CONTENTS
СОДЕРЖАНИЕRUSSIAN JOURNAL OF CARDIOLOGY, 2016, 6 (134)
Address to the readers
Russ J Cardiol 2016, 6 (134): 5
CLINICAL MEDICINE NEWS
Clinical medicine updates: a review of international news
Russ J Cardiol 2016, 6 (134): 6
EDITORIAL
NOSOLOGICALLY AND AGE-STRATIFIED MORTALITY STRUCTURE FROM CARDIOVASCULAR DISEASES IN THE YEARS 2006 AND 2014
Samorodskaya I. V.1, Starinskaya М. А.1, Semyonov V. Yu.2, Kakorina Е. P.3
Abstract
Aim. To study structure and dynamics of standardized mortality parameters (SMP) from cardiovascular diseases (CVD) in Russia, during 2006-2014; to compare mortality in 5-year age strates from CVD and myocardial infarction (MI).
Material and methods. The RosStat data was used, on the population number by the beginning of the next year, number of died by age groups, for mortality rates, listed in the Short registry of RosStat mortality causes. The SMP from CVD and literally close causes of death was calculated. Comparison was done using visibility indexes.
Results. In Russia, during 2006-2014yy, there is a strong decline of CVD mortality in general population (by 25,5%), as in separate age strates. Lowest decrease of mortality is shown in groups 20-24 (23,9%) and 35-39 y. o. (24,3%), maximum — in the age group 65-69 y. o. (41,1%). Regardless significant decline of CVD deaths (from general deaths) in 2014 comparing with 2006, in older groups this relation is disproportionally high. According to the Short registry of RosStat mortality causes, CVD class in 2014 had been presented by 35 nosological groups and/or separate diagnoses of ICD-10, in 2006 — 23. Part of deaths from non-clearly defined nosological death causes (codes 129-130, 132, 136, 140, 145, 147-150, 151-152, 155) was in 2014 — 58,8% from CVD and 29,4% from general causes. Most significant decrease of SMP was marked in cerebrovascular diseases group (42,7%); including cases related to stroke. SMP from IHD decreased by 31,1%; mortality from MI — by 12,4%.
Conclusion. The found significant decline of SMP from CVD is determined by the enforced prevention, improvement of medical care organization, increase of amount and accessibility of high-technology medical care. At the same time, it is not possible completely and correctly compare mortality due to changes of approaches for the main cause of death definition, including Ministry of Health guidelines and changes in the Short list of mortality causes of RosStat.
Russ J Cardiol 2016, 6 (134): 7-14
http://dx.doi.org/10.15829/1560-4071-2016-6-7-14
Key words: mortality, cardiovascular diseases, ICD-10, Short list of mortality causes of RosStat.
1National Research Center for Preventive Medicine of the Ministry of Health, Moscow;2A.N. Bakulev SCCVS of the Ministry of Health, Moscow;3I.M. Sechenov First Moscow State Medical University of the Ministry of Health, Moscow, Russia.
ORIGINAL ARTICLES
MORTALITY IN 55 YEARS AND OLDER POPULATION AND ITS RELATION WITH ISCHEMIC HEART DISEASE, TRADITIONAL RISK FACTORS AND INFLAMMATION MARKERS: THE RESULTS OF PROSPECTIVE COHORT STUDY
Shalnova S. A.1, Imaeva A. E.1, Kapustina A. V.1, Tyaeva E. M.1, Balanova Yu. A.1, Muromtseva G. A.1, Deev A. D.1, Shkolnikova М. А.2, Shkolnikov V. М.3
Abstract
Aim. To evaluate associations of ischemic heart disease (CHD), traditional risk factors (RF) and inflammatory biomarkers with all-cause and cardiovascular (CVD) mortality in the population aged 55 years or older.
