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Последствия применения препаратов сульфонилмочевины свидетельствуют о том, что с точки зрения сердечно-сосудистых эффектов сульфаниламиды не могут рассматриваться как однородная группа, и это необходимо учитывать при прогнозировании их применения. Сердечно-сосудистая активность препаратов сульфонилмочевины не обязательно коррелирует с величиной их сахароснижаюшего эффекта. В настоящей работе была поставлена цель оценить влияние приёма препарата новой генерации сахароснижаюших производных сульфонилмочевины ? глимепирида (Амарил, ?Aventis Pharma?) на ?ишемический порог? сердца у больных СД типа 2 с коронарной болезнью сердца.

Aim. To perform a population analysis of Non-High Density Lipoprotein Cholesterol level (non-HDL-c) in Russian population and to evaluate its association with cardiovascular events.Material and Methods. The material consisted of results obtained from 11 regions of the ESSE-RF1 Study and from 4 regions of the ESSE-RF2 Study. Study protocols were identical. The studies were performed in 2012-2014 and 2017, respectively. Endpoints were assessed in 19041 people aged 35-64 years. The median follow-up was 6.5 years in ESSE RF (1) and 3.8 years in ESSE RF(2). Analysis was performed for three lipid variables: total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and non-HDLC in two samples: the general population sample and the same sample without individuals with coronary heart disease (CHD), myocardial infarction (MI) and/or stroke history and not taking statins (the population sample of "without a history of cardiovascular diseases [CVD]". The analysis of nonlinear associations was performed using the generalized additive Cox model. The combined cardiovascular endpoint was represented by cardiovascular death and nonfatal MI and stroke. Traditional and laboratory FRs, socio-demographic parameters were analyzed. The significance level for all tested hypotheses was set to be 0.05.Results. The prevalence of elevated non-HDL-C level (>3.7 mmol/l) was found to be 74.6%. No gender differences were found: there was 74.6% for men and 74.5% for women. Both mean values and prevalence of elevated non-HDL-C were increased with age in women, and its level was slightly decreased in men after 55 years old. Almost all analyzed RFs were significantly associated with elevated non-HDL-C in these two population samples. In both samples elevated total CH and elevated LDL-C were associated with all-cause mortality after correction for all RFs. On the contrary, the non-HDL-C was associated with CVD combined end pints. It has been shown that the risk of these end points increases uniformly with increase in levels of non HDL cholesterol, no nonlinear associations were found.Conclusion. The results of a population-based analysis of non-HDL-C performed in the Russian population for the first time confirmed that elevated non-HDL-C levels contribute significantly to determining the risk of cardiovascular events in the medium term. It can be assumed that the new risk scales (SCORE2 and SCORE OP) proposed by the European Society of Cardiology and the European Society of Preventive Cardiology, which include non-HDL C instead of TC, will allow adequate assessment of 10-year cardiovascular risk for Russians. However, continued monitoring of endpoints in order to obtain stable associations is required.

Aim. To compare survival at a 30-year follow-up in the populations of Russia and USA.Material and methods. From the Russian studies of 1975-1982, 14728 men and 6140 women aged 18-71 years were included, with follow-up until 2017 (501016 person-years of follow-up). In addition, 2265 men and 2345 women aged 18-71 years from the US population (The Third National Health and Nutrition Examination Survey) were compared with survey data in 1988-1994, with mortality follow-up until 2019 (115523 person-years of follow-up). Kaplan-Meier curves were created in groups of men and women aged 18-29, 30-39, 40-49, 50-59, 60-71 years old. All-cause death was taken into account as an outcome. We analyzed the prevalence of a number of cardiovascular risk factors.Results. Comparison of Kaplan-Meier curves in Russia and USA shows significant differences in all five age groups of men; in Russia the prognosis was worse (p=0,000). In women, significant differences of the same direction appear only at the age of ≥60 years (p=0,003). Comparison of the prevalence of risk factors showed that in Russia hypertension occurs several times more often than in the United States, while the differences are significant in all age groups of men and women.Conclusion. At a 30-year follow-up, the prognosis for Russia is worse compared to the United States for all age groups of men and for women >60 years of age.

