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Aim. This study determined the level of public satisfaction with neighborhood design features in Kemerovo Oblast and their connection to cardiovascular disease risk factors.Subjects and methods. The study population included 1,598 respondents aged between 35 and 70, with 491 living in rural areas and others living in Kemerovo (1,221 women and 477 men). The assessment of neighborhood environment was done according to residents' subjective opinions about infrastructural features (the Neighborhood Environmental Walkability Scale). Depending on how participants responded to the questionnaire, some of these parameters were identified as adverse.Results. The residents of Kemerovo and rural areas of Kemerovo Oblast identified the following neighborhood design features as adverse: the lack of interesting places in neighborhood environment, the remote location of parks and restaurants, the absence of pavement, busy traffic, and a long distance between home and workplace. In the city, arterial hypertension prevalence was high among men, when grocery, fruit and clothing stores were distant, and among women, when banks, public transport stops were distant and the traffic was heavy. Lipid metabolism disorders were more common among women in urban areas, when there were no interesting places around. Obesity prevalence was high among urban female population, when the following adverse factors were present: the remote location of grocery stores, fruit stores, bank, pharmacy and public transport stops and the absence of pavement. Among rural male population, this risk factor was common when there were no pavements. The highest rate of carbohydrate metabolism disorders was found among women living in villages where the traffic is heavy and public transport stops are far away.Conclusion. The impact of infrastructure on the health status of the living population is a new direction of scientific research. Epidemiological studies in different geographic areas and population groups show significant differences in health status, morbidity and mortality from chronic noncommunicable diseases. To reduce the risks of developing diseases of the cardiovascular system, the formation of a socially comfortable health-saving environment is of great importance.

Background: The problem of high blood pressure in the framework of metabolic syndrome (MS) is one of the most important for modern medicine in connection with the predicted increase in the incidence in the future and an increase in the mortality rate from cardiovascular disease.Aims: the aim of the study is to examine the frequency of arterial hypertension (AH) as part of the MS among the members of the indigenous population of the Mountain Shoria and to state the degree of the interconnection between the expression level of the candidate genes ACE, AGT, AGTR1, MTHFR and NOS3 and certain health problem.Materials and methods: The sample included 901 members of the indigenous population living in the settlements of the Mountain Shoria region. All experimental subjects had their blood pressure measured, anthropometry (measurements of height, body weight, waist circumference) taken according to standard procedures, fasting blood taken to determine the lipid spectrum and glucose level, morning urine dose taken and albumin level detected. All the patients with hypertension underwent duplex scanning of the brachycephalic arteries and examination of the structural and functional state of the myocardium was performed using echocardiography. Gene polymorphisms ACE (I/D, rs4340), AGT (c.803T>C, rs699), AGTR1 (A1166C, rs5186), MTHFR (c.677C>T, Ala222Val, rs1801133) and NOS3 (VNTR, 4b/4a) were tested using polymerase chain reaction.Results: Among the indigenous population of the Mountain Shoria, the frequency of hypertension combined with abdominal obesity and any other additional component of MS was 28.2%. In the group of the patients with, organ changes in the form of left ventricular myocardial hypertrophy and an increase in the thickness of the intima-media complex were more common than in the group of patients with AH alone: 58.0% versus 45.1%, p = 0.029 and 81.9% versus 67 , 0%, p = 0.007, respectively. The high risk of hypertension within the framework of MS was determined by the D allel of the ACE gene [OR = 2.45; 95% CI (1.05-5.72)].Conclusions: The high frequency of the spread of high blood pressure within MS confirms that hypertension is less frequently manifested as an isolated disease, more often combined with other components of MS — abdominal obesity or disorders of carbohydrate and lipid metabolism. Stated genetic predisposition to hypertension within the MS in a specific small cohort of the Shors will undoubtedly help in the development and implementation of the health programs.

