The article discusses the issue of the high prevalence of cardiovascular risk factors and extremely high mortality rates from cardiovascular disease, especially among people of working ages, in Russia. It justifies the need to reduce excess mortality. Further, it analyzes the trends, structure and the burden of cardiovascular diseases, demonstrates prevalence of major cardiovascular risk factors (psychosocial factors, alcohol abuse, smoking, eating habits, arterial hypertension, low physical activity, obesity, and dyslipidemy) in the Russian population. The measures required to control high mortality from cardiovascular disease and existing barriers in Russia are addressed. A conclusion is made that the lessons learned in western countries over the past 50 years need to be applied in Russia.

BACKGROUND: Type 2 diabetes (T2D) is multifactorial disease. NATION epidemiological study may provide the information about the prevalence of T2D and prediabetic state in patients with different risk factor combinations in Russian population. AIMS: To evaluate the prevalence of T2D and prediabetic state in NATION cohort depending on the amount of diabetes risk factors. MATERIALS AND METHODS: NATION is an epidemiological, cross-sectional study, designed to assess the prevalence of T2D in Russian adult population, where HbA1c was used to establish T2D (HbAc6,5%) and prediabetes (5,7%HbA1c6,5%). Patients with T2D were either previously diagnosed or newly diagnosed. Current study presents an additional analysis of NATION cohort focused on the prevalence of T2D and prediabetic state among patients with different risk factor combinations. RESULTS: T2D and prediabetic state prevalence gradually increased among patients with following risk factors (prevalence of T2D and prediabetes respectively): low physical activity (4,3%, 18,3%), rare fruit and vegetable consumption (4,8%, 18,7%), T2D family history (7,7%, 20,3%), age 45 years (9,5%, 31,3%), obesity grade 1 (9,6%, 30,3%), obesity grade 2 (14,6%, 37,8%), obesity grade 3 (20,1%, 39,7%), hypertension (14,7%, 38,2%), history of diabetes during pregnancy (14,1%, 24,7%). Prevalence of T2D with single and multiple risk factors was compared to the prevalence of T2D in young patients (45 years) without additional diabetes risk factors. Age 45 years was associated with 7-fold increase in T2D prevalence; obesity 8,8-fold; family history 5,7-fold; hypertension 10,8-fold (p0,001 for comparisons of every group with patients 45 years of age without other risk factors). When one patient had several risk factors combined, the prevalence of T2D increased progressively: combination of age 45 years and family history led to 10,7-fold rise; combination of age 45 years and BMI30kg/m2 11,2-fold; combination of age 45 years, family history and BMI30kg/m2 15,3-fold; combination of age 45 years, family history, BMI30kg/m2 and hypertension 19,1-fold (p0,001 for comparisons of every group with patients 45 years of age without other risk factors). CONCLUSIONS: Presence of multiple risk factors, such as age 45 years, obesity and hypertension led to progressive increase in the prevalence of T2D and prediabetic state. These data are important to identify patients at the highest risk of T2D among Russian population.