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Background: The area of residence and its characteristics affect cardiovascular disease indicators at different spatial scales. Our study evaluated the impact of a wide range of characteristics of large administrative regions (socio-economic, etc.) on individual probability of the prevalence, awareness, treatment, and control of hypertension among the Russian adult population. Methods: We used data from the cross-sectional phase of the epidemiological study ‘‘Epidemiology of Cardiovascular Diseases in the Regions of the Russian Federation’’ (ESSERF) conducted in 2013-2014. A total of 19,791 individuals aged 25-64 years were examined. To calculate regional indices, 64 indicators were obtained from the official website of the Federal State Statistics Service of Russia. Results: There were no associations between the territorial characteristics and the prevalence of hypertension in the general population. However, the Socio-Geographical Index has a direct impact on men (OR = 1.18; 95% CI: 1.05-1.32), people with low education (OR = 1.14; 95% CI: 1.02-1.27) and older people (OR = 1.16; 95% CI: 1.02-1.32). Hypertension awareness is directly associated with the Demographic (OR = 1.13; 95% CI: 1.02-1.25) and Industrial Territory Index (OR = 1.15; 95% CI: 1.01-1.33). The deterioration of the social situation (Socio-Geographic Index) related to poor adherence to treatment (OR = 0.76; 95% CI: 0.64-0.90) and poor control of hypertension (OR = 0.79; 95% CI: 0.69-0.90). The influence of territorial characteristics on the awareness, treatment, and control of hypertension is less pronounced than the individual characteristics of the population and differs when stratified by gender, age and educational level. Conclusions: The analysis made it possible to assess the influence of the characteristics of the population living in large areas on the prevalence, awareness, treatment, and control of hypertension. These patterns reflect an empirical approach to the territorial characteristics. Key messages: The first attempt to understand why there are such significant differences in the prevalence, awareness, treatment and control of hypertension in the Russian regions. New knowledge about the impact of living conditions on the health status. [ABSTRACT FROM AUTHOR]

The goal of our study was to explore the effect of living conditions on the odd of major and minor ECG abnormalities on a large region scale in Russia. For the analysis, cross-sectional data of the Russian study, ESSE-RF 2013-2014, were used. They were collected on a sample of 16,400 subjects from 10 regions of the Russia. ECG abnormalities were grouped into two categories: Major and Minor (sensu the 2009 version of the Minnesota Code Classification System). Regional living conditions were considered comprehensively via five indices combining 33 characteristics of the regions. The estimates were presented as odds ratios and their 95% confidence intervals. The prevalence values of major abnormalities in the sample were 8.4% among women and 9.4% among men (p = 0.021). The prevalence of minor abnormalities constituted 34.1% and 45.9%, respectively (p < 0.001). In men, the odd of major ECG abnormalities increased with the demographic depression growth (1.08: 1.04-1.12) and with industrial development growth in the region (1.12: 1.07-1.17). In women, an increase in the odd of major ECG abnormalities was directly associated with industrial development (1.12: 1.07-1.16) and inversely related to the economic development in the region (0.94: 0.89-0.99). The odd of minor ECG abnormalities in men and women declined with the growth of the regional economic development: OR of 0.95: 0.93-0.98, and OR of 0.92: 0.87-0.99, respectively. The study demonstrated an effect of regional living conditions of the Russian population on the odd of major and minor ECG abnormalities. The most stable and logically explainable relationships were obtained for industrial and economic characteristics of living conditions., (© 2023. The Author(s).)

Population-based data on coronavirus disease in Russia and on the immunogenicity of the Sputnik V vaccine are sparse. In a survey of 1,080 residents of Arkhangelsk 40-75 years of age, 65% were seropositive for IgG. Fifteen percent of participants had been vaccinated; of those, 97% were seropositive.

Chronic non - communicable diseases, mainly cardiovascular diseases, are the leading cause of death worldwide, including in the Russian Federation (RF). The article analyzes the negative and positive trends of the most relevant risk factors for cardiovascular diseases for the period from 2013 to 2017, and also provides a strategy for reducing mortality in the Russian Federation for the period up to 2024 based on data from an epidemiological analysis.