Aim. To analyze prevalence of cardiovascular risk factors in the Kemerovo region based on the results of epidemiological studies (2013 and 2016).Material and methods. The study was based on two large epidemiological studies of the Kemerovo region: on 2013, «The epidemiology of cardiovascular diseases and their risk factors in the Russian Federation» and on 2016, «The prospective study of urban and rural epidemiology: study of the influence of social factors on chronic non-infectious diseases in low, middle and high income countries». In the study we analyzed cardiovascular risk factors using identical questionnaires, functional, anthropometric, biochemical means and measured on identical scales. As a result, we analyzed the prevalence of smoking, diabetes mellitus, overweight and obesity, abdominal obesity, hypercholesterolemia and hypertriglyceridemia, high levels of low-density lipoprotein (LDL).Results. Univariate analysis indicates that in the sample of 2016, compared to the sample of 2013, the prevalence of smoking is statistically significantly lower, as well as the proportion of participants with high cholesterol levels, but not taking lipid-lowering drugs. In contrast, the prevalence of diabetes, hypercholesterolemia and hypertriglyceridemia is higher. In women, the frequency of abdominal obesity on 2016 is lower than on 2013: at 35-44 age group odds ratio (OR) =0.67 with 95% confidence interval (CI) 0.44-1.03, at 45-54 age group OR =0.47 with 95% CI 0.31-0.72, 55-65 age group OR =0.49 with 95% CI 0.30-0.79. A high incidence of diabetes, hypercholesterolemia and hypertriglyceridemia is characteristic mainly of older women (55-65 age group): accordingly, OR =1.96 with 95% CI 1.19-3.22, OR =1.42 with 95% CI 1,02-1.97, OR =1.51 at 95% CI 1.08-2.12. In the 45-54 age group of men, they smoked statistically significantly less often on 2016 compared to 2013, OR =0.59 with 95% CI 0.36-0.96. The prevalence of overweight and obesity in both samples is the same: for women, the OR for overweight in different age groups is within 0.74-0.87, for men - within 0.95-1.78; for obesity OR in women is from 0.70 to 0.79, in men - from 1.03 to 1.34.Conclusion. A significant advantage of the study is the analysis of changes in prevalence in age and gender groups, which showed significant differences in the dynamics of men and women in different age categories for a number of risk factors. Analysis of the dynamics of the prevalence of cardiovascular risk factors makes it possible to assess the effectiveness of state and regional policies in the field of health protection and, first of all, "risk groups” that require closer attention, development and implementation of targeted health-saving technologies.

Aim of the study was to analyze the socio-economic determinants and prevalence of possibly presence CHD in residents of a large industrial region.Material and methods. The study sample included residents of rural settlements of the Kemerovo region and districts of the city of Kemerovo. The study involved 1600 respondents aged 35-70 years. The determinants of socio-economic status (SES) were assessed: the level of education and income, professional affiliation, marital status / family composition, place of living.Results. The majority residents of rural settlements (50.9 %) had a secondary vocational education, compared with urban residents (46 %). A high level of income (over 20 000 rubles) was observed 1.53 times more often among the urban population than rural population. It was revealed that one third (29.3 %) of the rural population is employed in agriculture, and about 40.4 % do work that does not require vocational qualification. Among residents of rural settlements, there are statistically significant more those marriage/living with a partner, than among urban residents (75.6 % versus 62.9 %, respectively). The SES analysis of the study participants with possibly presence CHD indicates a predominant share (50.9 %) of vocational secondary education and medium income level (48.9 %). It was revealed that among the lonely rural residents possibly presence CHD occurred 10.0 % more often (urban 26.7 %, rural 36.7 %, p = 0.035) than among those living in the city.Conclusion. In the Kemerovo Oblast CHD possibly presence is more common in women, depending on socio-economic determinants it is more often observed in persons with a secondary vocational education and medium income level, equally among both skilled and low/ unskilled workers living with partner in urban settings.

Aim. To study the possibility of the presence of coronary artery disease (CAD) depending on the smoking status, as well as to estimate the association of smoking with other traditional risk factors in residents of Kemerovo region aged 25–64 years.Materials and methods. We analyzed the results of the multicenter epidemiological study “Epidemiology of cardiovascular diseases and their risk factors in the Russian Federation” in Kemerovo region obtained from a random sample of 1,599 subjects aged 25–64 years. Besides the smoking status, the following parameters were analyzed: gender, age, education, diabetes mellitus (DM) and arterial hypertension (AH) history, hypercholesterolemia, hypertriglyceridemia, high level of low-density lipoproteins, low level of high-density lipoproteins (HDL), hyperglycemia, obesity, alcohol abuse, and depression.Results. Three groups were formed depending on the smoking status: group 1 included 484 (30.3%) current smokers, group 2 had 317 (19.8%) former smokers and group 3 had 798 (49.9%) individuals who had never smoked. The groups did not differ in the prevalence of CAD. When determining the rank significance of the impact of risk factors on the possibility of CAD development in the overall population, it was revealed that the age affected the risk of CAD the most, while smoking and low HDL had minimal impact. The impact of the smoking factor on CAD was higher in the representatives of the older age group; however, even in the subjects aged ≥ 50 years,the smoking factor was not the leading one and followed DM, hypertriglyceridemia, depression, and obesity. The possibility of CAD development in smokers, as opposed to individuals who had never smoked, increased when smoking was accompanied by hypercholesterolemia, hypertriglyceridemia, male sex, lack of higher education, depression, and age of ≥ 50 years. The possibility of CAD development in former smokers as opposed to nonsmokers increased when smoking was accompanied by hyperglycemia.Conclusion. Smoking is not the primary risk factor in CAD detection in the studied sample. In the presence of additional risk factors, the impact of smoking on the possibility of CAD detection increases.