The methodological rationale contains a description of epidemiological research methods, provides an analysis of the key concepts of epidemiology (population, sample, risk factor (RF)), in the context of prevention priorities, as well as describes each of the main RFs for noncommunicable diseases (NCDs), including cardiovascular diseases. Emphasis is placed on behavioral and mediated biological RFs, such as smoking and alcohol consumption, poor nutrition (low consumption of vegetables and fruits), physical inactivity, high blood pressure, dyslipidemia and obesity, hyperglycemia and diabetes. The methodological rationale was created with the aim of popularizing epidemiological studies, expanding the scope of its use by clinicians, primary care physicians, specialists from medical prevention centers, providers of preventive measures, as well as decision makers in the healthcare system. The sphere of the implementation of epidemiological data covers both the planning of preventive programs for the modification of risk factors in the population, and monitoring the effectiveness of preventive measures. These materials will also be useful in the development of a population, regional and municipal strategy for the prevention of NCDs and related RFs in Russia.

Aim. To study the prevalence of hypotension (HoTN) with an unfavorable prognosis in populations of the Russian Federation and the United States of America in a thirty-year perspective.Material and methods. We used data from Russian population-based studies performed in 1975-1982 at the now-familiar National Medical Research Center for Therapy and Preventive Medicine, and the study Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation (ESSE-RF) in 2012-2014. A comparison was made with data from studies of US population of the National Health and Nutrition Examination Survey (NHANES): NHANES II (1976-1980) and Continuous NHANES (2007-2012). Age, sex, systolic and diastolic blood pressure were analyzed. The proportion of persons with HoTN (prevalence) was calculated in men and women of five age groups using the original HoTN criterion. Results. We used the previously developed criterion of HoTN with an unfavorable prognosis: for Russian populations, the mean dynamic pressure is

Aim. To study trends in the prevalence of hypertension (HTN), obesity, elevated non-high-density lipoprotein cholesterol (non-HDL cholesterol) levels in Russia and the USA from 1975 to 2014.Material and methods. According to the data of cross-sectional population studies in Russia and the USA in 1975-1982 and 2007-2014, the prevalence of risk factors (RFs) in men and women aged 25-64 was studied. The data of Lipid Research Clinics studies, Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation (ESSE-RF) study, as well as data from National Health And Nutrition Examination Survey (NHANES) studies (USA) were used. The total number of persons analyzed was 41268. The proportion of individuals with risk factors and 95% confidence interval were calculated.Results. In the 1980s, the prevalence of studied RFs in Russia and the United States did not differ in most sex and age groups. Over the next 30 years, both populations are characterized by a decrease in the prevalence of HTN and elevated non-HDL cholesterol (≥ 3.7 mmol/l) and an increase in the prevalence of obesity. In 2012, HTN in men and women in Russia occurred more frequently than in the United States. Obesity was less common in men and women 25-44 years old in Russia and in women >54 years old in the USA. The prevalence of non-HDL cholesterol ≥3,7 mmol/l in Russia compared with the United States was higher in people >44 years old and lower in women 25-34 years old.Conclusion. In the 1980s, there were no differences in the prevalence of cardiometabolic risk factors in Russia and the United States. In the 2010s, HTn and partly dyslipidemia were more common in Russia, and the prevalence of obesity in young and middle-aged people was higher in the United States.

Aim. Based on Russian and United States population studies, to determine the criterion for distinguishing between normal and low blood pressure (BP), which is the most significant for predicting all-cause mortality.Material and methods. We used data from prospective Russian studies of 14730 men aged 19-82 years (9307 deaths per 342309 person-years of followup) and 6141 women aged 18-72 years (2101 deaths per 158727 person-years of follow-up), and two United States population studies: the First National Health and Nutrition Examination Survey (NHANES I) in conjunction with the NHANES I Epidemiologic Followup Study, and the Second National Health and Nutrition Examination Survey (NHANES II) in conjunction with the NHANES II Mortality Study. The total American cohort included only white subjects: 8618 men aged 25-75 years (3130 deaths per 121794 person-years of follow-up) and 11135 women 25-75 years (2465 deaths per 176676 person-years of follow-up). Primary examinations were carried out in 1971-1982, while the latest information on the subjects’ survival status was obtained in 2017 (Russia) and 1992 (USA). KaplanMeier curves and Cox proportional hazards models were created; all-cause death was taken into account as an outcome.Results. Survival analysis using Cox models, in which, in addition to BP levels, sex, age and risk factors were taken into account, showed that in persons with a pronounced BP decrease, survival is worse in comparison with those with normal BP. Mean dynamic BP, unfavorable for all-cause mortality, was below 70 and 68 mm Hg and 76 and 72 mm Hg in men and women in the Russian and US cohorts, respectively.Conclusion. Not only hypertension, but also severe hypotension is associated with increased all-cause mortality compared to normal BP. Survival decrease is manifested in severe hypotension, subject to sex and adjustment for age and risk factors.