An empirical assessment of diets using a posteriori analysis allows us to define actual dietary patterns (DPs) in the food consumption structure of a population. This study represents an a posteriori assessment of DPs for the Russian population in general as well as their dependence on socio-demographic and regional parameters. The data were obtained from 21,923 individuals aged 25-64 years old from a Russian multicenter study of "Epidemiology of Cardiovascular Diseases in the Regions of the Russian Federation" conducted in 2013-2014. Cross-sectional study subjects were interviewed face-to-face in order to obtain data on their diet. DPs were defined using principal component analysis. Four DPs were specified as "Rational", "Salt", "Meat", and "Mixed"; all these variants together accounted for 55.9% of variance. Diets in gender and age groups corresponded to those for an all-Russian population; in several regions, the defined diets differed from the all-Russian ones. More favorable diet trends were observed among women, people with no family, people not working, and urban dwellers, and diet trends were more favorable with an increase in age, level of education, and material wealth. Thus, a posteriori DPs were defined for the Russian population, which were stable in sex/age groups and were mediated by the socio-demographic characteristics of the population.

Purpose: Assessment of prevalence of arterial hypertension (AH), need for prescription of antihypertensive therapy (AHT), and efficacy of AHT in Russian population in accordance with novel guideline of the American College of Cardiology/American Heart Association ("American recommendations") on diagnosis and treatment of AH (2017)., Materials and Methods: Epidemiological study ESSE-RF (ЭССЕ-РФ) was carried out in 12 regions of Russian Federation (RF) with different climatic-geographic characteristics. Number of examined residents of RF aged 25-65 years was 20 652. The sample was stratified by  gender and age. Examination included anthropometry, laboratory tests, blood pressure (BP) measurement with the OMRON tonometer. The SCORE scale was used for evaluation of risk of development of cardiovascular diseases (CVD). In  American recommendations AH was defined as  follows: 1-st degree  - systolic BP (SBP) 130-139  and/or diastolic BP (DBP) 80-89 mm Hg, 2-nd degree - BP ≥140/90 mm Hg and/or presence of AHT. In recommendations of the European Society of Cardiology (2013, 2018) ("European recommendations") AH was defined as BP ≥140/90 mm Hg and/or presence of AHT., Results: We analyzed data of examination of  20 607  participants - 7806 men (37.9%) and 12 801  women (62.1%). According to  European recommendations AH was diagnosed in 10 347  persons (50.2%)  - 3987 men (51.1%) men and 6 360 women (49.7%). According to American recommendations AH was registered in 14 853 persons (72.1%) - 6 059 men (77.6%) and 8 794 women (68.7%). AHT received 6324 persons (61.1% of those with AH); according to American recommendations, the onset of AHT was indicated to additional 620 persons with 1-st degree AH because of high CVD risk. Among all participants with AH (on and without AHT) strengthening of AHT for achievement of target BP level was required in 77.8 and 92.6% of patients according to European and American recommendations, respectively., Conclusion: Application of novel criteria of AH diagnosis from 2017 ACC/AHA guideline to Russian population would increase prevalence of AH up to 72.1%. Onset of AHT would be indicated in 13.8% of patients with 1-st degree AH, while in 93% of patients receiving AHT its strengthening would be required.

Currently, in the epidemiology of nutrition, methodological approaches to the empirical assessment of the diets of the population and their relationship to health indicators are actively using. In Russia, these approaches have been used in a number of cohort and regional studies, however, such studies are not available for the entire Russian population. Aim . Identification of empirical dietary patterns in the Russian population and analysis of their associations with risk factors for chronic non-communicable diseases. Material and methods . The work was carried out as part of a multicenter epidemiological study "Epidemiology of cardiovascular diseases in the regions of the Russian Federation" (ECVD-RF) in 2013-2014. The final sample size was 19 520 people aged 25- 64 years. Arterial hypertension, general and abdominal obesity, hypercholesterolemia, hypertriglyceridemia, low HDL, high LDL, and hyperglycemia were observed as risk factors for chronic non-infectious diseases. The data on the frequency of consumption of 13 food groups, which were grouped into 10 groups by combining dairy products into one were collected by interviewing. The identification of dietary patterns and assessment of their sustainability was performed using factor analysis (principal component analysis). In accordance with the individual commitment of the participants to the selected dietary patterns the sample was grouped into quartiles for each of the patterns. In order to ensure associations between patterns commitment and risk factors, a logistic regression analysis was used adjusted for the socio-demographic characteristics of the participants. Results and discussion . Four stable dietary patterns with a total specific gravity of the explained variance of 55.9% were identified and conventionally designated as "Reasonable" (milk, sweets and confectionery, fresh fruits and vegetables, cereals and pasta), "Salt" (sausages, pickles and pickled products), "Meat" (meat, fish and seafood, poultry meat) and "Mixed" (beans, pickles and pickled products, fish and seafood). The set of products of the "Reasonable" patterns mainly corresponds to the "Healthy" or "Balanced" patterns in foreign studies, the combination of the "Salt" and "Meat" patterns - the "Western Salt". Adherence to a "Reasonable" pattern was associated with a decrease in the likelihood of risk factors for chronic non-communicable diseases, and to a "Salt" and "Meat" patterns, on the contrary, with an increase. The associations obtained generally correspond to the results of similar foreign studies. A "Mixed" dietary pattern was associated with a few risk factors, which did not allow an unambiguous assessment of the pattern in terms of its impact on health. Conclusion . The study identified empirical dietary patterns of the Russian population and characterized them in terms of associations with the state of health of risk factors for chronic non-communicable diseases., Competing Interests: The authors declare no overt and potential conflict of interest related to the publication of this article., (Copyright© GEOTAR-Media Publishing Group.)