Material and methods. The results were obtained from the prospective cohort study "Stress, aging and health in Russia". The population based sample of 1,876 Muscovites aged 55 years and older were enrolled. Traditional RF, inflammation biomarkers and type of CHD were included into analysis. CHD, "definite" and "possible" defined based on ECG criteria of Minnesota Code and angina pectoris algorithm from Rose questionnaire. Mean follow-up time was 7,05 years, and 411 deaths (247 death from CVD) were identified. Statistical analysis was performed using the statistical package SAS.
Results. All-cause and CVD mortality increased from 15% and 8,2% in patients without CHD to 32,2% and 22,1% in those with evidence of definite CHD. The proportion of CVD deaths in all-cause mortality was 60%. The cumulative risk of all-cause and CVD mortality was higher in patients with definite CHD compared with those who did not have CHD or had possible CHD. After adjusting for age and sex and (definite) CHD, to the all-cause mortality model were selected high blood pressure (p=0,001), smoking (p=0,0001), low levels of high-density lipoprotein cholesterol (p=0,02) and total cholesterol (p=0,02), elevated levels of high-sensitivity C-reactive protein (p=0,02) and interleukin-6 (IL-6) (p=0,007), and heart rate (HR) >80 per min (p=0,002). For CVD mortality significant risk factors were smoking (p=0,0001), high blood pressure (p=0,004), HR >80 per min (p=0,005) and IL-6 (p=0,005).
Conclusions. Definite CHD and risk factors were significantly associated with all-cause and CVD mortality in the population aged 55 years or older.
Russ J Cardiol 2016, 6 (134): 15-19
http://dx.doi.org/10.15829/1560-4071-2016-6-15-19
Key words: ischemic heart disease, risk factors, inflammatory markers, general mortality, cardiovascular mortality.
1National Research Center for Preventive Medicine of the Ministry of Health, Moscow, Russia; 2Yu. E. Veltishchev Separate Structural Department the Scientific-Research Clinical Institute of Pediatrics, N. I. Pirogov Russian National Research Medical University (RNRMU), Moscow, Russia; 3Max Planck Institute for Demographic Research, Rostock, Germany.
COMPARATIVE ANALYSIS OF DIAGNOSTIC METHODS FOR SUBCLINICAL VESSELS LESION (UNDER THE COHORT OF EPIDEMIOLOGICAL STUDY ESSE-RF)
Alieva A.S.1, Boyarinova М.А.1, Orlov А.V.1, Moguchaya E.V.1, Kolesova E.P.1, Vasilyeva Е.Yu.1, Solntsev V.N.1, Rotar О.P.1,2, Konradi А. О.1,2
Abstract
Aim. To assess correlations of vessel wall stiffness with traditional risk factors according to various diagnostics methods, and the relation of those to each other in population of Saint-Petersburg citizens with different level of cardiovascular risk.
Material and methods. Under the epidemiological study ESSE-RF framework, 452 citizens of Saint-Petersburg were investigated (men — 203, women — 249). Anthropometry, blood pressure measurement, blood chemistry were done according to standard protocols. In instrumental assessment we simultaneously studied carotidfemoral pulse wave velocity (cfPWV) with SphygmoCor device, and ankle-brachial index (CAVI) via Vasera device. Cardiovascular risk was estimated with SCORE.
Results. 341 (75,4%) of participants did not have any marker of arteries lesion. Non-significantly more common was the deviation from reference ranges of CAVI (33 (7,3%)) comparing to cfPWV (21 (4,6%)). Also the significant relations were found for cfPWV (β=0,04, p<0,001), and for CAVI (β=0,02, p=0,01) regardless the gender; cfPWV values were significantly related to SBP (β=0,03, p<0,0001 for both genders) and with glucose levels (β=0,24 for men (p=0,03) and β=0,40 for women (p=0,004)). In patients with arterial hypertension there is higher probability of higher vascular wall stiffness by cfPWV (OR=11,2 95%; CI=3,6-34,9, р<0,0001) if to compare with CAVI (OR=3,3; 95% CI=1,2-10,6, р=0,03).
