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Aim: To establish associations of the prevalence of ischemic heart disease (IHD) and factors of psychoemotional stress in men of the open urban population in the age group 4564 years after two decades of life., Materials and Methods: A cross-sectional epidemiological study using a model of the city of Tyumen was conducted on a representative sample of the population among males of mature age (4564 years). Based on standard epidemiological methods, IHD was established according to strict epidemiological criteria definite IHD. The study of the factors of psycho-emotional stress (depression, hostility, life exhaustion) was carried out according to the algorithms of the World Health Organization program MONICA-psychosocial. When calculating the odds ratio for the development of IHD, a low level of psycho-emotional stress factors was regarded as the absence of a sign, a combination of medium and high levels as a presence., Results: The prevalence of ischemic heart disease in the open population (on the model of Tyumen) according to strict epidemiological criteria in men aged 4554 years was 8.2%, at the age of 5564 years 19.2%, a predominance of painless form of ischemic heart disease was revealed. According to the levels of factors of psychoemotional stress in mature men, mainly the average level of depression and life exhaustion, a high level of hostility were established. In men of an open population (on the model of Tyumen), depending on the psychoemotional stress, a high risk of developing a certain coronary heart disease was established in the age categories 4554 and 5564 years old in the presence of depression, at the age of 5564 years in the presence of hostility or life exhaustion., Conclusion: Consequently, the data obtained indicate the importance of further studying the factors of psychoemotional stress in men of mature age in Siberian populations, their relationships with conventional risk factors for coronary artery disease, as well as the advisability of preventive measures aimed at weakening the influence of not only conventional risk factors, but also factors of psycho-emotional stress. among the Russian population.

Aim: To determine the gender differentiation and dynamics for 22 years of psychosocial factors (PSF) of the risk of cardiovascular disease among the population aged 25-64 years in Russia / Siberia (Novosibirsk)., Materials and Methods: Representative samples of the population of the city of Novosibirsk under the program of the World Health Organization "MONICA-MOPSY" in 1994-1995 were examined. III screening (men - 657, women - 870, 25-64 years old); IV screening project HAPIEE in 2003-2005 (men - 576, women - 1074, 45-64 years old) and V screening in 2013-2016. (men - 427, women - 548, 25-44 years old). We used Spielberger tests, MONICA-MOPSY tests, the Breckman - Sim test, the "Knowledge and attitude to your health" questionnaire., Results: In an open population of 25-64 years old, high levels of anxiety (T), depression (D), life exhaustion (LM), and hostility (B) were higher in women than in men. In the group of 55-64 years over 10 years, women have increased personality T, decreased D and LM. Over 22 years, in the group of 25-34 years, men and women decreased T and MI, but D and B increased, while women decreased T, LM and B and D. grew. Low and high close contact indices were higher among men. A low index of social ties prevailed in men, and a high index in women. High levels of stress in the family were more common in women, and at work - in men. For 10 years, the level of stress in the family and at work in men has decreased. Sleep disorders in the population in all age groups were more often in women., Conclusion: It was found that women have significantly higher PSF than men, with the exception of stress at work. The decrease in PSF in women and men in the dynamics.

Aim: The aim of the study was to determine the levels of depression and life exhaustion in men and women of the open urban population in the age range., Materials and Methods: A single-stage epidemiological study was conducted among people of both sexes aged 25-64 in Tyumen. A representative sample was formed from the electoral lists of citizens by the method of "random numbers" - 2000 men and women with a response among men 85.0%, among women - 70.3%. The study of depression was conducted according to the algorithms of the program of the world health organization "MONICA-psychosocial"., Results: The prevalence of depression in the Tyumen population and in the age and sex groups showed a predominance of the average level over the high, in the age categories 25-34 and 35-44 years - significantly higher prevalence of high levels of depression in women. The higher prevalence of the average level of men and women IN the open population was determined to be relatively high. The average level of LIFE significantly prevails in women in the older age categories and in the population as a whole, the high level of LIFE - at the age of 25-34 years in women and at the age of 55-64 years in men., Conclusion: Therefore, in the open population of the middle-urbanized Siberian city there is a need to form an integrated approach to the prevention of non-infectious diseases, especially cardiovascular diseases, as it is established that prevention programs lead to a reduction in the burden of depression and, and effective approaches to the prevention of psycho-emotional States at the level of individual communities include school-oriented programs to teach positive thinking among the population, starting from a young age.

Aim: The aim of the study was to determine the impact of stress on work on the risk of cardiovascular disease over a 16-year period in an open population of 25-64 years in Russia/Siberia., Materials and Methods: A random representative sample of the population of both sexes of 25-64 years old in Novosibirsk in 1994 (men: n=657, 44.3±0.4 years, response - 82.1%, women: n=689, 45.4±0.4 years, response - 72.5%). The screening survey program included: registration of socio-demographic data, determination of stress at work (Karazek scale). The period of prospective follow-up of participants was 16 years. The study identified the following "end points": the first cases of myocardial infarction (MI), stroke., Results: A high level of stress at work was in 29.5% of men and 31.6% of women, the average level in 48.9% of men and 50.7% of women (χ2=2.574, υ=2, p=0.276). The risk of developing MI for a 16-year period, among people experiencing stressful situations at work, was: in men, HR=3.592, and women HR=3.218 (95% CI 1.146-9.042); stroke risk - among men, HR=2.603 (95% CI 1.06-4.153) in women HR=1.956 (95% CI 1.008-3.795). In multivariate analysis, in men with stress at work, the risk of MI among men was HR=1.15 (95% CI 0.6-2.2), among women - HR=2.543 (95% CI 1.88-7.351); risk of stroke, was in men, HR=3.8 (95% CI 1.6-8.8), in women - HR=1.95 (95% CI 0.984-3.887). The risk of stroke was higher among single, divorced and widowed men, HR=4.2 (95% CI 1.5-13.2), and in women with secondary or primary education, HR=3 (95% CI 0.852-11.039)., Conclusion: It was established that a high level of stress at work is not gender-specific; the risk of developing MI over a 16-year period is higher in women than in men, stroke in men; the risk of myocardial infarction and stroke in both sexes is affected by the social gradient.