Aim: To assess the association between stroke and self-reported sleep disorders in the epidemiological studies of cardiovascular diseases in various regions of Russia (ESSE-RF)., Material and Methods: A questionnaire survey included unorganized male and female population, aged 25 to 64 years, from 13 regions of the Russian Federation. In the analysis, answers to the question related to history of stroke: 'Did the doctor ever tell you that you had / had the following diseases?' (the 'Diseases' module) were included. The authors also evaluated answers about sleep duration, insomnia complaints, and sleepiness (the 'Sleep assessment' module)., Results and Conclusion: Of 20 357 respondents, 422 (2%) confirmed the history of stroke. Both short and long sleep duration were not associated with stroke. Complaints of sleep disorders (snoring, sleep apnea, difficulty falling and maintaining sleep, as well as their combinations) were more frequently correlated with stroke. After adjustment for gender, age, body mass index, office blood pressure, the regression analysis showed that odds ratio was not significant for all complaints, except the combination of sleep apnea with frequent daytime sleepiness (1.7 (95% CI 1.04-2.8) (p=0.034). Therefore, symptoms of sleep-disordered breathing and insomnia are more common in respondents with the history of stroke. The combination of sleep apnea and frequent sleepiness complaints may indicate more severe sleep disorders in post-stroke patients.

Objective: To evaluate the prevalence and geographic distribution of overweight and obesity in Russian adults aged 25-64 years as well as the association between chronic risk factors and obesity., Methods: Data were obtained from the survey "Epidemiology of Cardiovascular Diseases and Its Risk Factors in Some Regions of the Russian Federation" (ESSE-RF). This is a large cross-sectional multicenter population-based study that included interviews and medical examination (anthropometry, blood pressure [BP] measurement, and laboratory analysis) applied in 2012-2014., Results: The sample included 20,190 adults (response rate 79.4%) aged 25-64 years. Approximately one third of participants (30.3%) had obesity and another third (34.3%) were classified as overweight. BMI increased with age in both sexes. The prevalence of obesity between regions ranged from 24.4 to 35.5%. Overweight and obesity levels decreased with higher education (men only). Overall obesity rates were higher in rural than urban populations, but rates of overweight were similar in rural and urban populations. Participants with obesity were more likely to have BP > 160/100 mm Hg (odds ratio > 2.0) and also > 140/90 mm Hg, raised blood glucose, and high triglycerides., Conclusion: The prevalence of overweight and obesity in Russian adults aged 25-64 years is not evenly distributed geographically, but it is comparable to that of other European countries. Individuals with obesity were also more likely to have indicators of poor cardiovascular and metabolic health., (© 2019 The Author(s) Published by S. Karger AG, Basel.)

