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Aim. To study the structural and functional features of the carotid and femoral arteries using ultrasound duplex scanning of them in patients with hypertension undergoing periodic preventive medical examination.Material and methods. Periodic preventive examination was carried out for 2431 employees (1311 men and 1120 women) aged 20-65 years using a specially developed questionnaire, blood pressure measurement, anthropometry, total cholesterol test. Hypertensive men were assessed for preclinical manifestations of atherosclerosis by ultrasound duplex scanning of the carotid and femoral arteries.Results. Hypertensive men (BP ≥140/90 mmHg and/or taking antihypertensive drugs; n=176, mean age 43.5 years) were included in the study. An increase in the thickness of the intima-media complex in the carotid arteries was found in 22.2% (n=38) people, in the femoral arteries – in 34.1% (n=60) people, in both basins – in 16.5% (n= 29) man. Atherosclerotic plaques in the carotid arteries were found in 40.3% of people (n=71), and in the femoral arteries – in 34.7% (n=61) of people, in both pools – in 23.9% (n=42) of men.Conclusion. Ultrasound diagnostic using modern ultrasound scanners is a highly informative method for non-invasive diagnosis of atherosclerosis in the arteries of the carotid and femoral basins in employees of a large industrial enterprise with arterial hypertension in the conditions of the medical and sanitary department. Carrying out these diagnostic approaches is advisable when organizing periodic medical examinations in order to improve primary prevention, as well as to prevent the aggravation of the identified pathological process, reduce complications, improve quality and increase life expectancy.

Aim. To study the incidence of arterial hypertension (HT) and prevalence of risk factors and occupational factors (OF) among people with HT on the base of engineering plant within "The program of formation of healthy lifestyle and prevention of chronic non-communicable diseases among the contingent, attached for the medical assistance for the period 2012-2016".Material and methods. The study included men (n=586), aged 20-65 years – the workers of the engineering plant directly involved in the works in conditions of industrial occupational exposures. These specified works occupied not less than 50% of the general time, and work experience at the enterprise in examined workers was at least 5 years.Results. All examined people were divided into 2 groups according to the office blood pressure (BP) levels: without HT – 380 people (64.8%) and with HT – 206 patients (35.2%). HT was observed more often among people without higher education (39.2 vs 28.3%; р

The role of endothelial dysfunction in the pathogenesis of ischemic heart disease and some other cardiovascular diseases is considered. The endothelial dysfunction takes place at the earliest stages of diseases. The interaction of vasodilator and vasoconstrictor factors produced by vascular endothelium is discussed. The treating effect of some medicinal products (nitrates, beta-blockers and others) is analyzed from the point of view of their correcting influence on endothelial function.

The refractory arterial hypertension (HT) is diagnosed, if therapy with three antihypertensive drugs from different classes (including a diuretic) in optimal doses did not provide target blood pressure (BP) level. Prevalence of a refractory HT is high and reaches up 10-30% among hypertensive patients. However, poor BP control is often caused by patient non-compliance with the medical recommendations, an inadequate estimation of BP level, and "white coat" HT. It is classified as a pseudo resistance. Obesity, salt and alcohol overconsumption, taking some drugs worsen BP control. Secondary HT causes (sleep apnea syndrome, kidney diseases, renal artery stenosis, and primary hyperaldosteronism) are more possible in patients with refractory HT. Specific treatment of these diseases improves BP control and long-term prognosis. Successful treatment of refractory HT includes detection and correction of reversible risk factors and reasons of the secondary HT, use of the effective combined therapy with the aldosterone antagonist. Improvement of patient compliance is one of key factors of effective treatment.

