russjcardiolРоссийский кардиологический журналRussian Journal of Cardiology1560-40712618-7620«SILICEA-POLIGRAF» LLC10.15829/1560-4071-2024-6013RCTDXTrussjcardiol-6013Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEWСкрининг на наличие аневризмы брюшного отдела аорты в мире и РоссииScreening for abdominal aortic aneurysm in the world and in Russiahttps://orcid.org/0000-0002-7273-6979БалахоноваТ. В.BalakhonovaT. V.

Д. м. н., профессор, отдел ультразвуковых методов исследований, г. н. с.

Москва

Moscow

tvbdoc@gmail.comhttps://orcid.org/0000-0001-7989-0760ЕршоваА. И.ErshovaA. I.

Д. м. н., лаборатория клиномики, руководитель, зам. директора по фундаментальной науке.

Москва

Moscow

alersh@mail.ruhttps://orcid.org/0000-0001-5902-3803ГенкельВ. В.GenkelV. V.

К. м. н., кафедра пропедевтики внутренних болезней, доцент.

Челябинск

Chelyabinsk

henkel-07@mail.ruhttps://orcid.org/0009-0002-3184-7573ГарбузоваЕ. В.GarbuzovaE. V.

Лаборатория клиномики, лаборант-исследователь.

Москва

Moscow

vostryakova.elizaveta@yandex.ruhttps://orcid.org/0000-0002-4529-3308ДроздоваЛ. Ю.DrozdovaL. Yu.

К. м. н., лаборатория поликлинической терапии, руководитель.

Москва

Moscow

ldrozdova@gnicpm.ruhttps://orcid.org/0000-0001-8652-8778СветликовА. В.SvetlikovA. V.

Д. м. н., кафедра госпитальной хирургии, профессор.

Санкт-Петербург

St. Petersburg

asvetlikov@mail.ruhttps://orcid.org/0000-0002-6726-4612АкчуринР. С.AkchurinR. S.

Д. м. н., академик РАН, отдел сердечно-сосудистой хирургии, руководитель, зам. генерального директора по хирургии.

Москва

Moscow

rsakchurin@list.ruhttps://orcid.org/0000-0003-2087-6483ШальноваС. А.ShalnovaS. A.

Д. м. н., профессор, отдел эпидемио­логии хронических неинфекционных заболеваний, руководитель.

Москва

Moscow

sshalnova@gnicpm.ruhttps://orcid.org/0000-0001-6998-8406БойцовС. А.BoytsovS. A.

Д. м. н., профессор, академик РАН, генеральный директор.

Москва

Moscow

prof.boytsov@gmail.comhttps://orcid.org/0000-0002-4453-8430ДрапкинаО. М.DrapkinaO. M.

Д. м. н., профессор, академик РАН, директор.

Москва

Moscow

drapkina@bk.ruФГБУ НМИЦ кардиологии им. акад. Е.И. Чазова Минздрава РоссииРоссияChazov National Medical Research Center of CardiologyRussian FederationФГБУ Национальный медицинский исследовательский центр терапии и профилактической медицины Минздрава РоссииРоссияNational Medical Research Center for Therapy and Preventive MedicineRussian FederationФГБОУ ВО Южно-Уральский государственный медицинский университет Минздрава РоссииРоссияSouth Ural State Medical UniversityRussian FederationФГБУ Северо-Западный окружной научно-клинический центр им. Л.Г. Соколова ФМБА; ФГБОУ ВО Санкт-Петербургский государственный университетРоссияSokolov North-Western District Research and Clinical Center; St. Petersburg State UniversityRussian Federation20241308202429860136013Copyright © Балахонова Т.В., Ершова А.И., Генкель В.В., Гарбузова Е.В., Дроздова Л.Ю., Светликов А.В., Акчурин Р.С., Шальнова С.А., Бойцов С.А., Драпкина О.М., 20242024Балахонова Т.В., Ершова А.И., Генкель В.В., Гарбузова Е.В., Дроздова Л.Ю., Светликов А.В., Акчурин Р.С., Шальнова С.А., Бойцов С.А., Драпкина О.М.Balakhonova T.V., Ershova A.I., Genkel V.V., Garbuzova E.V., Drozdova L.Y., Svetlikov A.V., Akchurin R.S., Shalnova S.A., Boytsov S.A., Drapkina O.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://russjcardiol.elpub.ru/jour/article/view/6013