Aim: The aim of the study was to establish associations of the prevalence of coronary artery disease (CAD), metabolic syndrome (MS) and arterial hypertension (AH) with family stress in open male population of Tyumen aged 25-64 years., Materials and Methods: Cross-sectional epidemiological survey was conducted on representative sample of 1000 individuals (250 in every 4 decades: 25-34, 35-44, 45-54, 55-64 years) formed from the election list of males in one of the administrative districts of Tyumen. The response to cardiac screening was 85.0% - 850 patients. Different types of CAD were defined based on standard methods in epidemiological surveys. "Certain" CAD and "possible" CAD were determined according to extended epidemiological criteria. IDF criteria (2005) were used for the MS assessment, AH was considered as a component of the MS. A questionnaire of WHO MONICA «Knowledge and attitude to health» was used to analyze stress in families., Results: The results of the study showed that more than 80% of males in open urban population, mostly older individuals, had a stable marital status last twelve months, while one-third of the male population had conflicts in their families and the fifth part did not have the opportunity to relax at home. Male patients with CAD had family stress more frequently during last 12 months on extended epidemiological criteria. In the open male population aged 25-64 years with MS and AH there was found more stable marital status versus comparison groups., Conclusion: Standardized methods and the accumulated database should be used to continue objective monitoring of the epidemiological situation of cardiovascular diseases and psychosocial risk factors in open urban population during regional preventive program.

Aim: To determine the 23-year dynamics (1994-2016) of attitudes toward one's health, behavioral characteristics and the prevention of cardiovascular diseases in an open population among women 25-44 years old in Russia / Siberia (Novosibirsk)., Materials and Methods: In the framework of the third screening of the MONICA program for the study of trends and control of cardiovascular diseases and the MONICA-psychosocial (MOPSY) subprogram, in 1994 a random representative sample of women aged 25-64 years of age from one from the districts of Novosibirsk (n = 870, the average age is 45.4±0.4 years); in the age group 25-44 years - 284 persons. In 2016 years. in the framework of screening studies on the budgetary issue of NIITPM No. gos. reg. 01201282292, a random representative sample of women aged 25-44 years old in the same district of Novosibirsk (n = 540) was examined. Attitude to their health, behavioral characteristics and the prevention of cardiovascular diseases were studied using the "Knowledge and attitude to their health" scale, validated for the Russian population under the WHO "MONICA" program. The chi-square test (x2) was used to calculate the indices. The criterion of statistical significance was the reliability of the result at p<0.05., Results: The analysis showed that in the open population among women aged 25-44 years, there is a positive dynamics in assessing their health (21% and 50.7%, respectively). But, despite this, 50% of women negatively assess their health and 96% note the probability of getting a serious illness for 5-10 years. Most women believe in the ability of medicine to successfully prevent and treat heart disease, but the proportion of people using health resources for preventive purposes remains extremely low and does not exceed 10%. In the open population among women aged 25-44 years for 23 years there is an increase in stress in the workplace and the trend of growth in changes in marital status. Recorded in the period 1994-2016 gg. changes in the behavior of women associated with health: increased the proportion of people who gave up smoking and regularly doing physical exercises, and improved eating behavior., Conclusion: It was found that among women aged 25-44 years there is a positive dynamics in relation to the prevention of behavioral risk factors for CVD. But despite this, half of women negatively assess their health and use health resources only slightly.

Aim: To establish the associations of the prevalence of coronary heart disease (CHD) with high levels of hostility in the open population of 25-64-year-old men in an average urbanized Siberian town., Subjects and Methods: A cross-sectional epidemiological survey was conducted in a representative sample of the electorate of a Tyumen administrative district among 1000 males, with 250 being in each of 4 life decades (25-34, 35-44, 45-54, and 55-64 years). There were 850 (85%) responses. Different forms of CHD were identified by standard methods (the WHO exertional angina questionnaire, resting EEG, and Minnesota coding) used in epidemiological surveys. Definite CHD (DCHD) and possible CHD were identified. A continuous survey method was used by self-filling out the WHO MONICA-psychosocial questionnaire to estimate the levels of hostility., Results: In an average urbanized Siberian town, the prevalence of high levels of hostility among 25-64-year-old men was 46.4% (age-adjusted rate). The high levels of hostility increased with age, peaking in the 55-64-year-old group. In the Tyumen male population aged 25-64-year-old, the odds ratio (OR) for coronary heart disease and high levels of hostility was 2.71; 95% confidence interval (CI), 1.63-4.52 (p<0.05); that for DCHD was almost twice higher (OR, 4.65; 95% CI, 2.14-10.12 (p<0.05). In the older men aged 55-64 years, OR for coronary heart disease and high levels of hostility was 5.42; 95% CI, 2.32-12.66 (p<0.05); that for DCHD was 25.85; 95% CI, 3.30-202.60 (p<0.05)., Conclusion: Consequently, the epidemiological criteria for psychosocial risk factors, including hostility, which are detected by the standardized survey methods, should be used in prophylactic examinations of a male population and in the selection of able-bodied people with cardiovascular disease to be comprehensively examined and followed up.