Aim. To prove the advantage of the long-term controlled antihypertensive therapy compared with the real usual standard therapy in patients with mild to moderate arterial hypertension.Material and methods. It was multicenter, randomized, prospective parallel-group study in patients with mild to moderate hypertension. One part of patients (treatment group) received the strongly regulated stepped antihypertensive therapy based on ACE-inhibitor spirapril, the second one (control group) continued their usual standard therapy prescribed by doctors of polyclinics or other patient care institutions. The study lasted one year.Results. 1742 patients were enrolled in the study, 854 patients were included in the treatment group and 888 – in the control group. 220 patients dropped out of the study by different reasons, and 1552 patients finished the study. There were 651 (37,6%) men and 1081 (62,4%) women. It was substantial decrease in blood pressure in both group, but distinctions between systolic and diastolic blood pressure in the treatment and control group during the study were significant.The target levels of blood pressure (systolic < 140 mm Hg and diastolic < 90 mm Hg) were registered substantially more frequent in the patients of treatment group than in control group (69,4% и 39,3% after three months and 83,6% и 66,9% after 12 months of the treatment correspondingly).Conclusion. Controlled stepped antihypertensive therapy resulted into more significant decrease in systolic and diastolic blood pressure and more frequent achievement of target levels of blood pressure in comparison with control group. It supposes better prognosis of patients.

Aim. To prove the advantage of the long-term controlled antihypertensive therapy compared with the real usual standard therapy in patients with mild to moderate arterial hypertension.Material and methods. It was multicenter, randomized, prospective parallel-group study in patients with mild to moderate hypertension. One part of patients (treatment group) received the strongly regulated stepped antihypertensive therapy based on ACE-inhibitor spirapril, the second one (control group) continued their usual standard therapy prescribed by doctors of polyclinics or other patient care institutions. The study lasted one year.Results. 1742 patients were enrolled in the study, 854 patients were included in the treatment group and 888 – in the control group. 220 patients dropped out of the study by different reasons, and 1552 patients finished the study. There were 651 (37,6%) men and 1081 (62,4%) women. It was substantial decrease in blood pressure in both group, but distinctions between systolic and diastolic blood pressure in the treatment and control group during the study were significant.The target levels of blood pressure (systolic < 140 mm Hg and diastolic < 90 mm Hg) were registered substantially more frequent in the patients of treatment group than in control group (69,4% и 39,3% after three months and 83,6% и 66,9% after 12 months of the treatment correspondingly).Conclusion. Controlled stepped antihypertensive therapy resulted into more significant decrease in systolic and diastolic blood pressure and more frequent achievement of target levels of blood pressure in comparison with control group. It supposes better prognosis of patients.

Aim. To study the rate and characters of masked arterial hypertension (HT) and masked ineffectiveness of HT treatment in industrial workers within annual preventive examination.Material and methods. Workers (n=185) with normal office blood pressure (BP) Results. The rate of masked HT among workers with normal office BP was 10.8%, and masked HT among treated subjects was 34.6%. Workers with masked HT, in contrast to the normotensive workers according to the office BP and ABPM measurements, had a higher left ventricular mass index (in males 129.0±21.2 vs. 109.5±28.8 g/m2, respectively, in women 105.2±43.2 vs. 82.4±25.3 g/m2, respectively, pConclusion. Masked HT and masked HT in treated subjects (masked ineffectiveness of HT treatment) can occur in almost a half of industrial workers with normal office BP. Ambulatory BP measurement methods, especially ABPM, as well as standard risk factors detection are necessary for early revealing of HT phenotypes during preventive examination.

Aim. To study the rate and characters of masked arterial hypertension (HT) and masked ineffectiveness of HT treatment in industrial workers within annual preventive examination.Material and methods. Workers (n=185) with normal office blood pressure (BP)

Aim. To study structural and functional changes of myocardium, that are explained as the signs of hypertensive heart disease (HHD), in covert arterial hypertension (CAH) at the workplace of a large factory employee using echocardiography (EchoCG). Material and methods. One-time cohort study under the frames of annual prophylactic medical screening of a large factory employee. Totally 376 workers studied with normotension and arterial hypertension (AH) (47,9% males), with office blood pressure (OBP) 115 g/m2 in men and >95 g/ m2 in women. Results. Among workers with normal OBP not receiving AHT, CAH revealed in 50% cases; in workers with AHT, covert treatment insufficiency of AH (CTI AH) — in 24,8%. In CAH and CTI AH by the data of EchoCG there are signs of LVH: increase of the left ventricle thickness, back wall, LVMMI, that are comparable with those in patients with stable AH (St. AH) — the ambulatory BP (Amb.BP) and OBP also increased. In CAH comparing to normotonics there is an increase of E/A equation by increase of the A (p