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

Aim. To assess the prevalence of wide QRS complex (≥110 ms) among the population, depending on sex, age, place of residence (urban or rural area), the presence of obesity and cardiovascular disease.Material and methods. The analysis was based on the ESSE-RF study (n=17,364, men — 38%). Twelve-lead resting electrocardiography (ECG) data from the regions participating in the study were analyzed according to the Minnesota code manual. Patients were divided into groups of QRS

Aim. To study the prevalence of hypotension according to several criteria in the Russia and the USA.Material and methods. We used data of Russian population studies performed in 1975-1982 and ESSE-RF study performed in 2012-2014 at the National Medical Research Center for Therapy and Preventive Medicine. A comparison was made with the data of cross-sectional stu - dies of the US population — National Health and Nutrition Examination Survey (NHANES): NHANES II (1976-1980) and Continuous NHANES (2007-2012). We analyzed age, sex, and systolic and diastolic blood pressure. The prevalence of individuals with hypotension was calculated in men and women of five age groups using four different criteria for hypertension.Results. The prevalence of hypotension in studies of different years according to different criteria was as follows: in the Russia — 0,3-9,0% in men and 2-15% in women; in the USA — 5-30% in men and 8-45% in women. In age group >30 years, the prevalence of hypotension in Russia, by most criteria, decreased approximately by 50% in men and did not change in women. In the United States, according to all criteria, the prevalence in men and women has increased 2-3 times.Conclusion. The prevalence of hypotension in the adult population ranges from decimal percentages to 45% and varies many times depending on the selected criterion.

Aim. To evaluate the dynamics of obesity and mean body mass index (BMI) in Russia and USA in various age and gender categories during 1975-2014.Material and methods. By a repeat analysis of one-moment studies of Russian and US population in 1975-1982 and 2007-2014, the values of obesity and BMI were assessed in men and women age 25-64 y. o. Into analysis, the data was included from Russian part of the Lipid Clinics study and multicenter ESSE-RF study (Epidemiology of cardiovascular diseases and risk factors in various regions of Russian Federation). American data acquired from the studies NHANES (National Health And Nutrition Examination Survey), open access. Total number of observations 48974.Results. In the 80s of XX century in all age groups of women the mean BMI levels were lower in USA comparing to Russia, in men there were no significant differences. For the following 30 years in Russia the situation improved for men and women 45 years old — in Russia.

Heart rate (HR) acceleration is one of the risk factors of the number of prevalent chronic non-communicable diseases.Aim. To evaluate changes in mean levels of HR in the Russian Federation (RF) and the United States of America (USA) in different age and sex groups from 1975 to 2014.Material and methods. HR levels in men and women of different age groups were evaluated in the populations of the RF and the USA in 1975-1982 and in 2007-2014 by the secondary analysis of cross-sectional trials data. A total number of cases was 48974.Results. In 80th years of XX century Russian men and women of all age groups had lower HR as compared to the USA, the distinctions were statistically significant in all age groups except for men aged 25-34 years (p

Aim. To conduct a comparative study of the changes in blood lipids profiles in populations of the Russian Federation (RF) and the United States of America (USA) in different age and gender groups over the period from 1975 to 2014.Material and methods. Using a secondary analysis of data obtained from the RF population studies carried out in 1975-1982, the multicenter epidemiological study of cardiovascular diseases in different regions of the RF (ESSE-RF), conducted in 2012-2014, as well as the NHANES series of crosssectional surveys in the civilian non-institutionalized population of the USA (NHANES II in 1976-1980 and Continuous NHANES in 2007-2012), we evaluated average lipids in blood tests in men and women of different age groups, with a total number of 48,974 observations.Results. At present, in the RF population, as compared to the USA one, most age groups demonstrate a higher concentration of total cholesterol, i.e. p

Aim. To improve diagnostics of arterial hypertension (AH) at early stages. Material and methods. In 34 relatively healthy individuals and 72 AH patients, 24-hour blood pressure monitoring (BPM) was performed. In all hypertensive patients, no target organ damage was registered, office BP levels were below 159/94 mm Hg. Results. Using the program imitating artificial neuronal nets, a model was developed that correctly diagnosed early AH stages, by 24-hour BPM data, in people without evident BP increase. Conclusion. Non-linear multiple modeling substantially improved early AH diagnostics in people without evident BP increase at rest.