Aim: To identify gender differences in the prevalence of depression in an open population of individuals aged 25-64 years and to evaluate its impact on the risk of cardiovascular diseases (CVD) in the population of Siberia., Subjects and Methods: A random representative sample of a 25-64-year-old Novosibirsk population (657 men and 689 women) was surveyed within the framework of the third screening of the WHO MONICA-psychosocial program in 1994. The screening program included sociodemographic data registration and depression detection. Over a 16-year study period, women had myocardial infarction (MI) in 15 cases and stroke in 35 cases and men had these conditions in 30 and 22 cases, respectively., Results: In the open 25-64-year-old population, depression was detected in 54.5% of the women and in 29% of the men; major depression was present in 11.8% of the women and 3.1% of the men (χ2=66.724; υ=2; p=0.0001). The risk of MI in the depressed patients was higher in the women (hazard ratio (HR)=2.5) than in the men (HR=2); when social parameters and age are included in the model, only a trend towards the impact of depression on the risk of MI persisted in the women (HR=3.4; p>0.05) and the men were observed to have a 1.6-fold higher risk for MI. The greatest risk of MI was seen in the men (HR=6.8) and women (HR=6.3) at the age of 55-64 years, as well as in the men who had incomplete secondary or primary education (HR=3.2); in blue-collar workers (HR=6.7), in the men who were single (HR=3.6), divorced (HR=4.5), or widowed (HR=6). The risk of stroke in the depressed patients during a 16-year study period was greater in the men (HR=5.8) than in the women (HR=4.6); after adjusting for age and social gradient, the risk of stroke in the women was higher in both the population and those who were aged 55-64 years (HR=8.5 and 6.9, respectively) than that in the men (HR=4.2 and 3.1, respectively). Among the men, the risk of stroke was higher in those who had primary education (HR=8.8), were widowed (HR=8.4) or divorced (HR=2.7)., Conclusion: The women are much more susceptible to depression than are the men. The risk of MI with depression is higher in the women than in the men; at the same time, the risk of stroke is higher in the men than in the women. The picture is opposite in the older age group. The risk of CVD in the depressed men is exacerbated by a social gradient; these relationships have not been revealed in the women.

Aim: To establish the population characteristics of the components of metabolic syndrome (MS) in the age range of 25-64-year-old males in an average urbanized Siberian town., Materials and Methods: A cross-sectional epidemiological survey was conducted in a representative sample of the electorate of a Tyumen administrative district among 1000 males, with 250 being in each of 4 life decades (25-34, 35-44, 45-54, and 55-64 years). There were 850 (85%) responses. The IDF criteria (2005) were used to evaluate MS., Results: In the Tyumen open population of 25-64-year-old men, the population characteristics of systolic blood pressure (BP) and waist circumference (WC) were shifted to the right in the normal distribution range, which determined the high prevalence of hypertension and abdominal obesity (AO). In the 25-64-year-old men with the high prevalence of hypertension (a standardized rate of 59.8%) and AO (a standardized rate of 42.6%), the age was positively related to systolic BP in the third to fifth decades of life, diastolic BP, and WC at all ages., Conclusion: Examining the epidemiological situation regarding the prevalence of MS components necessitates the elaboration of a scientifically sound prevention program in the specific conditions of an average urbanized Siberian town.

Aim: To establish gender differences in health attitudes and awareness of risk factors for cardiovascular diseases in an open 25-64-year-old population of Russia/Siberia., Subjects and Methods: A representative sample from the population of a Novosibirsk district was examined using the 1988 WHO MONICA-MOPSY (847 women and 739 men aged 25-64 years) and the 2003 HAPIEE (1074 women and 576 men aged 45-64 years) programs. The health awareness and attitudes questionnaire was used., Results: The number of persons who considered perfectly healthy was minimal (2%) in the open Siberian population aged 25-64 years. The view of health in the women proved to be more pessimistic than that in the men. The fact that two thirds of the population could fall ill with a serious disease in the coming 5-10 years was accepted. Mainly the men took the view that modern medicine might prevent heart disease. The men were regularly examined 2 to 3 times more often than the women. The latter versus the men were less frequently inclined to stop work if they felt not quite well on-site, with the difference being more marked in old age groups. The majority of the study participants considered preventive examination to be useful for health. At the same time only a small portion of the population itself undergoes examination., Conclusion: The changed socioeconomic situation in the country leads to the need to alter the established stereotypes of conscience and behavior of the population in health and to realize the need for personal responsibility for health.

Aim: To determine the impact of workplace stress on the hazard ratio (HR) of myocardial infarction (M) and stroke in an open female population aged 25-64 years in Russia/Siberia (Novosibirsk) for 16 years., Subjects and Methods: A random representative sample of 25-64-year-old women (n=870) residing in a Novosibirsk district was surveyed within the framework of the WHO <> program. Workplace stress was investigated using the Karasek scale; an attitude towards work and health prophylactic examinations was studied applying the Health Awareness and Attitude questionnaire of the WHO <> program. For 16 years (1994 to 2010), a cohort of all new cases of MI and stroke was examined employing the WHO <> program and all possible medical records. The Cox regression model was used to determine HR for MI and stroke in the open female population aged 25-64 years for 16 years., Results: The prevalence of high-level stress in the open female population aged 25-64 years was 31.6%. The high level of job stress was associated with a high responsibility, impossibility to have a rest at the end of a working day, frequent professional dissatisfaction, and a reduced work capacity. During 16 years, the women having high-level job stress showed a 3.22- and 1.96-fold increases in the HR of MI (p<0.05) and stroke (p<0.05), respectively. The incidence of MI and stroke was higher in married women expressing job stress as managers or manual laborers and having high and low educational attainment., Conclusion: The prevalence of high-level workplace stress was substantial in the open population of 25-64-year-old women in Russia/Siberia (Novosibirsk). The stress-related HR of Ml and stroke was 3-2 times higher than in those without high-level stress. The HR of MI and stroke is affected by a social gradient.

Aim: To reveal an association of the prevalence of coronary heart disease (CHD) and metabolic syndrome (MS) with a high level of depression in the open population of 25-64-year-old men in an average urbanized Siberian town., Subjects and Methods: The survey was conducted on a representative sample formed from the voting list of 25-64-year-old men in one of the administrative districts of Tyumen. The standard WHO MONICA-psychosocial questionnaire was used to study associations of the prevalence of CHD and MS with a high level of depression within cardiologic screening., Results: The age-adjusted prevalence of depression was 4.6% (a high rate) and 19% (a moderate rate) in the 25-64-year-old men of the average urbanized town of West Siberia. With advancing age, the high level of depression increased, peaking in a 55-64-year-old group. In high depression and CHD in the 25-64-year-old men, the odds ratio (OR) was 21.07 for high depression and 39.84 for a definite CHD form. High depression was significantly more common in MS patients in the open population of 25-64-year-old people of the average urbanized Siberian town and in the 55-64 year old age group. An association was found between high depression and a combination of MS components: a concurrence of abdominal obesity, hypertriglyceridemia, and lower high-density lipoprotein cholesterol (OR 13.13)., Conclusion: The epidemiological criteria revealed by standardized survey methods for psychosocial factors, depression in particular, should be used during the preventive examinations of a male population and during the selection of able-bodied people with cardiovascular disease to undergo in-depth examination and follow-up.