The article is considered on the questions of pathogenesis, clinic and diagnosis of myocardial disorders, first of all in persons with high blood pressure. Preference of ultrasound cardiography (UC) for detection of concentric and eccentric hypertrophy of left heart ventricle as well as concentric remodeling is shown. Authors claim the principle possibility to use UC methods in the plant out-patient department; it has principal significance for economically active persons. 2557 industrial workers 20–60 years (1492 men and 1065 women) were investigated. Hypertension (140/90 mm Hg or antihypertensive treatment) was diagnosed in 20% — 514 persons. Voltage ECG LVH criteria were found in 142 pts (28%); UC signs of LVH were found in 389 pts (76%). Increase of related thickness of heart walls diagnosed in 412 pts (80%) and increase of Mass myocardial index — in 347 pts (67%), diastolic dysfunction was found in 402 pts (78%). So the exclusive value of modern diagnostic methods including UC is proven which gives the possibility of early diagnostic of prevalent heart disorders in hypertensive industrial workers.

Aim. To assess social status and selected psychological characteristics in organised urban populations from 5 Russian regions; to compare the results with the prevalence of traditional risk factors (RFs) and chronic disease. Material and methods. In 2009-2010, representative samples of organised populations from 5 Russian cities were examined (total n=2227, 1336 women and 891 men). The questionnaires assessed socioeconomic status (SES), as well as somatic and psychological health. The assessed psychological parameters included Lifestyle Index (LI), psychological resilience mechanisms (PRM), social adaptation, sanogenic reflection, Eysenck phychoticism scale, personal moral potential, emotional burnout syndrome, Hospital Anxiety and Depression Scale (HADS), and Perceived Stress Scale (PSS). The examination included the measurement of blood pressure, heart rate, waist circumference, and hips circumference. Results. The proportion of higher-educated people ranged from 82% in Nalchik to 29,3% in Omsk. Low self-rated wealth levels were highly prevalent (from 10,4-13% to 40,4%). Arterial hypertension was registered in 1,29% and 1,64% of men and women aged 25-34 years. In people aged 65-74 years, the respective figures were 60% and 75,8%. Obesity (body mass index ≥30 kg/m2) was registered in over 50% of the participants from all social groups. Negative (pathological) levels of LI significantly correlated with the majority of somatic diseases (р

The paper reviews the results of the GALAXY international programme, a series of clinical (mostly comparative) studies of various statins. It has demonstrated the benefits of rosuvastatin in terms of normalization of lipid profile, inflammatory markers, and coronary or cerebrovascular atherosclerosis regression. This makes rosuvastatin medications promising for the prevention of severe organ complications at all atherosclerosis stages.

Aim. To evaluate the potential of dispersion ECG mapping (ECG-DM) in diagnosing cardiovascular disease (CVD) and general health problems (GHP) during the screening examination of various population groups. Material and methods. In total, ECG-DM was performed in 1000 Uryupinsk and Uryupinsk Region citizens (537 healthy people, 156 people with GHP, and 307 people with CVD). In 84 participants, ECG-DM was performed before and after a simple stress test (20 squats). Additional examination of 21 CVD patients was performed before Results. An optimal cut-off for separating “norm” and “pathology” was 15 % level of “myocardium” parameter (sensitivity 75,6 %, specificity 80,3 %). For differentiation between CVD and GHP, this parameter had specificity of 58,3 % and sensitivity of 68,4 %. Out of 537 “healthy” people, in 39 (7,3 %) “myocardium” parameter was elevated, and an additional examination revealed CVD. In all participants (n=1000), no correlation between “myocardium” parameter and age, gender, cholesterol, blood pressure, or heart rate levels was observed, which points to its independent value in CVD diagnostics. A combination of ECG-DM and stress test improved sensitivity. Negative changes in ECG-DM parameters after stress test reflect changes in myocardial electrophysiology, and should not be regarded as direct evidence of myocardial ischemia. During the treatment of CVD patients, an improvement in ECG-DM parameters was associated with subjective improvement in patients’ well-being. Conclusion. ECG-DM method could be recommended for various screening programs, to identify people in need for additional examination because of potential CVD and other pathology.

