Aim. Studying of the influence of socio-economic risk factors on relative risk (RR) of death from cardiovascular diseases (CVD) in non-organized population of Tyumen city. Material and methods. The epidemiological study was performed with standard approaches on relevant selection of Tyumen citizens aged 25-64 y. During next 12 years the whole cohort (795 men, 814 women) was analyzed for the deaths from cardiovascular diseases (CVD). Multivariate regression model of proportional Kox risk used to estimate RR for cardiovascular death. RR with 95% CI calculated with added concomitant RF like: age, SBP and DBP, BMI, total cholesterol, triglycerides, HDL, smoking state, coronary heart disease anamnesis and arterial hypertension.

Results. By 12 years of observation there were 85 (10,7%) cases of cardiovascular death in men and 33 (4,1%) in women. Higher risk of cardiovascular death was in men with low educational level than in those with higher education (RR: 1,94, 95% CI 1,12-3,34). In women the same (RR: 3,42, 95% CI 1,53-7,64) in comparison to more educated women. After standartization of all concomitant factors the risk of cardiovascular death was significantly higher in men and women involved in hard physical labour (RR: 2,51, 95% CI 1,03-6,08 and 5,47, 95% CI 1,69-17,74, resp.), comparing to those of higher labour qualification (RR: 4,08 (95% CI 2,12-7,8), RR 3,19 (95% CI 1,22-8,34) and RR 3,18 (95% CI 1,90-5,34), resp. In women the relation was opposite: RR for cardiovascular death was higher for married women (3,21, 95% CI 1,28-8,06; p<0,001), than for single.

Conclusion. The highest risk for cardiovascular death in non-organized Tyumen citizen cohort was found for those with lower educational level, involved into hard physical labour and single, divorced or widowed men. In women, opposite, being married was associated with higher risk of death from CVD.

Aim. To study clinical and economic efficacy of the organisational model for primary prevention of CVD in men working at railway system.

Material and methods. Organisational model for primary prevention of CVD (the group preventive consulting at the workplace and individualized profound prophylactic consulting in outpatient environment of locomotory depot rehabilitation centre) has been performed for the first group of locomotory teams in 2010­2012 y.; second group was under annual medical observation (screening and medical comission workout). The monitoring of risk factors and analysis of morbidity causing temporary disability (TD) by CVD; direct and indirect expenses calculation; expense-efficacy estimation.

Results. On the background of organisational model for primary CVD prevention in the first group there was a decrease of TD from CVD by 32,8% cases and 34,6% days, from DM by 55,6%; no cases of CHD; total expenses decreased by 44,1%. For three years of observation of 2nd group there was increase of TD from CVD by 19,2% and days — by 8,7%; TD from CHD and DM increased twice; total increase of expenses was by 24,3%. In the 1st group prevalence of smoking decreases 1,6 times and expenses for 1% — decrease of this addiction reached 10304,7 RUR; prevalence of abdominal obesity decreased 1,3 times, expenses for attaining the target waist circumference in 1% patients reached 20310,7 RUR; prevalence of hypercholestrolemia was 1,8 times rarer and expenses to reduce it in 1% patients were 8493,6 RUR by 100 workers. In the 2nd group prevalence of smoking decreased by 4,7% and expenses to reduce this addiction for 1% of men were 107607,4 RUR by 100 workers, that is 10,4 times more than in the 1st group; prevalence of abdominal obesity increased by 5,5%, of hypercholesterolemia — by 4,7%.

Conclusion. Realisation of the organisational model for primary CVD prevention in railway system workers during first 3 years showed clinical and economic efficacy in terms of the main risk factor prevalence decrease, TD decrease and overall expenses for CVD.

Aim. To conduct a comparative research of a variety of angiographic scales with the aim to choose strict and useful scoring system for coronary artery lesion estimation. Material and methods. The cohort of patients is investigated with the age of 25-86 y. (n=502, 70,7% males), who at FSBI "SSRCPM" of the Ministry of Health were underwent coronary arteriography. To evaluate the severity of atherosclerosis by the angiography results the scoring systems Gensisni and SYNTAX were used. Quantitative evaluation of stenoses was done using the software of "General Electric Innova 4100".

Results. The groups were formed acorrding to absence, mild or severe coronary atherosclerosis using the Gensini and SYNTAX scores, and also by coronary stenoses prominence. The significant association between all three methods was shown: Spearman correlation coefficient about 0,87. Quantity of points by Gensini and SYNTAX increases according to the quantity of arteries involved. But usage of Gensini score with addition of cut-off points makes more precise the identification of patients with severe coronary arteries lesion.