Aim: To determine an association between trait anxiety (TA) and variable number tandem repeat (VNTR) polymorphisms in the DRD4 and DAT genes, as well as the prevalence of TA and the risk of cardiovascular diseases (CVD) in 25- to 64-year-old males with TA., Subjects and Methods: A representative sample of 25 to 64-year-old males (n = 2149) was examined within the framework of the WHO MONICA program, MONICA-psychosocial subprogram, in 1984, 1988, and 1994. All new-onset arterial hypertension (AH), myocardial infarction (MI), and stroke cases were registered throughout the follow-up study (1984-2008). Spielberger's test was used to estimate the level of TA. The Cox proportional regression model was applied to assess a relative risk., Results: The high level of anxiety (HLA) was 50.9% in the open population of 25 to 64-year-old males. The DRD4 genotype 4/6 and DAT genotype 9/9 were significantly associated with HLA. The latter increased the risk for CVD: it was maximal for AH and stroke within the first five years and for MI within 10 years., Conclusion: HLA was significant in the Novosibirsk open population of 25 to 64-year-old males. It is substantially associated with certain VNTR polymorphisms in the DRD4 and DAT genes and considerably increases the risk of CVD.

Aim: To evaluate the effect of blood pressures (BP) on the risk of cardiovascular death (CVD) in a Tyumen open population through a 12-year prospective follow-up study., Subjects and Methods: Standard methods were used to make a cardiac screening of a representative sample of 25-to-64-year-old Tyumen citizens in 1996. The response rate was 80.4% or 1608 persons. CVD cases were recorded in 85 (10.69%) men and 33 (4.06%) women during the 12-year subsequent prospective follow-up study. The Cox regression model was used to assess the relative risk (RR) for CVD. Survival rates were analyzed with the Kaplan-Meier method., Results: In the men, RR for CVD statistically significant increased from the 4th quintile of the distribution of systolic blood pressure (SBP) (2.88) and from the 3rd quintile of that of diastolic BP (DBP) (2.33). The women showed a statistically significant increase i RR for CVD only in the 5th quintile both of SBP and DBP (11.0 and 7.95%, respectively). Analysis of the absolute risk showed that SBP made a greater contribution to CVD that DBP in both the men and women (52.8 and 46.9% for the men and 92 and 83.8% for the women, respectively)., Conclusion: The open population from Tyumen was ascertained to have a high RR for CVD starting with a SBP of > or = 141 mm Hg and a DBP > or = 86 mm Hg for the men and with a SBP of > or = 152 mm Hg and a DBP of > or = 95 mm Hg for the women, which determined a lower survival in the population with elevated SBP and elevated DBP.

Aim: To evaluate the impact of the blood levels of lipoproteins, such as total cholesterol (TC), high-density lipoproteins (HDL), triglycerides (TG), on the risk for cardiovascular death in an open Tyumen male population on the basis of a 12-year prospective follow-up study., Subjects and Methods: Standard methods were used to conduct an epidemiological study of a representative sample of Tyumen males aged 25-64 years in 1996. The cardiological screening response rate was 79.5% (n = 795). Eighty-five cardiovascular deaths (CVD) were registered in the male cohort during 12 years of the prospective follow-up study. The Cox proportional hazard regression model was employed to assess the relative risk (RR) of CVD. Survival rates were analyzed with the Kaplan-Meier method; the significance of lifespan differences in two groups was estimated using the log-rank test., Results: In the male cohort, a statistically significant increase in the RR of CVD occurred, starting with a TC level of > or = 230 mg/dl. The lowest survival rates were noted in the males with hypercholesterolemia (HC). The statistically significant increase in the RR of CVD depending on the levels of TG was found in its 5th quintile (138 mg/dl or more). Lower survival rates were stated in the males with hypertriglyceridemia (HTG) than in those with normal blood TG levels. There were neither statistically significant results in the assessment of RR and survival rates in relation to the level of low-density lipoprotein cholesterol, no data on the effect of the level of HDL cholesterol on the RR of CVD in the males., Conclusion: According to the data of a 12-year cohort study, the open Tyumen male population was found to have a high RR of CVD in those who had TC levels > or = 230 mg/dl and TG levels > or = 138 mg/dl, which determined the lowest survival rates in males with HC and HTG.

Aim: To reveal 30 year (1977-2006) trends of myocardial infarction (MI) morbidity, lethality and mortality in population of the West Siberia megapolis (Novosibirsk)., Material and Methods: WHO programs "Acute Myocardial Infarction Register (AMIR) and MONICA covered 3 districts of Novosibirsk., Results: MI morbidity in 25-64 year old population of Novosibirsk (high-risk population) in Russia is one of the highest in the world. MI morbidity was stable for 30 years excluding in 1988, 1994 and 1998 when it rose and in 2002-2004, 2006 when it lowered. Changes in mortality and lethality resemble changes in morbidity trend excluding 1977-1978 (fall) and 2002-2005 (rise). Prehospital mortality and lethality were much higher than those in hospital. Mortality and lethality in 1988, 1994, 1998 and 2002-2005 increased due to prehospital lethality and mortality, while it decreased in 1977-1978 due to hospital one. Reduction of mortality and lethality in stable MI morbidity shows improvement of medical care for MI patients, increased lethality and mortality in MI morbidity decline reflect deterioration of such care. Changes in behavioral and somatic factors of cardiovascular risk in population of Novosibirsk for 30 years were not observed while psychosocial risk factors gain a significant importance. By indirect indications, MI morbidity, mortality and lethality mark growing social stress in the population. MI mortality is 2-3 times higher than that of alcohol and is a basic factor of mortality increase in the population of Russia., Conclusion: MI morbidity, mortality and lethality are markers of social stress in population.