The paper reviews recent studies justifying high-dose statin therapy (in particular, atorvastatin treatment) in patients with coronary heart disease (CHD) and high risk of life-threatening coronary events. In the latest placebo- controlled and comparative studies of high statin doses (e.g., 80 mg/d of atorvastatin) in stable CHD or acute coronary syndrome (ACS), a dose-depended effect of statins has been demonstrated, especially during the first months after ACS and myocardial infarction.

Based on the analysis of clinical and experimental studies, an attempt to explain pleiotropic effects of statins and their numerous action mechanisms has been performed. The pleiotropic effect concept includes: (a) medication effects on numerous targets, triggering various biochemical processes in the organism; b) the divergence of bio­chemical and pathophysiological processes triggered by one target. The pathochemical mechanisms of statins’ effects as HMG-CoA reductase inhibitors are explained. The authors also justify the independence of therapeutic and adverse effects of statins from their lipid and cholesterol-related mechanisms of action.

Aim. To study losartan effects, as monotherapy and in combination with hydrochlorothiazide (HCH) and magnetic laser therapy (МГТ), on 24-hour blood pressure (BPM) and quality of life (QoP) parameters in patients with mild to moderate arterial hypertension (AH).Material and methods. Bighty-three men with mild to moderate AH were examined (mean age 51,4+5,6 years). At baseline and after 4 weeks of the treatment, 24-hour BPM and QoB parameters were measured in all participants.Results. After 4 weeks of the treatment, improved BP circadian rhythm (CR) was observed in all participants, especially in combined therapy groups. In the group of losartan, HCH and МГТ second 24-hour BPM demonstrated normalized BP CR, decreased prevalence of night CR type (from 39% to 25%), and reduced morning BP surge. Bosartan monotherapy, despite its good antihypertensive effect, did not result in BP CR normalization. Synergistic impact of combined pharmaceutical therapy and МГТ was observed in regard to antihypertensive effect and treatment tolerability Maximal changes in various Qor domains were registered among patients with initially low scores (73%); among participants with initially high scores (27%), Qor did not change significantly.Conclusion. Tosartan combination with HCH and МГТ was effective in AH patients, demonstrating not only good antihypertensive effect, but also Qor improvement.

Aim. To study prognostic value of plasma soluble CD40 ligand (sCD40L) level in patients with various coronary heart disease (CHD) forms.Material and methods. In total, 65 CHD patients were examined, including 26 with stable effort angina (SEA), functional class (FC) I6III; 23 – with unstable angina (UA), Stage II6IIIB; 15 – with myocardial infarction (MI). Levels of sCD40L, highly sensitive C-reactive protein (hsCRP), interleukin-6 (IL-6), and fibrinogen were measured. Follow-up period lasted for 24 months. End-points included death from any cause, non6fatal MI, ischemic stroke, myocardial revascularization, hospitalization due to SEA progression or UA development.Results. In SEA, UA and MI patients, sCD40L levels were similar. Type 2 diabetes mellitus (DM-2) patients had significantly higher sCD40L levels, comparing to other CHD participants. Cardiovascular event (CVE)-free survival analysis demonstrated that in CHD patients with low sCD40L levels, survival was significantly better than in participants with its higher levels, even after DM-2 patients' exclusion.Conclusion. In CHD patients, initially increased sCD40L level is an independent predictor of adverse CVE during two-year follow-up.

The review is devoted to acetylsalicylic acid (ASC) use in cardiology. Recent epidemiologic surveys demonstrated the important role of thrombosis as a factor provoking exacerbation of coronary heart disease, ischemic stroke, peripheral artery disease. Therefore, antithrombotic and antiplatelet therapy becomes most important in treating these diseases and in secondary prevention of vascular occlusion. Numerous studies proved that ASC therapy (75-325 mg/d) decreases risk of myocardial infarction, stroke, and cardiovascular mortality by approximately 25%. The review also contains the results of most reliable ACS trials, and comparison of ACS therapy with other antiplatelet regimens. An emphasis is put on ASC therapy safety. A relatively new medication, Cardiomagnyl, is described – a combination of ASC and non-absorbing antacid, Mg hydrate. This combination minimizes the risk of gastro-intestinal complications, including hemorrhage and perforation.

