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Aim: To analyze the efficiency of prophylactic medical examination for malignancies that considerably contributes to adult mortality., Material and Methods: The data of the national health statistics (Form 131/o, 7, 35) were used to make an expert analytical assessment of the results of prophylactic medical examinations for cancer in certain adult population groups in Russia in 2013-2014., Results: Medical examinations covered 20.5 and 22.5 million people in 2013 and 2014, respectively. The proportion of 21-36-, 39-60-, and over 60-year olds was 36, 42, and 22%, respectively. All the age groups showed a preponderance of women with their larger proportion in the older age groups (55, 58, and 64%, respectively). In 2013 and 2014 there were 27,173 and 34,638 detected patients with malignances, including 17,095 (62.9%) and 20,944 (60.5%) women and 10,078 (37.1%) and 13,694 (39.5%) men, respectively. In these years, the breast (28 and 30.5%), prostate (13.9 and 18.5%), rectum (6.5 and 7.5%), stomach (6.3% and 7.8%), lung (6.1 and 7.3%) ranked fifth in cancer sites. There was a 17.6% increase in the detection rate of malignancy among the first identified patients during prophylactic medical examinations and and a 10.2% increase among all actively detected patients in 2014 versus 2013. The older age groups exhibited a rise in cancer detection rates, the most significant (11.8%) increase being in the women older than 60 years of age., Conclusion: The malignancy detection rates were noted to be on the rise, although there are defects in organizing prophylactic medical examination, ensuring the complete scope of necessary investigations, and interpreting the findings. The measures methodically supported a by regional cancer may provide a guide to solving these problems. At the same time, efforts are needed to actively attract citizens in the participation in prophylactic medical examination and in the development of behavioral attitudes associated with the higher responsibility for maintaining personal and public health.

Aim: To estimate circulatory diseases (CD) detection rates during prophylactic medical examination of the adult population and to define their association with mortality rates and the spread of risk factors., Material and Methods: The results of the 2013-2014 prophylactic medical examinations for CD in the adult population of the Russian Federation as a whole and its subjects were comparatively analyzed using the data of statistical reports and official medical statistics on morbidity and mortality in the adult population., Results: The data of official statistical reports on the results of prophylactic medical examinations in 2013 (19.4 million) and 2014 (22.2 million) were analyzed. In 2013 and 2014, there were 85.9 and 82.7 CD cases per 1000 examinees, respectively. These years were marked by the detection of 50.0 and 46.2 hypertensive patients, 17.1 and 16.1 coronary heart disease (CHD) cases, and 11.5 and 11.2 cerebrovascular diseases (CVD) ones, respectively. In 2013 and 2014, most CD cases were caused by hypertension (58.4 and 57%, respectively). The proportion of CHD was 19.9 and 19.4% and that of CVD was 13.4 and 13.6%, respectively., Conclusion: The analysis carried out could provide evidence for the importance of continuous monitoring of prophylactic medical examination at the level of each specific healthcare facility for primary health care to improve its quality and completeness of diagnostic examination. The found interregional differences in the detection rate of CD call for detailed analysis and determination of their causes, which will ensure the preventive direction of a medical examination that is inextricably entwined with further active follow-up measures for patients having the identified diseases and a risk for their development.

Aim: To study the efficiency of a methodology for the active detection of coronary heart disease (CHD) and cerebrovascular diseases (CVD) during medical examination and to determine the need and possible ways of its improvement., Subjects and Methods: The medical examinations of 19.4 million people (94.6% of all the citizens who had undergone medical examinations in all the regions of Russia in 2013) were analyzed and the methodological aspects of identification of the circulatory diseases (CDs) that were induced by coronary and cerebral vessel atherosclerosis and had common risk factors, primarily CHD and CVD, were assessed., Results: The medical examinations revealed 2,915,445 cases of CDs and their suspicions, during which its clinical diagnosis was established in 57.2%. The suspected disease requiring that its diagnosis should be further specified; off-medical examinations revealed hypertension in more than 770,000 cases, CHD in 232,000, and CVD in 146,000. The proportion of stable angina pectoris of all angina cases was much higher at a young age (25.6%) than at middle (15.6%) and elderly (11.3%) ages. Brachiocephalic artery stenoses were detected in almost 13,000 cases. According to the official health statistics, within the years preceding the introduction of large-scale medical examinations, there was a slight rise in new CD cases among the adult population of Russia, which was more significant in 2013 (according to the preliminary data) than in 2012., Conclusion: The methodology for the active detection of CDs through a two-step medical examination, which is used during a follow-up, makes it possible to substantially increase detection rates for CDs. There has been shown to be a need for the better quality and completeness of diagnostic examination in real practice.

