[The association of polymorphisms of the serotonin transporter gene SLC6A4 with depression]. / Svyaz' polimorfizmov gena serotoninovogo transportera SLC6A4 s depressiei.

OBJECTIVE: To study the relationship of polymorphic variants of the SLC6A4 gene with depression among people aged 25-44 years in Novosibirsk. MATERIAL AND METHODS: Under the WHO program «MONICA-psychosocial (MOPSY)¼, a random representative sample of people aged 25-44 years from the population of the Oktyabrsky district of Novosibirsk (men n=725, mean age 43.4±0.4 years, response - 71.3%, women n=710, mean age 44.8±0.4 years, response - 72%). Depression was assessed using the MONICA-MOPSY psychosocial questionnaire. Every fourth respondent was examined for polymorphic variants of 5HTTLPR-VNTR SNP rs25531 A>G of the SLC6A4 gene. The study was carried out within the framework of the budget topic Reg. No. 122031700094-5. RESULTS: The high level of depression among people aged 25-44 was 12.8% (for men 9.1%, for women - 15.92%); the average level of depression occurred in 24.5% of the population (among men in 21.24%, among women in 26.76%) (χ2=17.071, df=2, p<0.001). The most common genotype of the SLC6A4 gene, among people aged 25--4 years old in Novosibirsk, was SLA - 43.29%, LALA - 26.53% - in second place, SS - 17.87% - third, LALG - 6 genotypes were less represented genotypes. 74%, SLG - 4.18%, LGLG - 1.39%. Carrying the SLA genotype (53.3% and 63.6%) increased the chance of developing both the average level of depression by 2.359 (95% CI 1.278-4.355) times, and depression in general by 1.933 (95% CI 1.142-3.271) times, compared with persons carrying the LALA genotype (32.0% and 46.9%), (χ2=7.674, df=1, p<0.01 and χ2=6.095, df=1, p<0.05). Persons carrying the LALG genotype (54.5%) also had a higher chance of developing a mean level of depression RR=2.929 (95% CI 1.039-8.261), compared with carriers of the LALA genotype (32.0%) (χ2=4.326, df =1, p<0.05) (p<0.05). CONCLUSION: Associative links between polymorphic variants of the SLC6A4 gene and depression have been established.

[Genes of the circadian rhythm and sleep disorders in an open population of men aged 25-64 years (an epidemiological study under the WHO MONICA-PSYCHOSOCIAL program)]. / Geny tsirkadnogo ritma i narusheniya sna v otkrytoi populyatsii muzhchin 25­64 let (epidemiologicheskoe issledovanie po programme VOZ MONICA-PSYCHOSOCIAL).

OBJECTIVE: To study an effect of polymorphisms of genes encoding circadian rhythm proteins (CLOCK, BMAL1, PER2, NPAS2) on sleep disorders in men aged 25-64 years. MATERIAL AND METHODS: The general examination was carried out according to standard methods included in the WHO MONICA-psychosocial (MOPSY) program. The standard Jenkins questionnaire was used to study sleep disorders. Genotyping of the polymorphisms of CLOCK, BMAL1, PER2, NPAS2 was carried out. RESULTS: Carriers of the C/T genotype of CLOCK rs2412646 were more likely to think that their sleep was «satisfactory¼ or «bad¼. Carriers of the C/T genotype of BMAL1 rs2278749 were more likely to experience disturbing dreams, they woke up tired and exhausted. Carriers of the A/A genotype of PER2 rs934945 were more likely (25%) to wake up two or more times a night, in general, from 4 to 7 times a week. In the population, the C/T and T/T genotypes of NPAS2 rs4851377 were significantly more common in individuals with 7-hour sleep (50% and 53.3%, respectively). CONCLUSION: An association of certain polymorphisms of tCLOCK, BMAL1, PER2, NPAS2 with sleep disorders was found.

[Gender differences of cardiovascular diseases risk in the population with sleep disorders: WHO's program MONICA-psychosocial]. / Gendernye osobennosti riska razvitiya serdechno-sosudistykh zabolevanii u naseleniya s narusheniem sna: programma VOZ MONICA-psychosocial.