Conclusion. In populational selection of Saint-Petersburg citizens there is low prevalence of subclinical arteries lesion. Applanation tonometry data shows that the severity of vascular stiffness is directly proportional to the increase of total cardiovascular risk. Mean values of cfPWV are significantly higher in men, probaly due to higher part of arterial hypertension and metabolic disorders. Increase of the age is associated with increased stiffness regardless of the method of investigation. Applanation tonometry makes it to reveal the increase of stiffness at earlier stage of arterial hypertension comparing to volumetric sphygmography. Values of vascular stiffness, obtained via different methods, correlate weakly with each other, so these methods cannot be treated as equal.
Russ J Cardiol 2016, 6 (134): 20-26
http://dx.doi.org/10.15829/1560-4071-2016-6-20-26
Key words: subclinical arterial lesion, arteriolosclerosis, markers of cardiovascular risk, atherosclerosis, risk stratification.
1Federal Almazov North-West Medical Research Centre of the Ministry of Health, Saint-Petersburg; 2Saint-Petersburg National Research University of Informational Technologies, Mechanics and Optics, Saint-Petersburg, Russia.
COMPARATIVE ANALYSIS OF THE CALCULATION MODELS FOR ISCHEMIC HEART DISEASE OVERALL RISK IN RAILROAD WORKERS
Gorokhova S. G.1, Muraseeva E. V.1, Pfaff V. F.1, Sboev A. G.2,3, Moloshnikov I. A.2, Atkov O. Yu.1,4
Abstract
Aim. To conduct a comparison of IHD risk prediction with the SCORE, PROCAM and Framingham scores, as novel developed models of IHD risk in cohort of the railroad workers.
Material and methods. Totally, 106 patients included — workers of locomotive crews, who had been under medical observation during 2006-2015 years with regular scheduled physician observations, incl. preflight, in-depth investigation during in-patient cardiological hospitalization. IHD diagnosis was set if documentarily confirmed signs of coronary ischemia of myocard were found, or coronary atherosclerosis (by angiography, MDCT). Individual total vascular risk was estimated by SCORE, PROCAM, Framingham scores and IHD prediction models developed with the principal components approach (PCA), probabilistic neural networks (PNN), Decision Trees based upon a complex of parameters (including body mass, low density lipoproteids, triglycerids, pulse BP, etc.). Quality of the models was assessed via the parameters of sensitivity, specificity, mean absolute prediction bias, square under ROC-curve (AUC).
Results. Dispersion to the categories of low, moderate and high by SCORE, PROCAM and Framingham was controversial. In IHD group with low risk by these scores, cardiovascular events (myocardial infarction and/or coronary surgery) happened in 51,9%, 5,56% and 42,6%, respectively. AUCs for SCORE, PROCAM and Framingham in "IHD" subclass were 0,72, 0,65 and 0,69, resp., but for subclass "Myocardial infarction" — just 0,34, 0,42 and 0,32. AUC for PNN on "IHD" was 0,55, "Myocardial infarction" — 0,60. Mean absolute prediction bias for high IHD risk by SCORE, PROCAM and PNN was 0,88, 0,56, 0,46, resp.
Conclusion. SCORE, PROCAM and Framingham scores are inconsistent for the assessed IHD risk category and are not sufficiently precise for prediction of myocardial infarction in cohort of adult men, workers on railroad, that reduces applicability of the scores. Novel developed model of PNN shows the prediction bias lower in models with added parameters as pulse pressure, platelets, triglycerides, myocardial mass index and other).
Russ J Cardiol 2016, 6 (134): 27-33
http://dx.doi.org/10.15829/1560-4071-2016-6-27-33
Key words: cardiovascular risk, ischemic heart disease, myocardial infarction.
1Scientific Clinical Canter of LLC "RZD", Moscow; 2National Research Center Kurchatov Institute, Moscow; 3National Research Nuclear University MEPHI, Moscow; 4Medical Academy of Postgraduate Education, Moscow, Russia.