The paper deals with the justification and description of clinical and organizational approaches to preventing cardiovascular diseases (CVD) in the primary health care system (PHCS) under the present conditions of health care modernization in Russia. It formulates the basic directions of systematic measures in integration strategies for the prevention of noncommunicable diseases (mainly CVD) at a federal level, in which practical measures are presented to improve a system for the early detection of high-risk individuals and to carry out measures for risk factor correction in PHCS, i.e. to implement high-risk strategies, including clinical and organizational approaches to reconstituting the medical prevention infrastructure in PHCS. This is favored by the new normative documents adopted by the Ministry of Health of Russia on the follow-up and prophylactic medical examinations of the adult population. The paper substantiates the objective need for such examinations and characterizes the main clinical and organizational approaches promoted in medical examinations, which is aimed at introducing the current science-based and economically expedient methods in the real practice of PHCS for the early identifications of atherosclerosis-induced major CVDs and, what is particularly important, a risk for their development. Prophylactic counseling as a compulsory component is first being introduced in medical examination procedures. The key clinical and organizational principle of effective CVD prevention in public health is the implementation of the relationship and continuity of preventive measures, which becomes realistic with the adoption of new regulations of clinical examinations, prophylactic medical examinations, and follow-ups. The improvement of CVD prevention is associated not only with the introduction of organizational innovation changes, but also with the need to create a prevention ideology in physicians at all levels. It is emphasized that a comprehensive approach and all integrated CVD prevention strategies both at the population level and in the PHCS facilities are the most efficient and cost-effective procedure to reduce premature deaths from CVD in the population and to improve the demographic situation in our country.

In total 256 patients with arterial hypertension were examined in one of the districts of out-patients clinic. Preventive clinical investigation revealed high frequency of nutrition disorders, overweight, obesity and hypercholesterolemia. On the base of these results necessary size and character of dieteologic intervention were evaluated. 90.2% patients with arterial hypertension need overweight and obesity correction, 90.3%--correction of hypercholesterolemia. It was determined that by majority patients recommendations must be aimed to decrease of fat consumption, cholesterol, simple carbohydrates, salt and vegetables and fruits.

Specialization computers programme investigation of dietary risk factors in organized population of universities employers revealed high abundance of this behavior chronic disease risk factors: disturbances of dietary regimen, high salt intake, high intake of saturated fats (butter) and eggs. The study showed significant relationship between abdominal obesity and high blood pressure, total plasma cholesterol also was significantly higher in persons with abdominal obesity.

Aim of the study was to assess efficacy of educational technology--School for patients with stable angina--in conditions of practical health care. We randomized 100 patients with ischemic heart disease (IHD) and stable FC I-III angina into 2 groups one of which went through learning in a School for patients with IHD (6 90 min sessions 2 times a week). Patients of both main and control groups were followed up for 12 months. During the whole term of the investigation in both groups observation and treatment of patients was conducted by physicians of city polyclinic in accordance with generally accepted method of care of patients with diagnosis "IHD, stable angina pectoris". Results of the investigation evidence that studying in the School for patients with stable angina significantly elevates level of medical information adopted by patients, ensures positive dynamics of the whole row of clinical and psychological parameters as well as integral parameters of quality of life of patients with IHD.

Novel innovative technology of assessment of level of total cardiovascular risk with consideration of a broad list of parameters of the state of individual health and its determining factors is described. The proposed model of risk is based on results of 20-year prospective observation of large contingents of population of Russia. For the first time the model of risk was constructed taking into account in addition to traditional risk factors and clinical characteristics peculiarities of population of Russia, in particular level of education. It was found in prospective studies that level of education in this country appeared to be an independent marker of risk and that traditional risk factors (behavioral, biochemical etc) had different prognostic value at different levels of education. Novel scale of risk and elaborated on its basis computer program of risk assessment allow to widen indications to its application, elevate accuracy of estimation of risk of development of fatal cardiovascular diseases for population of Russia, to obtain for a concrete patient parameters of absolute as well as relative risk (in % of excess or lowering of risk relative to its average statistical value for population with same age, sex, and level of education). The elaborated technology of estimation of total individual risk was tested on various contingents of patients with verified diagnoses of cardiovascular diseases as well as in groups of relatively healthy volunteers. Medical technology of risk assessment by novel scale is designed for application during primary screening of various population groups and can be fulfilled by both physicians and intermediate medical personnel. At present the computer program for assessment of cardiovascular risk based on this novel method is being prepared for clinical testing and subsequent implementation.