Purpose. To study the genetic aspects of increased heart rate (HR) in representatives of various ethnic groups living in Mountain Shoria. Material and Methods. The study involved residents of the villages of Mountain Shoria aged 18 years and older. Included are 901 people – representatives of indigenous nationality (Shors), 408 people – of nonindigenous nationality. The groups did not differ by gender and age. The analysis was carried out depending on the increased level of heart rate (over 80 beats/min). Typing of polymorphic sites of the ACE (I/D, rs4340), ADRB1 (p.145A> G, Ser49Gly, rs1801252), ADRA2B (I/D, rs28365031), MTHFR (c.677C> T, Ala222Val, rs1801133) and NOS3 (VNTR, 4b/4a) was carried out using polymerase chain reaction. The association of different genotypes with heart rates above 80 beats/min was judged by the odds ratio in five inheritance models (codominant, dominant, recessive, overdominant and log-additive), and its 95% confidence interval was calculated. Results. Ethnic features of the prevalence of increased heart rate have been established depending on the polymorphism of candidate genes involved in the pathogenesis of arterial hypertension. The respondents of the indigenous ethnic group had a high probability of developing tachycardia determined by the carriage of the C/T genotype of the MTHFR gene according to an overdominant type of inheritance [OR = 2.46]. Allele D of the ACE gene determined the tendency to the development of this pathology according to the recessive type of inheritance [OR = 1.91]. However, among young people and men, carriage of a prognostically unfavorable D/D genotype of this gene was associated with a high risk of increased heart rate [OR = 3.34] and [OR = 4.62], respectively. In a cohort of non-indigenous nationality, the heterozygous genotype I/D of the ACE gene determined the likelihood of tachycardia by an overdominant type of inheritance [OR = 2.08]. Conclusions. Most epidemiological studies show a significant difference in the contribution of the studied polymorphisms to the appearance of increased heart rate for various ethnic groups. For a small population of Mountain Shoria, genetic features of the development of tachycardia have been established. In this regard, it is advisable to take into account national characteristics when determining individual risk, and apply personalization to correction programs.

Purpose. To evaluate the association of clinical factors of cardiovascular risk with an increased heart rate (HR) in the population of Mountain Shoria, depending on ethnicity.Material and Methods. The study involved residents of the villages of Mountain Shoria aged 18 years and older. Included are 901 people – representatives of indigenous nationality (Shors), 408 people – of nonindigenous nationality. The groups did not differ by gender and age. The analysis was carried out depending on the increased level of heart rate (over 80 beats/min). As markers, we analyzed the factors used to stratify the overall cardiovascular risk.Results. In the population of Mountain Shoria, the prevalence of tachycardia was 21.1%: 19.3% among Shors and 24.2% among non-indigenous people (p = 0.030). Interethnic differences in increased heart rate were determined by the following cardiovascular risk factors: male gender, smoking, hypertriglyceridemia, low levels of high density lipoprotein cholesterol and high low-density lipoprotein cholesterol. The risk of this pathology, both in the group of Shors and non-indigenous people, was increased in individuals with arterial hypertension [OR = 3.50; 95% CI (2.31-5.32) and OR = 4.06; 95% CI (2.37-6.95)] and diabetes mellitus [OR = 2.10; 95% CI (1.19-3.72) and OR = 2.64; 95% CI (1.33-5.27)], respectively. In addition, the odds ratio for tachycardia increased among indigenous people who abuse alcohol [OR = 1.60; 95% CI (1.01-2.60)]; among representatives of an indigenous ethnic group with hypertriglyceridemia [OR = 1.86; 95% CI (1.19-2.93)].Conclusions. Ethnic features of associative relationships between tachycardia and cardiovascular risk factors have been established. A wide range of markers associated with increased heart rate suggests a further more detailed study of these relationships.

Aim. To study the prevalence of ECG changes associated with gender and age according to the program ESSE-RF, Kemerovo.Material and methods. The object of the study is a random sampling of male and female population aged 25-64, Kemerovo. The standard 12-leads ECG was captured in 1623 people. Coding was carried out according to the Minnesota code. The average age of the respondents was 49 years (37; 57), men, 47 years (36; 56), women, 50 years (38; 57), (p=0,004).Results. The ECGs changes were recorded in 265 people (16,3%), in 124 men (17,8%) and 141 women (15,2%) (p=0,159). Heart rhythm disturbances were revealed in 108 people (6,7%), intraventricular conduction disturbances in 147 (9%). The most frequently recorded changes in the T wave (in 11,2% of the subjects), ST segment changes take the second place (in 5,1%), the pathological Q wave was registered less frequently (in 2,5%). In men, the ECG signs of LV hypertrophy, rhythm disturbances, the pathological Q wave were more often detected. In the group of the 50-64-year-olds, the pathological Q wave, changes in ST segment and T wave, rhythm and conduction disturbances were detected significantly more often as well as the greater prevalence of risk factors of ischemic heart disease.Conclusion. Detection of ECG changes is an important stage in the formation of a risk group at the development and progression of the cardiovascular pathology.