THE INFLUENCE OF ECOLOGICAL RISK FACTORS ON MORTALITY IN MOSCOW POPULATION. RISK EVALUATION AND PREDICTION
Boytsov S.A.1, Lukyanov М.М.1, Deev A.D.1, Klyashtorny V.G.1, Ivanenko А.V.2, Volkova N.S.2, Kuznetsov А.S.2, Skvortsov А. S.2, Solovyev D.V.2
Abstract
Aim. To assess the influence of temperature, humidity, air pollution on the mortality of Moscow inhabitants in 2007-2014, to evaluate the possibility of mortality prediction by mathematic modelling.
Material and methods. For each day of 2007-2014 years, the data was analyzed for Moscow inhabitants mortality, temperature, humidity and air pollution (РМ10). Number of deaths was 956436 (48,1% of men and 51,9% women), of those from cardiovascular disorders (CVD) — 536625. Multifactorial regression analysis was done with generalized logistic regression, evaluation of risks ratios (RR), 95%, confidence analysis. The prognostic modelling applied, based on non-linear multifactorial analysis.
Results. The factor "heat wave" increased RR for the death from all cases and from CVD by 1,43 and 1,65 times. Heat waves mostly increased all-cause mortality, and from CVD in women (p<0,005), the increase of air pollution (РМ10) — in men (р<0,005). The highest increase of death risk was found for those 70 years and older, higher humidity worsened it. For the summer 2010 prediction was finer than for 2014 (correlation 90,1% and 45,1%), e. g. for the period of more significant anomalies of temperature and air pollution. Applying multifactorial prediction model for 2007-2014 period with additional evaluation of weather factors influence for last 4 days and all-cause mortality for the last month, correlation was higher for death risk prediction for 1-3 days (88,0%), than for month (45,2%).
Conclusion. Heat waves, increase of air temperature and pollution do increase the risk of all-cause mortality, especially from CVD, in those 70 y. o. and older. Anomal heat increases death risk for women higher than for men. Prediction of mortality by 1-3 days with multifactorial model show better correlation than prediction for month.
Russ J Cardiol 2016, 6 (134): 34-40
http://dx.doi.org/10.15829/1560-4071-2016-6-34-40
Key words: mortality, risk assessment, prediction, air temperature, pollution, humidity.
1National Research Center for Preventive Medicine of the Ministry of Health, Moscow; 2Center of Hygiene and Epidemiology of Moscow city, Moscow, Russia.
RELATION OF OXIDATIVE PARAMETERS OF LOW DENSITY LIPOPROTEIDES WITH THE AGE IN MALE POPULATION OF NOVOSIBIRSK CITY
Ragino Yu. I., Stakhneva E. M., Sadovskii E. V., Sherbakova L. V., Malyutina S. K.
Abstract
Aim. Assessment of the relation of oxidative LDL changes with the age (getting older), incuding the dependence from a row of the main cardiovascular risk factors in male population of Novosibirsk city.
Material and methods. Totally, 1024 males included, of 47-73 y. o. (mean age — 61,1±0,3 y. o.) of the population cohort of Novosibirsk. Biochemical methods were used to define baseline levels of lipid peroxidation products (LPP) in low density lipoproteides (LDL) and resistance of LDL to oxidation in vitro.
Results. The significant decrease of LPP was found in the separated LDL and the increase of LDL resistance to oxidation in vitro with increasing age in male population. There were no significant influences of smoking or increased BP on the association of oxidated LDL with the age. With significant relation of the total cholesterol, HDL-cholesterol and higher body weight on oxidation changes of LDL, nevertheless, in older cohort there were less prominent potentially atherogenic oxidative changes of LDL (lower baseline level of LPP in LDL and higher resistance of LDL to oxidation in vitro) comparing with younger men.
Conclusion. The results obtained, point on the significant influence of the age on the mentioned parameters and represent a tendency towards age-related decrease of atherogenic LDL oxidation processes activity.