Aim: Integration of noliprel treatment of arterial hypertension with educational programs on correction of associated risk factors in outpatient practice for reduction of the overall cardiovascular risk., Material and Methods: An open, multicenter, non-comparative trial with participation of 140 physicians from 14 regions of Russia comprised 1195 patients aged 30-65 years with mild-to-moderate hypertension (SBP = 140-179 mmHg, and/or DBP = 90-109 mm Hg) who had never received regular antihypertensive therapy. This one-year study had an active 3-month stage and follow-up stage for 9 months., Results: Noliprel significantly decreased both systolic and diastolic blood pressure. The response to the treatment was achieved in 95.6% patients, the target blood pressure was achieved in 76.2% patients. A mean level of total cholesterol lowered from 5.5 +/- 1.0 mmol/l to 5.1 +/- 0.8 mmol/l (p < 0.001), body mass index--from 28.4 +/- 4.5 to 27.2 +/- 4.3 (p < 0.001). Hypercholesterolemia occurred before the study in 65.5% patients, at the end of the study--in 49.2%, obesity was registered in 79 and 70.2%, smoking in 21.6 and 14.6%, respectively. The mean overall risk to develop fatal cardiovascular events reduced from 2.5 +/- 3.6% at initiation of the study to 1.3 +/- 1.8% in the end of the study (p < 0.001)., Conclusion: The integration of medication with noliprel and training program successfully lowered overall risk to develop fatal outcomes of cardiovascular diseases in primary health care service.

Background: Chronic obstructive pulmonary disease (COPD) is a worldwide public health problem with increasing morbidity and mortality. The aim of this proposal is to contribute to the improvement of COPD prevention by identifying groups at risk for COPD and targeting them for preventive interventions., Methods: Based on the existing organizational structures for COPD detection, detailed analysis of the determinants of COPD will allow to identify groups at high risk to develop COPD. The Stepwise Target Group-Oriented Prevention (STOP) model developed during this study proposes an integrated identification and intervention strategy for high-risk groups., Results: Apart from smoking, other environmental determinants and host factors contribute to further lung function's rapid decline. Combined with smoking, these factors increase the risk for COPD. Target groups for early disease detection and appropriate interventions can be identified by the presence of one or more known risk factors and by identification of high-risk groups., Conclusion: The Stepwise Target Group-Oriented Prevention (STOP) strategy is a step toward improvement in COPD prevention, by shifting the focus from the group of a focus symptomatic smokers aged 45+ years to much earlier and preventable stages of the disease, that is, from disease treatment to risk management.

The aim of the present study is to evaluate the alimentary disorders in patients with high risk for cardiovascular diseases, also in patients with arterial hypertension (AH) and njn--insulin-diabetes mellitus (DM). The results showed that patients with AH (155 patients) and DM (107 patients) have high prevalence of the alimentary disorders: high consumption of total fat--46% (DM) and 70.9% (AH), high consumption of carbohydrates--14.9% and 73%, salt intake--34.9% and 68.6%, respectively. Application of special training programs in groups provided stable modification of dietary habits and was more effective, compared with the traditional ones. These groups demonstrated better results in dietary habits modification, compared with the existing routine individual medical control groups.

On the basis of three-multiple research of character of a feed of the inhabitants of one of Moscow district by the standardized method of the 24-th hour interrogation reveals significant changes in structure of a feed of the population from 1986 to 1996. The shifts have appeared more dynamical in the second five-year from 1991 to 1996. Nevertheless, atherogenicity of ration of a researched population with superfluous consumption of the saturated fats and simple carbohydrates remains. Is established, in a feed of the women there were large shifts, than at the men. The structure of a feed of the inhabitants of Moscow differed from structure of a feed of the inhabitants of Russia.

With use of a method of daily reproduction at representative sample of an unorganized population of inhabitants of Moscow the sources of energy value and contribution of various products to supply organism by the basic food substances (protein, fats, carbohydrates and cholesterol) are investigated. Is established that the nutrition structure is obviously debalanced. More quarters of daily diet energy is provided for consumption of animal fats and simple sugars. Is shown that the main part of fat (2/3) enters in organism as the "latent" fats of animal products, the fats "in the pure form" half consist from butters. The main source of the saturated fats and cholesterol for men are meat, and for women--the dairy products. 12% researched refuse purified sugars.