Aim. To establish associations of polymorphisms of candidate genes coding for the components of the endothelial (NOS3, MTHFR) and sympathoadrenal systems (ADRB1, ADRA2B) with coronary heart disease (CHD) in the cohort of the small population of Mountain Shoriya.Material and methods. A clinical and epidemiological study was conducted in the areas of Mountain Shoriya (Orton, Ust-Kabyrza, Sheregesh, Tashtagol). Analysis of risk factors included recording the age, sex, body mass index, waist circumference, presence/absence of arterial hypertension (AH), smoking, and the presence of disorders of lipid and carbohydrate metabolism. CHD diagnosis was made by three epidemiological criteria: coding of the electrocardiogram according to the Minnesota code, Rose questionnaire, and a history of myocardial infarction. The patient underwent molecular genetic testing. DNA isolation from blood was carried out by the method of phenol-chloroform extraction. Statistical processing was carried out using the programs STATISTICA 6.1 (StatSoft Inc., USA) and SNPStats. Results. The prevalence of CHD in the Shoriya cohort was 9,7%. The results of our study established the relationship of genetic markers of the sympathoadrenal and endothelial systems with coronary atherosclerosis in the indigenous population of Shoriya. The high risk of atherosclerotic heart disease was associated with the 4b/4a genotype of the NOS3 gene (OR 2,57 95% CI (1,12-5,86), p=0,026) according to the dominant mode of inheritance. The relationship of the T/T genotype of the MTHFR gene with CHD by recessive inheritance was established (OR 13,28; 95% CI (1,79-98,40), p=0,024).Conclusion. Due to genetic research, there is a real opportunity not only to carry out accurate molecular diagnostics, but also to determine an underlying risk for a disease. Detection of genetic disposition to CHD can be carried out long before the onset of clinical symptoms, which can effectively prevent its development.

Aim. To study the combined effect of cardiovascular risk factors and genetic markers that encode the proteins of the main components of neurophysiological systems (renin-angiotensin-aldosterone, sympathetic-adrenal systems, endothelial dysfunction) on the development of arterial hypertension among the indigenous and non-indigenous population of Mountain Shoriya.Material and methods. We performed a clinical and epidemiological study of the compactly settled population in the remote areas of Mountain Shoriya. This region of middle mountains is situated in the south of Western Siberia. We examined 1409 subjects (901 subjects – the representatives of indigenous nationality [the Shors], 508 subjects – representatives of non-indigenous nationality [90% among them were the representatives of the European ethnicity]). Hypertension was diagnosed according to the National Guidelines of the Russian Society of Cardiology/the Russian Medical Society on Arterial Hypertension (2010). All patients underwent clinical, laboratory and instrumental investigation. Polymorphisms of genes ACE (I/D, rs 4340), АGT (c.803T>C, rs699), AGTR1 (А1166С, rs5186), ADRB1 (с.145A>G, Ser49Gly, rs1801252), ADRA2B (I/D, rs 28365031), MTHFR (c.677С>Т, Ala222Val, rs1801133) and NOS3 (VNTR, 4b/4a) were tested using polymerase chain reaction.Results. Cardiovascular risk factors associated with hypertension in cohort of Shorians: hypercholesterolemia [Odds Ratio (OR) 1.54, low density lipoproteinemia (OR 1.48), violation of carbohydrate metabolism (OR 1.53), obesity (OR 2.25), including its abdominal type (OR 1.53), the family anamnesis of early cardiovascular diseases (OR 1.88)] and rs4340 polymorphisms of the ACE gene (OR 4.39), rs5186 of the AGTR1 gene (OR 10.02); in the cohort of the non-indigenous ethnos – hypercholesterolemia (OR 1.87), hypertriglyceridemia (OR 1.87), obesity (OR 2.75), abdominal obesity (OR 2.73), family anamnesis of early cardiovascular diseases (OR 2.48), the polymorphism rs5186 of the AGTR1 gene (OR 26.77). Genotype G/G ADRB1 gene was characterized by protective effect against hypertension in the Shorians.Conclusion. Evaluation of the complex influence of clinical and genetic factors on the development of hypertension in the population of Mountain Shoriya showed their comparable importance among the indigenous population and the predominance of non-genetic factors among the non-indigenous population.

Aim. To assess the prevalence of polymorphism of the gene AGT and its relation with systemic hypertension risk in the ethnicities of Gornaya Shoria (Mountain Shoria).Material and methods. A clinical-epidemiological study conducted, of compactly inhabiting people of uneasily reachable areas of Gornaya Shoria (settlements Orton, Ust-Kabyrza) and city-like settlement Sheregesh. Based on the name lists, 1178 inhabitants included from the settlements. In 398 persons, blood was collected from cubital vein, fasting, in the morning for genotyping. Extraction of DNA from the blood was done with phenol-chloroform method. Polymorphism of AGT (М235Т, rs699) gene was tested with PCR.Results. In general, in both ethnicities, the prevalence of AGT did not differ significantly. However, among men there was national specifics found for the C/C genotype: in the Shortsy group its prevalence (27,8%) was higher comparing to non-native inhabitants (10,3%). In shortsy male cohort the carriers of T/C had odds ratio for glucose metabolism and arterial hypertension at 2,45 and 2,21, respectively; in females with C/C carriage the risk of dyslipidemia was 3,37. Among females of non-native nationality there were associations found for T/T genotype with hypercholesterolemia. The odds ratio for higher cholesterol among homozygotes T-allele was 4,3 times higher comparing to T/C and C/C.Conclusion. Regardless the absence of differences in genotypes prevalences of AGT, there were differences revealed of the association of risk factors of arterial hypertension according to ethnicity. In shortsy cohort the C/C genotype was associated with hyperbetacholesterolemia and dyslipidemia, and genotype T/C — with glucose metabolism. In non-native cohort T/T genotype was associated with dyslipidemia.