Conclusion. The Gensini scale and the cut-off points provided makes it possible a relevant estimation of coronary arteries lesion and improves the decision whether to revascularize or not.

Aim. To study the risk factor (RF) prevalence, target organ damage (TOD) and overall cardiovascular risk among patients with the first time revealed AH. Material and methods. Totally 90 patients included (48 women, 42 men) with increased blood pressure (BP) from those who requested medical care for the first time. After investigation the evaluation of cardiovascular risk was done according to National guidelines for Prophylaxy, diagnostics and treatment of AH, scales SCORE and PROCAM.

Results. Most patients had 2 or more RF. Absence of additional cardiovascular risk factors among patients with the first time revealed AH existed only for women; 29,2% women and 14,3% men had 1 RF The prevalence of 2 RF was the same for both genders: 42,9% and 43,8%, resp. Three and 4 RF were twice more prevalent in men, than in women.

Conclusion. In the population of patients with the first time revealed AH the average and high risk of cardiovascular complications was more common.

Aim. To study the interrelation of different MS components and parameters of cell and vessel aging.

Material and methods. Totally 136 patients studied with the age 25-75 y. without any signs of CVD or other chronic diseases, not receiving any continuous drug therapy. In all patients the antropometric parameters, BP levels, fasting plasma glucose, HDL cholesterol and triglycerides levels were measured. The PWV measurement was performed by the device SphygmoCor (AtCorMedical, Australia). Telomere length (TL) was measured by PCR.

Results. Multidimensional regression analysis revealed that among all MS risk factors studied only the age (р=0,0003), waist circumference (р=0,0434), systolic BP (р=0,0001), НОМА-IR (р=0,0033), fasting glycemia (р=0,0001) and TL (р=0,0001) are the independent determinants of PWV, and this relation is reversed for TL, but direct — with the other parameters. Independent reversed relation is with TL only for age (р=0,0033) and НОМА-IR (р=0,0027).

Concluson. Arterial hypertension can be named as the main hemodynamic component and impaired carbohydrate metabolism, insulin resistance and obesity as the main non-hemodynamic components of vessel wall rigidity increase and as the main target for therapeutical intervention.

Aim. To assess the influence of starvation on the prevalence of cardiovascular risk factors and diseases in survivors of Leningrad Siege, depending on the starvation occurrence. Material and methods. Leningrad Siege survivors from Primorsky district of Saint-Petersburg were invited and examined during December 2009 to January 2012. All participants were interviewed by a questionnaire regarding lifestyle, risk factors, cardiovascular disease, comorbidities and medication. Blood pressure (BP) measurements and anthropometry (weight, height, waist and neck circumference) were performed according to standard procedures. Fasting serum lipids and plasma glucose were measured on Hitachi-902. Echocardiography (Vivid 7) and electrocardiography (MAC1200ST) were performed. 305 survivors of Leningrad Siege (224 (73%) females and 81 (27%) males) were examined, the mean age was 70,5 yrs. In the control group were 46 patients with similar gender and age pattern — 31 (67%) females and 15 (33%) males, mean age was 71,3 years. All people were divided in two groups: who was born during the Leningrad Siege (45 (14,7%)) and before the Leningrad Siege (260 (85,3%) subjects) in the period from 1928 to 1941.

Results. Siege survivors had lower anthropometric indexes but higher HDL level comparing with control group. There were no significant differences in the prevalence of cardiovascular disease in 2 groups: only chronic CHD was more often (48,9% vs 33,3%, р=0,04) and prevalence of atrial fibrillation was slightly lower (17% vs 8.5%, p=0,05) in siege survivors comparing with the controls. Survivors who were undergone the starvation during childhood and adolescent period more often had hypertriglyceridemia comparing with subjects after intrauterine starvation. Diagnosis of myocardial infarction (16 (19,8%) vs 16 (7,2%), p=0,002) and AF (13 (16%) vs 12 (5,35%), respectively, p=0,02) were detected more often in men comparing with women. Males less often had hypercholesterolemia (39 (48,1%) vs 170 (75,8%), р<0,0001) and abdominal obesity (43 (53,0%) vs 162 (72,3%), р=0,001) than females.

Conclusions. No significant influence of starvation during Leningrad Siege on cardiovascular risk factors and diseases was revealed. Delayed consequences of starvation appeared to be less important than other risk factors and heredity predisposition.