Aim. To study carbohydrate, hormonal, and lipid parameters in patients with mild to moderate arterial hypertension (AH) and metabolic syndrome (MS) components. Material and methods. In total, 265 males (mean age 53.4±4.2 years) with mild to moderate AH and MS components were examined. Comparison group included 27 males with excess body mass (BM) without AH and carbohydrate metabolism disturbances, control group – 20 healthy males with normal BM. All participants underwent office blood pressure (BP) measurement, anthropometry, glucose tolerance test; lipid profile, levels of fasting and postglucose load insulin, leptin, thyroid hormones, cortisol, thyrotropic (TTH) and adrenocorticotropic hormone (ACTH) were measured. Results. Basal hyperinsulinemia was observed in 59% patients with isolated AH, and 52% of normotensive males with excess BM. In 93% of normotensive males with excess BM, hyperleptinemia was registered; insulin resistance (IR) was observed only in 52%. In AH and MS men, subclinical hypothyrosis (76%), increased levels of insulin, leptin, ACTH and cortisol were observed more often than in men with isolated AH or healthy participants. In obese individuals, there was a positive correlation of leptin level with BM, TTH, ACTH, cortisol, insulin, and triglycerides. Conclusion. In patients with AH and MS, increased cortisol, ACTH, insulin, and leptin production was linked to obesity severity, and was associated with subclinical hypothyrosis. In its turn, chronic increase in cortisol and insulin levels could facilitate IR and fat tissue percentage increase.

The article is devoted to the role of modern beta-adrenoblockers (BB) in arterial hypertension (AH) treatment. Their indications include not only AH, but also coronary heart disease, heart failure (HF), and some cardiac arrhythmias. At present, it is widely accepted that BB are important in HF treatment: they decrease the negative effects of sympathic myocardial stimulation – myocardial overload, hypertrophy, fibrosis, and apoptosis. Beta-1 antagonist, bisoprolol, is a highly cardioselective agent. Therefore, it is often used in patients with AH and HF. This medication does not provoke hypoglycemia in diabetic individuals, or require oral anti-diabetic medication dosage correction. Concor® can be successfully combined with other medications, to effectively decrease cardiovascular morbidity and mortality

Aim. During 12-week perindopril (PR) and hypothiazide (HT) therapy, to study its antihypertensive efficacy, as well as its influence on endothelial function (EF) and angiotensin-converting enzyme (ACE) serum activity, in patents with essential arterial hypertension (EAH). Material and methods. The study included 20 males (mean age 48.8±8.4 years) with mild to moderate AH. Antihypertensive efficacy was assessed during office BP measurement (Korotkoff method) and 24-hour blood pressure monitoring (BPM). EF was assessed by endothelium-dependent vasodilatation (EDVD) during reactive hyperemia test (RHT). Results. According to office BP measurements, target BP level (

A study of social and economical factors in the development of cardiovascular diseases with a screening of 4 towns in the Moscow region.

Antihypertensive efficacy and metabolic influence of long-acting calcium channel blocker – altiazem RR (diltiazem) was studied in 18 mild hypertensive patients with dislipoproteinemias. It was established that the daily use of 180 mg of49 the drug led to the effective control of blood pressure in majority of pts.The drug provided 24-hour control of blood pressure and induced mild decrease of pulse rate. Moreover, it appeared to be metabolicaly neutral : it did not affect lipid prоfile and blood glucose level. We conclude that altiazem RR is a modern drug of choice in hypertensive pts with accompaning metabolic disorders.

Significance of baseline ACE activity in patients with metabolic syndrome when administration of ACE inhibitors and imidazoline agonists is considered.