Aim. To analyze the relation of alcohol consumption level with cardiovascular diseases and risk factors in the population of Kemerovskaya Oblast.Material and methods. The study was performed under the framework of multicenter epidemiological trial ESSE-RF in Kemerovskaya Oblast, with 1628 participants with the age 25-64 y.o. The data was analyzed concerning the prevalence, volume and type of alcohol beverages by the respondents, as the prevalence of a range of cardiovascular diseases and risk factors. By original formulae, total volume was calculated of the consumed alcohol in units of the “safe” ethanol dose (24 grams) with further grouping to “non consuming” and consuming “moderately”, “in-between” and “over”.Results. Overconsumption of alcohol, comparing to non-consumers, is associated with high risk of hypercholestrolemia (OR 1,76; 95% CI: 1,12-2,75), hypertriglyceridemia (OR 2,69: 1,52-4,77), body overweight (OR 1,68: 1,04-2,71), smoking (OR 2,24: 1,48-3,41). The relation of low physical activity with alcohol consumption is found in all grades. Increase of the mean daily ethanol dosage is positively linearly related with the risk of arterial hypertension (OR 1,04: 1,11-2,75), hypercholesterolemia (OR 1,06: 1,01-1,12), increased level of low density lipoproteins (OR 1,09: 1,02-1,16), smoking (OR 1,17: 1,10-1,24), low physical activity (OR 1,09: 1,02-1,16). There is U-shaped and upside-down J-shaped relation for the level of psychological risk factors (stress, anxiety, depression) and volumes of consumed alcohol. By the considered cardiovascular diseases it can be noted only, the existence of statistically non-significant (0,1>р>0,05) tendency to decrease myocardial infarction risk and stroke in anamnesis, with the increase of the consumed alcohol volumes comparing to non-drinkers.Conclusion. The study shows that overconsumption of alcohol, as the increase of mean daily dosage of ethanol are associated with the range of cardiovascular risk factors. There is U-shaped and upside-down J-shaped relation of psychoemotional risk factors with the volumes of consumed alcohol. By the considered cardiovascular dseases, there are no significant relations for the level of consumed alcohol, however, there is non-significant tendency for myocardial infarction and stroke risk factors diminishing in the anamnesis, with the increase of consumed alcohol volumes.

Aim. To study the associations of ACE, ADRA2B, ADRB1, MTHFR and e-NOS3 candidate genes of arterial hypertension with its risk factors among the indigenous and non-indigenous population of Mountain Shoriya.Material and methods. Clinical epidemiological community-based study was conducted in hard-to-reach regions of Mountain Shoriya (villages Orton, Ust’-Kabyrza, Sheregesh in Kemerovo Region). 1178 inhabitants of the mentioned villages were examined by the continuous method, selection consisted of adult population (18 years old and above), 565 people were genotyped. All patients underwent clinical, laboratory and instrumental examination. Polymorphisms of genes ACE (I/D, rs 4340), ADRB1 (s.145A> G, Ser49Gly, rs1801252) ADRA2B (I/D, rs 28365031), MTHFR (c.677S>T, Ala222Val, rs1801133) and e-NOS3 (VNTR, 4a/4b) were tested by polymerase chain reaction.Results. Maximum number of associations with risk factors was revealed in indigenous population for genotype D/D ACE gene, in non-indigenous representatives – for genotype D/D ADRA2B gene. In indigenous carriers of genotype D/D ACE gene, the odds ratio of hypercholesterolemia, hyper-betacholesterolemia, obesity and abdominal obesity were 11.20 (р=0.018); 4.65 (р=0.001); 2.31 (р=0.031) and 1.83 (р=0.059), respectively. In the cohort of non-indigenous ethnic group in those with genotype D/D gene ADRA2B the risk of hypercholesterolemia, hyperbetacholesterolemia, hypertriglyceridemia and carbohydrate metabolism disorders was higher in 5.11 (р=0.006), 5.41 (р=0.021), 2.73 (р=0.035) and 4.13 (р=0.005) times, respectively. In the indigenous group the genotype D/D of ACE gene was associated with obesity, hypercholesterolemia, hyperbetacholesterolemia; the genotype D/D of ADRA2B gene – with hypertriglyceridemia; the genotype 4а/4а of e-NOS3 gene – with abdominal obesity. In the group of non-indigenous ethnic group genotype D/D of АСЕ gene was associated with hypoalphacholesterolemia; genotype I/I of АСЕ gene – with carbohydrate metabolism disorders; genotype D/D of ADRA2B gene – with hypercholesterolemia, hyperbetacholesterolemia and hypertriglyceridemia, carbohydrate metabolism disorders; genotype Т/Т of MTHFR gene – with hypoalphacholesterolemia, genotype C/C of MTHFR gene – with abdominal obesity.Conclusion. The determination of polymorphisms of candidate genes and the identification of associations with modifiable risk factors broadens the understanding of the genetic component of cardiovascular diseases and creates the prerequisites for the development of a more advanced and effective prevention program.