Несмотря на общемировую тенденцию к снижению распространённости аневризмы брюшной аорты (АБА), это бессимптомное до определенного момента и потому коварное заболевание остается одной из причин внезапной смерти у пожилых. Это обусловливает необходимость проведения скрининговых исследований, эффективность и целесообразность которых уже не раз доказана в крупных научных, в т. ч. популяционных, исследованиях и метаанализах. Традиционным и более предпочтительным методом скрининга является ультразвуковое исследование (УЗИ). Согласно рекомендательным документам разных стран показания к проведению УЗИ брюшной аорты для исключения АБА различаются. На сегодняшний день в России нет точных данных о распространенности АБА, не определена целевая группа для проведения скрининга, в связи с чем в стране необходимо проведение крупных популяционных исследований для изучения распространённости заболевания и факторов риска его развития, а также расчета показателей клинико-экономической эффективности внедрения программы скрининга АБА в структуру профилактических мероприятий.

Despite the global trend towards a decrease in the prevalence of abdominal aortic aneurysm (AAA), this disease remains one of the sudden death causes in the elderly. This necessitates the need to conduct screening studies, the effectiveness and feasibility of which has been proven in large studies, including population-based ones, and meta-analyses. The traditional and most optimal screening method is ultrasound examination. According to the guidelines of different countries, the indications for abdominal aorta ultrasound vary. Today in Russia there is no accurate data on the prevalence of AAA, while the target group for screening has not been defined, and therefore the country needs to conduct large population studies to study its prevalence and risk factors, as well as to calculate indicators of the clinical and economic effectiveness of implementation AAA screening programs.

