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1.
Kardiologiia ; 59(10S): 31-40, 2019 Jul 23.
Artículo en Ruso | MEDLINE | ID: mdl-31876460

RESUMEN

Purpos. To assess the effectiveness of preventive counseling with focus on diet modification followed by remote support via telephone on awareness of cardiovascular (CV) risk factors (RFs) in patients (pts) with high/very high CV risk. Material and methods. This is a prospective randomized controlled study of 100 pts with high/very high CV risk (5-9% and ≥10% according to the SCORE scale) and any 2 criteria for metabolic syndrome.  Pts were randomized into 2 groups in 1:1 ratio - the intervention group (n=50) and the control group (n=50). The intervention group received comprehensive preventive counseling with focus on diet modification followed by remote preventive counseling by phone every two weeks for the first 3 months after enrollment (a total of 6 sessions). The control group received usual care in Health centers which also included basic preventive counseling. A specially designed questionnaire was used to evaluate the awareness of the basic CV RFs, including open questions. The awareness was assessed at baseline, 6 and 12 months. Results. The groups were well balanced according to demographic and clinical features. The results of the study revealed an extremely low awareness of major CV RFs of pts in both groups at baseline: practically none of them indicated as RFs for cardiovascular disease elevated cholesterol (8,0% and 4,0%, respectively) and blood pressure (14.0% and 4.0%). At 6 month the level of awareness of CV RFs has increased significantly. Moreover, pts of the intervention group were more informed about elevated cholesterol (58,0% vs. 28,0%; p<0,01) and unhealthy diet (76,0% vs. 52,0%; p<0,05). At 12 month the level of awareness of CV RFs was significantly higher in both groups  to compare from baseline. Conclusion. Preventive counseling with focus on diet modification followed by 3 months  remote support via phone provided a significant improvement of awareness of CV RFs in pts with high/very high CV risk.


Asunto(s)
Enfermedades Cardiovasculares , Presión Sanguínea , Consejo , Humanos , Estudios Prospectivos , Factores de Riesgo
2.
Kardiologiia ; 59(11S): 53-62, 2019 Jul 23.
Artículo en Ruso | MEDLINE | ID: mdl-31884941

RESUMEN

PURPOSE: The search for optimal approaches to the diagnosis of subclinical atherosclerosis using a wide range of traditional and psychosocial risk factors (RFs), as well as clinical and instrumental diagnostic methods in patients (pts) with high or very high cardiovascular (CV) risk. METHODS: This cross-sectional study enrolled52 pts, aged 40 to 65 years with high or very high CV risk (5-9 and ≥10% by the Systematic Coronary Risk Estimation Scale [SCORE], respectively). All participants underwent cardiac computed tomography (CT)angiography and calcium scoring. Traditional RFs (family history of premature CVD, smoking, overweight/obesity and abdominal obesity, hypertension, type 2 diabetes mellitus, lipids parameters (total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides) and lipids-related markers (apolipoprotein A1, apolipoprotein B, ApoB/ApoA1 ratio), biomarkers of inflammation (high-sensitivity C-reactive protein [hs CRP], fibrinogen), indicator carbohydrate metabolism (glucose), ankle-brachial index, stress-test, carotid plaques according to ultrasound, arterial stiffness were evaluated in all pts. Psychological RFs were evaluated using Hospital Anxiety and Depression Scale and DS-14 for type D personality. RESULTS: All pts were divided into 2 groups according to the CT angiography results: pts in the main group (n=21) had any non-obstructive lesions or calcium score >0, pts in the control group (n=31) had intact coronary arteries. The groups did not differ in age or gender. It was found that patients with subclinical atherosclerosis significantly more often have a very high (≥10%) CV risk (42.9% vs.16.3%, p<0.05), a long (≥5 years) history of arterial hypertension (47.6% vs. 12.9% , p<0.01) and longer duration of antihypertensive therapy (61.9% vs. 29.0%, p<0.05), higher heart rate in rest (87. ± 14 vs. 77 ± 10 beats/min, p<0.01), increased arterial stiffness according to aortic pulse wave velocity (85.7% vs. 61.3%, p<0.05) and high level of hs-CRP (100% vs. 90.3%, p<0.05). CONCLUSION: Using in routine clinical practice of additional anamnestic (hypertension lasting ≥ 5 years and the intake of any antihypertensive drugs) and clinical-instrumental parameters (high heart rate in rest, hs CRP and arterial stiffness in pts with high and very high CV risk increases effectiveness of early detection of subclinical atherosclerosis.


Asunto(s)
Aterosclerosis , Enfermedades Cardiovasculares , Adulto , Anciano , Aterosclerosis/diagnóstico , Biomarcadores , Estudios Transversales , Diabetes Mellitus Tipo 2 , Humanos , Persona de Mediana Edad , Análisis de la Onda del Pulso , Factores de Riesgo
3.
Kardiologiia ; 59(11): 21-30, 2019 Dec 11.
Artículo en Ruso | MEDLINE | ID: mdl-31849296