Metabolic effects of moxsonidine (cynt) were examined in 15 patients with mild and moderate arterial hypertension (blood-pressure within 140-179/90-109 mm Hg, according to recommendations of WHO and WOH ,1999) combining with compensated diabetes of type II. After 3 month of treatment with the drug (titration of dosage from 0,2 mg to 0,6 mg) significant lowering of insuline and glucose levels in blood happened; level tests were performed two hours after standard breakfast (an equivalent of the tolerance test to glucose). Average level of glucose was 9,28±0,62 mM/l before treatment and 8,44±0,51 mM/l after treatment (p

Based on scientific literature and own data, the article discusses the problem of hypertensive heart disease in real outpatient practice and especially in conducting preventive examinations in the working population. It is shown that the use of modern diagnostic methods, in particular electrocardiography with dopplerography, including pulse-wave tissue mode, should be an integral study included in the professional examination, as well as medical examination, which covers an increasing number of the population of our country. Echocardiography should be performed to clarify the cardiovascular risk and confirm the electrocardiographic diagnosis of left ventricular hypertrophy (LVH), left atrial dilatation, or suspected heart diseases (coronary heart disease, atrial fibrillation, other rhythm disorders). It has been shown that concentric LVH is the strongest predictor of an increased risk of heart failure, although the degree of LVH is not always directly related to the degree of hypertension and the duration of the disease.

Существует множество доказательств причинно-следственной связи между потреблением соли и артериальным давлением (АД). Однако исследования по изучению влияния ограничения потребления соли на АД продолжаются до сих пор. Цель. Изучить влияние ограничения потребления натрия на уровень АД у лиц обоего пола с высоким нормальным АД в течение длительного времени. Материал и методы. Обследованы 2205 человек от 25 до 45 лет обоего пола в 2 организованных популяциях, которые были опрошены по питанию методом суточного диетического опроса и заполнили анкету на привычку досаливать пищу во время еды для выявления среднего потребления натрия в сутки. На основании скринирующего обследования, включавшего осмотр, рост, массу тела, АД, ЭКГ, опрос по питанию и анкету по суточному потреблению соли, были сформированы 2 группы лиц обоего пола с высоким нормальным АД - группа вмешательства (ГВ) и группа сравнения (ГС) из 2 обследованных популяций. Для лиц, пожелавших ограничить соль в своем рационе питания, была сформирована ГВ, в которой были 203 человека (114 женщин), регулярно получавшие индивидуальные консультации по питанию в течение всего исследования. В ГС были 252 человека (138 женщин), она была сформирована по идентичным критериям из обследованных в одной из популяций и наблюдалась в течение 3 лет. Потребление соли в ГВ было сокращено на 50% за счет уменьшения при готовке, отказа от досаливания во время еды, обогащения пищевого рациона натуральными продуктами вместо промышленно обработанных, рафинированных продуктов. Результаты. Оказалось, что потребление соли в обследованных популяциях было в среднем 12 г/сут. Кроме того, выявлена высокозначимая связь между потреблением натрия и систолическим АД (САД) у женщин (p=0,0016) и мужчин (p=0,0003) и диастолическим АД (ДАД) у женщин (p=0,0039) и мужчин (p=0,0180). В результате 3-летнего диетического вмешательства выявлено достоверное снижение САД у женщин в ГВ с 135,8 до 132,5 (-3,27) мм рт. ст., у мужчин - с 136,6 до 134,7 (-1,92) мм рт. ст. (p

There is much evidence for a relation between sodium intake and blood pressure (BP). The aim of this study was to investigate the efficiency of a BP reduction when sodium was limited in men and women with high normal BP. Three-year dietary intervention significantly lowered systolic and diastolic BP (SBP and DBP) in the men and women from the intervention group (p

