Electrocardiography (ECG) takes the lead in assessing the prevalence of coronary artery disease (CAD) in the population. ECG disorders, grouped in the Major (certain) and Minor (possible) categories, ...are prognostic markers of a high risk of cardiovascular diseases and sudden cardiac death. Unified assessing methods of ECG disorders prevalence and their associations with socio-demographic parameters have not previously been made in Russia.
Aim.
To study the prevalence of ECG parameters of certain and possible coronary artery disease among population of Russia, depending on the socio-demographic characteristics — age, sex, education and place of residence (city or country).
Material and methods.
We used 17504 ECGs from representative samples of population (25-64 years old), who participated in the epidemiological study “Epidemiology of cardiovascular diseases and their risk factors in the Russian Federation”. The analysis using Minnesota code was carried out among men and women of four age groups, two educational levels, among citizens and countrymen.
Results.
The highest prevalence was observed in the “Certain” (5,7%) and “Possible signs of CAD” (7,1%) categories, in the “Certain” (3,8%) and “Possible myocardial ischemia” groups (4,9%), the smallest is in the “Rhythm and conduction disorder” (0,7%) and “STT changes in left ventricular hypertrophy” (0,4%) groups. It was shown that the frequency of ECG disorders increases with age, has an sharp increase after 55 years, regardless of sex. In the age dynamics of categories, STT changes and atrial fibrillation have a decrease of gender differences. All groups of ECG disorders are detected more often among men than women, except for STT changes. With an increase in the level of education, the frequency of ECG pathologies decreases, with the exception of the groups of “major” and “minor Q (QS)”, “major rhythm and conduction disorders”. The prevalence of most ECG disorders does not depend on the place of residence. However, signs of major myocardial ischemia in men are more common in country than in the city (3,9% vs. 2,7%, p<0,05).
Conclusion.
The results confirm the patterns identified earlier. There is a steady association of ECG data with socio-demographic characteristics.
We assessed effect of 6-weeks therapy with atorvastatin on parameters of lipid metabolism and some hemorheological characteristics in 27 patients with arterial hypertension (AH) and ...dyslipoproteinemia (DLP). In addition to general clinical examination we studied hemorheological profile including hematocrit, blood plasma and whole blood viscosity with the method of rotational viscosimetry at various shear rates, deformability of erythrocytes by filtration method, and cytoarchitectonics of erythrocytes. At the background of pronounced lipid lowering effect of atorvastatin we noted obvious improvement of microrheological properties of erythrocytes appearing as significant decrease of rigidity index of erythrocytes and of their aggregation. Basing on these findings we concluded that improvement of fluidity of erythrocytes promoting facilitation of blood flow efficacy in microcirculatory vascular bed can be a supplementary reason for administration of atorvastatin to patients with AH and DLP.
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.
It was investigated possibilities correction of quality of life and vegetative regulation in women with a primary osteoporosis in postmenopausal period by means of physiotherapy exercises course. ...Significant improvement of quality of life in patients with osteoporosis for the account antidepressive and analgesic properties of physiotherapy exercises, normalizing influence of physical rehabilitation on sympathetic department of vegetative nervous system is revealed. Dependence of influence of physiotherapy exercises on a condition of vegetative regulation of women with a primary osteoporosis from expressiveness of osteoporosis was established.
Aim. To reveal the associations of carotid arteries atherosclerosis severity and cardiovascular events in mostly middle aged population.Material and methods. In the study, 1100 persons participated ...of the ATHEROGEN-Ivanovo trial (substudy of ESSE-RF), age 40-67 y. o. All participants underwent duplex scan of carotid arteries (Samsung Medison MySono U6) with assessment of the number of atherosclerotic plaques (AP), maximum stenosis and total stenosis with calculation of gender-specific quintiles. With the Cox regression model, risk was estimated for combinatory endpoint including all-cause death, myocardial infarction, novel onset of coronary heart disease, stroke, any area revascularization. Median follow-up 3,8 years.Results. The AP were found in 74,5% males and 58,0% females. In males atherosclerosis was more severe: maximum stenosis 27 (0-34)% in males vs 22 (0-58)% in females (р<0,001), total stenosis — 48 (0-90)% vs 22 (0-31)% (р<0,001) and plaques number — 2 (0-3) vs 1 (0-2) (р=0,000). There were 24 endpoints documented. 23 of 24 endpoints occurred in persons with at least any ultrasound marker value within quintile ≥3. Regression showed that if at least one ultrasound marker should have reached the quintile ≥3 (e. g., maximum stenosis ≥25% in men), than the risk of events from combinational endpoint would increase 8,5 times — 95% CI 1,12-64,76 (p=0,039). Also, coronary heart disease increases the risk 4,05 times — 95% CI 1,46-11,21 (p=0,007), acute stroke 3,49 times — 95% CI 1,19-10,23 (p=0,023). The number of males with AP <25% was 15%.Conclusion. The presence of AP in carotid arteries does 8,5 times increase the risk of cardiovascular events, and for 15% of males in population with AP in carotid arteries that narrow the lumen <25%, it is needed to clarify the risk.
