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The paper provides a review of the literature on a relevant non-drug prevention problem, namely the negative effect of trans isomers of unsaturated fatty acids (trans-UFA) on the risk of circulatory system diseases (CSD) and other chronic noncommunicable diseases. It gives data on the specific features of the structure and ability of trans-UFA to elevate the plasma levels of atherogenic low-density lipoproteins and to lower those of non/antiatherogenic high-density lipoproteins. The natural sources of their moderate content in the animal fats from ruminants and those of their redundant content in the margarines manufactured by hydrogenation of liquid vegetable oils are described. A new technology for preparing soft margarines (spreads) is presented, which can produce fatty products that do not virtually contain trans-UFA. There is evidence that trans-UFA can considerably raise the risk of CSD and their acute complications. It is concluded that the manufacture of fatty products with low and even no trans-UFA levels should be expanded in Russia to improve its population's health.

Aim: To evaluate effects of dynamic exercise (DE) and static leg exercise (SE) varying by intensity on blood serum spectrum of lipoproteins and apolipoproteins in healthy persons and patients with coronary heart disease (CHD)., Material and Methods: Healthy 12 men and 12 CHD patients of functional class I performed bicycle DE of maximal (for age) intensity (100%), submaximal (80, 70 and 60%), SE of maximal and submaximal intensity. Blood samples were taken before the exercise, after it and 3 hours after the exercise., Results: DE of high intensity (80% and higher) and SE of maximal and moderate intensity (100 and 60%, respectively) produced atherogenic changes in the blood of both healthy subjects and CHD patients: a rise in total cholesterol, LDLP cholesterol, triglycerides, apolipoprotein (apo) B and apo B/ apo AI. Moderate (60%) DE gave rise to antiatherogenic changes in the blood: a fall in lipoproteins containing apoB and a rise in concentration of apo AI both in healthy and CHD subjects., Conclusion: To prevent atherosclerosis by correction of atherogenic lipid disorders, CHD patients and healthy persons should do DE of moderate intensity in addition to other prophylactic measures.

Aim: To examine relationships between lipemia, atherogenicity of blood lipoproteins spectrum after fat loading (FL) and severity of angiographic manifestations of coronary atherosclerosis., Material and Methods: The study enrolled 72 males free of ischemic heart disease (IHD)--group 1; 60 IHD patients with moderate affection of the coronary arteries (CA), i.e. maximal narrowing of one CA 50%--group 2; 107 IHD patients with severe CA affection, i.e. CA narrowing > 50%--group 3. FL was given by J. R. Patsch technique, blood sampling was made before meal, 3 and 6 hours after FL., Results: It was shown that intake of food fats in IHD and IHD-free patients stimulated development of postprandial lipemia of different severity and duration. It appeared due to increased fraction of lipoproteins rich in triglycerides. In group 2 and 3 there was a definite and up to 6 hours in duration postprandial hypertriglyceridemia associated with proatherogenic deviations in lipid and protein components (LDL and HDL) by FL hour 6: growing of LDL cholesterol, apoB, apoB/apoAI and lowering of HDL cholesterol and apoAI. Patients with severe CA atherosclerosis (> 50% narrowing of three CA) had the most severe atherogenic affections in the postprandial lipoprotein spectrum., Conclusion: Postprandial lipemia/hypertriglyceridemia and atherogenic changes in the spectrum of lipoproteins after FL correlate directly with angiographic manifestations of coronary atherosclerosis.

Aim: To evaluate efficacy of combined use of moderate exercise and nicotinic acid drug enduracin in patients with coronary heart disease (CHD) with moderate dyslipidemia (DE)., Material and Methods: The effects of exercise therapy alone, enduracin alone and their combination on physical performance (PP), hemodynamics, blood lipid spectrum and clinical course of CHD were studied in 93 CHD patients with moderate DE. The results were evaluated clinically after 1-year treatment., Results: Combined used of exercise and enduracin in CHD patients showed its efficacy manifesting in improvement of PP, hemodynamics at rest and exercise test, left ventricular systolic function, clinical course, reduction of DE. Enduracin + exercise appeared more efficient than their use in monotherapy. Enduracin monotherapy had a positive action on PP, arterial pressure and anginal attacks frequency., Conclusion: Enduracin is recommended as monotherapy and in combination with moderate exercise in outpatient rehabilitation and secondary prophylaxis of CHD patients with moderate dyslipidemia and angina pectoris to relieve myocardial ischemia under exercise, to raise PP, improve lipid composition of blood and prevent maladaptive left ventricular remodeling.