OBJECTIVE: To determine the gender differences in the effect of sleep disorders (SD) on the risk of myocardial infarction (MI) and stroke in an open population, aged 25-64 years, of Russia/Siberia over 16 years of follow-up. MATERIAL AND METHODS: Within the framework of the III screening of WHO's MONICA-psychosocial program, a random representative sample of the Novosibirsk population, which comprised both sexes (657 men, 689 women), aged 25-64 years, was examined in 1994. The screening included socio-demographic data, the assessment of SD according to the Jenkins scale. The analysis included people without MI, stroke. In 16 years, new-onset cases of MI and stroke were identified in women (15 and 35 cases, respectively) and in men (30 and 22 cases, respectively). RESULTS: In the open population among the population of 25-64 years, 48.6% of men and 65.9% of women had SD (c2=24.427, df=1, p=0.0001). In people with SD, a single-factor Cox regression analysis revealed that the risk of stroke was higher in men than in women within a 16-year period. Multivariate Cox regression analysis revealed that in people with SD, the risk of stroke in men and women is approximately the same. Widowed men with SD had an increased risk of stroke. The risk of stroke was higher in men with incomplete secondary / primary education than in women. There was an increased risk of stroke in women with secondary education and those having sleep problems. Cox single-factor regression analysis showed an increased risk of MI (by 2.4 times) in men with SD for a 16-year period. SD did not influence the risk of MI in women. The risk of MI was 3 times higher in never-married men, 4.3 times higher in divorced men and 7.5 times higher in widowed men. CONCLUSION: SD are a risk factor for stroke in men and women, and a risk factor of MI in men. A negative social gradient increases the risk of cardiovascular diseases in people with SD.

[Psychosocial risk factors for cardiovascular disease: gender differences and 22-year dynamics among the population of Siberia (WHO MONICA-Psychosocial Program, HAPIEE)].

AIM: To determine the gender differentiation and dynamics for 22 years of psychosocial factors (PSF) of the risk of cardiovascular disease among the population aged 25-64 years in Russia / Siberia (Novosibirsk). MATERIALS AND METHODS: Representative samples of the population of the city of Novosibirsk under the program of the World Health Organization "MONICA-MOPSY" in 1994-1995 were examined. III screening (men - 657, women - 870, 25-64 years old); IV screening project HAPIEE in 2003-2005 (men - 576, women - 1074, 45-64 years old) and V screening in 2013-2016. (men - 427, women - 548, 25-44 years old). We used Spielberger tests, MONICA-MOPSY tests, the Breckman - Sim test, the "Knowledge and attitude to your health" questionnaire. RESULTS: In an open population of 25-64 years old, high levels of anxiety (T), depression (D), life exhaustion (LM), and hostility (B) were higher in women than in men. In the group of 55-64 years over 10 years, women have increased personality T, decreased D and LM. Over 22 years, in the group of 25-34 years, men and women decreased T and MI, but D and B increased, while women decreased T, LM and B and D. grew. Low and high close contact indices were higher among men. A low index of social ties prevailed in men, and a high index in women. High levels of stress in the family were more common in women, and at work - in men. For 10 years, the level of stress in the family and at work in men has decreased. Sleep disorders in the population in all age groups were more often in women. CONCLUSION: It was found that women have significantly higher PSF than men, with the exception of stress at work. The decrease in PSF in women and men in the dynamics.

Effect of stress at work on the risk of cardiovascular diseases among the population of 25-64 years in Russia/Siberia (WHO program "MONICA-psychosocial").

AIM: The aim of the study was to determine the impact of stress on work on the risk of cardiovascular disease over a 16-year period in an open population of 25-64 years in Russia/Siberia. MATERIALS AND METHODS: A random representative sample of the population of both sexes of 25-64 years old in Novosibirsk in 1994 (men: n=657, 44.3±0.4 years, response - 82.1%, women: n=689, 45.4±0.4 years, response - 72.5%). The screening survey program included: registration of socio-demographic data, determination of stress at work (Karazek scale). The period of prospective follow-up of participants was 16 years. The study identified the following "end points": the first cases of myocardial infarction (MI), stroke. RESULTS: A high level of stress at work was in 29.5% of men and 31.6% of women, the average level in 48.9% of men and 50.7% of women (χ2=2.574, υ=2, p=0.276). The risk of developing MI for a 16-year period, among people experiencing stressful situations at work, was: in men, HR=3.592, and women HR=3.218 (95% CI 1.146-9.042); stroke risk - among men, HR=2.603 (95% CI 1.06-4.153) in women HR=1.956 (95% CI 1.008-3.795). In multivariate analysis, in men with stress at work, the risk of MI among men was HR=1.15 (95% CI 0.6-2.2), among women - HR=2.543 (95% CI 1.88-7.351); risk of stroke, was in men, HR=3.8 (95% CI 1.6-8.8), in women - HR=1.95 (95% CI 0.984-3.887). The risk of stroke was higher among single, divorced and widowed men, HR=4.2 (95% CI 1.5-13.2), and in women with secondary or primary education, HR=3 (95% CI 0.852-11.039). CONCLUSION: It was established that a high level of stress at work is not gender-specific; the risk of developing MI over a 16-year period is higher in women than in men, stroke in men; the risk of myocardial infarction and stroke in both sexes is affected by the social gradient.