Aim. To find out and evaluate interrelation between inhabitants mortality in Tyumenskaya region and quantity of PCI for ACS in this region during 2006-2012 y. Material and methods. The data on PCI procedures used that is provided in the information and analytical digests "Cardiovascular surgery. Diseases and inherited anomalies of circulation system". The data on mortality and morbidity is published in statistical issues of the Health Department of Tyumen region. Results. During the period studied at the south of Tyumen region there was progressive descrease of morbidity and the quantity of PCI procedures for ACS increased significantly. Negative correlation found for PCI and total mortality (r= -0,857, р=0,014), total mortality among economically active population (r=-0,893, р=0,007) cardiovascular mortality (r= -0,857, р=0,014). The quantity of PCIs for MI was related to general mortality (r= -0,929, p=0,003), to general mortality of economically active population (r= -0,964; р<0,001), MI mortality of economically active population (r=-0,893; р=0,007) and among men of economically active age (r= -0,893; р=0,007).

Conclusions. The data revealed confirms that the decrease of cardiovascular mortality in Tyumen region is at most relies upon progressing increase of PCI procedures for acute CHD during 2006-2012 y.

Aim. To evaluate the pattern of nocturnal penile episodes during polysomnography and the lipid profile for the risk of cardiovascular diseases development in men with OSAS.

Material and methods. Totally 51 men aged 46-55 years participated in the study. After enhanced PSG by the GRASS-TELEFACTOR Twin PSG (Comet) system with As 40 amplifier and integrated module SPM-1 (USA) with in-built into the software option for nocturnal penile episodes (NPT) registration the participants were divided into 2 gropus. First 37 men made up the group of OSAS patients (av. age 53,16±3,45 y., body mass index — 33,19±5,76 kg/m²). Other 14 men were the control, with the same age and BMI, but free from respiration disorders during the night sleep. The serum utilized as the specimen for chemistry. Results. In men with OSAS the disorderd sleep structure was found, represented by significant prevalence of low-deepness sleep, deep sleep deficiency and lack of REM sleep. Also there was impairment of night spontaneous erection during REM sleep — retardation of the beginning and prolongation of detumescence. The quantity of NPT was lower during the sleep. Lipid profile showed lower levels of antiatherogenic and increased levels of atherogenic cholesterol fractions with increased atherogenity index. Relative risk for cardiovascular pathology was 4 times higher in patients erectile dysfunction (RR=3,9; 95% CI 1,44-10,61). Attributive risk for ED in regard to cardiovascular pathology was 66% (95% CI 44,6%-87,4%). Conclusion. The results make possible to regard the ED in OSAS as early predictor for cardiovascular pathology in men.

Aim. To study an interrelation between obstructive sleep apnea syndrome with lipid metabolism disorders and atherosclerotic lesion of carotid arteries in patients with arterial hypertension.

Material and methods. The article presents the results on the study of 150 patients with arterial hypertension, of those 75 also had obstructive sleep apnea syndrome (main group); 75 patients without apnea constituted control group. This study included patients with variable body mass index — from normal values (18,5-24,9 kg/m²) to 2-3 grade obesity.

Results. A reliable correlation interrelation was found for the sleep apnea episodes quantity during the night and risk of different types of hyperlipidemias, with intima\ media thickness in carotid arteries.

Aim. To study electrocardiographic (ECG) markers of metabolic cardiomyopathy (MC) in men with coronary atherosclerosis (CA) in association with 5-year long-term results of coronary artery bypass grafting (CABG).

Material and methods. The study included 77 men aged 42-77 years with stenotic CA verified during selective coronary angiography (CAG) without acute coronary syndrome (ACS) and stable angina FC II-IV — the inhabitants of Western Siberia, admitted to the hospital for CABG. All patients before CABG underwent ECG at rest in 12 standard leads, followed by coding Minessota code. We analyzed ECG markers of MC, as the length of the interval QT, corrected interval QT, ST segment above the contour >5mm, ST segment depression below the contour >5mm non-ischemic type, T-wave changes (flattening or reduction of amplitude), the inversions, syndrome TV1>TV6 (amplitude of T in V1 exceeds the amplitude of T in V6), signs of left ventricular hypertrophy (LVH), arrhythmias and conduction disorder. Results. In men with CA before the CABG registered the following ECG markers MK: arrhythmias in 38 patients, LVH — in 55, the syndrome TV1>TV6 — in 24, the change of the T wave — in 58, segment ST elevation — in 44, segment ST depression — in 23, prolongation of the interval QT — in 5. The results were obtained in 5-year course of CA after surgical myocardial revascularization. The group of men with complicated CA (adverse long-term prognosis) was revealed. A positive correlation between the presence of the syndrome TV1>TV6 and fatal outcomes in the long term was found. The relative risk of death during 5-year period after CABG in patients with the syndrome TV1>TV6 was higher than in the group without the syndrome. In patients with the TV1>TV6 syndrome the relative risk of unfavourable later period as a whole (death, myocardial infarction, reoperation) was higher than of favourable. A positive correlations between ST-segment elevation before CABG and long term fatal outcomes, and in general, an unfavourable long term prognosis, were found. In patients with ST-segment elevation the relative risk of unfavourable later period is generally higher than of favourable. Conclusion. There is an association of electrocardiographic markers of MK (syndrome TV1>TV6, segment ST elevation) with 5-year long-term results of coronary revascularization in men with coronary atherosclerosis.