Aim: To elucidate if there are any peculiarities in HDL composition in Muscovites with different HDL C levels, and to reveal which HDL components could determine the disturbances in their antiatherogenic properties at higher HDL C level., Material and Methods: Sixty men aged 40-59 years with low HDL C level < 40 mg/dl (36 +/- 0.8 mg/dl; n = 30) and high HDL C level > 50 mg/dl(58 +/- 1.6 mg/dl; n = 30) were compared. Enzymatic, immunonephelometric methods and thin-layer chromatography were used., Results: Men with high HDL C level had higher concentration of apo AI, HDL phospholipids (PL), ratios of HDL C/apo AI and HDL C/HDL PL but lower ratio of HDL C free/HDL PL. The analysis of HDL PL composition revealed in subjects with high HDL C higher proportion of phosphatidylcholine (PC) and lower lysoPC, whereas the relative content of sphingomyelin and phosphatidylethanolamine did not differ between the groups., Conclusion: The peculiarities in components of HDL found among men with different HDL C levels could explain less effective HDL atheroprotective properties in Muscovites with elevated HDL C.

Aim: To study the relationship between major hemostasis parameters and hypertriglyceridemia with or without insulin resistance/hyperinsulinemia in men suffering from mild or moderate arterial hypertension., Material and Methods: Major hemostasis parameters including fibrinogen level, coagulation factor VII activity and fibrinolytic activity were analysed in groups of men with moderate or mild AH who had normal or elevated triglycerides level regarding presence or absence of insulin resistance/hyperinsulinemia., Results: High factor VII activity was found in both groups with insulin resistance irrespective of their triglycerides level. Patients with insulin resistance combined with hypertriglyceridemia had low fibrinolytic activity., Conclusion: In men with metabolic syndrome components insulin resistance is accompanied with activation of coagulation external pathway, whereas combination of insulin resistance with hypertriglyceridemia was associated with hypofibrinolysis.

Aim: To assess parameters of blood cholesterol lipid-protein spectrum and characteristics of blood cholesterol (C) transport system in patients with systemic lupus erythematosus (SLE)., Materials and Methods: Lipid-protein blood spectrum was studied in 60 patients (45 females and 15 males) with verified SLE aged 15-44 years (mean age 28.9 +/- 8.1 years). The duration of the disease varied from 2 months to 28 years (mean 8.6 +/- 6.6 years). SLE course and activity were defined according to V. A. Nasonova's classification. The control patients (35 healthy subjects) were matched by age (30.0 +/- 6.1 years) and gender (27 females and 8 males)., Results: Elevated levels of C and C of low-density lipoproteins (LDLP), triglycerides (TG) were found in 35% and 30% of patients, respectively. C of high-density lipoproteins (HDLP) was low in 32% of patients. HDLP phospholipids were also subnormal, their proportion changed: concentrations of phosphatidylcholine were low, those of lisophosphatidylcholine, sphingomyelin, diethanolamine, cardiolipin were higher than in the controls. TG and proportion apo/B/AI were higher, content of HDLP components low in patients with the disease duration up to 5 years. Patients with highly and moderately active SLE had high levels of TG, apo/B, apo/B/apo/AI, low levels of HDLP C, apo/AI and HDLP phospholipids., Conclusion: Marked dyslipidemias were detected in 1/3 of SLE patients. Cholesterol transport changes arise at early SLE stages. Alterations in the blood lipid-protein spectrum appeared more pronounced and atherogenic in maximal SLE activity. Quantitative and qualitative shifts in HDLP composition induce changes in antiatherogenic properties of relevant lipoproteins in SLE patients.

