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).
Aim. To study prevalence of arterial hypertension (AH), mean values of systolic and diastolic blood pressure (SBP, DBP), awareness of patients about their disease, medication consumption (MC) and efficacy of treatment in several regions of Russia.Material and methods. Representative selections were made in 9 regions of Russia: men (n=5563), women (n=9737) of 25–64 y.o., studied in 2012–2013 with the response 80%. Systematic stratified multilevel random selection was formed with localilty criteria (Kisch method). The Questionnaire on the presence of AH included: awareness of the patient about his disease, drug intake. BP measurement was performed on the right arm by automatic tonometer Omron in sitting position after 5 minutes resting. The mean value of two measurements was used. BP defined as SBP ≥140 mmHg, DBP ≥90 mmHg, or if the patient had taken antihypertensive therapy. Efficacy of treatment — the part of patients (in %) who reached target BP. Control group — part of patients (in %) with BP <140/90 mmHg. Statistic data calculation was done with computer-based statistic software — SAS with standardising by age stratification of Europe.Results. Mean SBP and DBP were 130,7±0,1 mmHg and 81,6±0,1 mmHg respectively. Prevalence of AH — 44%, higher in men (p<0,001). Prevalence of AH was higher in rural area citizens in men — 51,8% vs 47,5% (р<0,02) and in women — 42,9% vs 40,2% (р<0,05). Awareness was 67,5% in men, 78,9% in women. Medications were taken by 60,9% of women and 39,5% of men. Effectively treated were 53,5% of women and 41,4% of men. With the age the part of effectively treated decreases (p<0,0005). BP is under control only in 1/3 of women and 14,4% of men.Conclusion. The role of AH as one of the main modifiable risk factors of cardiovascular diseases is proved, however it is depressing that the percent of controlled AH is low. BP control is the main task of outpatient surveillance at every local outpatient department, where now less than a half of those affected are being observed.
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 assess the prevalence of stress and its association with socio-demographic characteristics, cardiovascular risk factors and cardiovascular diseases (CVD) in the Siberian population.Material and methods. A cross-sectional study was performed in the framework of the Russian multicenter epidemiological study ESSE-RF in the Kemerovo Region in 2013. The presented study included 1628 individuals aged 25 to 64 years. Information was assessed on the presence of stress, some socio-demographic and economic characteristics, a history of CVD, as well as behavioral habits and quality of life. To eliminate the modifying effect of socio-demographic characteristics, a logistic regression analysis was used. The odds ratio (OR) and the 95% confidence interval (CI) were calculated.Results. The prevalence of stress was 22,6%; stress was statistically significantly more often recorded in women (28,1%) than in men (11,7%). After adjusting for sociodemographic characteristics, stress was statistically significantly more often recorded in people with secondary and primary education compared with those with higher education (24,9% and 19,1%, p=0,006), as well as in people with middle and high financial affluence compared with low affluence (24,5% and 11,3%, p<0,001). This association is observed only at the expense of women. For unemployed participants, the stress rate is higher only among males — 18,8% versus 11,4% among workers (p=0,015). Stress was also statistically significantly more often recorded in groups with arterial hypertension, lack of sleep, quality of life on the EQ-VAS scale and on the EuroQol scale. Smokers are more likely to have stress (23,8% vs 22,0%) and have a history of stroke (35,3% vs 22,2%). Among all CVDs and their risk factors, an inverse association of stress with obesity was revealed only in men.Conclusion. Study showed that people with stress are under large load of some cardiovascular risk factors. At the same time, ambiguous associations between stress and arterial hypertension and quality of life were obtained. This confirms the need for further study of the association of stress with other factors of cardiovascular risk, taking into account age and gender and socio-economic characteristics of the population.
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