Aim: To study prevalence and instensity of smoking in middle-aged male population of Tyumen, follow-up changes in smoking during monitoring, fat and cholesterol content in diet., Material and Methods: Two cardiological screenings were performed during 5-year monitoring of Tyumen population: basic smoking study in 25-64-year old males and second screening with 24-hour diet control in the groups of 35-54 year old males., Results: Smoking prevalence in Tyumen males was moderate while intensity was high in all age groups. The proportion of males who quitted smoking was small. For 5 years the number of nonregular smokers in 45-54 year old males, of those who never smoked, hard smokers rose, while number of persons who smoked a small number of cigarettes diminished. Diet of the studied population was non-rational with mean caloric value but animal fat excess., Conclusion: The diet of the examinees contained high amount of fat, saturated fatty acids, mono- and polyunsaturated fatty acids, food cholesterol. The proportion of smokers was high.

Aim: To study effects of hostility on the risk of arterial hypertension (AH), myocardial infarction (MI) and stroke in males aged 25-64 years., Materials and Methods: A screening study of the population was performed in 1994 according to WHO program MONICA-psychosocial. The response in a random representative sample of 25-64-year-old males (n = 657) living in Novosibirsk was 82.1%. New cases of MI, AH and stroke were registered in the control periods 1994-2000, 1994-2002. Computer program package SPSS-10 was used for statistic processing. Cox regression model of the relative risk (RR) was employed., Results: Hostility was rather prevalent among the examinees (76.9%). MI risk for 8 years was 4.65 times higher in hostile men. Hostility was not associated with higher risk of AH and stroke. Hostility was seen more frequently in men with poor education, workers and retired persons. These groups are also at the highest risk of MI., Conclusion: Hostility raises MI risk in unstable society but had no effect on the risk of AH and stroke.

Aim: To study depression effects on the risk of myocardial infarction (MI) for 8 years in men aged 25-64 years., Material and Methods: A random representative sample of men (n = 657) at the age between 25 and 64 living in Novosibirsk were screened in 1994 in the scope of WHO program "MONICA-psychosocial". The response was 82.1%. WHO "Register of Acute Myocardial Infarction" detected 58 cases of MI in the control period 1994-2002. Statistics were obtained with the program set SPSS-10. Cox regression model was used for estimation of a relative MI risk (RMIR)., Results: RMIR in 25-64-year-old men for 8 years was 2-fold higher in men with depression than without it, in the age group of 55-64-old men--5-fold. Depression was in 65.8% MI patients. The highest RMIR was in men with depression engaged in hard labour, retired, poorly educated, divorced, widowed., Conclusion: Risk of MI in men is related to depression due to social and economic status.

Aim: To study five-year trends in main risk factors of coronary heart disease (CHD) among 35-54-year-old population of Tyumen., Material and Methods: Five-year monitoring of 1597 males and females aged 35-54 years was performed as two cardiological screening trials. The risk factors were assessed both by standard and extended WHO criteria., Results: Risk factors studied had the following prevalence trends: a rise in the rate of obesity (7.2-14.5%), hypercholesterolemia by standard criteria (14.4-27.8%) and hypertriglyceridemia (5.8-16.7%) among men aged 35-44 years; a rise of the rate of isolated systolic arterial hypertension by extended criteria (3.5-8.8%), smoking (10.6-19.2%), hypo-alphacholesterolemia (3.9-11.6%) among women aged 35-44 years; a rise in the rate of isolated systolic arterial hypertension (3.9-14.7%), a decrease of diastolic arterial hypertension rate by extended criteria (49.0-31.3%) among women aged 45-54 years. Five-year monitoring revealed that among 45-54-year-old men the number of those who smoke irregularly significantly increased (7.3-21.5%), while the number of non-smokers fell (44.3-21.5%)., Conclusion: Tyumen population is characterized by a high prevalence of the risk factors with a negative 5-year trend. The results of the screenings give grounds for conduction of a large-scale prophylactic program in an open Tyumen population with a focus on priorities of prophylactic interventions.

Aim: To study correlations between personal anxiety (PA) as one of the leading psychosocial factors and ischemic heart disease (IHD)., Material and Methods: The third screening (1994) of the program MONICA and subprogram MOPSY-MONICA-psychosocial covered a random representative sample of males at the age of 25-64 years living in Novosibirsk. The response was 82% (657 responders, mean age 44.3 +/- 0.4 years). Statistical analysis was based on the SPSS-10 software package., Results: Prevalence of PA as an indication of social stress in a male population of 25-64-year-olds is very high especially in young age groups. PA is maximal among persons with elementary education and workers. Persons with PA experience strong stress in job and in family settings. An IHD rate is higher among PA patients. High PA is often associated with depression, high hostility, cachexia, sleep problems, low social support. PA patients have a negative opinion of their health but their attempts to improve it are insufficient. The proportion of those who quit smoking, reduce the number of cigarettes, keep diet, restrict physical activity grow in PA persons., Conclusion: PA is prevalent among male population especially in young persons. A PA level correlates with social status. IHD occurs more frequently in PA persons. High PA often associates with other psychosocial factors.

Aim: To evaluate levels of total cholesterol (TC), HDLP cholesterol, triglycerides (TG), occurrence of hypercholesterolemia (HCE), hypertriglyceridemia (HTG) and low HDLP cholesterol in the Tyumen population., Material and Methods: 866 men and women aged 25-64 years have been examined in one-stage cardiological screening within a two-stage epidemiological study of serum lipoproteins by WHO criteria., Results: HCE was registered in 15.6% males and 18.8% females, a low HDLP cholesterol--in 5.3 and 4.2%, HTG--in 5.8 and 4.3% males and females, respectively. A high TC level and HCE occurred more frequently in women over 54 years of age; a low HDLP cholesterol level in insignificant fall in HDLP cholesterol and no age-related changes of this index were found both in males and females; TG were elevated in older males in moderate prevalence of HTG in the population., Conclusion: It is shown that Tyumen population is at high risk of cardiovascular diseases. Further studies are needed to specify targeted preventive programs.