[Dynamics of sleep disorders and health characteristics, relationship to prevention of cardiovascular diseases among women 25-44 years old in Russia/Siberian]. / Dinamika narushenii sna i kharakteristiki zdorov'ia, otnosheniia k profilaktike serdechno-sosudistykh zabolevanii sredi zhenshchin 25-44 let v Rossii (Sibir').

AIM: To determine the 23-year dynamics (1994-2017) of the relationship between sleep disorders (SD) and attitudes toward their health, behavioral characteristics and prevention of cardiovascular diseases in the open population among women 25-44 years old in Russia/Siberia (Novosibirsk). MATERIAL AND METHODS: In the third screening of the WHO program 'Study of trends and control of cardiovascular diseases' MONICA, 'the subprogram' MONICA-psychosocial (MOPSY), a random representative sample of women, aged 25-64 years, of one of the areas of Novosibirsk (n=870) was examined in 1994. In 2016, in the framework of screening studies, a random representative sample of women, aged 25-44 years, was examined in the same district of Novosibirsk (n=668). Sleep assessment was performed using the Jenkins Sleep Questionnaire. Attitude to their health, behavioral characteristics and prevention of cardiovascular diseases were studied using the 'Knowledge and attitude to one's health' scale proposed by the WHO 'MONICA' program and validated in the Russian population. RESULTS: The prevalence of SD among women 25-44 years old decreased from 59.6% to 47.3% from 1994 to 2017. The proportion of women with SD, who consider themselves not completely healthy or sick, decreased from 86.2% to 67.6%. The majority of women with SD (57%) consider the high probability of getting a serious illness in the next 5-10 years, but only 7% of women with SD have regular screening tests. The share of those, who were satisfied with medical care, increased by 2017 but does not exceed 13%. In case of malaise, only 1 in 10 women apply to a doctor, as in 1994. The intensity of work of young women with SD is higher compared to those with good sleep; they more often (more than 40%) do additional work, are more responsible. An increase in the level of family stress among women with SD is characterized by more frequent illness/death of a loved one, rare opportunity to relax in home environment. Recently, the number of women smokers has increased, their physical activity has decreased, and their adherence to dietary recommendations has been low. CONCLUSION: Over the studied period, there were: the decrease in SD; in case of SD, a more careful attitude towards one's health in the sick; the increase in the intensity of work, responsibility at work, stress in the family. Adverse, statistically significant trends towards increasing in the intensity of smoking, reducing physical activity, low adherence to compliance with dietary recommendations in women with SD have been obtained.

Interleukin-1ß, interleukin-1 receptor antagonist, interleukin-6, interleukin-10, and tumor necrosis factor-α levels in CSF and serum in relation to the clinical diversity of Parkinson's disease.

Several parameters representing the clinical diversity of Parkinson's disease (PD), including severity, phenotypes, cognitive decline, anxiety and depression were analyzed to examine the link with interleukin-1ß (IL-1ß), the interleukin-1 receptor antagonist (IL-1RA), IL-6, IL-10, and tumor necrosis factor-α (TNFα) and also to determine the relationship between levels of these factors in serum and cerebrospinal fluid (CSF). Significantly elevated serum IL-1ß and IL-6 and reduced IL-1RA levels were found in the PD group. In CSF and serum, inflammatory factors behaved differently, with increased CSF TNFα indicating rapid PD progression, and increased IL-1ß in serum. A low level of IL-6 was associated with a longer duration of PD. Anxiety, depression, non-tremor phenotype and late-onset PD correlated with a high serum level of IL-10. The serum TNFα level was lower in PD patients with mild cognitive impairment compared to controls. Serum IL-1ß, IL-6 and IL-10 levels correlated with CSF markers.

