Search

Aim. To examine associations of cardio-ankle vascular index (CAVI) with classical, behavioral and social risk factors (RFs) of cardiovascular disease (CVD) in adult population.Material and methods. The study included 1365 people (women, 59%) from a representative sample aged 25-64 years (ESSE-RF), who underwent standard cardiology screening and volume sphygmography (VaSera-1500). All respondents signed an informed consent to participate in the study. The analysis included blocks of classical, social and behavioral risk factors for CVD. A linear model was used to identify associations. An error rate of Results. Age, sex, systolic blood pressure (SBP), triglycerides were associated with higher CAVI values, and body mass index (BMI) was associated with lower values, respectively. After 45 years, a direct association with heart rate (HR) became increasingly important, while after 50 years — with diabetes and the intake of beta-blockers, while the association between diabetes and CAVI was observed only among individuals not taking angiotensin-converting enzyme (ACE) inhibitors. A direct association was found with high-sensitivity C-reactive protein (hsCRP) in men, and an inverse association with diuretics in women, respectively. A sedentary work in combination with a history of bronchitis or with positive family history for CVD showed a direct relationship, while a sufficient physical activity (PA) showed an inverse relationship with the studied indicator, but only among people with belowaverage income.Conclusion. According to the data obtained, in addition to age and sex, the following risk factors made a significant contribution to CAVI parameters in the examined population: BMI, SBP, triglycerides, diabetes, HR, intake of betablockers, diuretics, ACE inhibitors; hsCRP, PA. The unfavorable role of betablockers, high HR, diabetes, sedentary work, chronic lung pathology, hereditary burden, as well as the protective role of ACE inhibitors, diuretics and intense PA in relation to arterial stiffness in the working-age population has been shown. Additional studies are needed to determine the nature of a number of associations. The results obtained may contribute to the study of CAVI role in risk stratification and further development of methodological approaches to CVD prevention.

Aim. To study the relationship between carotid plaque burden and conventional, behavioral, and social cardiovascular risk factors.Material and methods. The object of the study was 469 people (women, 49%) from a representative sample of the general population aged 25-64 years (crosssectional ESSE-RF study) with the presence of one or more atherosclerotic plaques in the carotid arteries. The study participants underwent cardiac screening and carotid ultrasound. All respondents signed informed consent. The number of involved segments and the average plaque height were studied. The associative analysis included blocks of conventional, social, and behavioral risk factors for cardiovascular diseases. The study of relationships was carried out using linear and log-linear models. An error probability Results. According to multivariate analysis, age (in men), male sex, smoking, systolic blood pressure (SBP), total cholesterol, heart rate, alcohol abuse, statin and β-blocker therapy were interrelated with the number of involved segments. In turn, the average plaque size was associated with age (in men), male sex, higher education, alcohol abuse, smoking, and high-sensitivity C-reactive protein.Conclusion. The results obtained confirm the leading role of age (in men), smoking, SBP, total cholesterol, β-blockers as indicators of the number of involved segments. Alcohol abuse and heart rate have shown associations between the ages of 40-50 years and thus may contribute to premature atherosclerosis. Key role of age (in men), sex (among those ≥50 years old), and educational status in average plaque height in this study was confirmed. A significant contribution was also made by alcohol abuse, smoking, high-sensitivity C-reactive protein. The obtained data do not confirm the hypothesis about the contribution of atherogenic lipoproteins and SBP to average plaque height. The study results can be useful for studying the plaque burden role in risk stratification and further development of cardiovascular prevention.

Aim. To study the prevalence and predictors of statin therapy in the general working-age population.Materials and methods. As a part of the ESSE-RF study, we examined 1,600 people aged 25-64 years (women — 59%) from the general population. All subjects signed informed consent. Association analysis included blocks of socio-economic, psychosocial, behavioral, and medical variables. We used methods of univariate and multivariate statistics. Error probability < 5% was considered significant.Results. The prevalence of statin therapy in the general population was 3,3%: 5,5% in subjects ≥45 years, 8,1% in the group of 55-64 years old. We revealed that 2,5%, 2,9% and 10,9% of individuals with moderate, high and very high risk received statins, respectively. Among those receiving statins, 28,8% took it for primary prevention, 50% — due to cardiovascular diseases (CVD), and 21,2% — due to other disorders specifying risk. With priori indicators of very high risk, statins were taken more often than with SCORE ≥10 without risk indicators. According to multivariate model, older age, the presence of CVD + moderate and severe carotid atherosclerosis, antihypertensive therapy, stage 3 chronic kidney disease, and diabetes increased the likelihood of statin therapy, and SCORE ≥10 without risk indicators reduced it. The obtained data do not confirm the hypothesis about the significant role of sex, social gradient, and behavioral factors.Conclusion. Statins are one of the primary tools for primary and secondary prevention of CVD. Only a minor part of the population takes these drugs, in most cases due to CVD. Therefore, the prevention potential of statins at the population level has not yet been exhausted. More attention is required for individuals with SCORE ≥5 and without CVD who are less likely to receive therapy, but who may benefit more by taking statins. The decision to take statins for primary prevention of CVD should be based on the baseline risk, the value of absolute risk reduction, and how much this reduction justifies possible harm and long-term daily intake of the drug.

Aim. To analyze spread of alleles and genotypes of ACE gene in CHD patients of different gender and age and to study their realtion with MI risk. Material and methods. Totally 326 individuals of both age, Tomsk city inhabitants, aged 34-79 y. o., included into the study. Of those 173 CHD patients having MI anamnesis and 153 healthy individuals. For the entire group the I/D polymorphism of ACE gene with PCR method using primers by AmpliKit Company (Saint-Petersburg). For the analysis of frequency spread of alleles and genotypes the χ2 criteria used, precise Fischer test and relative risk estimation. Results. By the results of statistic analysis there were no difference between control and patient groups by the prevalence of ACE genes and alleles. While studying women separately there were no siginificant differences between patients and controls in genotypes and alleles. In men with MI in anamesis there was increase of DD genes prevalence comparing to healthy individuals (p=0,038). The analysis of MI prevalence and I/D polymorphism in men and women was performed with relation to age. It is shown that in men younger than 50 y.o. homozygotes there are moreprevalent II and DD genotypes, than in men older than 50 y.o., whom ID genotype is more prevalent (p=0,031). In women group the difference between those younger and older than 55 y.o. the spread of genotypes was similar, but there were more prevalent MIs in older group (p=0,020). Conclusion. The important points of I/D polymorphism of ACE genes influence on MI risk was shown. Among women, sick and healthy, and of various age, there were no significant differences in genitypes prevalence. However there are statistically significant differences in the genotype spread was found in healthy men and men after MI, and in men with the age of 34-50 and 51-79 y.o.