Aim. To study the correlation of arterial pressure variability on brachial artery and central arterial pressure variability with condition of target organs among menopausal women.

Material and methods. This research included 93 women of menopause age — 37 premenopausal women and 56 women at early postmenopause. The age was 49,1 (48,0; 51,0) and 53,9 (50,0; 56,0), resp. Of those 69 (74,2%) had arterial hypertension. No one received continuous antihypertension therapy. 24-hour blood pressure mon itoring with variability estimating of systolic and diastolic pressure and evaluation of arterial stiffnes was taken by oscillometric method. Daily index of arterial stiffness, ambulatory index of arterial stiffness, augmentation index and indicators of central aortal pressure were estimated. Echocardiogram was used for left ventricular remodeling estimation. Pulse wave velocity was measured by ultrasonic method. Vascular regulation of endoltelium of brachial artery was estimated by the test of reactive hyperemia. As a sign of large elastic arteries remodeling the intima-media thickness was used. All women with arterial hypertension divided into 2 groups depending on variability of arterial pressure — 16 women with high levels of systolic and dyastolic arterial pressure were in first group and 53 women with normal indicators of variability were in second group. Control group consisted of 24 women that had no arterial hypertension with normal indicators of arterial pressure variability. Results. Disordered arterial pressure was prevalent among women in early postmeno­pause. Raise of variability of arterial pressure was correlated with morphofunctional changes of the heart, structure-functional vascular changes, increase of arterial stiffeness, disturbances of endoltelial vascular regulation and subclinical kidneys damage. Conclusion. Central arterial pressure variability has no additional advantages in comparison with estimated variability of brachial artery pressure. Increased variability of arterial pressure among menopausal women can be considered as additional factor of target organ damage in early stages of climacteric.

The review provides the current information about the role of antiplatelet therapy in the cardiovascular prevention in patients with coronary artery disease and coronary revascularization. Recent drugs as components of dual antiplatelet therapy after percutaneous interventions are considered. The review includes features of antiplatelet therapy after coronary bypass surgery. The paper contains points of European and American recommendations. Authors discuss the controversial and unsolved issues of antiplatelet therapy. The necessity for new dosing forms synthesis and further research for development effective prevention of adverse cardiovascular events after coronary revascularization is noted.

The ageing is the main risk factor for arterial hypertension (AH) and cardiovascular diseases. Natural ageing with normal BP is followed by changes in large arteries (rigidity), myocardium (hypertrophy) and diastolic relaxation and filling of cardiac muscle (diastolic dysfunstion). In AH these changes develop earlier and progress faster. These can be found at any age in AH. The telomere length (TL) — a special terminal structures on somatic cells chromosomes — is dependent on the age and is being shortened with age. This review concerns modern views on the role of telomeres as biological markers of ageing to understand the pathophysiology of essential arterial hypertension as a syndrome of accelerated cardiovascular system ageing.

The article concerns the review of different approaches to reduce table salt consumption by human beings. The levels for harmless consumption are reviewed those were recommended in terms of target organ damage prevention. The guidelines for salt consumption consuming regulation are presented, that are in use in various world countries. The foundations for personal, social aEnd state policy for practical implication of these guidelines are provided. The predicted outcomes for the realization of the policy in relation to decrease of general and cardiovascular mortality and also correction of arterial hypertension are given. The article can be in the field of interest of physicians — internists of broader profile, cardiologists, health managers.

Currently, it is proved that physical training (FT) should be a compulsory component of programmes for complex rehabilitation of patients with coronary heart disease after PCI. However, given the heterogeneity of clinical status of patients after conducting PCI medical rehabilitation should be personalized as for the choice of intensity and exposure of FT and with obligatory monitoring of their effectiveness and safety. This greatly extends the possibilities of wide use of FT at the stage of rehabilitation in the real clinical practice.

The article is dedicated to the memory of professor G. I. Kassirsky, one of the  founders of the novel direction in fatherhood cardiology — cardiorehabilitation. The biography, data on scientific works and adherents provided.