23-year dynamics (1994-2016) relationships to its health, behavioral characteristics and prevention of cardiovascular diseases among women 25-44 years in Russia /Siberia.

AIM: To determine the 23-year dynamics (1994-2016) of attitudes toward one's health, behavioral characteristics and the prevention of cardiovascular diseases in an open population among women 25-44 years old in Russia / Siberia (Novosibirsk). MATERIALS AND METHODS: In the framework of the third screening of the MONICA program for the study of trends and control of cardiovascular diseases and the MONICA-psychosocial (MOPSY) subprogram, in 1994 a random representative sample of women aged 25-64 years of age from one from the districts of Novosibirsk (n = 870, the average age is 45.4±0.4 years); in the age group 25-44 years - 284 persons. In 2016 years. in the framework of screening studies on the budgetary issue of NIITPM No. gos. reg. 01201282292, a random representative sample of women aged 25-44 years old in the same district of Novosibirsk (n = 540) was examined. Attitude to their health, behavioral characteristics and the prevention of cardiovascular diseases were studied using the "Knowledge and attitude to their health" scale, validated for the Russian population under the WHO "MONICA" program. The chi-square test (x2) was used to calculate the indices. The criterion of statistical significance was the reliability of the result at p<0.05. RESULTS: The analysis showed that in the open population among women aged 25-44 years, there is a positive dynamics in assessing their health (21% and 50.7%, respectively). But, despite this, 50% of women negatively assess their health and 96% note the probability of getting a serious illness for 5-10 years. Most women believe in the ability of medicine to successfully prevent and treat heart disease, but the proportion of people using health resources for preventive purposes remains extremely low and does not exceed 10%. In the open population among women aged 25-44 years for 23 years there is an increase in stress in the workplace and the trend of growth in changes in marital status. Recorded in the period 1994-2016 gg. changes in the behavior of women associated with health: increased the proportion of people who gave up smoking and regularly doing physical exercises, and improved eating behavior. CONCLUSION: It was found that among women aged 25-44 years there is a positive dynamics in relation to the prevention of behavioral risk factors for CVD. But despite this, half of women negatively assess their health and use health resources only slightly.

[Gender peculiarities of the risk of cardiovascular diseases in a population with symptoms of depression in Siberia (the WHO MONICA-psychosocial program)]. / Gendernye osobennosti riska razvitiia serdechno-sosudistykh zabolevanii u naseleniia s simptomami depressii v Sibiri (programma VOZ 'MONICA-psikhosotsial'naia').

AIM: To identify gender differences in the prevalence of depression in an open population of individuals aged 25-64 years and to evaluate its impact on the risk of cardiovascular diseases (CVD) in the population of Siberia. SUBJECTS AND METHODS: A random representative sample of a 25-64-year-old Novosibirsk population (657 men and 689 women) was surveyed within the framework of the third screening of the WHO MONICA-psychosocial program in 1994. The screening program included sociodemographic data registration and depression detection. Over a 16-year study period, women had myocardial infarction (MI) in 15 cases and stroke in 35 cases and men had these conditions in 30 and 22 cases, respectively. RESULTS: In the open 25-64-year-old population, depression was detected in 54.5% of the women and in 29% of the men; major depression was present in 11.8% of the women and 3.1% of the men (χ2=66.724; υ=2; p=0.0001). The risk of MI in the depressed patients was higher in the women (hazard ratio (HR)=2.5) than in the men (HR=2); when social parameters and age are included in the model, only a trend towards the impact of depression on the risk of MI persisted in the women (HR=3.4; p>0.05) and the men were observed to have a 1.6-fold higher risk for MI. The greatest risk of MI was seen in the men (HR=6.8) and women (HR=6.3) at the age of 55-64 years, as well as in the men who had incomplete secondary or primary education (HR=3.2); in blue-collar workers (HR=6.7), in the men who were single (HR=3.6), divorced (HR=4.5), or widowed (HR=6). The risk of stroke in the depressed patients during a 16-year study period was greater in the men (HR=5.8) than in the women (HR=4.6); after adjusting for age and social gradient, the risk of stroke in the women was higher in both the population and those who were aged 55-64 years (HR=8.5 and 6.9, respectively) than that in the men (HR=4.2 and 3.1, respectively). Among the men, the risk of stroke was higher in those who had primary education (HR=8.8), were widowed (HR=8.4) or divorced (HR=2.7). CONCLUSION: The women are much more susceptible to depression than are the men. The risk of MI with depression is higher in the women than in the men; at the same time, the risk of stroke is higher in the men than in the women. The picture is opposite in the older age group. The risk of CVD in the depressed men is exacerbated by a social gradient; these relationships have not been revealed in the women.