Aim. To analyze health care resource utilization and temporary disability in people of pre-retirement age in the Russian population.Material and methods. The analysis was carried out on the basis of ...the ESSE-RF study materials (13 regions of the RF). Standard epidemiological survey methods and evaluation criteria were used. The analysis included results of a survey of the ESSE-RF study participants about health care resource utilization and temporary disability (TD) during 12 months before the survey. The following characteristics were ascertained: a number and reasons of outpatient visits for medical assistance, hospital admissions (including duration of in-hospital treatment), emergency calls and temporary disability (a number of days and cases), their mean number per one study participant, mean number of cases and days of TD per 100 working participants, associations with social-demographic parameters, risk factors, chronic non-communicable diseases, stress and anxiety levels by the Hospital Anxiety and Depression Scale (HADS).Results. A total of 8334 people aged 50-64 years were examined: men – 2784 (33%) and women – 5550 (67%). A share of the hospitalized (at least one time) was 11% in the age group of 50-54 years, 12% – in the age group of 55-59 years and by the age of 60-64 this indicator increased to 15%. 20% of the participants at least one time were admitted to hospital and/or called an ambulance. A share of people who had utilized health care resources at least one time was increasing with age. Unemployed people were hospitalized more frequently than employed ones. Number of chronic non-communicable diseases correlated with the probability of hospitalization and/or emergency call. Categories 2 and 3 of disability, presence of diabetes mellitus, ischemic heart disease and hypertension were statistically significantly associated with the probability of hospitalization and/or emergency call. Smoking did not increase the probability of hospitalization and/or emergency call in comparison with absence of this risk factor, at that, people who had given up smoking were 1.3 times more likely to be hospitalized than non-smokers. People with low and moderate alcohol consumption were hospitalized and called an ambulance significantly less often than those who abstained from alcohol. Clinically significant anxiety increased the probability of hospital admission and/or emergency call as compared to people without this factor by the HADS. Subclinical and clinically significant anxiety, mean and high levels of stress were associated with the probability of hospitalization and/or emergency call. Number of TD days turned out to be rather low - 0.3 day per 1 working man and 0.4 day - per 1 working woman, this index did not significantly differ with age.Conclusion. So, pre-retirement age (50-64 years) is characterized by increase in health care resource utilization due to health state worsening. At the same time significant share of people of this age (40%) did not seek medical help. These 40% of pre-retirement age people can be possible reserve for health state improvement by means of their active involvement in preventive activity of primary health care system (the study had been conducted before the preventive medical examination program starting).
Aim. To study hemorheological disturbances in patients with essential arterial hypertension (AH) and dyslipidemia (DLP). Material and methods. In total, 83 AH patients without target organ disease ...were examined, including 30 without lipid metabolism disorders and 53 with DLP (total cholesterol, TCH >5 mmol/l and/or triglycerides, TG >1,7 mmol/l). All participants underwent general clinical examination and hemorheology assessment (hematocrit, plasma viscosity, blood viscosity by rotation viscosimetry at various shift speeds, erythrocyte aggregation (EA) by optic and automatic methods, erythrocyte deformability (ED) by filtration method, and erythrocyte cytoarchitectonics). Results. In patients with AH and DLP, comparing to healthy participants, impaired blood rheology was observed, manifesting in increased blood viscosity in high and average shift speeds, increased EA and impaired ED, which correlated with lipid metabolism disturbances. Conclusion. In patients with AH and DLP, blood rheology parameters were significantly affected due to disturbed lipid metabolism.
Aim. To study social and economic gradients — educational and occupational statuses, wealth level, behavioral risk factors (FR) in Russian population by the ESSE-RF data.Material and methods. The ...data for the analysis consisted of representative selections of 13 regions of RF (n=22906) participants of the study, incl. men (n=8353) and women (n=13553) of 25-64 y.o., with response 80%. We calculated the odds ratios for the presence of behavioral FR: smoking, excessive alcohol consumption, insufficient physical activity (IPA), nonrational food consumption, anxiety and depressive disorders, — in persons from different social and economic groups by education level, type of inhabitation, professional status, wealth level.Results. Higher education was associated with better FR profile, except IPA (negative association) and alcohol consumption (absence of association). "White in general had less FR probability than Blue, excl. IPA and psychoemotional deviations (in men). As for the wealth association with the FR there is backward gradient, i.e. lesser the income, higher the risk of FR presence, excl. IPA and excessive alcohol intake in women. For example, in very wealthy men the odds ratio for depressive states was 3,09 95% CI 2,08-4,57 comparing to the persons with low income. The type of territory of inhabitance was associated with less behavioral FR in Russian population, as significant associations are found only for depression and excessive salt consumption in both genders and IPA in men. Conclusion. The significant social and economic gradients of behavioral FR prevalence are found, the direction of those is not necessary the same as in European countries. The analysis of association with social and economic parameters would help to develop the directed preventive interventions.
Psychological characteristics of 59 women with low parameters of bone mineral density (BMD) in comparison with 21 woman with normal BMD in postmenopausal period were investigated. Dual energy x-ray ...absorpiometry performed to all patients. Symptoms of anxiety were estimated by Spielberg and Khanin's method, a level of depression by CES-D questionnaire, subjective characteristics of state of health and level of pain by visual - analog scale.
Clinically significant symptoms of anxiety and depression took place at women with low BMD. The interrelation of level BMD with expressiveness of depression and anxiety was revealed at patients with osteoporosis.
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