Aim. To examine associations of cardio-ankle vascular index (CAVI) with classical, behavioral and social risk factors (RFs) of cardiovascular disease (CVD) in adult population.Material and methods. The study included 1365 people (women, 59%) from a representative sample aged 25-64 years (ESSE-RF), who underwent standard cardiology screening and volume sphygmography (VaSera-1500). All respondents signed an informed consent to participate in the study. The analysis included blocks of classical, social and behavioral risk factors for CVD. A linear model was used to identify associations. An error rate of <5% was considered significant.Results. Age, sex, systolic blood pressure (SBP), triglycerides were associated with higher CAVI values, and body mass index (BMI) was associated with lower values, respectively. After 45 years, a direct association with heart rate (HR) became increasingly important, while after 50 years — with diabetes and the intake of beta-blockers, while the association between diabetes and CAVI was observed only among individuals not taking angiotensin-converting enzyme (ACE) inhibitors. A direct association was found with high-sensitivity C-reactive protein (hsCRP) in men, and an inverse association with diuretics in women, respectively. A sedentary work in combination with a history of bronchitis or with positive family history for CVD showed a direct relationship, while a sufficient physical activity (PA) showed an inverse relationship with the studied indicator, but only among people with belowaverage income.Conclusion. According to the data obtained, in addition to age and sex, the following risk factors made a significant contribution to CAVI parameters in the examined population: BMI, SBP, triglycerides, diabetes, HR, intake of betablockers, diuretics, ACE inhibitors; hsCRP, PA. The unfavorable role of betablockers, high HR, diabetes, sedentary work, chronic lung pathology, hereditary burden, as well as the protective role of ACE inhibitors, diuretics and intense PA in relation to arterial stiffness in the working-age population has been shown. Additional studies are needed to determine the nature of a number of associations. The results obtained may contribute to the study of CAVI role in risk stratification and further development of methodological approaches to CVD prevention.

Aim.To study sex and age distribution of ultrasound parameters characterizing carotid atherosclerotic (CAS) severity in the unorganized urban population.Material and methods. The data obtained in Tomsk as a fragment of the ESSE-RF study are presented (n=1600; 25-64 years age; 59% – women). All participants signed informed consent. We studied CAS plaque count, both total and maximum plaque thickness and stenosis degree in the carotid arteries.Results. The general population quantitative indicators of CAS increased with age, most actively in 40-54 years in men and 45-59 years in women. At the age of 40-44 years in men, the growth of the general population indicators was due to a noticeable increase in both plaque prevalence and of CAS severity. In 45-49 years, the prevalence increased intensively, whereas in 50-54 years growth of plaque count/size indicators were more attributive. In women 45-59 years old formation of the general population indicators concerned was mostly due to steady increase in the plaque prevalence, while out of all quantitative CAS parameters the total stenosis degree only increased significantly in 50-54 years. The general population indicators of CAS severity were higher in men than in women starting up with the age of 40 and until 55 the gender effect was merely explained by the difference in the plaque prevalence.Conclusion. Features of the gender and age distribution of the quantitative parameters of CAS among the adult urban population are determined; the age periods of their most active growth are established. The presented data on the CAS severity percentile distribution can be useful as an additional tool for risk stratification and the choice of therapy/lifestyle modification tactics in people of working age. Further studies are needed to help to explain the trends and to clarify the predictive role of the indicators studied.

Распространенность хронических неинфекционных заболеваний (ХНИЗ) и их факторов риска (ФР) в нашей стране остается высокой. Оценить особенности частоты ФР и ХНИЗ в популяции можно только при проведении эпидемиологического исследования-увидеть, что происходит при естественном течении заболевания, какие показатели можно считать ФР, как оценить прогноз заболевания у отдельного больного, или прогноз на уровне популяции региона, страны в целом. Такие исследования трудоемки, и что важно, требуют не только материальных затрат, но и большой подготовки. На примере исследований ЭССЕ-РФ и МЕРИДИАН-РО описаны основные этапы организации и проведения эпидемиологического исследования: формирование представительной выборки, обучение команды исследователей, приглашение населения на обследование, собственно обследование и анализ данных. Кроме того, приведен опыт регионовучастников с описанием трудностей, возникших на местах при выполнении работы, и путях их преодоления. Общей и самой трудной стала проблема отклика населения, исходное недоверие к любым приглашениям, расцениваемым как мошенничество или сомнительное мероприятие. Эта проблема усугублялась сжатыми сроками проекта. Заключение. Несмотря на исходно разный уровень опыта специалистов в регионах, эпидемиологическое исследование в каждом из них было проведено полностью. Результаты исследования позволили дать оценку профилю ФР и ХНИЗ в регионе, которая широко используется организаторами системы здравоохранения.

Highlights. The leading factor of ineffective arterial hypertension (AH) control in the population taking medications was the number of metabolic risk factors (RF). In addition, in men, the odds of reaching the blood pressure targets were lower if there was a history of kidney disease and bronchitis, and higher, if statins and hypotensive drugs were taken together, respectively. In women, heart rate equal or higher than 75 beats/min and total carotid atherosclerotic plaque thickness were associated with lower and a visit to a physician in the past year - with higher odds of effective hypertension control, respectively.Aim. Analysis of factors associated with reaching blood pressure targets in hypertensive population taking medications.Methods. We examined men and women of 25-64 y.o., randomly drawn from general population, having hypertension and receiving medications. All participants underwent standardized cardiac screening, including a survey on a number of socio-demographic, psychosocial, behavioral variables, traditional and metabolic cardiovascular risk factors, life quality. We measured anthropometric and blood pressure variables, "intima-media" thickness, presence and total thickness of carotid atherosclerotic plaques. Analysis included data from 480 respondents. Parametric and nonparametric statistics were used. To analyze relationships, multivariable logistic regression was used. An error probability <5% was considered statistically significant.Results. After adjustment for age, wealth level, cardio-vascular deseases and the number of antihypertensive drugs, the following factors increased the chances of effective treatment for hypertension in men - statins, positive answer to the question “Do you feel pain or discomfort?” on the EQ5D scale. Lower odds for detecting target blood pressure levels were associated to the count of metabolic syndrome components according to IDF criteria except arterial hypertension (0-4), kidney disease, previous bronchitis, age. A direct association with the effectiveness of treatment for hypertension in women was shown by a visit to the doctor during the past year, and the opposite - the number of metabolic syndrome components, heart rate ≥75 per minute and the total thickness of carotid atherosclerotic plaques, respectively.Conclusion. Lack of hypertension control was associated to metabolic risk factors count, age, kidney disease, heart rate ≥75 per minute, previous bronchitis, lack of visit to a doctor over the past year, as well as total thickness of carotid atherosclerotic plaques. The situation can be improved by deliberately losing weight, taking statins by all people at very high and high risk, and seeing a doctor regularly. It is necessary to further study the factors that hinder achievement of blood pressure targets, as well as methods aimed at the prevention and effective correction of metabolic disorders.