Life quality (LQ) is an integrated parameter of the health, applied for integral characterization of population health, and as the parameter of healthcare interventions effectiveness.Aim. To assess LQ in Russian population at the age 25-64 y. o. in general and in various socio-economical groups using EQ-5D, by the results of ESSE-RF (2012-2013) study.Material and methods. LQ was assessed on representative selections of inhabitants of 13 Russian Federation regions, aged 25-64 (males 8327, females 13497) with response 80%. LQ was assessed via international questionnaire EUROQOL — EQ-5D: 1) no decline; 2) mild decline; 3) significant decline; scoring also performed with visualanalogue scale (VAS). Integral LQ by EUROQOL performed with Shaw JW et al. method (ranging from 0,0 (death) to 1,0 (perfect health)).Result. EQ-5D index of Russian population was 0,87 with no gender difference. By the increase of the age LQ declines. Educational gradient of LQ was significant only in VAS (p

Aim. To assess rate of familiarity and specifics of treatment with statins among the citizens of economically active age with various cardiovascular risk by the data from epidemiological study ESSE-RF (Epidemiology of Cardiovascular Diseases in Different Russian Federation Regions). Material and methods. In the work the data from ESSE-RF study was used, of representative selection of non-organized male and female inhabitants aged 25-64 y.o. from 13 regions, investigated during 2012-2014. Responded ~80%. The study included questionning by standard scale that included data on the anamnesis, etc. Lipid profile, including total cholesterol (TC), cholesterol of lipoproteids low and high density were measured at SSRCPM and RSPCC.Results. Analysis of the whole selection showed that 20% of men and 32% of women knew their TC, and 13,6% and 18,2% were even familiar having increased level of TC. Part of those with high and very high risk was 31,3%, incl. men — 42,2%, women — 30,9%. Statins took ~7,0% of patients from this risk category. Effectiveness of treatment (target levels reached of low density cholesterol) in these groups of men and women was 14,4% and 4,8%, respectively.Conclusion. The data obtained in populational study points on insufficient knowledge and low rate of statin treatment of the persons with high and very high cardiovascular risk in RF, which confirms the anxiety provoking data of registries and other studies. The data dictates necessity of development and implementation of specific educational programs for citizens, of physician improvement and availability of cheap but effective lipid-lowering medications.

Purpose. To evaluate the effect of the changed living conditions during the last decade, the prevalence of obesity as a risk factor for cardiovascular disease among residents of Mountain Shoria. Materials and methods. During the periods since 1998 till 2002 and since 2012 till 2015 in field conditions by continuous method we examined 1215 and 774 inhabitants correspondingly in the outlying hard-to-reach villages of Mountain Shoria. About half of them was represented by indigenous inhabitants - Shors, the other half by more than 95% was represented by Russians. The examination included: clinical examination, measurement of height, body mass, waist circumference (WC), hip circumference (HC), body mass index, WC/HC index. Obesity diagnosis was made in accordance with WHO criteria (1997). Results. During all the examination periods women of non-indigenous nationality revealed obesity more often (3.9% of obesity cases among Shor women, 31.3% cases among non-Shor women over the period since 1998 till 2002 (р=0.0001), 7.3% of obesity among indigenous female inhabitants and 31.4% among non-indigenous women over the period since 2012 till 2015 (р=0.0001)). Over the last 15 years a number of individuals with obesity and overweight has significantly increased: the percentage of men with obesity (over the period since 1998 till 2002 - 0.8% of Shor and 2.4% of non-Shor men had BMI≥30 kg/m2 (р=0.072), as compared to 2012-2015 period - 7.3% of Shor and 27% of non-Shor men had obesity (р=0.00001). Among Shor women the percentage of obese individuals increased significantly at the age of 40-49, 60-69 and over 70 years old. In representatives of male indigenous population the number of obese individuals increased significantly at the age of 40-49 years old, in non-Shor men - at the age of 18-29, and 30-39 years old. Conclusion. Regardless of gender and ethnicity the number of individuals with overweight and obesity increased significantly among the inhabitants of Mountain Shoria, as well as the value of WC/HC index, especial among Shor women.