Aim: To study knowledge of cardiovascular disease (CVD) risk factors (RF) in open population of Tyumen with reference to social gradient., Material and Methods: Knowledge of CVD RF was studied in 2248 citizens of Tyumen (men and women, age 25-64 years) by means of mail questionnaire survey. The knowledge was assessed with consideration of education, occupation and marriage status., Results: The examinees with primary education and manual labour workers were found to have little knowledge of the CVD RF while those with university education, engineers and specialists were well informed. Married population, widows and widowers knew about CVD RF more than divorced., Conclusion: The results of the study can serve a basis for a large-scale prophylactic program in open population of Tyumen.

Aim: To evaluate changes for a decade in the attitude of men in Novosibirsk to health problems., Material and Methods: WHO program MONICA has covered males aged 25-64 years (a representative sample from the population in one of the districts of Novosibirsk city). A total of 3 trials were made (in 1984, 1988 and 1994) which included questioning, registration of ECG, arterial pressure, height, body mass, biochemical tests of the blood., Results: Attitude of men to their health depended on their age. There was a trend to evaluate their health as more and more poor in men at the age of 25-43 and 35-44 years. In the group of 45-54-year-olds positive assessment of health was encountered 1.9 times more frequently, but the difference was not significant. At the age 55-64 years a growing number of men tend to assess their health as good. Since 1994 alcoholics among the elderly men grew in number as a response to the social and economic crisis., Conclusion: The change in health evaluation from negative to positive in older men may relate to less intensive work.

Aim: To assess the attitude of the Novosibirsk population towards its health, its readiness to participate in preventive measures and to implement guidelines for changing lifestyle., Materials and Methods: A random representative sample of males and females (a total of 2400 individuals) aged 24 to 64 years from one of the Novosibirsk districts was examined within the framework of the second screening of the MONICA program studying the trends and monitoring cardiovascular diseases and the "MOPSY-MONICA-psychosocial" subprogram. The examination included the conventional procedures described in the MONICA project. Sleep disorders, health self-assessment, and attitude to smoking were studied by means of the questionnaire "Awareness and Attitude towards Health" adapted to the studied population., Results: More than 60% of the males and 85% of the females reported that they were not quite healthy or ill, only 7% of the individuals had their health examined although almost 100% noted that they were most likely to fall ill with a serious disease within 5-10 years. The males were more optimistic in their assessments than were the females. With age, the frequency of assessments, such as "not quite healthy" and "ill", concern about their health, and participation in prophylactic examinations increased. 45% of the respondents reported about the high level of stress in their working place. The opportunity of the examinees to have a rest at home was extremely little. Family stress was significant for both sexes. The females showed a more negative attitude towards smoking than did the males (55% of the males and 5% of the females were smokers). The males more frequently considered that they did not need to alter dietary habits and to do exercises than did the females. A total of 2.4% of the males and 2.5% of the females changed their dietary habits for their health. Only 50% of the males and 31% of the females slept well or very well, this parameter decreased with age., Conclusion: Despite a positive motivation in the context of prophylaxis, there are negative trends in both social and behavioral characteristics of the population. The most intensive measures for altering the behavioral characteristics of the population and for softening the impact of stress on the population are required at the governmental level.

Aim: To study correlations between coronary heart disease (CHD) and psychosocial risk factors., Material and Methods: CHD affected more frequently workers engaged in hard physical labour, in poorly educated persons; the least CHD morbidity was recorded in managers and highly educated persons. CHD males think of their health much worse than males free of CHD. The former smoked much more before CHD diagnosis, but when CHD comes they quit and reduce smoking much more frequently. This fact explains why smokers are encountered among CHD patients two times less frequently than in CHD-free males. In spite of stronger motivation for adequate diet, CHD males changed their nutrition pattern only in 3.7%. CHD males sleep worse: good sleep was registered in CHD-free males two times more frequently. Psychological risk factors such as personal anxiety, sleep disorders were reported much more frequently in CHD patients proving the fact of social stress involvement in development of CHD. So-called coronary behavior was observed in both groups of males with the same rate. Thus, the coronary behavior is not associated with CHD., Conclusion: Development of CHD is associated not with the behavior but its components (depression, anxiety, etc.).

Aim: Seeking medical advice (SMA) in myocardial infarction (MI) has been reviewed for 22 (1977-1998) years. Causes of late SMA have been analysed., Material and Methods: SMA was studied in 4093 MI patients. In 757 cases the time of SMA was considered depending on the diagnostic category, intensity of pain syndrome, first or repeated MI., Results: SMA early after MI (within the initial hours) in 1977-1991 was low. Later (in 1992-1998), the situation became worse. SMA depends on sex and age. Young men and old women seek medical advice late after MI. Early SMA does not depend on awareness of having ischemic heart disease. The majority of the patients are unaware of the risk of the first MI hours, while half of them do not know symptoms of MI., Conclusion: As SMA in MI is a behavioral characteristic of the population, the problem is social and can be solved only by relevant education of the population.

Aim: A 22-year study of diagnostic categories of myocardial infarction (MI), a prodromal period, behavioral characteristics of the patients., Material and Methods: WHO programs Acute Myocardial Infarction Register and MONICA were performed in Novosibirsk population aged 25-64 years. From January 1, 1977, to December 31, 1998, monitoring registered 5180 cases of MI (1774 lethal outcomes)., Results: The diagnostic category "Possible" MI occurred more frequently than "definite" MI, this difference being more noticeable in women than in men. In both diagnostic categories the disease presented with a typical clinical picture. In the category "definite" MI there were many cases of atypical disease. Most cases of MI developed at home though it occurred outdoors more frequently in men and at home in women. Half of the patients had arterial hypertension (AH) and effort angina (EA), one third of the patients had survived MI before. 91% of MI men were heavy smokers. Alcohol intake at MI onset was insignificant. Pain syndrome 2 weeks before MI was the same in survivors and the deceased. Those who died suddenly felt extremely tied before MI, those whose death was not sudden experienced exacerbation of EA and dyspnea, those who survived experienced exacerbation of EA., Conclusion: Long-term monitoring showed that MI clinical presentation did not differ for 2 decades. A significant number of MI patients with a history of hypertension, effort angina, previous MI, heavy smoking evidenced for the lack of prophylactic education among population.