Aim: To detect the correlation between complete metabolic syndrome (MS) and combinations of arterial hypertension (AP) with abdominal obesity (AO), hyperlipidemia (HLP), and both without disorders in glucose tolerance., Materials and Methods: 122 men aged 35-66 years were examined, in whom AP was diagnosed 4-6 years before. The following criteria were used for detecting MS components: AP was diagnosed at diastolic AP of at least 90 mm Hg or systolic AP of 140 mm Hg; HLP was confirmed at total cholesterol (CS) level of at least 5.2 mmol/liter and/or triglyceride (TG) level of at least 2.3 mmol/liter; AO was diagnosed at body weight index of at least 26 kg/m2 and the ratio of waist/hip circumferences more than 0.90. Poor glucose tolerance was diagnosed at glucose level in capillary blood 120 mg/dl and higher, but no more than 180 mg/dl 2 h after 75 g glucose loading, if glucose level after an overnight fasting was no higher than 120 mg/dl., Results: The majority of patients (39.3%) had combinations of AP with AO and HLP; complete MS was diagnosed in 21%. Isolated AP was found in only 8.2% of examinees. Dyslipidemia in the presence of MS and in combinations of AP with AO and HLP was characterized by increased levels of TG and total CS and decreased content of CS and high-density lipoproteins, which was associated with basal hyperinsulinemia., Conclusion: MS alone and clusters of AP, AO, and HLP characterized by insulin resistance, accelerate the development of cardiovascular diseases associated with atherosclerosis.

A comparative analysis of major blood lipoprotein values in 108 males aged 16-65 years with lower limbs amputations has shown a higher level of triglycerides (TG) and a reduced level of high density lipoprotein cholesterol (HDL C) in them than in control males with normal limbs. In the subgroup of patients who had undergone the amputation as a result of obliterative arterial disease, the TG level was the highest while HDL C the lowest; moreover, these values appeared to be the same as in the age-matched subgroup of patients with manifestations of atherosclerosis. In the subgroup of older men with posttraumatic lower limb amputations (aged 40-59 years) the TG and HDL C levels did not differ from the corresponding parameters in age-matched subgroup of healthy subjects, whereas young amputees (17-39 years) had the increased blood TG concentration and reduced level of HDL C and apolipoprotein AI. The conclusion is made: disability following limb amputation accompanied by restricted mobility, inadequate physical static efforts as well as by chronic psychological stress seem especially dangerous for young invalids because of associated lipoprotein profile changes which can be regarded as highly atherogenic.

Novel antihyperlipidemic micronized phenofibrate lipantil 200 M was tested for safety and efficacy (one 200 mg capsule a day for 3 months) in 27 patients having cholesterol level above 6.5 mmol/l. The effect emerged upon 1 month of administration and persisted till the end of the treatment. In combined hyperlipidemia triglycerides decreased by 45-60%, total cholesterol and LDL cholesterol by 10-12%. In isolated hyperlipidemia the latter two values appeared lower by 20-23 and 22-27%, respectively. After lipantil 200 M treatment HDL cholesterol went up by 9% in low baseline level (< 1 mmol/l) by 27%. No negative clinico-biochemical shifts were seen, while fibrinogen and uric acid reduced by 16%, apoB by 23-30%. Lipantil 200 M proved active against hyperlipidemia and is recommended for clinical practice.

A number of epidemiological surveys have recently established that in populations with the lowest levels of total cholesterol (TC) and LDL cholesterol (LDLC) death rates grow due to both malignant and cardiovascular diseases. The results of a detailed study on multifactor prevention of coronary heart disease (CHD) in an open population of Moscow males aged 40-59 to elucidate the relations between TC, HDL cholesterol, LDLC and CHD mortality demonstrated that low levels of TC are markers, but not a factor of CHD and sudden death risk in low-educated subjects free of CHD symptoms. When planning mass measures to primarily prevent CHD, subjects with low cholesterol levels should be given a special care as well as those with hypercholesterolemia.

Short-term maximal and long-term submaximal regimens of physical exercise had been assessed for effect on serum lipoproteins in healthy subjects, in preclinical coronary heart disease (CHD) sufferers and in manifest CHD patients having food fat-induced lipemia. Fat loading caused hypertriglyceridemia in all the examinees. In healthy subjects it was associated with a rise in apo AI, while in CHD patients with relevant fall. Maximal exercise in preexisting alimentary hyperlipidemia provoked elevation of total cholesterol, triglycerides, LDL cholesterol, being atherogenic. Apo AI grew with a decrease in apo B/apo AI ratio in healthy subjects, in coronary patients apolipoprotein changes were of atherogenic origin. Prolonged submaximal exercise at the height of food lipemia resulted in lowering of total cholesterol, triglycerides and LDL cholesterol along with elevation of HDL cholesterol and apo AI both in healthy and coronary subjects evidencing anti-atherogenicity. It is noted that the response of lipids and apolipoproteins to fat and physical exercise loads was similar in subclinical and manifest CHD patients.