В настоящее время натрий признан наиболее значимым фактором питания в контроле артериального давления (АД), и влияние потребления натрия на уровень АД продолжает оставаться актуальной темой научных исследований.Цель. Оценить влияние ограничения потребления натрия на уровень АД в течение длительного времени у мужчин и женщин с высоким нормальным АД.Материал и методы. Для исследования были отобраны мужчины и женщины в возрасте от 25 до 45 лет в организованных популяциях. Скрининг включал: опрос по питанию методом суточного диетического опроса, заполнение анкеты на привычку досаливать пищу во время еды, рост, массу тела, измерение АД, ЭКГ. Были отобраны 2 группы лиц обоих полов с высоким нормальным АД: группа вмешательства (ГВ) и группа сравнения (ГС). ГВ была сформирована из мужчин и женщин, которые пожелали изменить свое питание, т.е. ограничить соль в своем рационе (203 человека). В соответствии со схемой исследования все они получали индивидуальные консультации диетолога в течение всего исследования для поддержания приверженности. ГС включала 252 человека, отобранных по идентичным критериям из обследованных в другой популяции, и наблюдалась также в течение 3 лет. В ГВ удалось сократить потребление соли на 50% за счет снижения употребления при готовке, отказа от досаливания уже готовой пищи во время еды, обогащения пищевого рациона натуральными продуктами вместо консервов и полуфабрикатов.Результаты. Потребление соли в обследованных популяциях было в среднем 12 г/сут. Далее, была выявлена высокозначимая связь между потреблением натрия и систолическим АД (САД) у мужчин и у женщин ( р =0,0016 и р =0,0003 соответственно). С диастолическим АД (ДАД) также выявлена высокозначимая связь у мужчин у женщин ( р =0,0039 и р =0,0180 соответственно). Через 3 года немедикаментозного диетического вмешательства в ГВ САД достоверно ( р

Цель. Изучить влияние психосоциальных факторов на здоровье организованной популяции и параллельно - синдром эмоционального выгорания (СЭВ).Материал и методы. По специальной шкале были протестированы 2227 рабочих и служащих в 5 городах России. СЭВ - это неминуемое последствие неадекватного разрешения стресса на рабочем месте и профессионального кризиса (самоощущение собственной профессиональной некомпетенции). Непрекращающееся воздействие на человека стрессовых ситуаций приводит к интеллектуальному, душевному и физическому переутомлению. Если стресс имеет негативные последствия для здоровья - это дистресс (СЭВ). Проявления СЭВ - организационные недостатки. К ним относятся такие коллизии, как высокая рабочая нагрузка и при этом дефицит времени для выполнения работы; отсутствие поддержки со стороны коллег и начальства; недостаточное вознаграждение за работу. Сюда же следует отнести противоречивые требования к сотруднику, постоянную угрозу штрафных санкций и т.п. Опасность СЭВ заключается в том, что «выгоранию» свойственно изо дня в день прогрессировать. На его фоне могут обостряться разные хронические заболевания, развиваться новые болезни и меняться физиологические параметры с саногенных на патогенные. Как правило, профессиональная помощь врача не приносит быстрого и стойкого облегчения.Результаты. Низкие значения (0-1) СЭВ (характерно для эмоционально здоровой части популяции) отмечены у 47,6 и 58,7% наиболее молодых (25-34 года) мужчин и женщин. С возрастом этот процент снижается до 23,3 и 32,4% в 35-44 года и до 9,1 и 10,9% - в 65-74 года. Зато возрастает частота менее благоприятных значений СЭВ (2-6 балла), это касается лиц зрелого и особенно пожилого возраста. В 35-44 года такие значения отмечены более чем в 60% наблюдений, а у пожилых - более чем в 80%. Явный же СЭВ диагностирован, конечно, существенно реже, но все же у ~15% мужчин и 6-8% женщин зрелого и пожилоговозраста (65-74 года).Заключение. При проведении профилактики хронических неинфекционных заболеваний в производственных коллективах должны учитываться психологическая обстановка и правильная организация труда.