Aim. Analysis of the prevalence of cardiovascular diseases and risk factors depending on occupation.Material and methods. Under the multicenter epidemiological study ESSE-RF (Epidemiology of Cardiovascular Diseases and their Risk Factors in Russian Federation) the questioning performed and 1627 persons investigated in Kemerovo Region at the age 25-64 y.o. Two comparison groups were created: employed (n=1214), unemployed (n=413). The data obtained on the occupation and cardiovascular risk factors: smoking, alcohol consumption, obesity, cholesterol level, lipoproteids, glucose, anamnesis of cardiovascular diseases and real presence of arterial hypertension, ischemic heart disease (IHD) by Minnesota criteria, and angina pectoris by Rose score. In statistical processing, with the aim to relieve age differences of the groups we standardized by the age via direct method, and in regression analysis there was a parameter "age".Results. In employed men there was statistically significant lower prevalence of smoking — among workers 40,2%, unemployed 52,6% (p=0,011). CHD in anamnesis in 5,4% and 11,9%, resp. (p=0,0047), arterial hypertension — 47,9% and 57,1%, resp. (p=0,043), angina by Rose score — 5,3% and 13,6%, resp. (p=0,00001), CHD by Minnesota code — 5,0% and 9,2%, resp. (p=0,048), CHD by 3 epidemiological criteria — 9,4% and 20,4%, resp. (p=0,00020). In women employment was related to lower prevalence of smoking — 15,4% among workers, 22,4% — unemployed (p=0,038) and CHD by Minnesota code —5,4% and 9,6%, resp. (p=0,019). Occupational status for men leads to the decrease of arterial pressure by 3,4 mmHg in average (p=0,051), increase of total cholesterol concentration by 0,231 mmol/L (p=0,041), and in women — increase of HDL by 0,135 mmol/L (p=0,0024).Conclusion. Better cardiovascular health do have employed people comparing to unemployed: tendency is stronger in men. The results reflect common tendency of the higher level of health among employed young inhabitants comparing to unemployed.

Aim. To study the prevalence of ischemic heart disease as one of the most common cardiovascular disorders, together with arterial hypertension (AH), diabetes mellitus (DM) and liver diseases (LD) in adult (25-64 y.o.) population of selected RF regions, the variance of those with gender and age, and association of cardiovascular risk factors (FR).Material and methods. Into analysis we included the results of representative selections studies from 13 RF regions, studied according to the program of multicenter study ESSE-RF during the years 2012­2014; totally 21923 patients studied. Investigation included standard questioning, including anamnesis. For statistics we used applied software SAS.Results. In men the prevalence of IHD is associated with the growth of comorbidity from 0 in the age group 25-34 y. to 77% in the age 55-64 y., almost duplicating every decade. For women there is analogic tendency, less prominent. In men there are significant associations only with AH, which increases the risk of IHD 2,5 times, though in women together with AH the associations are significant for LD. Comorbidities with DM do not influence the prevalence of IHD in men and women. At the same time, any association with two diseases increases the risk of IHD >304 times. The most negative is the association of all three diseases, with which IHD is 8,7 times more prevalent, than in their absence. Using multidimensional logistic regression after correction for the age and comorbidity in the patients with IHD of both genders, there are associations revealed of high density cholesterol lipoproteids (HDL) in blood and abdominal obesity. In men there are also positive associations with smoking and negative — with increased cholesterol.Conclusion. Comorbidities of IHD with AH, DM and LD in adult population are common, are associated with the general FR, are increasing with the age. Taking modern tendencies of population ageing, it is plausible to expect an increase of the prevalence of comorbidities, that requires a necessity of the healthcare services to these changes.

Aim. To study social and economic gradients — educational and occupational statuses, wealth level, behavioral risk factors (FR) in Russian population by the ESSE-RF data.Material and methods. The data for the analysis consisted of representative selections of 13 regions of RF (n=22906) participants of the study, incl. men (n=8353) and women (n=13553) of 25-64 y.o., with response 80%. We calculated the odds ratios for the presence of behavioral FR: smoking, excessive alcohol consumption, insufficient physical activity (IPA), nonrational food consumption, anxiety and depressive disorders, — in persons from different social and economic groups by education level, type of inhabitation, professional status, wealth level.Results. Higher education was associated with better FR profile, except IPA (negative association) and alcohol consumption (absence of association). "White in general had less FR probability than Blue, excl. IPA and psychoemotional deviations (in men). As for the wealth association with the FR there is backward gradient, i.e. lesser the income, higher the risk of FR presence, excl. IPA and excessive alcohol intake in women. For example, in very wealthy men the odds ratio for depressive states was 3,09 [95% CI 2,08-4,57] comparing to the persons with low income. The type of territory of inhabitance was associated with less behavioral FR in Russian population, as significant associations are found only for depression and excessive salt consumption in both genders and IPA in men. Conclusion. The significant social and economic gradients of behavioral FR prevalence are found, the direction of those is not necessary the same as in European countries. The analysis of association with social and economic parameters would help to develop the directed preventive interventions.