аневризма брюшного отдела аортыскринингпрофилактикаультразвуковое исследованиедуплексное сканированиеabdominal aortic aneurysmscreeningpreventionultrasoundduplex scanningReferencesГолощапов-Аксенов Р. С., Комаров Р. Н., Белов Ю. В. История стентирования грудной аорты. Кардиология и сердечно-сосудистая хирургия. 2014;5:41-6.Goloshchapov-Aksenov RS, Komarov RN, Belov IuV. History of thoracic aortic sten­ting. Russian Journal of Cardiology and Cardiovascular Surgery. 2014;5:41-6. (In Russ.)Livesay JJ, Messner GN, Vaughn WK. Milestones in the treatment of aortic aneurysm: Denton A. Cooley, MD, and the Texas Heart Institute. Tex Heart Inst J. 2005;32:130-4.Livesay JJ, Messner GN, Vaughn WK. Milestones in the treatment of aortic aneurysm: Denton A. Cooley, MD, and the Texas Heart Institute. Tex Heart Inst J. 2005;32:130-4.Wanhainen A, Van Herzeele I, Bastos Goncalves F, et al. Editor's Choice — European Society for Vascular Surgery (ESVS) 2024 Clinical Practice Guidelines on the Management of Abdominal Aorto-Iliac Artery Aneurysms. Eur J Vasc Endovasc Surg. 2024;67:192-331. doi:10.1016/j.ejvs.2023.11.002.Wanhainen A, Van Herzeele I, Bastos Goncalves F, et al. Editor's Choice — European Society for Vascular Surgery (ESVS) 2024 Clinical Practice Guidelines on the Management of Abdominal AortoIliac Artery Aneurysms. Eur J Vasc Endovasc Surg. 2024;67:192-331. doi:10.1016/j.ejvs.2023.11.002.Lindeman JHN. The pathophysiologic basis of abdominal aortic aneurysm progression: a critical appraisal. Expert Rev Cardiovasc Ther. 2015;13:839-51. doi:10.1586/14779072.2015.1052408.Lindeman JHN. The pathophysiologic basis of abdominal aortic aneurysm progression: a critical appraisal. Expert Rev Cardiovasc Ther. 2015;13:839-51. doi:10.1586/14779072.2015.1052408.Kessler V, Klopf J, Eilenberg W, et al. AAA revisited: A comprehensive review of risk factors, management, and hallmarks of pathogenesis. Biomedicines. 2022;10:94. doi:10.3390/biomedicines10010094.Kessler V, Klopf J, Eilenberg W, et al. AAA revisited: A comprehensive review of risk factors, management, and hallmarks of pathogenesis. Biomedicines. 2022;10:94. doi:10.3390/biomedicines10010094.Ying AJ, Affan ET. Abdominal Aortic Aneurysm Screening: A Systematic Review and Meta-analysis of Efficacy and Cost. Ann Vasc Surg. 2019;54:298-303.e3. doi:10.1016/j.avsg.2018.05.044.Ying AJ, Affan ET. Abdominal Aortic Aneurysm Screening: A Systematic Review and Meta-analysis of Efficacy and Cost. Ann Vasc Surg. 2019;54:298-303.e3. doi:10.1016/j.avsg.2018.05.044.Sampson UKA, Norman PE, Fowkes FGR, et al. Estimation of global and regional incidence and prevalence of abdominal aortic aneurysms 1990 to 2010. Glob Heart. 2014;9:159-70. doi:10.1016/j.gheart.2013.12.009.Sampson UKA, Norman PE, Fowkes FGR, et al. Estimation of global and regional incidence and prevalence of abdominal aortic aneurysms 1990 to 2010. Glob Heart. 2014;9:159-70. doi:10.1016/j.gheart.2013.12.009.Summers KL, Kerut EK, Sheahan CM, et al. Evaluating the prevalence of abdominal aortic aneurysms in the United States through a national screening database. J Vasc Surg. 2021;73:61-8. doi:10.1016/j.jvs.2020.03.046.Summers KL, Kerut EK, Sheahan CM, et al. Evaluating the prevalence of abdominal aortic aneurysms in the United States through a national screening database. J Vasc Surg. 2021;73:61-8. doi:10.1016/j.jvs.2020.03.046.Krafcik BM, Stone DH, Cai M, et al. Changes in global mortality from aortic aneurysm. J Vasc Surg. 2024. doi:10.1016/j.jvs.2024.02.025.Krafcik BM, Stone DH, Cai M, et al. Changes in global mortality from aortic aneurysm. J Vasc Surg. 2024. doi:10.1016/j.jvs.2024.02.025.Golledge J, Thanigaimani S, Powell JT, et al. Pathogenesis and management of abdominal aortic aneurysm. Eur Heart J. 2023;44:2682-97. doi:10.1093/eurheartj/ehad386.Golledge J, Thanigaimani S, Powell JT, et al. Pathogenesis and management of abdominal aortic aneurysm. Eur Heart J. 2023;44:2682-97. doi:10.1093/eurheartj/ehad386.Kobeissi E, Hibino M, Pan H, et al. Blood pressure, hypertension and the risk of abdominal aortic aneurysms: a systematic review and meta-analysis of cohort studies. Eur J Epidemiol. 