Russ J Cardiol 2016, 6 (134): 41-44
http://dx.doi.org/10.15829/1560-4071-2016-6-41-44
Key words: age, resistance of LDL against oxidation, lipid peroxidation, risk factors, male population.
SRI of Therapy and Preventive Medicine, Novosibirsk, Russia.
LIPOPROTEIN(A) MEANING AS AN ADDITIONAL MARKER OF CARDIOVASCULAR RISK IN PATIENTS WITH FAMILIAL HYPERCHOLESTEROLEMIA
Korneva V. A.1, Kuznetsova T. Yu.1, Tikhova G. P.2
Abstract
Aim. To analyze the relation of Lp(a) and atherosclerosis development in familial hypercholesterolemia (FHCE).
Material and methods. Totally, 81 patient with definite FHCE studied, mean age 39,1±0,4 y. o. The participants were selected to two groups: first — with increased level of Lp(a) >0,3 g/L (n=34); mean age — 44,5±0,3; second — with normal Lp(a) <0,3 g/L (n=47, 58,1%); mean age — 37,5±0,3 y. o.
Results. Mean level of Lp(a) in various age persons did not differ significantly. In both subgroups in about a half of all participants there was arterial hypertension (AH) revealed (50,8% and 42,6%, respectively), obesity was diagnosed in one third of both groups, number of smokers was higher in higher Lp(а) group (11,8% and 8,5%). IHD had 25,9% of participants. Revalence of IHD in IHD group was 44, 4%, in nonsmoker group — 25,8% (RR 1,72 (0,75; 3,99)), acute myocardial infarction prevalence (MI) in smoking subgroup was — 44,6% versus 13,5% (RR 3,26 (1,26; 8,43)). Among lipid profile parameters LDL level was definitive for IHD development (p=0,012). Presence of obesity increased MI risk 2,54 times in FHCE (OR 2,4 (1,05; 5,63)). With increase of Lp(a) IHD was diagnosed more commonly: 32,4% versus 19%, non-significant (p=0,47). Prevalence of MI in the first group was higher than in the second: 8 (23,5%) and 4 (8,5%), respectively, (OR 3,3 (1,1; 9,8), р=0,03).
Conclusion. In FHCE, the risk of IHD was influenced by traditional RF (smoking, obesity, LDL level).
Russ J Cardiol 2016, 6 (134): 45-49
http://dx.doi.org/10.15829/1560-4071-2016-6-45-49
Key words: familial hypercholesterolemia, lipoprotein (a), ischemic heart disease.
1Petrozavodsk State University, Petrozavodsk; 2The Institute of Forest of Karelsky Scientific Center of RAS, Petrozavodsk, Russia.
RELIABILITY AND VALIDITY OF RUSSIAN VERSION OF DS14 SCORE FOR ISCHEMIC HEART DISEASE PATIENTS
Pushkarev G. S., Kuznetsov V. A., Yaroslavskaya E. I., Bessonov I. S.
Abstract
Aim. The aim of the study is to evaluate the factorial, construct validity and reliability of the Russian version of DS14 score among ischemic heart disease patients (IHD).
Material and methods. Totally, 977 IHD patients included (334 with acute coronary syndrome and 643 with stable angina), all patients fully completed the questionnaires DS14, HADS, MSPSS and STPI.
Results. The prevalence of type D among IHD patients was 31,6%. Bifactorial structure of DS 14 (negative affectivity, social suppression) was confirmed by exploratory and confirmatory factor analysis, and the parameters of intrinsic relative homogeneity, Tacker-Lewis index, incremental index of relation and meanquartile approximation bias for bifactorial solution were 0,90, 0,88, 0,90 and 0,069, respectively, that witnesses on the matching of theoretical bifactorial model with experiment. Intrinsic homogeneity of the Russian version of DS14 was adequate. Cronbakh alpha for negative affectivity was 0,78, for social suppression 0,74. Mean value for correlated points for negative affectivity was 0,35, for social suppression — 0,30, that confirms the adequacy of intrinsic structure of DS14. It was found, that the negative affectivity scale positively correlates with anxiety by HADS and anxiety as personal trait by STPI, and with depression by HADS and depressivity by STPI. The same, but less prominent relations were established for social inhibition. Also there was negative correlation of openness and positive correlation with aggressiveness as personal traits by STPI.
