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Aim. To assess vascular age (VA) and the main cardiovascular risk factors (chronological age, body mass index (BMI), carotid-femoral pulse wave velocity (PWV), blood pressure (BP)) in women in the Moscow region.Material and methods. We assessed BP levels, BMI, PWV, and also calculate vascular age for women participating in the forum. BMI was calculated using the Quetelet index as weight divided by height squared (BMI=kg/m2). BP levels were measured in a sitting position three times on both arms, with the highest result recorded. PWV and vascular age were calculated using AngioScan01. The association between anthropometric measures, vascular stiffness, and VA differences was examined using multivariate linear regression, adjusting for traditional cardiovascular risk factors. Intergroup (systolic blood pressure

Alcoholic cardiomyopathy (ACM) is considered an independent disease, the diagnosis of which is based largely on prior alcohol abuse and the exclusion of other cardiomyopathy causes.Aim. To discuss the accounting and accuracy of the analysis of ACM mortality, including assessing the variability and changes of regional standardized mortality rates (SMR) for 2013-2021, as well as to conduct an analysis of Medical Certificate of Cause of Death (MCCD) and discuss the criteria for ACM as the underlying cause of death (UCD).Material and methods. Rosstat data on the average annual population and ACM death rate (I42.6) in 2013-2021 by region were analyzed. SMRs were calculated using software. To analyze MCCDs, anonymized data from the Department of Civil Registration of the Moscow Oblast (3538 MCCDs in total) were used.Results. In 2013, the regional average SMR from ACM was 14,0±13,9 per 100 thousand population, in 2021 — 13,2±13,6. The only region with annual SMR decrease was the Tyumen Oblast. Zero values were registered in the republics of Ingushetia and Chechnya. In other regions, “wave-like” changes were noted — a decrease or increase in SMR. The coefficient of variation of the SMR was minimal in 2016 (73%) and maximum in 2021 (103%). The contribution to mortality varied from 0 to 6%. Heart failure group codes (I50) were indicated as the immediate cause of death in 93,3% of MCCDs. Part II of the MCCDs was completed in 39,1%. The most common cause of death is group F10 (mental and behavioural disorders due to use of alcohol) and group K70 (alcoholic liver disease). In the literature and guidelines there are no clear criteria for ACM as UCD. The indication of alcohol-related codes in Part II of the MCCD is contrary to the ICD rules.Conclusion. Significant regional variability in SMR from ACM may be due to problems in UCD determination. And despite the small contribution of ACM to allcause mortality, a consensus statement is required on the criteria for diagnosing and completing the MCCD.

Aim: To perform clinical characterization of patients with chronic heart failure (CHF) in the Moscow Region and to assess if their current treatments meet the current clinical guidelines.Materials and methods: Based on the information submitted from 11 outpatient clinics in the Moscow Region in December 2019, we analyzed retrospective data on 286 patients with CHF, including their concomitant diseases, types of assessments and their results, as well as current treatments.Results: The most common concomitant disease was arterial hypertension (95.1% of the patients). 53.8% of the patients had previous myocardial infarction, 37.8%, diabetes mellitus, and 34.6%, atrial fibrillation. Chronic kidney disease was present in 18.5% of the patients, valvular heart disease in 11.9%, and past stroke in 10.5%. Of non-cardiovascular diseases, the most common were gastrointestinal disorders (25.2%), chronic obstructive pulmonary disease or asthma (9.8%), and anemia (5.2%). Only 8% of the patients had one concomitant disease, whereas 72% had 2 to 3 diseases, and 20% had at least 4 concomitant diseases. Mean number of comorbidities per patient was 2.7. Echocardiography had been performed in 82.9% of the cases. Mean left ventricular ejection fraction was 51.0±10.11%; in 11.5% of the patients it was≤40%. Glomerular filtration rate (GFR) was calculated in 58.7% of the patients. 35.9% of the patients had a GFR of less than 60 mL/min/1.73 m2 , in 3.6% it was≤30 mL/min/1.73 m2 . 83.2% of the patients were treated with renin angiotensin aldosterone system blockers (angiotensin-converting enzyme inhibitors, angiotensin receptor antagonists, sacubitril/valsartan), 79.0% with beta-blockers, 53.1% with mineralocorticoid receptor antagonists. Glycosides had been administered to 6.9% of the patients, and diuretics, to 51.1%. In most cases, the doses administered were below those recommended by the international clinical guidelines.Conclusion: We have confirmed the need to increase the adherence of doctors to the clinical guidelines on assessment and management of CHF patients.

Aim. According to data from the Moscow Oblast civil registry office in 2020, to analyze medical certificates of cause of death (MCCD), where the code from “Ischemic heart disease” (IHD) (I20-I25) group is indicated as underlying cause of death (UCD).Material and methods. A total of 23193 deaths with I20-I25 codes (UCDs) were included. We assessed the prevalence of individual IHD types, the frequency and patterns of complications, the average age of deceased persons, the proportion of women and men, place of death registration.Results. The average age of the deceased was 73,6±12,5 (men, 68,8±10,5; women, 78,4±12,5; p50%. Half of the deaths were registered at home, a third in a hospital, and the rest elsewhere. Taking into account age and sex, inhospital death from myocardial infarction (MI) is recorded 12 times more often than in “other forms of acute IHD”. Chronic forms of IHD were registered in 76,9% of cases; in 47,3%, such IHD form as “Atherosclerotic heart disease” was noted. The proportion of deaths from acute MI and deaths after MI was 37,3%. In 92,1% of MCCDs of “other forms of acute IHD”, “acute coronary insufficiency” is indicated. Differences in the prevalence of various IHD forms between men and women were significant (p

The role of heart failure (HF) in mortality rates is ambiguous, and much depends on assessment criteria and accounting potential.Aim. Using medical certificates of cause of death (MCCD), to assess rates of HF, taking into account different types of coronary artery disease (CAD), sex, age and place of death.Material and methods. Data on deceased persons for 2020 were obtained from the electronic database of the Main Department of Civil Registry Office of Moscow Oblast, using the 4-digit codes of the International Classification of Diseases, Tenth Revision (ICD-10). All deaths with CAD codes (I20-25) were selected. A total of 23193 deaths were included in the analysis. The codes and verbal descriptions of complications were assessed and 3 groups were formed: without indication of heart failure (HF), with indication of HF (without chronic HF) and CHF in MCCD. Comparison of the average age of deceased, the proportion of women and men, the detection rates of certain CAD types and the place of death was carried out. Using logistic regression, the probability of chronic HF/HF as a death cause was determined, taking into account other factors.Results. Any HF was indicated in 78,9% of the MCCD (acute CAD — 44,5%, chronic CAD — in 89,1%). Chronic HF was indicated in 27% of the MCCD (men, 30,9%; women, 22,9%; p

Changes in provision of elective care during coronavirus disease 2019 pandemic require search for new forms of doctor-patient communication. Telemedicine technologies have become widely used for monitoring of patients, especially those with noncommunicable diseases. However, the introduction of telemedicine care is associated with a large number of medical, legal and technical issues. Rational use of telecommunication within the modern clinical guidelines will significantly increase the availability of high-quality healthcare and reduce the hospitalization rate for exacerbation of chronic diseases, as well as improve disease outcomes.