2019;34:547-55. doi:10.1007/s10654-019-00510-9.Kobeissi E, Hibino M, Pan H, et al. Blood pressure, hypertension and the risk of abdominal aortic aneurysms: a systematic review and meta-analysis of cohort studies. Eur J Epidemiol. 2019;34:547-55. doi:10.1007/s10654-019-00510-9.Takagi H, Umemoto T, ALICE (All-Literature Investigation of Cardiovascular Evidence) Group. A Meta-Analysis of the Association of Chronic Obstructive Pulmonary Disease with Abdominal Aortic Aneurysm Presence. Ann Vasc Surg. 2016;34:84-94. doi:10.1016/j.avsg.2015.12.023.Takagi H, Umemoto T, ALICE (All-Literature Investigation of Cardiovascular Evidence) Group. A Meta-Analysis of the Association of Chronic Obstructive Pulmonary Disease with Abdominal Aortic Aneurysm Presence. Ann Vasc Surg. 2016;34:84-94. doi:10.1016/j.avsg.2015.12.023.Aune D, Schlesinger S, Norat T, et al. Diabetes mellitus and the risk of abdominal aortic aneurysm: A systematic review and meta-analysis of prospective studies. J Diabetes Complications. 2018;32:1169-74. doi:10.1016/j.jdiacomp.2018.09.009.Aune D, Schlesinger S, Norat T, et al. Diabetes mellitus and the risk of abdominal aortic aneurysm: A systematic review and meta-analysis of prospective studies. J Diabetes Complications. 2018;32:1169-74. doi:10.1016/j.jdiacomp.2018.09.009.Altobelli E, Rapacchietta L, Profeta VF, et al. Risk Factors for Abdominal Aortic Aneu­rysm in Population-Based Studies: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2018;15:2805. doi:10.3390/ijerph15122805.Altobelli E, Rapacchietta L, Profeta VF, et al. Risk Factors for Abdominal Aortic Aneu­rysm in Population-Based Studies: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2018;15:2805. doi:10.3390/ijerph15122805.Accarino G, Giordano AN, Falcone M, et al. Abdominal aortic aneurysm: natural history, pathophysiology and translational perspectives. Transl Med UniSa. 2022;24:6. doi:10.37825/2239-9747.1037.Accarino G, Giordano AN, Falcone M, et al. Abdominal aortic aneurysm: natural history, pathophysiology and translational perspectives. Transl Med UniSa. 2022;24:6. doi:10.37825/2239-9747.1037.Pinard A, Jones GT, Milewicz DM. Genetics of Thoracic and Abdominal Aortic Diseases. Circ Res. 2019;124:588-606. doi:10.1161/CIRCRESAHA.118.312436.Pinard A, Jones GT, Milewicz DM. Genetics of Thoracic and Abdominal Aortic Diseases. Circ Res. 2019;124:588-606. doi:10.1161/CIRCRESAHA.118.312436.Qian G, Adeyanju O, Olajuyin A, et al. Abdominal Aortic Aneurysm Formation with a Focus on Vascular Smooth Muscle Cells. Life. 2022;12. doi:10.3390/life12020191.Qian G, Adeyanju O, Olajuyin A, et al. Abdominal Aortic Aneurysm Formation with a Focus on Vascular Smooth Muscle Cells. Life. 2022;12. doi:10.3390/life12020191.Takagi H, Goto S-N, Matsui M, et al. A further meta-analysis of population-based screening for abdominal aortic aneurysm. J Vasc Surg. 2010;52:1103-8. doi:10.1016/j.jvs.2010.02.283.Takagi H, Goto S-N, Matsui M, et al. A further meta-analysis of population-based screening for abdominal aortic aneurysm. J Vasc Surg. 2010;52:1103-8. doi:10.1016/j.jvs.2010.02.283.Kapila V, Jetty P, Wooster D, et al. Screening for abdominal aortic aneurysms in Canada: 2020 review and position statement of the Canadian Society for Vascular Surgery. Can J Surg. 2021;64:E461-E466. doi:10.1503/cjs.009120.Kapila V, Jetty P, Wooster D, et al. Screening for abdominal aortic aneurysms in Canada: 2020 review and position statement of the Canadian Society for Vascular Surgery. Can J Surg. 2021;64:E461-E466. doi:10.1503/cjs.009120.Campbell A, Waggett H, Armer M, et al. Quality assurance for the NHS abdominal aortic aneurysm screening programme in England. BJS Open. 2022;6. doi:10.1093/bjsopen/zrab148.Campbell A, Waggett H, Armer M, et al. Quality assurance for the NHS abdominal aortic aneurysm screening programme in England. BJS Open. 2022;6. doi:10.1093/bjsopen/zrab148.Thompson SG, Ashton HA, Gao L, et al. Final follow-up of the Multicentre Aneurysm Screening Study (MASS) randomized trial of abdominal aortic aneurysm screening. Br J Surg. 2012;99:1649-56. doi:10.1002/bjs.8897.Thompson SG, Ashton HA, Gao L, et al. Final follow-up of the Multicentre Aneurysm Screening Study (MASS) randomized trial of abdominal aortic aneurysm screening. Br J Surg. 2012;99:1649-56. doi:10.1002/bjs.8897.Wanhainen A, Hultgren R, Linné A, et al. Outcome of the Swedish Nationwide Abdominal Aortic Aneurysm Screening Program. Circulation. 