. However there are statistically significant differences in the genotype spread was found in healthy men and men after MI, and in men with the age of 34-50 and 51-79 y.o.

Objective: to study prevalence of abdominal obesity and arterial hypertension as metabolic syndrome components among secondary school teachers of Tomsk, aged 35-64 years. Cardiac screening in the organized population of teachers was performed at the working place, the response rate was 84%. The study revealed high prevalence of abdominal obesity -64% by IDF-2005 and VN0K-2009 criteria, and 41.4% by NCEP ATP III 2005 criteria. Elevated blood pressure as per metabolic syndrome criteria was found in 46.9% of cases. Arterial hypertension was fixed at the working place in 33.5% of the respondents. Growth of abdominal obesity and arterial hypertension rates was found to be associated with age.