Aim: Assessment of the probability of decreasing cardiovascular mortality by detecting and treating coronary patients and patients with arterial hypertension and correcting the risk factors., Materials and Methods: A prospective ten-year registration of the mortality of the male population aged 40 to 59 years was carried out at a Moscow territory with two health centers. The subjects were routinely screened for coronary disease, arterial hypertension, hypercholesterolemia, excess body weight, tobacco smoking, insufficient exercise. During the first five years of the follow-up they were involved in treatment and prophylaxis measures varying in activity and direction (the two health centers were specialized in prevention and common treatment)., Conclusion: Multifactorial prophylactic intervention helped delay untimely death in all the population examined, mainly due to detection of cardiovascular diseases. The life prognosis was improved most appreciably in the cases when the levels of risk factors were decreased due to multifactorial prevention in comparison with the life prognosis for subjects with a similar decrease of risk factors but without prophylactic intervention.

Dietary intake was studied in 295 of Moscow's residents by 24-hour recall method. High level of animal fat, sugar and cholesterol (Ch) were found in diet of man and women. Energy intake of men is higher than that of women at the expense of animal fat and protein. Women consume less amount of cholesterol-containing food. The levels of serum Ch, HDLP-Ch, triglycerides are in close relation with blood pressure values. The levels of serum Ch, HDLP-Ch, systolic and diastolic blood pressure are connected with variables of age and body mass index.

When studying a nutrition status of patients with disturbance of carbohydrates tolerance and diabetes, high correlation between intake of carbohydrates, body mass, lipid and carbohydrates metabolism and blood pressure was found.

Sample examination of the population aged 25-64 basing on the disease history, fasting blood glucose test, glucose tolerance test, WHO criteria, diabetes mellitus was found in 6% of males and 6.9% of females. Only 2.7% of males and 3.1% of females were aware of their disease. Glucose tolerance test discovered abnormal carbohydrate tolerance in 5.6% and 13.3% of male and female examinees, respectively. Thus, a total of 12.2% of males and 20.2% of females had various disorders of carbohydrate metabolism. Diabetes mellitus patients had often hypercholesterolemia, hypertriglyceridemia, obesity, hypertension, low 10-year survival.

Novel antihyperlipidemic micronized phenofibrate lipantil 200 M was tested for safety and efficacy (one 200 mg capsule a day for 3 months) in 27 patients having cholesterol level above 6.5 mmol/l. The effect emerged upon 1 month of administration and persisted till the end of the treatment. In combined hyperlipidemia triglycerides decreased by 45-60%, total cholesterol and LDL cholesterol by 10-12%. In isolated hyperlipidemia the latter two values appeared lower by 20-23 and 22-27%, respectively. After lipantil 200 M treatment HDL cholesterol went up by 9% in low baseline level (< 1 mmol/l) by 27%. No negative clinico-biochemical shifts were seen, while fibrinogen and uric acid reduced by 16%, apoB by 23-30%. Lipantil 200 M proved active against hyperlipidemia and is recommended for clinical practice.

A number of epidemiological surveys have recently established that in populations with the lowest levels of total cholesterol (TC) and LDL cholesterol (LDLC) death rates grow due to both malignant and cardiovascular diseases. The results of a detailed study on multifactor prevention of coronary heart disease (CHD) in an open population of Moscow males aged 40-59 to elucidate the relations between TC, HDL cholesterol, LDLC and CHD mortality demonstrated that low levels of TC are markers, but not a factor of CHD and sudden death risk in low-educated subjects free of CHD symptoms. When planning mass measures to primarily prevent CHD, subjects with low cholesterol levels should be given a special care as well as those with hypercholesterolemia.

The paper provides the results obtained from implementation of the programme on multifactorial prevention of coronary heart disease (CHD) in Moscow, which provided strong evidence for a reduction in the levels of major risk factors and mortality from cardiovascular diseases, including coronary heart disease. The efficiency of comprehensive prophylactic measures in persons with clinical signs of CHD showed up at year 3 of their implementation and retains in subsequent years. At the same time in persons without CHD signs a mortality reduction starting at years 4-5 of the follow-up virtually came to an end when a further active intervention ceased. The impact of aftereffect of active prophylactic measures after intervention cessation turned out to be different in the examinees at various baseline risk factor levels, which suggests that continuous prophylaxis should be done, on the one hand, and it requires a differential approach, on the other. The reduction in the extent and mean levels of major risk factors, which had been achieved during a 5-year prophylactic intervention, retained, though it was less pronounced and 10 years later. However, this was followed by an increase in the mortality from myocardial infarction and stroke and their incidence in the population that had undergone active prophylactic measures, though the value of these parameters was lower at the end of the tenth year than in the controls.