2016;134:1141-8. doi:10.1161/CIRCULATIONAHA.116.022305.Wanhainen A, Hultgren R, Linné A, et al. Outcome of the Swedish Nationwide Abdominal Aortic Aneurysm Screening Program. Circulation. 2016;134:1141-8. doi:10.1161/CIRCULATIONAHA.116.022305.Chun KC, Dolan KJ, Smothers HC, et al. The 10-year outcomes of a regional abdominal aortic aneurysm screening program. J Vasc Surg. 2019;70:1123-9. doi:10.1016/j.jvs.2019.01.053.Chun KC, Dolan KJ, Smothers HC, et al. The 10-year outcomes of a regional abdominal aortic aneurysm screening program. J Vasc Surg. 2019;70:1123-9. doi:10.1016/j.jvs.2019.01.053.Leach JR, Shen H, Huo E, et al. Impact of Implicit Abdominal Aortic Aneurysm Screening in the Veterans Affairs Health Care System Over 10 Years. J Am Heart Assoc. 2022;11:e024571. doi:10.1161/JAHA.121.024571.Leach JR, Shen H, Huo E, et al. Impact of Implicit Abdominal Aortic Aneurysm Screening in the Veterans Affairs Health Care System Over 10 Years. J Am Heart Assoc. 2022;11:e024571. doi:10.1161/JAHA.121.024571.Salata K, Syed M, Hussain MA, et al. Statins Reduce Abdominal Aortic Aneurysm Growth, Rupture, and Perioperative Mortality: A Systematic Review and Meta-Analysis. J Am Heart Assoc. 2018;7:e008657. doi:10.1161/JAHA.118.008657.Salata K, Syed M, Hussain MA, et al. Statins Reduce Abdominal Aortic Aneurysm Growth, Rupture, and Perioperative Mortality: A Systematic Review and Meta-Analysis. J Am Heart Assoc. 2018;7:e008657. doi:10.1161/JAHA.118.008657.Li R, Liu Y, Jiang J. Research advances in drug therapy for abdominal aortic aneurysms over the past five years: An updated narrative review. Int J Cardiol. 2023;372:93-100. doi:10.1016/j.ijcard.2022.11.058.Li R, Liu Y, Jiang J. Research advances in drug therapy for abdominal aortic aneurysms over the past five years: An updated narrative review. Int J Cardiol. 2023;372:93-100. doi:10.1016/j.ijcard.2022.11.058.Golledge J, Moxon JV, Singh TP, et al. Lack of an effective drug therapy for abdominal aortic aneurysm. J Intern Med. 2020;288:6-22. doi:10.1111/joim.12958.Golledge J, Moxon JV, Singh TP, et al. Lack of an effective drug therapy for abdominal aortic aneurysm. J Intern Med. 2020;288:6-22. doi:10.1111/joim.12958.Wanhainen A, Unosson J, Mani K, et al. The Metformin for Abdominal Aortic Aneurysm Growth Inhibition (MAAAGI) Trial. Eur J Vasc Endovasc Surg. 2021;61:710-1. doi:10.1016/j.ejvs.2020.11.048.Wanhainen A, Unosson J, Mani K, et al. The Metformin for Abdominal Aortic Aneurysm Growth Inhibition (MAAAGI) Trial. Eur J Vasc Endovasc Surg. 2021;61:710-1. doi:10.1016/j.ejvs.2020.11.048.Golledge J, Arnott C, Moxon J, et al. Protocol for the Metformin Aneurysm Trial (MAT): a placebo-controlled randomised trial testing whether metformin reduces the risk of serious complications of abdominal aortic aneurysm. Trials. 2021;22:962. doi:10.1186/s13063-021-05915-0.Golledge J, Arnott C, Moxon J, et al. Protocol for the Metformin Aneurysm Trial (MAT): a placebo-controlled randomised trial testing whether metformin reduces the risk of serious complications of abdominal aortic aneurysm. Trials. 2021;22:962. doi:10.1186/s13063-021-05915-0.Lieberg J, Pruks L-L, Kals M, et al. Mortality After Elective and Ruptured Abdominal Aortic Aneurysm Surgical Repair: 12-Year Single-Center Experience of Estonia. Scand J Surg. 2018;107:152-7. doi:10.1177/1457496917738923.Lieberg J, Pruks L-L, Kals M, et al. Mortality After Elective and Ruptured Abdominal Aortic Aneurysm Surgical Repair: 12-Year Single-Center Experience of Estonia. Scand J Surg. 2018;107:152-7. doi:10.1177/1457496917738923.Isselbacher EM, Preventza O, Hamilton Black J 3rd, et al. 2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. Circulation. 