In the frame of Multicenter observational study ECVD-RF (Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation) by the unique protocol the investigation of representative selections of adult population at the age of 25-64 y.o. of 11 regions RF (n=18305, including males, n=6919 and females n=11386): Volgograd, Vologda, Voronezh, Ivanovo, Kemerovo, Orenburg, Samara, Tomsk, Tyumen, Saint-Petersburg and Northern Osetia-Alania. The prevalence of the following risk factors (RF) of cardiovascular diseases is evaluated: high blood pressure — 33,8%, obesity — 29,7%, high total cholesterol — 57,6%, high glucose level or diabetes — 4,6%, smoking (tobacco consumption) — 25,7%, insufficient (low) level of physical activity — 38,8%, excessive salt consumption — 49,9% and insufficient vegetables and fruits consumption — 41,9%. Gender differences and an increase with the age of the parameters mentioned are described.The absence of a epidemiologic monitoring system at the Federal level leads to an impossibility of clear conclusions on the RF dynamics in Russian population. While comparing the ECVD-RF study with previous epidemiological studies we can just cautiously suppose the existence in 21st age of negative dynamics of one RF (obesity, dyslipidemia) and positive dynamics of the others (smoking).

от имени участников исследования ЭССЕ-РФ # 1 ФГБУ "Государственный научно-исследовательский центр профилактической медицины" Минздрава России. Москва; 2 ФБГУ "Северо-Западный федеральный медицинский исследовательский центр им. В. А. Алмазова" Минздрава России. Санкт-Петербург; 3 ФБГУ "Российский кардиологический научно-производственный комплекс" Минздрава России. Москва, Россия Цель. Изучить информированность и особенности лечения статинами среди населения трудоспособного возраста с различным сердечно-сосудистым риском по данным эпидемиологического исследования ЭССЕ-РФ (Эпидемиология сердечно-сосудистых заболеваний в различных регионах Российской Федерации). Материал и методы. В работе использованы результаты многоцентрового исследования ЭССЕ-РФ представительной выборки из неорганизованного мужского и женского населения в возрасте 25-64 лет из 13 регионов обследованных 2012-2014гг. Отклик составил ~80%. Обследование включало опрос по стандартной анкете, содержащей данные о заболеваниях в анамнезе и др. Показатели липидного спектра, включая уровни общего холестерина (ОХС), триглицеридов, холестерина липопротеинов низкой и высокой плотности определяли в ГНИЦПМ и РКНПК. Результаты. Анализ всей обследованной выборки показал, что 20% мужчин и 32% женщин знали свой уровень ОХС, а 13,6% и 18,2%, соответственно, были осведомлены, что у них повышен уровень ОХС. Доля лиц высокого и очень высокого риска составила 31,3%, в т. ч. у мужчин -42,2%, у женщин -30,9%. Принимали статины ~7,0% пациентов в этой категории риска. Эффективность лечения (достижение целевых уровней холестерина липопротеинов низкой плотности) в этих группах у мужчин и женщин составила 14,4% и 4,8%, соответственно. Заключение. Полученные на популяционном уровне результаты о недостаточной информированности и невысокой частоте лечения статинами больных с высоким и очень высоким сердечно-сосудистым риском в РФ еще раз подтвердили тревожные данные регистров и других исследований. Полученные результаты диктуют необходимость разработки и внедрения специальных образовательных программ для населения, повышения профессиональной грамотности врачей и недорогих, но эффективных липид-снижающих препаратов. Ключевые слова: исследование ЭССЕ-РФ, информированность, риск по SCORE, уровень общего холестерина и холестерина липопротеинов низкой плотности, статины, эффективность лечения.Кардиоваскулярная терапия и профилактика, 2016; 15(4): 29-37 http://dx.

