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Aim: to study associations between elevated blood plasma concentration of N-terminal pro-brain natriuretic peptide (NT-proBNP), risk factors and cardiovascular diseases (CVD) in samples of adult population of Russian Federation (RF) aged 25-64 years., Materials and Methods: We analyzed data of examination of representative samples of population of 5 regions of RF obtained within the framework of the multicenter ESSE-RF study (2012-2013). Number of examined subjects was 8 077 (3 176 men). Methods included use of standard questionnaire, measurements of height, body mass, blood pressure (BP), and plasma NT-proBNP level. The following CVD were included into analysis: arterial hypertension (AH), ischemic heart disease (IHD), atrial fibrillation (AF), and stroke., Results: Women compared to men had higher NT-proBNT concentration was higher in women compared to men, in both genders it rose with age. Overall 17.9 % of examinees had elevated NT-proBNT levels (14.2 and 20.3 % among men and women, respectively). Elevated NTproBNP level was associated in men with age, myocardial infarction, angina pectoris, ischemic ECG changes, left ventricular hypertrophy, AF, bradycardia, smoking, in women with age, IHD, ischemic ECG changes, AF, bradycardia, heart rate ≥80 bpm, BP ≥160/95 mm Hg., Conclusion: In studied RF population elevated NT-proBNP level was significantly associated with gender, age, smoking, and CVD.

The CLARIFY register (The prospeCtive observational LongitudinAl RegIstry oF patients with stable coronary arterY disease) combined data of outpatients with stable coronary artery disease (CAD) from 45 countries including Russia. Purpose of this publication was to analyze dynamics of stable angina during 5 years of follow up in the Russian CLARIFY cohort compared with cohorts of patients from European and non-European countries., Material and Methods: Number of patients recruited in Russia was 2249., Results: During 5 years of observation proportion of angina decreased by 65.5, 39.5 and 37.0% in Russia, European and non-European countries, respectively. Proportion of patients with heart rate (HR) <60 bpm at the beginning of observation was 17.4, 25.4 and 23.4% in Russia, European and non-European countries, respectively. By the end of 5 years there was a significant increase in the proportion of patients with HR <70 bpm in Russia, while in Europe and other countries response to HR reducing therapy was much more modest. Perhaps this was due to improved treatment of patients recruited in Russia, for example, ivabradine at the end of the observation period was prescribed two times more than in the beginning. Patients from Russia had significantly lower all cause mortality compared with patients recruited in European countries (p<0.03); no significant differences were observed between Russian and European cohorts in cardiovascular mortality and rates of fatal and non-fatal myocardial infarction and stroke., Conclusion: Results of the CLARIFY register showed that continuous monitoring of patients with (annual visit and telephone contact between visits) was associated with reduction of angina in stable coronary artery disease from 75 to 58%. Only 26.6% of patients did not reach HR of 70 bpm. During 5 years of follow up mortality from cardiovascular diseases among patients from Russia did not differ from that among patients from non-European countries and was significantly lower than among patients from Europe (RR=0.83, p<0.05).

Modeling is the common approach for predicting not only the population health, but also the social and economic burden of disease, which is an important argument while making decisions in health care and prevention., Aim: To develop the model for predicting cardiovascular risk, applicable for the assessment of clinical and socio-economic effects of preventive and therapeutic actions at the level of the whole population or part (region, city, group of patients)., Material and Methods: An analytical model for making decision was performed by using a Markov model consisting of Markov states and probabilities of transition from one state to another within a certain time interval. The model included risk factors and cardiovascular diseases (blood pressure, cholesterol, smoking) and probabilities of transition between them. Data was standardized by age for both males and females. Multivariate sensitivity analysis was performed. The literature search conducted using eLIBRARY.RU (http://elibrary.ru) and CyberLeninka (http://cyberleninka.ru). Consultations with experts in the field of coronary heart disease, stroke, heart failure were carried out., Results: The model, allowing to compare the outcomes of two scenarios (absence/presence of intervention). The model included risk factors: arterial hypertension, smoking, hypercholesterolemia, and important CVD: coronary artery disease, myocardial infarction, unstable angina, heart failure, chronic heart failure after myocardial infarction, transient ischemic attack, stroke, atrial fibrillation. There was absorbent state - death. At the output from the model the patient state was defined as the sum of the Markov states characteristics during the model time horizon. Each result had the cost and outcome, which values could be calculated by simulation modeling ("cohort simulation"). The data analysis from prospective study had shown that mortality increases with age, as expected, but in different age groups impact of cardiovascular causes was different and declined with age. In the case of the blood pressure there was the expected increase of the death risk with the growth of pressure levels, both for males and females, except for males 60-64 years old who had a minimal risk of death at the blood pressure 140-149/90-99 mmHg, and among males with normal blood pressure the risk was higher. Smoking was associated with an expected increase of the death risk among all age groups in both sexes. In males, aged 40-64 years, the death risk was higher at the normal levels of cholesterol (2-5 mmol/l), than at the cholesterol levels equal 5-7 mmol/l. There were no data sources to assess probability of occurrence of the risk factors (hypertension, smoking, hypercholesterolemia) in patients who did not have these factors previously in our studies, and available literature. This requires the prospective studies on at least two slices of surveys (not just with the endpoint analysis). Analysis of the literature on search of prospective Russian studies that would evaluate the probability of transition from one state to another, and consultations with experts have identified that currently conducted studies do not provide all the necessary probability of transition on the basis of national data. In the absence of local data for the model is acceptable to use the results of meta-analyzes of international studies., Conclusion: Markov model will allow for prediction the effectiveness of different interventions, including their socio-economic consequences. The created model will allow in the future to make changes with the appearance of the results of new studies or new data in order to improve modeling accuracy.

Aim: to elucidate contribution of atrial fibrillation (AF) to mortality from various causes among men and women in Russia., Material and Methods: We analyzed data from samples of population of Moscow and Petersburg (Leningrad) aged 35-74 years examined in different years. Total number of subjects was 20045 (15107 men), response rate was 75%. Examination was carried out according to unified protocol incorporating collection of standard information on social and demographic parameters, smoking status and alcohol consumption, history.

We present in this review data on home blood pressure variability (HBPV) with consideration of its definition and threshold values. We also present own classification and discuss analysis of results of HBPV and their interpretation in observational and clinical studies, including own data. Experience in this area accumulated during last 30 years, information on pathophysiological mechanisms, prognostic properties of HBPV may be useful for a physician from practical point of view.