2022;146:e334-e482. doi:10.1161/CIR.0000000000001106.Isselbacher EM, Preventza O, Hamilton Black J 3rd, et al. 2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. Circulation. 2022;146:e334-e482. doi:10.1161/CIR.0000000000001106.Chaikof EL, Dalman RL, Eskandari MK, et al. The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm. J Vasc Surg. 2018;67:2-77.e2. doi:10.1016/j.jvs.2017.10.044.Chaikof EL, Dalman RL, Eskandari MK, et al. The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm. J Vasc Surg. 2018;67:2-77.e2. doi:10.1016/j.jvs.2017.10.044.Erbel R, Aboyans V, Boileau C, et al. 2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC). Eur Heart J. 2014;35:2873-926. doi:10.1093/eurheartj/ehu281.Erbel R, Aboyans V, Boileau C, et al. 2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC). Eur Heart J. 2014;35:2873-926. doi:10.1093/eurheartj/ehu281.Owens DK, Davidson KW, et al. Screening for Abdominal Aortic Aneurysm: US Preventive Services Task Force Recommendation Statement. JAMA. 2019;322:2211-8. doi:10.1001/jama.2019.18928.Owens DK, Davidson KW, et al. Screening for Abdominal Aortic Aneurysm: US Preventive Services Task Force Recommendation Statement. JAMA. 2019;322:2211-8. doi:10.1001/jama.2019.18928.AIUM Practice Parameter for the Performance of Diagnostic and Screening Ultrasound Examinations of the Abdominal Aorta in Adults. J Ultrasound Med. 2021;40:E34-E38. doi:10.1002/jum.15668.AIUM Practice Parameter for the Performance of Diagnostic and Screening Ultrasound Examinations of the Abdominal Aorta in Adults. J Ultrasound Med. 2021;40:E34-E38. doi:10.1002/jum.15668.Балахонова Т. В., Ершова А. И., Ежов М. В. и др. Фокусированное ультразвуковое исследование сосудов. Консенсус российских экспертов. Кардиоваскулярная терапия и профилактика. 2022;21(7):3333. doi:10.15829/1728-8800-2022-3333.Balakhonova TV, Ershova AI, Ezhov MV, et al. Focused vascular ultrasound. Consensus of Russian experts. Cardiovascular Therapy and Prevention. 2022;21(7):3333. (In Russ.) doi:10.15829/1728-8800-2022-3333.Visseren FLJ, Mach F, Smulders YM, et al. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur J Prev Cardiol. 2022;29:5-115. doi:10.1093/eurjpc/zwab154.Visseren FLJ, Mach F, Smulders YM, et al. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur J Prev Cardiol. 2022;29:5-115. doi:10.1093/eurjpc/zwab154.Magnussen C, Ojeda FM, et al. Global Effect of Modifiable Risk Factors on Cardiovascular Disease and Mortality. N Engl J Med. 2023;389:1273-85. doi:10.1056/NEJMoa2206916.Magnussen C, Ojeda FM, et al. Global Effect of Modifiable Risk Factors on Cardiovascular Disease and Mortality. N Engl J Med. 2023;389:1273-85. doi:10.1056/NEJMoa2206916.Averina M, Nilssen O, Brenn T, et al. High cardiovascular mortality in Russia cannot be explained by the classical risk factors. The Arkhangelsk Study 2000. Eur J Epidemiol. 2003;18:871-8. doi:10.1023/a:1025626202235.Averina M, Nilssen O, Brenn T, et al. High cardiovascular mortality in Russia cannot be explained by the classical risk factors. The Arkhangelsk Study 2000. Eur J Epidemiol. 2003;18:871-8. doi:10.1023/a:1025626202235.Lakunchykova O, Averina M, Wilsgaard T, et al. Why does Russia have such high cardiovascular mortality rates? Comparisons of blood-based biomarkers with Norway implicate non-ischaemic cardiac damage. J Epidemiol Community Health. 2020;74:698-704. doi:10.1136/jech-2020-213885.Lakunchykova O, Averina M, Wilsgaard T, et al. Why does Russia have such high cardiovascular mortality rates? Comparisons of blood-based biomarkers with Norway implicate non-ischaemic cardiac damage. J Epidemiol Community Health. 2020;74:698-704. doi:10.1136/jech-2020-213885.

The authors declare that there are no conflicts of interest present.