Background Mortality from cardiovascular diseases is particularly high in Russia compared with the European average. The National Priority Project 'Health', launched in 2005, aimed to promote prevention of non-communicable diseases, particularly cardiovascular diseases, in primary care and to increase availability of state-of-art cardiovascular disease management. Methods This is a multiregional population based study with analysis of indicators for cardiovascular health and coronary heart disease in Moscow, St Petersburg, the Moscow region and across Russia, including a total population of 143.7 million inhabitants between 2005 and 2013. Data were collected using conventional methodology and originate from open statistical sources. Results The overall age-standardized coronary heart disease mortality decreased in 2005-2013 by 24.7% from 383.6 to 289.0 per 100000 population, but with substantial interregional differences: it declined from 306.1 to 196.9 per 100,000 in Moscow (-35.7%), from 362.1 to 258.9 per 100,000 in St Petersburg (-28.5%) and from 433.8 to 374.3 per 100,000 in the Moscow region (-13.7%). Income in Moscow exceeded the national average 2-3-fold, and Moscow had the highest availability of modern treatments and interventions. Although vegetables, fruits and fish consumption increased overall in Russia, this trend was most prominent in Moscow. Indicators for psychosocial well-being also were best in Moscow. Life expectancy in Moscow is almost six years higher than the Russian average. Conclusion Health policy interventions turned out to be successful but with substantial interregional differences. Lower coronary heart disease mortality and higher life expectancy in Moscow may be due to a more favourable socioeconomic and psychological environment, more healthy eating and greater availability of medical care.

Background: This study analyzes the current and evolving physical rehabilitation needs of BRICS nations (Brazil, Russian Federation, India, China, South Africa), a coalition of large emergent economies increasingly important for global health. Methods: Secondary, cross-national analyses of data on Years Lived with Disability (YLDs) were extracted from the Global Burden of Disease Study 2017. Total physical rehabilitation needs, and those stratified per major condition groups are analyzed for the year 2017 (current needs), and for every year since 1990 (evolution over time). ANOVAs are used to detect significant yearly changes. Results: Total physical rehabilitation needs have increased significantly from 1990 to 2017 in each of the BRICS nations, in every metric analyzed (YLD Counts, YLDs per 100,000 people, and percentage of YLDs relevant to physical rehabilitation; all p < 0.01). Musculoskeletal & pain conditions were leading cause of physical rehabilitation needs across the BRICS nations but to varying degrees: from 36% in South Africa to 60% in Brazil. Country-specific trends include: 25% of South African needs were from HIV-related conditions (no other BRICS nation had more than 1%); India had both absolute and relative growths of pediatric rehabilitation needs (p < 0.01); China had an exponential growth in the per-capita needs from neurological and neoplastic conditions (p < 0.01; r2 = 0.97); Brazil had a both absolute and relative growth of needs coming from musculoskeletal & pain conditions (p < 0.01); and the Russian Federation had the highest neurological rehabilitation needs per capita in 2017 (over than three times those of India, South Africa or Brazil). Conclusions: total physical rehabilitation needs have been increasing in each of the BRICS nations, both in absolute and relative values. Apart from the common growing trend, each of the BRICS nations had own patterns for the amount, typology, and evolution of their physical rehabilitation needs, which must be taken into account while planning for health and physical rehabilitation programs, policies and resources.

Background.Psychosocial (PS) risk factors (RF) make a substantial contribution in populational burden of cardio-vascular diseases (CVD) and their complications.Purpose.The KOMETA (Comet) study was directed to obtaining actual information on PSRF among ambulatory patients with arterial hypertension (AH) and / or ischemic heart disease (IHD) in 30 cities of Russian Federation.Materials and methods.This multicenter cross-sectional study was conducted in 2016–2017. Doctors participating in the study (n=325) recruited in state polyclinics 2775 patients aged ≥55 years with AH and / or IHD. Information collected from these patients comprised social-demographic and clinical characteristics, data on RF, adherence to therapy. Assessment of PSRF was carried out with consideration of levels of anxiety, depression and stress, presence of personality type D. Results. Population of patients studied (72 % women) was characterized by considerable prevalence of PSRFs. Low levels of education and income were found in 24.5 and 44.2 % of patients, respectively; 25.2 % of patients reported living alone, 6.3 % – felt social isolation. Elevated, extremely high levels of stress, type D personality were detected in 67.8, 10, and 37.6 % of patients, respectively; clinically significant symptoms of anxiety and depression were found in 25.5 and 16.3 %, respectively. Most RFs were significantly more often detected in women, and older people. One third of patients (33.1 %) during a year preceding inclusion took some psychotropic drugs mainly herbal or barbiturate-containing (27.1 %). Moreover, 30 % of patients had lowering of cognitive functioning.Conclusion.In this large-scale study we revealed high prevalence of PSRFs among ambulatory patients with AH and / or IHD in Russia. Despite positive dynamics of prevalence of states of anxiety and depression relative to earlier studies in this country their negative impact on prognosis of CVD and quality of life of affected patients requires optimization of efforts for organization of adequate care and directed to timely diagnosis and correction of these states.

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