[Tendencies in cardiovascular morbidity and mortality in the population of Siberia].

Aim: To characterize differences in the risk of development (RD) of myocardial infarction (MI) and stroke during 16 years in an open Siberian population aged 25-64 years and suffering vital exhaustion (VE). Materials and methods: We examined a random representative sample of 657 men and 870 women from the Novosibirsk population in the framework of the WHO «MONICA-psychosocial¼ screening III program (1954). It included registration of socio-demographic data and cases of VE. A total of 15 episodes of MI and 35 strokes were documented in 30 women and 22 men. Results: The level of VE in men was 66,8% (high in 14,6%), in women75,7% (high in 44,4%). RD of MI estimated from the relative risk (RR) in men with VE(RR=2) was higher than in women. It was higher in divorced women (RR=5,4) than in men (RR=4,7). RD of MI was higher in men with VE (OR=2,2 in subjects having elementary education, OR=3,7 in bachelors, OR = 7 in widowers;at the age from 45 to 54 years OR=3,8, at the age from 55 to 64 years OR=5,9) than in women. The overall RD of stroke in subjects of either sex with VE was not significantly different (OR=3,34 in women and 3,1). However, it was higher than in women in men with VE having partially completed secondary-level and elementary education RR=4.8), in divorced and widowed men (RR=3.8 and 3.6 respectively. Conclusion: The study showed that the prevalence of VE in the population aged 25-64yearsis higher than in other age groups and higher in women than in men. VE is a more reliable predictor of MI in men than in women; it is a predictor of stroke in either sexes.

[Workplace stress and its impact on the 16-year risk of myocardial infarction and stroke in an open female population aged 25-64 years in Russia/Siberia (WHO MONICA-psychosocial program)].

AIM: To determine the impact of workplace stress on the hazard ratio (HR) of myocardial infarction (M) and stroke in an open female population aged 25-64 years in Russia/Siberia (Novosibirsk) for 16 years. SUBJECTS AND METHODS: A random representative sample of 25-64-year-old women (n=870) residing in a Novosibirsk district was surveyed within the framework of the WHO <> program. Workplace stress was investigated using the Karasek scale; an attitude towards work and health prophylactic examinations was studied applying the Health Awareness and Attitude questionnaire of the WHO <> program. For 16 years (1994 to 2010), a cohort of all new cases of MI and stroke was examined employing the WHO <> program and all possible medical records. The Cox regression model was used to determine HR for MI and stroke in the open female population aged 25-64 years for 16 years. RESULTS: The prevalence of high-level stress in the open female population aged 25-64 years was 31.6%. The high level of job stress was associated with a high responsibility, impossibility to have a rest at the end of a working day, frequent professional dissatisfaction, and a reduced work capacity. During 16 years, the women having high-level job stress showed a 3.22- and 1.96-fold increases in the HR of MI (p<0.05) and stroke (p<0.05), respectively. The incidence of MI and stroke was higher in married women expressing job stress as managers or manual laborers and having high and low educational attainment. CONCLUSION: The prevalence of high-level workplace stress was substantial in the open population of 25-64-year-old women in Russia/Siberia (Novosibirsk). The stress-related HR of Ml and stroke was 3-2 times higher than in those without high-level stress. The HR of MI and stroke is affected by a social gradient.

[Gender differences in health awareness and attitudes as a subjective-objective health index in the population of Russia/Siberia (WHO MONICA-psychosocial program, HAPIEE project)].

