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Представлен обзор литературы, посвященный целям и возможностям статиновой и нестатиновой гиполипидемической терапии, а также их комби-нирования при цереброваскулярных заболеваниях, ассоциированных с дислипидемией. Обсуждаются вопросы безопасности комбинированной ли-пидснижающей стратегии, возможности первичной и вторичной профилактики нарушений мозгового кровообращения (ишемического и геморра-гического инсультов, а также транзиторной ишемической атаки). Ключевые слова: атеросклеротическая болезнь, дислипидемия, цереброваскулярные заболевания, инсульт, статины, эзетимиб, ингибиторы про-теиновой конвертазы субтилизин/кексин типа 9 (PCSK9), комбинированная гиполипидемическая терапия. Для цитирования: Сабиров И.С., Муркамилов И.Т., Фомин В.В., Юсупов Ф.А. Цели и возможности комбинированной гиполипидемической терапии цереброваскулярных заболеваний, ассоциированных с дислипидемией. Consilium Medicum. 2020; 22 (9): 46–51. DOI: 10.26442/20751753.2020.9.200459

Objective: To define epidemiological and nosological structure of patients with chronic heart failure (CHF) according to hospitals of tertiary level of the Kyrgyz Republic (National Center of Cardiology and Therapy and Scientific Research Institute of Heart Surgery and Organs Transplantation). Methods: Overall, 25415 patients medical records, patients of all ages provided treatment in the period of 2017 - 2018 in hospitals of tertiary level of the city of Bishkek were studied and analyzed. We also retrospectively studied cases with CHF referred to SRIHSOT outpatients department from city of Bishkek, observed from 2005 to 2018. In total, we included 3420 outpatient cards in the analysis. Results: According to National Center of Cardiology and Therapy, patients with NYHA FC I-II - 57.18% (14533) prevail and in this category, female persons - 57.60% prevail. The basic etiological reason of development of CHF in adult patients with FC – I-II is coronary heart disease in 33.00% of cases. Arterial hypertension, which occurred in 5624 patients (24.43%), was the most frequent accompanying pathology. According to Scientific Research Institute of Heart Surgery and Organs Transplantation among the referred patients with CHF the females (1930, 56.4%) prevail and patients with CHF and preserved ejection fraction (50% and more) (2706, 79.1%) prevail. Conclusion: Thus, in patients with CHF referred to NCCT, patients with FC I-II prevail and in this category female sex prevail. The main etiological reason of development of CHF in adult patients with FC – I-II is coronary artery disease followed by arterial hypertension. Among patients with CHF referred to SRIHSOT, female sex and CHF with preserved ejection fraction prevail. The 1st stage of CHF is registered in the majority of patients. Overall 72.4% of patients referred to SRIHSOT with CHF underwent surgery.

Objective To study the prevalence of cardiovascular (CV) risk factors (RFs) in the rural population of the Chui region of Kyrgyzstan (Central Asia). Methods The sample was representative of the population in terms of age and sex and included at least 10% of the population aged 18-65 y. Of the 1,672 people included in the cohort, 1.330 people responded to the invitation (79.5% of the total sample population). All study participants were interviewed using standardized questionnaires and examined by a cardiologist. Blood pressure (BP), weight, height, waist circumference (WC), fasting serum glucose, and fasting lipid level were measured. Results The prevalence of major CV RFs in the examined sample was as follows: arterial hypertension 34.1%, obesity 25.7%, and abdominal obesity 52.3%; the factors were significantly more prevalent in women (68.2%) and increased with age. The frequency of lipid metabolism disorders was 88.4% in the examined subjects, and an increased level of low-density cholesterol (70.5%) was common. Hypodynamia was detected in 15.6% of the subjects, diabetes mellitus in 3.76%, and a family history of cardiovascular disease was present in 34.8% of the examined subjects. The frequency of smoking was 24.6% and was significantly higher in men (46.9%). Conclusion Abdominal obesity, followed by hypercholesterolemia and arterial hypertension were the most common RFs among the rural population of the Chui region of Kyrgyzstan. Smoking was the most common RF among men. The prevalence of traditional CV RFs, except smoking, increased with age.

Objective: The data on the relationship between the level of TNF-α and interleukin-10 with the presence of left ventricular hypertrophy and myocardial remodeling in patients with essential hypertension is presented. Methods: Overall, 156 patients with essential hypertension aged 40 to 75 years (with mean age 55.8 ± 7.5 years) were examined; of which 57 were women and 99 were men. All patients were divided into two groups. The first group included 73 patients showing the presence of left ventricular hypertrophy (LVH), established by echocardiography; the second group included 83 patients who showed no signs of LVH on the echocardiogram. Results: According to the study, no relationship was found between the concentration of tumor necrosis factor α (TNF-α) and the development of LVH. It was also shown that only men, but not women with, were associated with the presence of LVH with low levels of interleukin-10 ( IL-10). In addition, a negative correlation was found between the concentration of tumor necrosis factor α (TNF-α) and IL-10 with the thickness of the left ventricular walls at the initial stages of myocardial remodeling on the echocardiography. Conclusion: Thus, our study demonstrates the modulating role of inflammation on the processes of myocardial remodeling in hypertension.