Conclusion. Russian version of DS14 matches with the English version by reliability and intrinsic structure, construct validity is confirmed by the results of correlational analysis. In general, the method can be applied for personality type D assessment in IHD patients.
Russ J Cardiol 2016, 6 (134): 50-54
http://dx.doi.org/10.15829/1560-4071-2016-6-50-54
Key words: type D personality, DS 14, reliability, validity, confirmatory factor analysis, ischemic heart disease.
Branch of SRI of Cardiology Tyumen Cardiological Center, Tyumen, Russia.
ASSESSMENT OF PATIENTS COMPLIANCE FOR AMBULATORY INSTITUTIONS VISITS AND ITS INFLUENCE ON THE QUALITY OF TREATMENT BEFORE DEVELOPMENT OF ACUTE CORONARY SYNDROME, BY THE LIS-3 REGISTRY
Martsevich S. Yu.1, Semenova Yu. V.1, Kutishenko N. P.1, Zagebelniy А. А.1, Ginzburg М. L.2
Abstract
Aim. To study the compliance of patients to visits in outpatient institutions (OI) with the data from acute coronary syndrome registry (ACS) LIS-3, prior to ACS development, and evaluate the quality of pre-hospital therapy among patients with different compliance.
Material and methods. Patients (n=320), hospitalized to Lubertsy District Hospital №2 with ACS, were selected to 3 groups depending on OI visiting before ACS: group A — compliant (n=139); group B — partially compliant; group C — non-compliant to OI (n=78). A score invented for the assessment of pre-hospital quality of management, made up via comparison of real life therapy with the recommended in Clinical Guidelines (CG) taken anamnesis of cardiovascular pathology.
Results. Compliance for OI visiting was associated with female gender, older age, CVD anamnesis (especially 2 and more CVD comorbidity) (p<0,0001), acute brain circulation disorder (ABCD), diabetes (DM). Compliance is lower in working patients and in smokers. Educational level, as marital status and obesity did not influence OI visiting compliance. There was low prescription rate for any medication, even among those with CVD in anamnesis. There is a decrease traced of prescription deficit for some drug groups for primary and secondary prevention of ACS together with the patients compliance decrease. Better compliance is associated with better quality of pre-hospital therapy (p<0,0001).
Conclusion. Compliance for OI visiting before ACS onset is higher among women, older and sedentary people, CVD patients, after ABCD and having DM. Management quality before ACS onset is generally poor, even in presence of CVD diagnosed during pre-hospital stages. Patients compliance for OI visiting generally improves quality of therapy, but not completely matches with the guidelines.
Russ J Cardiol 2016, 6 (134): 55-60
http://dx.doi.org/10.15829/1560-4071-2016-6-55-60
Key words: compliance for outpatient institutions visiting, therapy quality, acute coronary syndrome.
1National Research Center for Preventive Medicine of the Ministry of Health, Moscow; 2Lyubertsy District Hospital №2, Moscow, Russia.
CLINIC AND PHARMACOTHERAPY
SLOW RELEASE MELATONINE IN METABOLIC SYNDROME SYMPTHOMATICS CORRECTION
Smirnova V. O., Barykina I. N., Salasyuk A. S., Khripaeva V. Yu., Palashkin R. V., Nedogoda S. V.
Abstract
Aim. To compare effectiveness of metformin monotherapy (Mf) and combination of metformin with slow release melatonine (MfM) from the perspective of correction of anthropometric, hemodynamical parameters, premature vascular ageing and somnological status in patients with metabolic syndrome (MS).