Aim: The aim of the study is to determine the prevalence of AO in the population and to assess the association with socioeconomic factors according to the data of the ESSE-RF study (Epidemiology of Cardiovascular diseases in the Regions of the Russian Federation)., Materials and Methods: The object of the study is a random population sample of men and women aged 25-64 years from 13 regions of the Russian Federation (n=21 817). Abdominal obesity in men was defined as waist circumference (WC) &gt;94 cm, and in women - WC &gt;80 cm. Body mass index (BMI) &gt;30.0 kg/m2 was adopted as the criterion of common obesity., Results: The prevalence of AO in Russia was 55% (61.8% in women and 44% in men), while the percent of people with obesity, defined by BMI was significantly lower (33.4%). The number of examined patients with AO increased with age among both men and women (p&lt;0.0001). A person with AO more often were people with low and very low income and low education levels (p&lt;0.0001). Direct association between employment status and family status and AO in present study did not find, but WC was statistically significantly important criterion among male workers in comparison with those who never worked (p&lt;0.0001), young men and women married, as well as married men of older age groups (p&lt;0.0001).

The article presents data on the mortality trends in Russia during the last decade in comparison with other countries in Europe. It is shown that in spite the decline in death rates, Russia remains among the countries with the highest mortality rates from CVD. The specifics of mortality that distinguish Russia from other countries are described: a large variability between regions in mortality levels, differences between sexes, dependence on geographical location and socio-economic development of the regions, and late referral to a doctor in life-threatening conditions. The article emphasizes the role of risk factors and accessibility and quality of medical care to the population, as the two main components of the mechanism for changing mortality from CVD.

Aim: To estimate the prevalence of insomnia symptoms and their association with socio-demographic characteristics in the regions participated in the study., Material and Methods: Data from participants of the cohort study Epidemiology of cardiovascular disease in various regions of the Russian Federation (ESSE-RF), aged 25-64 years, from 13 regions of the Russian Federation were analyzed. They were interviewed about sleep complaints: difficulties falling asleep, maintaining sleep, sleepiness and sleeping pill intake (response variants: never, less than once a week, 1-2 times a week, three and more times a week). Responses with complaints occurring at least three times a week were considered as insomnia symptoms. Social and demographics characteristics from survey included: age, gender, education, marital status, job/employment, type of housing. The final analysis included 20 359 respondents., Results: Clinically significant frequent (≥3 times a week) difficulties of falling asleep were reported by 17.2% respondents, difficulties in maintaining sleep by 13.6%; drowsiness by 6.3%, taking sleeping pills by 2.9% respondents. Women reported sleep complaints twice more after comared to men. The occurrence of frequent difficulties to falling asleep and nocturnal awakenings increased with age - from 11.4% and 5.9% to 24.2% and 20.7%. The highest occurrence of insomnia symptoms to such as difficulties in falling asleep and nocturnal awakenings was found in women, older age groups, divorced subjects or living separately, those with primary education, retired or disabled and living in a communal apartment or 'other' type of housing., Conclusion: Symptoms of insomnia are widespread among participants of the ESSE-RF study and associated with socio-demographic characteristics. Groups with high risk of insomnia include women, older age groups, divorced or living separately, those with primary education, unemployed pensioners and people with disabilities living in a communal apartment or 'other' type of housing.

Aim: to study associations between elevated blood plasma concentration of N-terminal pro-brain natriuretic peptide (NT-proBNP), risk factors and cardiovascular diseases (CVD) in samples of adult population of Russian Federation (RF) aged 25-64 years., Materials and Methods: We analyzed data of examination of representative samples of population of 5 regions of RF obtained within the framework of the multicenter ESSE-RF study (2012-2013). Number of examined subjects was 8 077 (3 176 men). Methods included use of standard questionnaire, measurements of height, body mass, blood pressure (BP), and plasma NT-proBNP level. The following CVD were included into analysis: arterial hypertension (AH), ischemic heart disease (IHD), atrial fibrillation (AF), and stroke., Results: Women compared to men had higher NT-proBNT concentration was higher in women compared to men, in both genders it rose with age. Overall 17.9 % of examinees had elevated NT-proBNT levels (14.2 and 20.3 % among men and women, respectively). Elevated NTproBNP level was associated in men with age, myocardial infarction, angina pectoris, ischemic ECG changes, left ventricular hypertrophy, AF, bradycardia, smoking, in women with age, IHD, ischemic ECG changes, AF, bradycardia, heart rate ≥80 bpm, BP ≥160/95 mm Hg., Conclusion: In studied RF population elevated NT-proBNP level was significantly associated with gender, age, smoking, and CVD.