AIM: To establish gender differences in health attitudes and awareness of risk factors for cardiovascular diseases in an open 25-64-year-old population of Russia/Siberia. SUBJECTS AND METHODS: A representative sample from the population of a Novosibirsk district was examined using the 1988 WHO MONICA-MOPSY (847 women and 739 men aged 25-64 years) and the 2003 HAPIEE (1074 women and 576 men aged 45-64 years) programs. The health awareness and attitudes questionnaire was used. RESULTS: The number of persons who considered perfectly healthy was minimal (2%) in the open Siberian population aged 25-64 years. The view of health in the women proved to be more pessimistic than that in the men. The fact that two thirds of the population could fall ill with a serious disease in the coming 5-10 years was accepted. Mainly the men took the view that modern medicine might prevent heart disease. The men were regularly examined 2 to 3 times more often than the women. The latter versus the men were less frequently inclined to stop work if they felt not quite well on-site, with the difference being more marked in old age groups. The majority of the study participants considered preventive examination to be useful for health. At the same time only a small portion of the population itself undergoes examination. CONCLUSION: The changed socioeconomic situation in the country leads to the need to alter the established stereotypes of conscience and behavior of the population in health and to realize the need for personal responsibility for health.

Polymorphism of dopamine transporter gene DAT1 and individual variability of defense cardiac response in humans.

We evaluated association of BP stress-reactivity on the model of cardiac defense response in 45-70-year-old men with variable number of tandem repeat polymorphism in genes encoding dopamine transporter protein (DAT1) and serotonin transporter protein (5-HTTLPR). It was found that individuals carrying long allele variant (l) of DAT1 gene (l/l: allele l homozygotes) in the genotype in comparison with short variant (s) carriers (heterozygous genotype l/s) demonstrate hyperreactive profiles of cardiovascular stress reactivity characterized by a significant increase in the amplitude and duration of long-latency BP components in cardiac defensive response.

[Genetic markers for trait anxiety as one of the risk factors for cardiovascular diseases (WHO-MONICA program, MONICA-psychosocial subprogram)].

AIM: To determine an association between trait anxiety (TA) and variable number tandem repeat (VNTR) polymorphisms in the DRD4 and DAT genes, as well as the prevalence of TA and the risk of cardiovascular diseases (CVD) in 25- to 64-year-old males with TA. SUBJECTS AND METHODS: A representative sample of 25 to 64-year-old males (n = 2149) was examined within the framework of the WHO MONICA program, MONICA-psychosocial subprogram, in 1984, 1988, and 1994. All new-onset arterial hypertension (AH), myocardial infarction (MI), and stroke cases were registered throughout the follow-up study (1984-2008). Spielberger's test was used to estimate the level of TA. The Cox proportional regression model was applied to assess a relative risk. RESULTS: The high level of anxiety (HLA) was 50.9% in the open population of 25 to 64-year-old males. The DRD4 genotype 4/6 and DAT genotype 9/9 were significantly associated with HLA. The latter increased the risk for CVD: it was maximal for AH and stroke within the first five years and for MI within 10 years. CONCLUSION: HLA was significant in the Novosibirsk open population of 25 to 64-year-old males. It is substantially associated with certain VNTR polymorphisms in the DRD4 and DAT genes and considerably increases the risk of CVD.

[The influence of depression on the risk of acute cardiovascular diseases in women].

The aim of the work was to elucidate the relation of depression to the awareness of and attitude to health as well as effect of depression on the risk of acute cardiovascular diseases in women aged 25-64 yr during 16 years. A random representative sample of 870 women residing in Novosibirsk was examined in the framework of MONICA-psychosocial program (WHO) in 1994. The MOPSY test was used for the purpose. All new cases of myocardial infarction and stroke were recorded. The prevalence of depression was estimated at 55.2%. Positive self-evaluation of health decreased as severity of depression increased. Almost 100% of the patients with this condition complained of poor health and were dissatisfied with the care given to improve it. Severe depression is associated with stress experienced at the workplace and in the family; such women rarely keep to the diet and make physical exercises. The relative risk of myocardial infarction and stroke in depressed women during 16 years was 2.53 (p < 0.05) and 4.63 (p < 0.05) higher respectively than in the absence of depression.

[Myocardial infarction and stress at work place and in the family: 10-year risk of development in an open population of 2564 year old men (epidemiological study in a framework of the WHO program MONICA-PSYCHOSOCIAL)].