Material and methods. An open label prospective comparative study conducted, in 3 parallel groups: 238 MS patients (IDF, 2005) having, at the moment of prescreening, sleep disorders (less than 19 points in Questionnaire of self sleep evaluation), were randomized to 3 groups. During 12 weeks all patients underwent life style correction that included regimen of meal intake, normalization of "sleepwakefulness" rhythm, physical activity. In addition to this, first group patients (n=80) received Mf, and second (n=78) — combination MfM (Circadin 2 mg). Controls (n=80) were patients without pharmaceutical interventions. Groups were comparable by the baseline clinical and demographic characteristics. Sleep quality, anthropometric and metabolic parameters, adipocytokine level and vascular elasticity parameters were assessed at baseline and in 12 weeks after treatment.
Results. The results of the study performed have proved the feasibility of melatonine slow release addition to standard MS therapy in circadian disorders (CD). MfM no only normalizes the rhythm "sleep-wakefulness", but also retards vascular ageing, has positive profile of cardiovasular and metabolic effects, acting on insulin resistance as trigger of MS development. Serious adverse events were not marked during the study.
Conclusion. Combination therapy by MfM is more effective than monotherapy by Mf in correction of body overweight, carbohydrate and lipid metabolism disorders in MS with CD.
Russ J Cardiol 2016, 6 (134): 61-67
http://dx.doi.org/10.15829/1560-4071-2016-6-61-67
Key words: metabolic syndrome, desynchronosis, obesity, slow release melatonine, metformin.
Volgograd State Medical University, Volgograd, Russia.
ACTUAL TOPICS
EUROPEAN INITIATIVE "STENT FOR LIFE" IN RUSSIA Ganyukov V. I.1, Protopopov A. V.2, Bashkireva A. L.1, Alekyan B. G.3, Shlyakhto E. V.4
Abstract The article presents data on implementation of European Initiative "Stent for Life" (modern system of care organization for myocardial infarction patients) in Russian Federation.
Russ J Cardiol 2016, 6 (134): 68-72
http://dx.doi.org/10.15829/1560-4071-2016-6-68-72
Key words: initiative Stent for Life, acute myocardial infarction.
1Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo; 2Regional Clinical Hospital, Krasnoyarsk; 3A.N. Bakulev SCCVS of the Ministry of Health, Moscow; 4Federal Almazov North-West Medical Research Centre of the Ministry of Health, Saint-Petersburg, Russia.
LITERATURE REVIEW
OBESITY AS A RISK FACTOR FOR CHRONIC NON-COMMUNICABLE DISEASES
Drapkina O. M., Eliashevich S. O., Shepel R. N.
Abstract. Among the risk factors of years of life loss, with correction for disability, the leading are arterial hypertension, smoking, high body mass index. Results of large prospective studies confirm the relation of excessive body mass with the increase of cardiovascular risk. Relative risk of cardiovascular disorders (CVD) in obese is comparable to the total impact of BP raise by 20 mmHg. However, most of current CV risk stratification models do not include obesity as one of the risk factors. There are several phenotypes of obesity. Presence of any leads to increased cardiovascular and diabetes (type 2, DM) risk. Metabolically healthy obesity comparing to the situation of comorbid obesity with metabolic syndrome is associated with lower DM risk, but cardiovascular risk is high equally in both obesity phenotypes. Hence, metabolically healthy obesity is not "benign" condition and demands the actions from us, interventions for loss of weight and strict control of modifiable risk factors.
Russ J Cardiol 2016, 6 (134): 73-79
http://dx.doi.org/10.15829/1560-4071-2016-6-73-79
Key words: obesity, obesity phenotypes, metabolically healthy obesity, metabolic syndrome, reclassification index.
National Research Center for Preventive Medicine of the Ministry of Health, Moscow, Russia.
PRESS RELEASE
Russ J Cardiol 2016, 6 (134): 80-81, 82
