Cardiovascular diseases are the leading diseases in Ukraine and are the cause of more than half of deaths. They are inextricably linked to lifestyle, diet, bad habits, physical activity, stressors and are the cause of other risk factors. The most common of these are unmodified factors, such as: gender, age, heredity; and modified: dyslipidemia, arterial hypertension, overweight and obesity, diabetes mellitus, smoking, psychosocial factors. According to the results of the published STEPS study in 2019, conducted together with the WHO, which analyzed risk factors among the civilian population of Ukraine aged 18 to 69 years. It was noted that 32,8% of the population had risk factors for CVD. High blood pressure or hypertension was observed in 34,8% of the population. The prevalence of hyperglycemia was 7,1%. Only 39,6% of the population of Ukraine had a normal weight for BMI, 59,1% were overweight, including 24,8% of the population were obese. 33,9% were active smokers, and alcohol consumption was observed in 19,7% of the population. Given the data from the STEPS study, we were interested in the frequency of detection of the main risk factors for cardiovascular events among servicemen. The objective: of the study is to determine the frequency of detection of the main risk factors for cardiovascular events among active servicemen and retirees of the Ministry of Internal Affairs at the stage of inpatient treatment in the conditions of NVMKC «GVKG». Materials and methods. Random sampling was used to analyze 104 case histories of patients in the cardiology department of NVMKC «GVKG» for the period from January 2018 to December 2019. Risk factors and the frequency with which they occur in different categories of patients were studied. The examination group consisted of male patients (100% of cases) aged 33 to 93 years, the average was 66,55±1,47 years. To study the age characteristics of the prevalence of CVD risk factors, patients were divided into two groups: Group I active servicemen, whose average age was 46,41±1,78 years; Group II retirees MOU, whose average age was 71,95±1,26 years. Statistical processing of the results was performed by methods of variation, parametric and non parametric statistics of medical and biological profile using a package of original applied statistical programs «Microsoft Ecxel», «Statistica 7.0». Results. According to the results of the study, the indicators of blood pressure in group I were analyzed: the indicators of mean systolic and diastolic pressure were 129,09±3,86 / 80,45±2,71 mm Hg (n=22). In group II, the average systolic and diastolic pressure were: 138,84±2,41 / 82,99±1,22 mm Hg (n=82). To assess blood pressure, we chose the classification proposed by the WHO in the study (STEPS-2019) for the possibility of compara tive analysis. The percentage of patients in group I with normal blood pressure was 77,27%; high blood pressure was observed in 22,73% of patients, according to the results of their own study, high blood pressure was not detected. In patients of group II normal blood pressure was registered in 63,41%, elevated in 26,83% of patients and high blood pressure was observed in 9,76% of patients. Examining the indicators of laboratory studies, we found that an increase in cholesterol was observed in 45,5% of cases in group I, and in 22,7% of cases the level of cholesterol was not determined. In group II, an increase in cholesterol levels was found in 35,4% of cases, in 13,4% of cases the cholesterol level was not determined. According to the results of the study, an increase in blood glucose levels was observed in 10,6% of cases and 55,8% of cases in group II. Normal blood glucose levels were in 33,7% of patients. The percentage of patients with concomitant type II diabetes was 1,9% of cases of group I, and 14.4% of cases of group II. 72,2% of Group I servicemen and 64.6% of Group II servicemen had an elevated BMI. 50% had a bad habit – smoking in the first group and 18,3% in the second group. Conclusions. We found that the indicators of high blood pressure in groups I and II were 22,73% and 26,83%, which is 12,07% and 6,77% less than among the civilian population of Ukraine where the rate of high blood pressure was 34,8%. The level of total cholesterol is 4,8% higher in patients of group I (45,5%) than among the civilian population of Ukraine (40,7%). In group II by 5,3% less (35,4%), respectively, from the study. The rate of elevated fasting blood glucose in group I (10,6%) is 3,5% higher, and in group II (55,8%), 48,7% higher than the results obtained among the civilian population of Ukraine, where the level of glycemia was 7,1%. The incidence of type II diabetes mellitus in group I (1,9%), which is 1,9% less than the results obtained among the population of Ukraine, where the result was 3,8%, and in group II (14,4%) by 10,6% more, respectively. The increase in BMI in patients of groups I and II was 40,9% and 46,3%, which is 18,2% and 12,8% lower than the data obtained among the civilian population of Ukraine, where the percentage of overweight was 59,1%. The prevalence of smoking among servicemen is 6,68% lower than among the civilian population of Ukraine (33,9%) and amounted to 27,04%.