With the aim of assessment of 10 year risk of myocardial infarction (MI) development in men in dependence on stress at work place and in the family in a framework of the WHO program "MONICA-PSYCHOSOCIAL" we examined random representative sample of men (n=657) aged 25-64 years inhabitants of one of districts in Novosibirsk. During 10 years (1994-2004) we registered all cases of MI. For assessment of relative risk of MI development we used COX proportional regression model. Among men with first MI 47.4% had high level of stress in the family and 57.9% were subjected to stress at work place. Five and 10 year risk of MI in men with high test levels of stress at home and work place was 2-5 times greater than in those without. Among men subjected to stress in the family MI risk was the highest at age 55-64 years, while permanent stressful situations at work place were more common in age group 45-54 years. Among men with high levels of stress in the family and at work place higher rate of MI development was observed in widowers, divorced men with incomplete high or elementary education, heavy or moderate manual labor workers, and pensioners. The results indicate that critical life events as well as chronic stressful influences increase risk of MI among men aged 25-64 years. The group of greatest risk - middle and old age persons who are less protected against social, political and economical disbalance in the society.

[Effects of hostility on the risk of arterial hypertension, myocardial infarction, stroke in a sample of males aged 25-64 years (epidemiological trial on the base of WHO program MONICA)].

AIM: To study effects of hostility on the risk of arterial hypertension (AH), myocardial infarction (MI) and stroke in males aged 25-64 years. MATERIALS AND METHODS: A screening study of the population was performed in 1994 according to WHO program MONICA-psychosocial. The response in a random representative sample of 25-64-year-old males (n = 657) living in Novosibirsk was 82.1%. New cases of MI, AH and stroke were registered in the control periods 1994-2000, 1994-2002. Computer program package SPSS-10 was used for statistic processing. Cox regression model of the relative risk (RR) was employed. RESULTS: Hostility was rather prevalent among the examinees (76.9%). MI risk for 8 years was 4.65 times higher in hostile men. Hostility was not associated with higher risk of AH and stroke. Hostility was seen more frequently in men with poor education, workers and retired persons. These groups are also at the highest risk of MI. CONCLUSION: Hostility raises MI risk in unstable society but had no effect on the risk of AH and stroke.

[Study of myocardial infarction risk factors within the framework of the WHO Monica-psychosocial program].

Three screening population studies were carried out within the framework of the WHO MONICA-psychosocial program in 1984, 1988, and 1994. The subjects of the study were male inhabitants of one of Novosibirsk districts aged 25 to 64 years. The cohort was studied during 18 years, from 1984 to 2002, using the WHO Acute Myocardial Infarction Register program. The statistical analysis was performed using SPSS-10 software package. The relative risk (RR) of myocardial infarction (MI) was estimated using Cox proportional regressive model. The greatest proportion (38.9%) of patients with MI was among men aged 45 to 54 years. Among men with MI, 58.7% had a high personal anxiety (PA) level. RR of MI was high among widowers, divorced and single men with a high PA level, in men with incomplete secondary or primary education, and men of hard or moderate physical labor. In the age group of 24 to 44, RR of MI during the first 5 and 10 years was 7.5 times higher in men with a high PA level vs. men with a medium PA level (p < 0.01). This explains the bigger number of men with MI in the group of 45 to 54 years of age.

[Sleep disturbances and a risk of myocardial infarction].

The aim of the study was to investigate the influence of sleep disturbances on the 8-year risk of myocardial infarction (MI) in men aged 25 to 64 years old. Screening of male inhabitants of one of Novosibirsk districts, aged 25 to 64 years, was performed within the framework of the WHO MONICA-psychosocial program in 1994. The cohort was followed up during 8 years (1994 - 2002) to determine end-points (MI). The statistical analysis was performed using SPSS- 10 software package. The relative risk (RR) of MI was evaluated using Cox proportional regressive model. Only one third of the 25 to 64-year-old male subjects with the first MI referred to their sleep as "good" whereas two thirds had sleep disturbances. The 8-year RR of MI in men aged 25 to 44 was 9.25 times higher in those whose sleep was estimated as '"poor" vs. those with "good" sleep, i. e. in this age group sleep disturbances were one of the most important MI risk factors; in 45 to 64 age group these differences were insignificant. RR of IM in men with sleep disturbances was higher in widowers, divorced men, men with low social support level, men with only primary education, working class men, and pensioners. The results demonstrate that sleep disturbances present a social problem and contribute greatly to the risk of MI in men of young age group.