[Gerontological problems and prospects of regional management. Strategy and structure of interdepartmental gerontological assistance in the Kabardino-Balkarian Republic.]

The article presents the structure of interdepartmental gerontological care in the Kabardino-Balkarian Republic. The basic principles, directions and prospects of work are stated. The main principles, directions and prospects of work.

[DYNAMICS OF TWENTY-FOUR HOUR MONITORING OF BLOOD PRESSURE IN ELDERLY PATIENTS WITH BRONCHIAL ASTHMA].

Twenty-four hour blood pressure monitoring in groups of patients of elderly age with bronchial asthma and hypertension was conducted. The study showed an increased variability of blood pressure and insufficient reduction in night time that leads to development of cardiovascular complications.

[The influence of psychological factors on the integral health characteristic (data from a prospective population study)].

AIM: To develop integral assessment of the health status based on the examination of representative samples from different regions of Russia (Veliky Novgorod, Nizhni-Novgorod, Vologda, Omsk and Nalchik) with the use of special questionnaires and simple anthropometric and functional methods in the framework of a prospective 3-year population study of organized groups. METHODS: The above questionnaires allowed to elucidate the socio-economic status of the patients, their somatic and psychological conditions (lifestyle index or psychological protection mechanisms (PPM), social adaptation, sanogenic reflexia; also used were Eysenck's psychotism scale, hospital anxiety and depression scale, the perceived stress scale (PSS), and moral potential of personality development scale. RESULTS: It was shown that the profile of psychological protection mechanisms is dominated by primitive reactions, such as projection, protection, and negation. Most subjects from the sample formed the pathogenic type of reflexia (inability to resolve a problem situation based on the cognitive components of the patient's mental state). Mathematical treatment of the so-called "simple cross-tabulation" with unification of all negative PPM revealed the highly significant relationship of LSI (not norm) with most previous somatic diseases (p<0.001), i.e. the history of myocardial infarction, angina of effort, cardiovascular syndromes, diabetes, hypertension, chronic broncho-pulmonary, hepatic, gastrointestinal, urogynecological, oncological, and psychic diseases. (p<0.007). CONCLUSION: Pyschological changes have greater influence than somatic ones on physiological parameters determining the population health status which suggests the necessity of taking them into account when planning health promotion measures.

[Autonomic regulation of cardiac rhythm in elderly patients with bronchial asthma].

Evaluation of independent and combined interrelations of bronchial obstruction and autonomic regulation of cardiac rhythm in elderly patients with bronchial asthma was carried out. Positive correlation of the extent of bronchial obstruction and decrease of absolute indices of cardiac rhythm variability was established.

[Priorities of secondary prevention of ischemic heart disease in conditions of a depressive region: preliminary results of the North Caucasian project].

AIM OF THE STUDY: was detection of behavioral factors, main risk factors of development of cardiovascular diseases (CVD), assessment of adequacy of their management, as well as assessment of quality of life in a cohort of patients with ischemic heart disease from three republics of the North Caucasian region. METHODS: A sample of patients with ischemic heart disease (IHD) aged 40-69 years (n=1500) from 3 republics of the North Caucasian Federal Okrug (Ingushetia, Kabardino-Balkaria, and North Ossetia - Alania) were included in a clinico-epidemiological project. In this work we present results obtained in three towns and districts of the Republic Ingushetia (300 men and 230 women with IHD and class II-III effort angina). Socio-demographic factors, family history of CVD, disturbances of nutrition, and physical activity were assessed by standard WHO questionnaires. For assessment of anthropometric deviations we measured height, body mass, and waist circumference. With the aim of detection of hyperlipidemia and disturbances of carbohydrate metabolism we measured levels of total cholesterol and fasting glucose in venous blood. Quality of life was assessed by EQ-5D questionnaire which comprised 5 points: movement, self service, everyday activity, pain/discomfort, and anxiety/depression. RESULTS: Each forth men (24.3%) smoked, and 12% were alcohol abusers. Each forth patient had severe disturbance of nutrition. Disturbances of nutrition of medium degree were detected twice more often. Way of life was sedentary in 63% of women and 46% of men. Abdominal obesity was detected in 46% of men and 72.6% of women. Prevalence of hypercholesterolemia was 96.7% among men and 90.7% among women. Every fifth patient with IHD had diabetes, in 10% of patients diabetes was newly detected. Quality of life changed in every second IHD patient with angina because of limitation in carrying out everyday work, movement and presence of chest discomfort, this was associated with presence of anxiety/depression. CONCLUSION: Main priority of secondary prevention in the Republic Ingushetia is adequate correction of hypercholesterolemia and arterial hypertension. However every forth patient requires complex therapy of 3-4 risk factors (hypercholesterolemia, hypertension, and/or diabetes, and/or smoking, and/or alcohol abuse).

[Features of parameters of twenty-four hour blood pressure monitoring in elderly and middle-aged patients with hypertension].

Twenty-four hour blood pressure monitoring in group of patients of elderly and middle age with hypertension has been carried out. Features of daily average parameters have been studied. The hypertension in elderly patients shows an increase in variability of blood pressure and insufficient decrease in blood pressure at night that leads to development of cardiovascular complications.

[The comparative analysis of prevalence of accompanying conditions in geriatric patients with hypertension].