Aim: To study trends of mortality due to alcoholism (A) and cardiovascular diseases (CVD) in Novosibirsk in 1981 to 1998., Materials and Methods: The WHO MONICA and Acute Myocardial Infarction Register programmes were used to survey the population of 3 Novosibirsk districts. There were notified 9016 cases of nonviolent death, by exclusing another pathology, with the exception of CVD and alcoholic intoxication., Results: Mortality rates due to myocardial infarction (MI) were relatively stable throughout the observation period, except for 1988, 1994, and 1998 (a significant increase). Those due to A showed the following trend: stabilization in 1981-1982, a significant increase in 1983-1987, stabilization in 1988-1991, a significant increase in 1992-1994, and a decrease in 1995-1998. Mortality rate from MI were 2-3 times greater than that from A, with the exception of 1994-1995 when they were equal, i.e. the trends of mortality from MI and A did not coincide. Social stress is a factor that greatly influences MI death rates, mainly due to prehospital mortality. As social stress increases, younger age groups, both males and females, are afflicted, which is extremely hazardous for the population. By taking into account the mortality trends, it may be stated that A hardly affects death rates from MI. In the pattern of mortality from CVD, death rates from MI and A were 50-70% in males and 35-60% and females; those from MI were 35-55 and 30-45%, respectively. The increase in alcoholism mortality is associated with the population's addictive behavior in the period of social upheavals in the community., Conclusion: According to official statistics, the mortality trends do not reflect the actual state of things. This may be done only by stringently standardized programmes with their schemes of data collection and diagnosis verification. The WHO MONICA and Acute Myocardial Infarction programmes belong to such programmes.

Aim: To study prevalence of ischemic heart disease (IHD) in free living population of Tumen., Material and Methods: A one-stage cardiological screening covered 1608 Tumen residents (70.3% of the respondents of the mail questionnaire survey). IHD was stated by the standard methods., Results: IHD incidence among male and female population of Tumen was rather high. Angina of effort was found in 4.5% of males and 5.1% of females, painless IHD was detected in 3.2 and 3.7% of male and female 55-64-year-old population, respectively, by extended criteria. IHD incidence rate by the extended criteria reached 12.5%., Conclusion: Primary results of the survey indicate that Tumen population is at high risk of cardiovascular diseases. This fact requires a detailed analysis of the trends in IHD prevalence in a prospective study.

Aim: To reveal trends in incidence rates of acute cardiovascular diseases (ACD) in a large industrial city of the West Siberia., Materials and Methods: Studies on WHO programs "Acute Myocardial Infarction Register" and "MONICA" have been performed in three districts of Novosibirsk. The diagnostic categories were detected without difference. The observation covered stable population of 500,000 residents aged 25-64 years. Trends in the myocardial infarction (MI) mortality, morbidity and lethality were analysed for 1977-1996., Results: The above trends were stable except for 1986 when MI mortality, morbidity and lethality decreased and 1988 and 1994 when they went up. The reduction was due to 7-year prevention program while the rise was consequent to discontinuation of the preventive measures. Major risk factors of ischemic heart disease, according to screenings conducted in 1984, 1988 and 1994 remained at about the same level. Social stress closely correlates with a rise in MI morbidity and mortality. The latter in 1994 grew owing to higher rates of MI mortality and morbidity among the oldest men and females of different age groups., Conclusion: Urgent intensification of prophylactic measures is needed both at the populational level and the level of high risk strategy.

Aim: To estimate prevalence and intensity of smoking among adult Tyumen citizens by mail questionnaire survey., Materials and Methods: A representative sample of adult population of Tyumen (central district) was randomly selected using the list of the electors. The questioning covered a total of 3200 citizens (8 groups per 400 age- and sex-matched subjects). The response reached 71.5%. Smoking in the population was studied in three aspects: prevalence, intensity and passive smoking., Results: Overall prevalence of smoking was not great (28.8%), but smoking was frequent in women, especially young, was intensive in males of all the age groups. The number of smokers who had quit smoking was small. Passive smoking at jobs was prevalent., Conclusion: The data of the survey indicate difficulties of social adaptation for the studied population who fall under risk to develop cardiovascular diseases.

Aim: To study a 5-year prevalence of and changes in anxiety, behavior of the coronary type, social support, health self-estimation, attitude to smoking, sleep disorders in male population., Materials and Methods: In the context of the program "MONICA-psychosocial", a random representative sample of males aged 25-64 living in Novosibirsk has been examined (screening in 1988-1989--739 males, and in 1994-1995--657 males)., Results: Personal anxiety in the study population has increased for 5 years from 49.5 to 51%. The number of males with coronary behavior has reduced from 25.9 to 16.9% (p < 0.001). Health self-estimation has improved and frequency of sleep disorders diminished. Negative tendencies also manifested: less number of males quit smoking, social connections and contacts decreased., Conclusion: A close correlation between psychosocial factors and ischemic heart disease necessitate intensification of the preventive programs aimed at weakening of influence of psychosocial factors on the population. Otherwise no reduction in ischemic heart disease incidence in population can be expected.

Aim: To evaluate epidemiological situation by cardiovascular diseases and their risk factors in Tyumen., Materials and Methods: An open population of the Central Tyumen district was studied (1608 patients) for prevalence of obesity, arterial hypertension, systolic and diastolic arterial pressure., Results: It was found: high incidence of arterial hypertension both in males and females (25.6 and 24.6%, respectively) with predominance of isolated systolic arterial hypertension in younger patients, high incidence of borderline hypertension in young men, higher predisposition to obesity in males vs females. Body mass index was higher in 25-34-year-old males but increased with age in females., Conclusion: It is necessary to perform a cohort study of epidemiological parameters to detect persons with cardiovascular disease risk.