The prediction of ability for military service by the health of patients who are experienced (with war experience) military persons with arterial hypertension (AH) with existing comorbid pathology is an urgent issue of today and a component of national security. The objective: to analyze the of factors that influence on the prognosis of health service for the military service of patientsmilitary personnel with AH – the participants of anti-terrorist operation / operation of the united forces (ATO / OUF), taking into account the available comorbid pathology. Materials and methods. Medical card of 213 military personnel – ATO/OUF participants with AH and comorbid pathology were analyzed. The first group included medical cards of 126 patients with AH stage I, the second group – medical cards of 87 patients with AH stage II. Clinical and laboratory, instrumental methods of research and consultation of narrow specialists and cumulative CIRS disease scale, which provides a separate total assessment of the condition of each of the organ systems on the range of Likert scale were used. Results. During the study, the professional longevity was forecasted using program Statistica SSP 10.0 and the forecasting of professional longevity using IBM SPSS 23.0. The most important prognostic factors that affect the change in the category of suitability for military service for the health of patients with AH of military personnel – ATO/OUF participants with comorbid pathology were determined, namely: age, sum of points on the cumulative CIRS scale and stage of AH (87.0 –91.8 % of the correct classifications of generated artificial neural networks, the area index under the ROC-curve AUC 0.971–0,992). Conclusions. Based on the statistics obtained data in the construction and analysis of artificial neural networks, the “algorithm for predicting a category of suitability for military service for the health of patients with arterial hypertension of military personnel – ATO/OUF participants with comorbid pathology” was developed.

Arterial hypertension (AH) without proper treatment can lead to heart attack, stroke, kidney or heart failure, vision impairment and other complications. The determination of effective preventive measures to prolong siutability for military service based on the health status of experienced military persons with existing comorbid pathology is an urgent issue today and a component of national security. The objective: to analyze the effective measures that influence on the prolongation of the suitability for military service of military personnel with AH – the participants in the anti terrorist operation / operation of the United Forces (ATO/OUF), taking into account the existing comorbid pathology. Materials and methods. 213 servicemen – the participants of the ATO/OUF with AH and comorbid pathology were examined, who were divided into two statistically homogeneous groups according to the age. The first group included 126 patients with AH stage I, the second group – 87 persons who were diagnosed with AH stage II. CIRS cumulative disease scale was used to assess comorbidity. Results. It has been established that the most important prognostic factors (predictors) that influence on the prolongation of the professional longevity of servicemen with AH – the participants of ATO/OUF with comorbid pathology are timely diagnosis and secondary prevention of atherosclerotic cardiovascular diseases, reduction of total cholesterol and triglyceride levels, the prescribtion of hypolipidemic and antiplatelet drugs therapy, normalization of carbohydrate metabolism disorders, body weight and smoking cessation. Conclusion. The «Algorithm for determination of preventive measures for prolonging suitability for military service based on the health status of servicemen with AH – the participants in ATO/OUF with comorbid pathology was developed».

A third part of the world’s population has a steady increased blood pressure (BP). According to scientific data, there is a tendency to increase the incidence of arterial hypertension (AH) up to 60 %. It is important in AH treatment to perform an optimal control of BP level, for this purpose it is necessary to consider both the risk factors for the disease development and the risk factors for the development of pathology complications. The objective: to identify risk factors in patients with AH and body mass index (BMI) more than 25 kg/m2. Materials and methods. The study included 339 patients with AH. The I group involved 299 persons with BMI≥25 kg/m2, and 40 patients with AH and BMI <25 kg/m2 were included in the II group. The average age of the patients was 49.4±10.7 years, the average duration of the disease – 7.5 years. Anthropometric data, daily monitoring of BP, morphological and functional state of the heart, biochemical parameters of the blood (lipidogram, transaminase and bilirubin, urea and creatinine, glucose level) were determined in all patients. The levels of interleukin-1β, interleukin-10 and homocysteine were also detected. The speed of glomerular filtration was determined accord ing to the Cockroft–Hault formula, a psycho-emotional examination was done (a questionnaire for determining of anxiety and depression levels, the presence of alexitimia). Results. The analysis of the lipidogram indicators demonstrated a higher level of atherogenicity index in patients with excess body weight (respectively 3.4±1.3 versus 3.1±1.4; p<0.05). Among patients with AH and overweight or obesity compared to patients with normal body weight, significant differences have been revealed about the frequency of complications of targetorgans (AH stage II was 2 times more common among patients in the II group). Glycemia level on empty stomach was higher in patients with overweight (5.5±1.8 mmol/l versus 4.8±0.8 mmol/l; p>0.05) and 3 times more common among patients in the I group (35.6 % versus 11.5 % of patients; p<0.05). Hyperuricemia was found in 48 % of patients. In patients with normal BMI, the level of uric acid was within reference values (p=0.015). In 27 % of patients with overweight the increased IL-10 was determined, in 45 % – IL-1β, while in patients with normal BMI these indicators were normal (p<0.05). Patients with AH had increased levels of anxiety, and patients with excess weight had a risk of depression. Conclusions. The results of the study showed that there is a clear association of increased blood pressure (BP) with weight gain. Patients with AH and high body mass index (BMI) had additional risk factors that can cause high BP and require personalized treatment. Excessive body weight causes an acceleration of the development of target organs (1.5 times more often), in particular increases the risk of progression of systolic and diastolic dysfunction of the left ventricle and sudden cardiac arrest, leads the development of atherosclerosis and immune inflammation. The association of AH and high BMI with PPARG gene (33 % of cases) was determined.

No abstract