The comparative analysis of accompanying diseases depending on the form of hypertension in elderly has been carried out. Prevalence of the isolated systolic or systolo-diastolic essential hypertension in elderly has been studied. The analysis of data has shown that systole-diastolic hypertension in patients is more often accompanied with diseases of heart, and in patients with isolated systolic hypertension is more often accompanied with cerebrovascular diseases. Both forms of a hypertension in elderly persons are adverse by the occurrence of cardiovascular and cerebral complications.

[Incidence of arterial hypertension in Kabarda-Balkaria and the experience with its prevention among automobile transport workers]. / Chastota arterial'noi gipertonii v Kabardino-Balkarii i opyt ee profilaktiki na avtotransportnykh predpriiatiiakh.

Cross-sectional studies covered 2562 males (a urban population), 580 miners, 1126 agricultural drivers, 682 rural habitants and 4323 urban drivers. The mean blood pressures were basically identical in males of various occupations and age, except for urban and rural drivers aged 20-29 and 40-49 years who had significantly lower mean systolic blood pressures than those from the other groups under study. All the males showed elevation in systolic and diastolic blood pressures with age; the differences in blood pressures were insignificant only in rural drivers aged 30-39 and 40-49 years and miners aged 40-49 and 50-59 years. The incidence of arterial hypertension increased with age: from 3.2 to 7.7% in 20-29-year-old males to 34.2-37.2% in 50-59-year olds. Low (less that 50%) awareness of hypertension was identified in hypertensives. A prospective 5-year follow-up and implementation of prophylactic measures at the urban motor enterprises positively affected the incidence of hypertension and the level of hypertension awareness, and morbidity rates.

[The efficacy of a program of arterial hypertension prevention among an organized population (the results of a 5-year observation)]. / Effektivnost' programmy profilaktiki arterial'noi gipertonii sredi organizovannogo naseleniia (rezul'taty 5-letnego nabliudeniia).

An epidemiological examination of 4323 motor transport workers made according to the program of the All-Union Cardiology Research Center, USSR AMS, revealed high arterial pressure (AP) in 22.6% of cases. The knowledge of hypertension was found to be low (34%) as was the coverage with hypotensive treatment (7.1%) and the efficacy of the latter one (1.8%). The follow-up studies (for 5 years) demonstrated the efficacy of non-medicamentous and medicamentous AP control exercised in motor transport workers. It was proved that in the principle AP might adequately be decreased and maintained for a long time at the safe level in the overwhelming majority of subjects with AP.

[Prevention of arterial hypertension in automobile transport workers and ways of reducing traffic accidents]. / Profilaktika arterial'noi gipertonii u rabotnikov avtotransporta i puti snizheniia dorozhno-transportnykh poroisshestvii.

Conducting a program on prophylaxis of arterial hypertension among automobile transport workers, the researchers revealed higher blood pressure among 22.6% of the examines. Prophylactic measures during 5 years induced decrease in prevalence of arterial hypertension from 23.6% to 13.7% among the exposed group members, whereas the reference group members demonstrated increase of the parameter from 21.5% to 34.3%. Prophylaxis of arterial hypertension among drivers should be based on non-pharmacologic methods, if inevitable, the drug therapy should be selected under control of psychophysiologic tests.

[Significance of psychological personality testing of motor vehicle drivers in the traffic safety system]. / Znachenie psikhologicheskogo issledovaniia lichnosti voditelei avtotransporta v sisteme obespecheniia bezopasnosti dorozhnogo dvizheniia.

The study using multifactor personality questionnaire (shorter variant of MMPI) covered 619 drivers aged 20 to 59. Professional success was assessed according to occupationally important psychophysiologic parameters (OIPP) and number of committed traffic accidents (TA) in 4 groups of the drivers. Individual psychologic traits appeared to correlate with reliability criteria (OIPP and TA). Approaches evaluating the drivers' reliability should therefore consider personal features for better differentiated correction of psychophysiologic parameters. Advances in programs of traffic safety is strongly associated with complex approaches of prophylaxis that should consider significance of psychologic factor.

[Cardiovascular diseases in motor vehicle drivers and traffic safety]. / Serdechno-sosudistye zabolevaniia u voditelei avtotransporta i bezopasnot' dorozhnogo dvizheniia.

Epidemiologic, electrophysiologic and psychophysiologic studies among urban and rural automobile drivers helped to reveal occurrence of coronary artery disease (CAD), arterial hypertension (AH) and their risk factors. In addition, special studies (monitoring of ECG in natural conditions) among 118 drivers diagnosed the signs of coronary failure and arrhythmias. Psychophysiologic studies among the individuals suffering from cardiovascular diseases (CAD, AH and arrhythmias) proved worse parameters important for occupational activities and for traffic safety.

[Non-pharmacological methods of the treatment of initial stages of arterial hypertension in automobile drivers]. / Nemedikamentoznye metody lecheniia nacha'lnykh stadii arteria'l- noi gipertonii u voditelei avtotransporta.

The difficulties in hypotensive treatment of arterial hypertension (AH) in drivers encouraged the search for effective methods of correction of elevated arterial pressure (AP). During 5 years a group of 631 drivers with different levels of elevated AP was examined. For their treatment a complex of non-pharmacological methods was proposed, i.e., exercise therapy, preshift gymnastics, psychoemotional relief, autotraining, punctate massage, electric sleep, balneotherapy, decoction of sedative and plant diuretics. The dynamics of mean indices of diastolic pressure and high efficiency of using non-pharmacological methods for treating AH in drivers were demonstrated. The absence of adverse and undesirable effects of non-pharmacological AH-control methods enabled one to regard them as an effective means of treatment of the drivers with the initial AH stages.