Aim: To elucidate attitude of urban population of Tyumen city to own health and compare the knowledge of cardiovascular disease risk factors in different population groups using postal questionnaire., Materials and Methods: 3200 men and women were included into the lists of population selection, 400 subjects in each group according to the age and sex. 71.5% of those on the lists agreed to take part in the survey., Results: The population knew about the risk factors in the following order: hypercholesterolemia (44.6%), arterial hypertension (74.8%), low physical activity (75.2%), smoking (75.7%), obesity (83.7%), stress (93.7%). The knowledge of the risk factors among persons with higher education was greater than among less educated individuals., Conclusion: Most respondents worried about their health, especially males, understand the importance of preventive approach to cardiovascular diseases, are aware of the major risk factors but they have low trust in public health service.

Monitoring of the main risk factors of ischemic heart disease was conducted in an ordered population of males aged 20-59. The examinees worked in expeditions engaged in oil production at the West Siberia oil fields. The prospective epidemiological survey lasted 3 years for the study population and 2 years for two representative comparison groups. The examination program involved filling WHO risk factor questionnaire, two measurements of arterial pressure, anthropometric examination, total blood cholesterol assay. Systolic pressure was found to increase upon service duration 2.9 and 4.3 years, diastolic pressure rose after 2.9 years of service, body mass index after 4.3 and 5.6 years. It is evident that preventive measures should be taken within 3 years of service in conditions of expedition work schedule.

The tendencies in and control of cardiovascular diseases were studied for three years according to the MONICA psychosocial program. A random representative sample of 753 men aged 25-64 years (in the first screening) and 739 men (in the second screening) permanently living in one of the districts of Novosibirsk were examined. The purpose was to investigate the knowledge of the population of the issues related to the health status: self-estimation of the health status, knowledge of blood pressure magnitude, attitude to the prophylaxis, tobacco smoking and changes in nutrition. The data obtained indicate that self-estimation of the health status changed for the worse in all the age groups. The share of persons asserting that they are ill or not entirely well rose by 12% and amounted to 62%. A decrease was recorded in the number of men not aware of the level of their blood pressure, namely from 27% in the first screening to 17% in the second screening. The number of tobacco smokers remained practically unchanged (55 and 54%). However, the number of men who would like to change their attitude toward tobacco smoking increased more than 1.5-fold. The treatment of the proposals concerning alterations in nutrition changed for the better in persons aged 45-64 years. On the contrary, it changed for the worse in persons aged 25-44 years.

Available are the results of WHO programs (Acute Myocardial Infarction Register, Monitoring of Trends in Cardiovascular Diseases and Underlying Factors) investigations in three districts of Novosibirsk. The trends in mortality, case incidence, lethality for 15 years in 25-64-year-old myocardial infarction patients have been established as well as these trend relationships with main IHD risk factors, treatment efficacy, environmental factors, social stress.

The data on the studies using WHO programs "Register of Acute Myocardial Infarction", "Register of Brain Apoplexy", "MONICA" in one of the districts of Novosibirsk have been pooled and analyzed. The studies have established objective trends in the incidence, mortality, lethality of myocardial infarction and brain apoplexy in the population aged 25-64 for 10 years.

The authors analyze the results of investigations in accordance with the WHO program "MONICA" in one of the districts of Novosibirsk. The bases of the objective information system pertaining to the tendencies in mortality, morbidity and lethality due to cardiovascular diseases, the prevalence of risk factors in the population, the possibilities of their monitoring have been established.

To study the incidence of coronary heart disease (CHD), cerebrovascular diseases (CVD), combined pathology (CHD and CVD), and their risk factors such as arterial hypertension (AH), overweight (OW), hypercholesterolemia (HC), and tobacco smoking in the same population, a random representative sample of male and female populations were examined in three districts of Novosibirsk. AH and tobacco smoking were found predominant among men, whereas OW and HC among women. It turned out that almost every fourth person out of the men and almost every second woman suffered from cardiovascular diseases. In the men, the CHD/CVD ratio was 1:1, that in the women, was 1:7. In the men and women, suffering from combined pathology, AH occurred more frequently as compared to those with CHD or CVD alone. OW promoted the development of CVD and combined pathology in women to a greater degree, whereas HC favoured the development of CHD and CVD in men.

In order to study CHD prevalence in an organized population (aged 20 to 59) in Novosibirsk a simultaneous cardiological study of workers and employees at one of the factories was conducted in 1985. CHD prevalence rate among all examinees was 12.2%. The growing number of risk factors brought about an increase in the number of detected CHD cases. Particular attention should be drawn to patients with risk factors and to prophylaxis among them.

The paper is concerned with the data on the prevalence of various ECG changes in an open male and female population (aged 25 to 64) in Novosibirsk obtained on examination of a random representative sample. The analysis permitted defining groups of persons with prognostically unfavorable ECG changes serving as a basis for further study of regularities of their appearance.

Changes in the incidence of myocardial infarction, and associated mortality and lethality rates are reviewed over a 8-year period in an Novosibirsk district. Data on late postinfarction outcomes, obtained in a WHO-sponsored study, "Acute myocardial infarction register", are also presented. The incidence, mortality and lethality rates are showing a stabilization trend at present; in late outcomes, the greatest mortality and lethality rates fall to the first postinfarction year.

The paper treats the data concerning the acute cardiovascular pathology occurrence examined during ten years in an open population of one of the districts of Novosibirsk. It is shown that at first there was a tendency towards the incidence increase followed by its stabilization and then by a tendency towards reduction over the last year. It is proved that the district selected for prolonged monitoring is a typical district of the city and that the tendencies in the incidence among its community should be classified as objective. Comparison of the WHO programs: The Register of Acute Myocardial Infarction (1969) and the Monitoring of the Trends in Cardiovascular Diseases and Determining Factors (1983) has shown no substantial differences in the incidence and death rates obtained in accordance with both programs. It is stressed that this enables one to compare the data of both programs applied to different populations.