Study objectives: examine the frequency of genotypes and alleles of I/D polymorphism of gene ADRA2B of native people living in Mountain Shoria (the Shors), as well as their association with risk factors for cardiovascular diseases.Material and methods. Overall 221 native people of Shoria were examined. The average age is51.07 ± 1.46 among males, 52.93 ± 0.96 among females (p = 0.286). Anthropometric characteristics, lipid levels of blood and I/D polymorphism of ADRA2B were studied.Results. DD genotype of the gene ADRA2B in the native population of the Shor people is associated with adiposis and high index of "waist/hip", hypertriglyceridemia. The average values of Quetelet index is higher in carriers of this genotype compared with carriers of genotype ID. Average waist indications in homozygous insertions were lower than those in homozygous deletions and heterozygotes. Patients with genotype DD have higher average levels of triglycerides, atherogenic index, cholesterol, very low density lipoproteins.Conclusion. DD allele ADRA2B genotype is responsible for adiposis and high levels of TG among native population of Shoria.

In the frame of Multicenter observational study ECVD-RF (Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation) by the unique protocol the investigation of representative selections of adult population at the age of 25-64 y.o. of 11 regions RF (n=18305, including males, n=6919 and females n=11386): Volgograd, Vologda, Voronezh, Ivanovo, Kemerovo, Orenburg, Samara, Tomsk, Tyumen, Saint-Petersburg and Northern Osetia-Alania. The prevalence of the following risk factors (RF) of cardiovascular diseases is evaluated: high blood pressure — 33,8%, obesity — 29,7%, high total cholesterol — 57,6%, high glucose level or diabetes — 4,6%, smoking (tobacco consumption) — 25,7%, insufficient (low) level of physical activity — 38,8%, excessive salt consumption — 49,9% and insufficient vegetables and fruits consumption — 41,9%. Gender differences and an increase with the age of the parameters mentioned are described.The absence of a epidemiologic monitoring system at the Federal level leads to an impossibility of clear conclusions on the RF dynamics in Russian population. While comparing the ECVD-RF study with previous epidemiological studies we can just cautiously suppose the existence in 21st age of negative dynamics of one RF (obesity, dyslipidemia) and positive dynamics of the others (smoking).

Aim. To study prevalence of arterial hypertension (AH), mean values of systolic and diastolic blood pressure (SBP, DBP), awareness of patients about their disease, medication consumption (MC) and efficacy of treatment in several regions of Russia.Material and methods. Representative selections were made in 9 regions of Russia: men (n=5563), women (n=9737) of 25–64 y.o., studied in 2012–2013 with the response 80%. Systematic stratified multilevel random selection was formed with localilty criteria (Kisch method). The Questionnaire on the presence of AH included: awareness of the patient about his disease, drug intake. BP measurement was performed on the right arm by automatic tonometer Omron in sitting position after 5 minutes resting. The mean value of two measurements was used. BP defined as SBP ≥140 mmHg, DBP ≥90 mmHg, or if the patient had taken antihypertensive therapy. Efficacy of treatment — the part of patients (in %) who reached target BP. Control group — part of patients (in %) with BP

The relationships of risk factors with hypertension in workers of coal enterprises were studied. Based on the identified predictors developed risk prediction scale of this disease in miners.Surveyed 792 employees of the mine “Polosukhinskaya”. Along with a complete clinical, anthropometric and laboratory testing, conducted settlement criterion relative risk of developing hypertension.The most important factors determining the increased risk of disease in workers of coal enterprises were: increased body weight, age, waist circumference, and the index “waist/hip”, elevated levels of total cholesterol, triglycerides, low density lipoprotein cholesterol, atherogenic index. These signs and have the greatest prognostic factors that increase the risk of developing the disease.

Aim. To analyse the association between occupation and the prevalence of arterial hypertension (AH) or AH risk factors in a working-age population. Material and methods. The study included 3664 working residents of Kemerovo Region, representing 18 occupational groups. AH risk factors included gender, age, body mass index (BMI), education, marital status, smoking, and hazardous alcohol consumption. Decision tree models were used as a method of classification and prognosis. Results. In decision tree models, assessed predictors correctly confirmed the diagnosis of AH or its absence in 75,2% participants. The most important predictors were BMI, age, and occupation (100, 83, and 63 units, respectively). Occupation also influenced the prognostic value of other predictors. Conclusion. Occupation should be regarded not only as an important predictor of AH, but also as an effect modifier for other predictors, such as age, BMI, or marital status. This should be taken into account when performing the complex assessment of AH risk across working population groups.

There had been 935 people examined native to Turochaksky district of the Altai Republic (663 — indigenous people (Tubalars) and 272 — non-indigenous population) so as to identify the proportion of population with hypertension, assessment of risk factors and genetic predisposition to the disease according to the blood systems such as ABO, Rh, MN, P and Kell. The proportion of people with hypertension in the Altai Republic was 38.6 % among Tubalars and 40.8 % among non-indigenous population. The high body mass index (BMI) — (Quetelet index) values and. index: waist / hip and. waist circumference are associated, with risk of hypertension, for both ethnic groups, but only Tubalars have such risk factors as smoking and salt abuse. There had been revealed some ethnic differences in the distribution for such systems as blood group Rh factor, and MN. The indigenous ethnic group is marked with a risk of hypertension for the people with Rh(-) blood group, positive associative connection with the disease for those with the phenotype of MN and the resistance for the persons with the blood group Rh(+) and. the phenotype of NN.