The death diagnosis of myocardial infarction (including acute heart failure) was recorded and verified on the basis of standard criteria during a 5-year implementation of the Program on Multifactorial Prevention of Coronary Heart Disease among males aged 40-59 years. The analysis demonstrated that the hyperdiagnosis of acute heart failure as a death cause was observed in 29.0% of cases, death being due to acute alcohol intoxication in 43% of all the inconsistent diagnoses.

The prognostic significance of some behavioral habits was examined in an open male population aged 40 to 59 years in respect to mortality. The analysis has demonstrated that tobacco-smoking leads to an increase in the total mortality rate and in mortality from cardiovascular and cancer diseases. The total mortality in the population was on the whole 1.5 times higher as a result of frequent alcohol use, mainly at the expense of the mortality growth because of other reasons (traumas, accidents). The work characteristics being the same, the total mortality from cardiovascular diseases and other reasons appeared significantly less in persons who were physically active in their leisure time as compared to those who were inactive. The analysis has also shown that studies into behavioral habits made by questionnaires in patients suffering from coronary heart disease should be performed in combination with other measures. At the same time the use of the questionnaire allowing the assessment of physical activity is advisable only in persons without coronary heart disease.

Multifactorial prophylaxis carried out for 5 years among men aged 40 to 59 years brought about a significant decrease in the total death rate (by 22.2%), mainly because of the lowering of the death rate due to cardiovascular diseases (by 41.3%), determined by a reduction of these indicators among persons who initially had coronary heart disease. The data indicate that in order to reach a positive effect, the primary care should be exercised for a longer time. At the same time, the prophylactic measures are to be multifactorial and include not only correction of risk factors but also the screening and treatment of patients suffering from coronary heart disease.

Prognostic value of tentatively identified levels of risk (coronary heart disease, risk factors, their combinations) for total, and cardiovascular mortality and myocardial infarction and stroke incidence was evaluated within the framework of the multifactorial coronary heart disease prevention programme. It was found that subjects without CHD in the presence of 3 risk factors or more represented a group at the same high risk for myocardial infarction and death as CHD patients without myocardial infarction, which requires that this population be comprehensively medically monitored. The multifactorial prevention programme has made it possible to reduce the level of a relative risk in subjects with CHD or those without CHD in the presence of 3 risk factors or more in the population of males aged 40-59 years. It may be thus expected mortality rates from chronic noncommunicable disease to be reduced among the general population.

Blood serum of 63 persons out of 191 men examined, randomly selected among non-organized population, caused in primary culture of mice peritoneal macrophages the 1.3-4-fold increased accumulation of intercellular cholesterol. Blood serum of other 128 men studied did not exhibit any atherogenic properties in the culture. The atherogenic potential of blood serum did not correlate with content of blood serum lipids, apolipoproteins B and A-I, while it correlated with the ratio apo B/apo A-I in blood serum and with one of ischemic heart disease risk factors--increased arterial pressure. Blood serum atherogenic potential, detected in experimental model, appears to be involved in development of human atherosclerosis.

The paper provides the results obtained in the course of the cooperative All-Union programme on multifactor prevention of coronary heart disease (CHD), which has been implemented over 3 years to examine the efficiency of preventive actions aimed at correcting the levels of CHD risk factors. The study was conducted in 6 centers of the country among a non-organized male population aged 40-59 years. The outcome of the preventive measures, largely nonpharmacological ones, made during 3 years suggests that the prevalence of the major CHD risk factors may be reduced in the population. The preventive actions are the most beneficial in arterial hypertension and smoking.

In a population of males aged 40-59 years, a routine epidemiological survey was performed, which was followed by a 5-year follow-up to examine the mortality rates and incidence of myocardial infarction and stroke treated by an active prophylactic measure program (Group 1) and conventional regimen (Group 2). The total cholesterol levels of 260 mg/dl or more were found to be of highly prognostic value to death from all causes, largely cardiovascular diseases, to development of myocardial infarction, stroke, and to higher risk of fatal cases of the diseases. It was ascertained that it was difficult to modify the dietary habits in subjects of mature age. By the end of the fifth follow-up year, the examined patients from Group 1 showed a reduction in the mean level of total cholesterol and hypercholesterolemia rates, following by a decrease in total and cardiovascular mortality by 6.5 and 5.7%, respectively, the incidence of myocardial infarction and stroke and the risk of death from these complications becoming lower.