The CLARIFY register (The prospeCtive observational LongitudinAl RegIstry oF patients with stable coronary arterY disease) combined data of outpatients with stable coronary artery disease (CAD) from 45 countries including Russia. Purpose of this publication was to analyze dynamics of stable angina during 5 years of follow up in the Russian CLARIFY cohort compared with cohorts of patients from European and non-European countries., Material and Methods: Number of patients recruited in Russia was 2249., Results: During 5 years of observation proportion of angina decreased by 65.5, 39.5 and 37.0% in Russia, European and non-European countries, respectively. Proportion of patients with heart rate (HR) <60 bpm at the beginning of observation was 17.4, 25.4 and 23.4% in Russia, European and non-European countries, respectively. By the end of 5 years there was a significant increase in the proportion of patients with HR <70 bpm in Russia, while in Europe and other countries response to HR reducing therapy was much more modest. Perhaps this was due to improved treatment of patients recruited in Russia, for example, ivabradine at the end of the observation period was prescribed two times more than in the beginning. Patients from Russia had significantly lower all cause mortality compared with patients recruited in European countries (p<0.03); no significant differences were observed between Russian and European cohorts in cardiovascular mortality and rates of fatal and non-fatal myocardial infarction and stroke., Conclusion: Results of the CLARIFY register showed that continuous monitoring of patients with (annual visit and telephone contact between visits) was associated with reduction of angina in stable coronary artery disease from 75 to 58%. Only 26.6% of patients did not reach HR of 70 bpm. During 5 years of follow up mortality from cardiovascular diseases among patients from Russia did not differ from that among patients from non-European countries and was significantly lower than among patients from Europe (RR=0.83, p<0.05).

Objectives: Russia faces a high burden of cardiovascular disease. Prevalence of all cardiovascular risk factors, especially hypertension, is high. Elevated blood pressure is generally poorly controlled and medication usage is suboptimal. With a disease-model simulation, we forecast how various treatment programs aimed at increasing blood pressure control would affect cardiovascular outcomes. In addition, we investigated what additional benefit adding lipid control and smoking cessation to blood pressure control would generate in terms of reduced cardiovascular events. Finally, we estimated the direct health care costs saved by treating fewer cardiovascular events., Methods: The Archimedes Model, a detailed computer model of human physiology, disease progression, and health care delivery was adapted to the Russian setting. Intervention scenarios of achieving systolic blood pressure control rates (defined as systolic blood pressure <140 mmHg) of 40% and 60% were simulated by modifying adherence rates of an antihypertensive medication combination and compared with current care (23.9% blood pressure control rate). Outcomes of major adverse cardiovascular events; cerebrovascular event (stroke), myocardial infarction, and cardiovascular death over a 10-year time horizon were reported. Direct health care costs of strokes and myocardial infarctions were derived from official Russian statistics and tariff lists., Results: To achieve systolic blood pressure control rates of 40% and 60%, adherence rates to the antihypertensive treatment program were 29.4% and 65.9%. Cardiovascular death relative risk reductions were 13.2%, and 29.6%, respectively. For the current estimated 43,855,000-person Russian hypertensive population, each control-rate scenario resulted in an absolute reduction of 1.0 million and 2.4 million cardiovascular deaths, and a reduction of 1.2 million and 2.7 million stroke/myocardial infarction diagnoses, respectively. Averted direct costs from current care levels ($7.6 billion [in United States dollars]) were $1.1 billion and $2.6 billion, respectively.

Examination of blood pressure (BP) and heart rate (HR) measurements at rest and during exercise in samples of USA and Russian middle-aged men and women show significant differences between countries for both genders. Russian men had higher resting systolic blood pressure (SBP) than USA men but lower SBP at both stages of exercise. Russian women had significantly higher resting SBP than USA women at rest and also during exercise. Russian men and women had significantly lower HR at rest and during exercise than USA men and women. Differences between countries were also noted for mean body weight, height, lipid levels, percentages of smokers and several other variables, and it was postulated that differences in these factors might be responsible in part for differences in SBP and HR during exercise. After adjustment for these variables, differences in SBP during exercise between USA and Russian men remained, but differences between USA and Russian women disappeared. For both genders, differences in HR during exercise remained after adjustment. Mortality analyses in USA and Russian men indicated that stage 2 SBP response during exercise was generally not a significant mortality risk factor after adjustment for age, BMI, TC, smoking and resting SBP. In a similar model, stage 2 HR response during exercise was also a non-significant risk factor in mortality.