Цель. С целью разработки алгоритма интегральной оценки общественного здоровья, основанного на результатах обследования представительных выборок в 2009-2011гг. в разных регионах России в организованных популяциях: Нижний Новгород, Великий Новгород, Вологда, Омск и Нальчик (2227 человек) с использованием специально разработанных вопросников, данных диспансеризации и простейших антропометрических (в том числе индекс массы тела - ИМТ) и функциональных методов, проводится проспективное (через 3 года) популяционное исследование.Методы. Методами для оценки индивидуального и общественного здоровья служили опросники на выявление социально-экономического статуса, соматического и психологического состояния здоровья (индекс жизненного стиля, социальной адаптации, саногенной рефлексии, шкала психотизма Г.Айзенка и нравственный потенциал развития личности, синдром эмоционального выгорания, госпитальная шкала тревоги и депрессии, международная шкала на выявление стресса - PSS). Комплексно эти методы были впервые нами применены для популяционных научных исследований. Математическая, статистическая обработка полученных данных осуществлялась с использованием статистических пакетов SAS.Результаты. В 2012г. был проведен скрининг в городах Нижний Новгород и Нальчик. Скрининг одной и той же организованной популяции проведен у 831 человека (359 мужчин и 472 женщины). Отклик (охват обследованием) составил в Нижнем Новгороде 96,2%, а в Нальчике - 78,2%. Такой отклик является вполне репрезентативным, однако в Нальчике для усиления эффекта значимости исследуемых параметров в 2013 г. будет сделана попытка дополнительно дообследовать 110 человек. Кроме того, в 2013 г. буду проскринированы по 500 человек в Великом Новгороде и Омске. Конечные точки (новые случаи всех заболеваний и смертей по расширенным критериям) составили 13%. Мы проанализировали частную корреляцию по Спирмену, где изучали корреляционную связь новых конечных точек в зависимости от двух типов переменных - физиологических и психологических параметров. Оказалось, даже анализируя данные на 831 человека (первично были обследованы 2227 человек), выявлено, что психологические признаки сильно опережают по значимости влияния на состояние здоровья популяции физиологические параметры ( р< 0,0078 против р

Большинство исследователей отдают предпочтение немедикаментозным методам профилактики сердечно-сосудистых заболеваний (ССЗ), оставляя медикаментозную профилактику для определенных групп населения, у которых неэффективно немедикаментозное воздействие. Из немедикаментозных методов вмешательства самым физиологичным и постоянно действующим является питание.Цель. Определение возможностей немедикаментозного контроля артериального давления (АД) изменением питания у мужчин и женщин среднего возраста с пограничной артериальной гипертензией (АГ) и факторами риска (ФР) ССЗ для профилактики АГ. Материалы и методы. Из двух организованных популяций одинаковых профессий по критериям включения и исключения были отобраны 2 группы: группа вмешательства (ГВ) - 287 человек, из них 203 согласились изменить питание, и группа сравнения (ГС) - 252. Критерии включения: лица 25-39 лет с АД=130-159/85-94 и 40-45 лет с АД=135-159/85-94 мм рт. ст.; 25-39 лет с АД

Aim. The aim of the present study was to evaluate the contribution of 11 singlenucleotide polymorphisms (SNPs) and production factors to the development of arterial hypertension (AH) in men in an organized workers cohort of machinebuilding plant.Material and methods. The study included men aged 20-65 years who had contact with production factors (PF) during at least 50% of the working time. Genotyping of 11 SNPs was performed using TaqMan real-time PCR. Data statistical analysis was carried out using statistica 8.0 and SAS, v. 6.12 software.Results. 583 men were included in the study, 205 of those had AH, 378 did not. The groups differed significantly in age, presence of higher education, the frequency of combination of two or more components of the metabolic syndrome and the severity of its individual components: weight, waist circumference, level of total cholesterol, triglycerides, low density lipoprotein cholesterol, glucose. As a result of genotyping, it was found that the frequency distribution of genotypes between groups with and without AH significantly differed for two SNPs — rs2932538 (p=0,0414) in the MOV10 gene and rs4373814 (p=0,0344) in the CACNB2 gene. Combining information on several SNPs in the genetic risk SCORE (GRS) it was shown that the mean value of the total GRS in the groups with and without AH was 0,0382±0,119 and 0,0195±0,111, correspondingly. The differences between the groups were significant (p=0,032). Based on the results of multivariate analysis, it was shown that the independent factors associated with the presence of AH in participants were age (OR=1,057 (1,037-1,076), p=0,0001), the presence of two or more components of the metabolic syndrome (OR=2,519 (1,621-3,914), p=0,0001) and the total GRS, consisting of 11 SNP (OR=1,479 (1,02-2,143), p=0,04). PF adjusting for the age were not associated with the presence of AH.Conclusion. In men, who had direct contact with PF at machine-building plant, GRS consisting of 11 SNPs was an independent factor influencing the presence of AH. The results show the necessity of practical USAge of genetic tests together with traditional risk factors assessment with the aim for increase of AH risk estimation precision and for carrying out individual prevention.