The results of a prospective study of participants and non-participants in population surveys conducted in Moscow and Kaunas are presented. The average follow-up period was 5.5 years. There were 6656 male participants (P) and 5200 non-participants (NP) in Moscow and 5945 and 2528, respectively, in Kaunas. In Kaunas, indicators of both total mortality and mortality from cardiovascular diseases, injuries and accidents, malignant neoplasma and other diseases were higher in NP than in P. In Moscow the general tendency was the same but the difference between P and NP was significant only for mortality from injuries and accidents. As for the incidence of new cases of acute myocardial infarction, there was a tendency to higher figures in participants, especially in Moscow. The authors point to the danger of drawing incorrect conclusions on the mortality and morbidity in the population if they are based only on data gained from participants.

The paper treats the results of an analysis of the assessment of the main risk factors within the framework of the program for multifactorial prophylaxis of coronary heart disease in the populations with varying involvement into preventive measures. Using standard methods altogether 6566 men aged 40-59 years were examined in the area of two district polyclinics with a purpose of diagnosing coronary heart disease and risk factors of its development. During 5 years, measures aimed at active primary and secondary prophylaxis of coronary heart disease were carried out in one of the groups. Prospective survey over the death rate has demonstrated that cardiovascular diseases rank the first in the structure of the death rate among the adult male population, with their portion being increased with age. Studies into the relationship between the death rate and the main risk factors in the population provided evidence that risk of the death from cardiovascular diseases rises with an increase in the systolic and diastolic arterial pressure, in the body weight index, and in total cholesterol. The active composite preventive measures brought about a significant reduction in risk of the death from cardiovascular diseases, in the incidence of the fresh cases of myocardial infarction, and brain stroke. At the same time the death rate of cardiovascular diseases dropped by 40.7% as compared to the expected one, the number of lethal cases due to various reasons by 12.7%, an the incidence of myocardial infarction and brain stroke by 18.8%.

Isolated working rat hearts were subjected to a 3-hour ischemia followed by reperfusion. The defense effects of the heart cooling to 6-7 and 12-15 degrees C were assessed according to the degree of postischemic recovery of hemodynamic (arterial pressure, heart rate, coronary flow, cardiac output) and biochemical (ATP, phosphocreatine, Pi, and lactate content) characteristics and electron microscopic evidence. The energy resources of the myocardium and its cellular structures were effectively preserved during one-hour ischemia at 12-15 degrees C. At 6-7 degrees C, the energy resources of the hearts were better preserved in long-term ischemia, where the functional characteristics were recovered to the same extent as in the 12-15 degrees C hypothermia, but some cell damage was observed. The obtained findings suggested that the temperature of 12-15 degrees C should be the temperature of choice for heart cooling in cardiosurgery.

Alcohol consumption practice was studied by a method of interview in an unorganized male population aged 40 to 59 investigated by a program of multifactorial CHD prevention. The frequency of spreading of this habit and its intensity were determined. The frequency of alcohol consumption was decreased with age and was associated with the examinees' educational level. Persons consuming alcohol more frequently had raised arterial hypertension and smoked. These factors increased the risk of CHD development which was confirmed by a 5-year prospective study of mortality. Alcohol abusers were characterized by higher rates of general mortality, including that from cardiovascular diseases, traumas and accidents, in particular, alcoholic intoxication.

The authors analyzed the prevalence of coronary heart disease (CHD) and its various types detected by routine epidemiological methods among the examinees in four cities (Moscow, Kaunas, Kiev, and Kharkov). The results were obtained in the collaboration study, adhering to the rigid standardization of all the procedures applied. Examination of 17, 168 males aged 40-59 years revealed signs of CHD in 13.8%; 3.3% had a history of myocardial infarction; 5.3% suffered from exertional angina without prior myocardial infarction; 5.2% showed a painless course of CHD. The analysis demonstrated that simultaneous use of the standard epidemiological methods is the only way of ensuring a more complete detection of CHD. In different cities, from 36.4 to 60.8% were not aware of the presence of the disease. Secondary preventive measures should involve methods for identifying the major risk factors and eliminating the latter.