The authors provide the results of a prospective study carried out for almost 10 years among men who underwent screenings in 1975-1977 at an age of 40-59 years in Moscow and Leningrad (overall 6431 persons) with a purpose of analyzing potential causes of high risk of death from coronary heart disease in a group of subjects with hypocholesterolemia. Based on a mathematical-statistical analysis, variants of the interpretations of the indicated fact are presented.

The diet enriched with omega-3 polyunsaturated fatty acids (5 g/day for 4 weeks) was applied to the treatment of patients (n-22) with angina pectoris occurring for the first time. Meanwhile 6 patients received the control diet similar to the fish one as regards the protein, fat, carbohydrate, cholesterol and caloric ratio. The control group patients showed no alterations in blood lipids and apoproteins of in platelet function. The patients who received the fish diet manifested an appreciable decrease in the concentration of triglycerides (p less than 0.01), a slight reduction of cholesterol content. The level of high density cholesterol remained unchanged. There was a decrease in the concentration of thromboxane (p less than 0.05) and in the platelet count (p less than 0.05). In some patients, individual reactions of ADP-induced platelet aggregation were revealed: from the lowering (-60-10%) seen in the third of the examined up to the rise (+10+90%) in the other third. The decrease of apoprotein A1 established as safe for the protective cholesterol-transport properties of high-density lipoproteins was established.

The paper is devoted to the characterization of the spectrum of lipoproteins (LP) including the determination of the content of apoproteins AI and B by quantitative "rocket" immunoelectrophoresis in 75 male patients aged 40 to 59 with normal body mass, with types I and II diabetes mellitus, in the state of compensation of carbohydrate metabolism, with and without signs of coronary heart disease. Sixty healthy men were controls. It was shown that in diabetic (types I and II) patients with CHD changes in LP spectrum values were similar to those in CHD patients without diabetes. In patients with type I diabetes without clinical signs of CHD, LP spectrum values including the content of apo-AI, apo-B and the ratio of apoB/apo-AI did not differ from those of the controls. Changes in LP-containing apo-AI expressed not only in the reduction of the total content of CH-HDIP but also in change of the composition of HDLP particles, were found in diabetic (type II) patients without clinical signs of CHD.

In current studies of dyslipoproteinemia (DLP) development great emphasis is laid on the type of nutrition, its quantitative and qualitative characteristics, harmful habits, their formation in childhood and an attempt to influence them. However the problem of the start of stable DLP development and the role of dietary habits is yet to be solved. A random subsample of 169 school children aged 13 to 16 in the Krasnopresnensky District of Moscow was examined, among them 73 boys and 96 girls. High values of mean alimentary cholesterol, total and saturated fats and low mean amounts of consumed polyunsaturated fats were revealed. It could be inferred that the examined population was characterized by a high risk of the formation of atherogenic DLP stability. An analysis of the findings showed a considerable increase in the consumption of total and saturated fats as well as food rich in cholesterol in the group of children with stable DLP forms confirming the effect of the environmental factors including the alimentary ones, on processes of DLP formation in childhood. Further investigation of DLP in children should be conducted in the form of prospective studies otherwise design of activities in early prevention of atherogenic DLP seems impossible.

The authors presented the results of a study of the level of blood plasma apo-B and apo-A-I in random samples (by age decades from 20 to 60) of the organized male population (n = 309) and additionally of CHD patients who were not entered into the random samples (n = 82). Age differences in the level of blood plasma apo-B and apo-A-I were noted; a significant positive correlation with age of the level of apolipoprotein B at the age of 20 to 59 and a negative correlation of apo-A-I in males aged 20 to 39 were revealed. By the percentile distribution of apo-LP-B and A-I the relative borders of their high and low values were defined in random samples of males aged 20 to 39 and 40 to 59. Significant differences in the prevalence of high and low levels of apo-B and apo-A-I were demonstrated among patients with CHD and persons without this pathology.