Aim. To evaluate the economic burden of cardiovascular diseases (CVD) in the Russian Federation (RF) in 2016, including the direct costs and the economic losses caused by reduced productivity. Material and methods. Main data sources: data of the Federal state statistics service, data of state statistical reporting (forms №14, №141, №12 and №16-VN), and data of State Guarantee Program of Free Medical Care to the Citizens of the RF, statistical data of CVD, ischemic heart disease (IHD), myocardial infarction, cerebrovascular diseases, stroke. The direct medical costs were calculated based on the number of hospitalizations, including daycare center, emergency calls and outpatient visits due to CVD using the costs of the State Guarantee Program. The amount of disability benefits payments was calculated based on the number of disabled persons from each group and by the amount of the disability allowance. Indirect costs (economic losses) included a shortage of gross domestic product (GDP) due to premature mortality and disability in economically active age and loss of earnings due to temporary incapacity for work. The potential years of life lost (PYLL) were calculated using the number of life years not reached in economically active age due to premature death. Losses associated with premature mortality in the economically active age included unproduced GDP due to lost life years in the corresponding age group due to deaths from CVD, meaning the population' employment rate. Statistical analysis was performed by Microsoft Excel 10.0. Results. PYLL due to premature death from CVD-4.5 million years of potential life in economically active age, mostly men (3.3 million PYLL). Among almost 50% of men PYLL were due to ischemic heart disease. Economic burden because of CVD in 2016 in the RF reached 2.7 trillion ₽, which is equivalent of 3.2% of GDP for this year. In the structure of burden among all blood circulatory system diseases, IHD was in the first place (over 1 trillion ₽). In the burden structure, direct costs were only 8.1%, losses in the economics-91.9% of the total burden. In the cumulative burden of CVD, IHD determined as 39.8% (over a trillion ₽), cerebrovascular diseases-fifth part (560 billion ₽); strokes and heart attacks-424 billion ₽ and 213.1 billion ₽, respectively. Conclusion. The economic burden because of CVD in the RF in 2016 was 2.7 trillion ₽ (3.2% of GDP). Economic losses caused by premature mortality of people in economically active age prevailed in the structure of the burden (over 90%). Such the significant economic burden is a weighty argument for increasing investments in the prevention and treatment of CVD.

Aim. To study the prevalence of arterial hypertension (AH) in the population of Kyrgyz small towns and countryside and to analyse ethnic features of AH.Material and methods. This cross-sectional epidemiologic study was performed as a part of the international study INTEREPID. A random sample of small town and countryside residents included 1774 people. The examination included a questionnaire survey, measurement of blood pressure, height, weight, and waist circumference, and laboratory tests. AH prevalence was age-standardised.Results. In Kyrgyz small town and countryside residents aged 18–65 years, the prevalence of AH was 44% (33,2% in men and 46,7% in women). Among Kyrgyz participants, AH prevalence was significantly lower than in their Russian peers (36,8% vs. 46,2%, respectively). This difference was observed in women, while men did not demonstrate any marked ethnic differences in AH prevalence.Conclusion. The results obtained suggest that AH prevalence in the Kyrgyz Republic is high (with a 40–50% increase over the past 20 years) and is characterised by marked gender and ethnic differences. Further research is required to identify whether race/ethnic group could be a risk factor for AH development.

The article analyzes key instruments of international legal regulation of preimplantation genetic diagnostics (PGD) procedure. The authors substantiate the conclusion that the requirements and principles formulated in these instruments can be successfully used for the development and improvement of the national legal framework aimed at regulating the PGA. The main directions of such use are defined. First, it is necessary to consider the existence of genetic predisposition to a particular disease or chromosomal disorder (the medical purpose) and provide a qualified consultation of a genetic scientist concerning the mechanism and consequences of diagnostics. Secondly, the legal regulation of genetic information obtained through the PGA requires an independent normative framework: determining the framework the law-maker must be guided by the fact that any intervention in the human genome aimed at modifying it may be carried out only for preventive, diagnostic or therapeutic purposes. In this regard, it is important to prohibit the PGA for social purposes (selection of embryo according to specific characteristics, establishment of compatibility between a donor and a recipient, looking beyond the prohibition to choose the embryo gender that is currently imposed under Russian legislation). Third, a separate regulatory framework is needed to resolve the problem of informing the patient about the results of examination: in addition to the right to be informed of the results of examination, it is also necessary to recognize the individual’s «right not to know,» particularly relevant to predictive genetic research.