RESUMEN

Background Long-term secondary preventive programs in coronary heart disease (CHD) are of highest efficacy but numerous logistical problems often compromise their implementation. Contemporary remote technologies have a potential to overcome these barriers. AIM: To assess  the impact of 2 preventive counselling programs with subsequent remote support in CHD patients with concomitant obesity. METHODS: A prospective randomized parallel-group study in 120 stable CHD patients hospitalized for elective coronary revascularization who were from 40 to 65 years old and had concomitant obesity. Patients were randomized (1:1:1) into 3 groups (n=40 each). Before discharge, Groups 1 and 2 received a single-session comprehensive counselling with focus on diet followed by remote counselling by phone (Group 1) or via text messages (Group 2). Remote counselling was delivered weekly (Months 1-3) and then monthly (Months 4-6). Group 3 received only standard advice from their attending physicians. The patients were followed for 12 months with assessment of adiposity measures, self-reported dietary patterns, physical activity (IPAQ questionnaire), smoking status, blood pressure (BP), fasting blood glucose, lipids and C-reactive protein (CRP) levels, as well as of clinical events. RESULTS: At 1 year of follow-up, the patients from both intervention groups showed a marked improvement of several risk factors including obesity: the body mass index was reduced by 1.48±0.13 kg/m² in Group 1 and by 1.53±0.18 kg/m² in Group 2; the waist circumference went down by 7.62±0.49 and by 7.41±0.74 cm, respectively; the height-normalized fat mass decreased by 4.66±0.40 kg and 5.98±0.63 kg, respectively (all P values are <0.01 vs corresponding changes in the control group). These changes were coupled with more healthy dietary patterns and less sedentary lifestyles in both intervention groups: the proportion of patients with low activity level fell from 87.5% to 2.5% in Group 1 and from 80% to 10% in Group 2 (both p values <0.01 vs control). In Group 1, BP decreased by 18.08±2.20 mmHg (systolic) and 8.56±1.61 mmHg (diastolic); both р values <0.01 vs Group 3. In Group 2 systolic BP dropped by only 11.95±2.50 mmHg (non-significant) and diastolic BP by 6.33±1.52 mmHg (р<0.05 vs control). The proportion of smokers went down from 30% to 5% in Group 1 and from 22.5% to 0% in Group 2 (both p values <0.01 vs control). The fasting glucose levels decreased by 0.21±0.20 mmol/L in Group 1 and by 0.48±0.25 mmol/L in Group 2 (<0.01 vs control, both), but there were no meaningful improvements in blood lipids or CRP. CONCLUSION: Long-term (6 months) secondary prevention programs incorporating remote support technologies result into sustained improvement of key secondary prevention indicators in obese CHD patients, irrespective of the support modality (by phone or via electronic messaging).


Asunto(s)
Enfermedad Coronaria , Obesidad Abdominal , Adulto , Anciano , Enfermedad Coronaria/complicaciones , Humanos , Persona de Mediana Edad , Obesidad Abdominal/complicaciones , Estudios Prospectivos , Factores de Riesgo , Prevención Secundaria
4.
Kardiologiia ; 59(12): 11-19, 2019 Dec 11.
Artículo en Ruso | MEDLINE | ID: mdl-31849306

RESUMEN

BACKGROUND: Quality of life, which is determined both by the physical symptoms and by psychosocial risk factors, is among the primary treatment goals in coronary heart disease (CHD). Therefore, it is reasonable to assess the impact of any therapeutic interventions in CHD on these measures. AIM: To assess the changes of psychological status and quality of life in patients with CHD and abdominal obesity (AO) over time during 2 secondary prevention programs using two different modalities of remote support. METHODS: An open-label randomized study with 3 parallel groups enrolling hospitalized patients with stable CHD and AO (most hospitalizations were due to elective revascularization procedures). The patients were randomized into 2 intervention groups (Group I and Group II) and into Group III (control). Both intervention groups received secondary prevention programs including one in-hospital preventive counselling session with focus on healthy eating habits and subsequent remote support for 6 months (Month 1 to 3: once a week; Month 4 to 6: once a month). Group I received this subsequent counselling via phone calls and Group II received text messages via different platforms according to patient preferences. Group III received standard advice at discharge only. During 1 year of follow-up motivation for lifestyle changes and continued participation in secondary prevention programs, anxiety and depression symptoms (HADS), stress levels (10-point VAS) and quality of life (HeartQol) were assessed. RESULTS: A total of 120 patients were enrolled (mean age±SD, 57.75±6.25 years; men, 83.4%) who had a high baseline motivation to participate in preventive programs. At 1 year of follow-up there was a substantial improvement in anxiety and depression symptoms in Groups I and II which was absent in Group III. As a result, the proportion of patients with HADS-A score ≥8 dropped from 45.0% to 10.0% in Group I and from 40.0% to 7.5% in Group II (both р values <0.01 vs control), and the proportion of participants with HADS-D ≥8 decreased from 30.0% to 10.0% (р<0.01 vs control) and from  12.5% to 0% (р<0.05 vs control), respectively. Stress level decreased in Groups I and II by 3.95±0.38 and 3.56±0.39 баллов, respectively (both р values <0.01 vs control). The HeartQol global score increased by 1.07±0.08 points in Group I and by 0.98±0.13 points in Group (both р values <0.01 vs control). CONCLUSION: Both secondary prevention programs with long-term remote support targeting obese CHD patients resulted in improvement of pivotal measures of their psychological status i.e. into a decline of anxiety and depression symptomatology, stress reduction and into a better quality of life.


Asunto(s)
Enfermedad Coronaria , Obesidad Abdominal , Anciano , Enfermedad Coronaria/complicaciones , Femenino , Humanos , Masculino , Persona de Mediana Edad , Obesidad , Obesidad Abdominal/complicaciones , Calidad de Vida , Prevención Secundaria
5.
Kardiologiia ; 59(9S): 31-41, 2019 Jul 23.
Artículo en Ruso | MEDLINE | ID: mdl-31644415

RESUMEN

OBJECTIVE: To study medical awareness of cardiovascular risk factors (RFs) in different types of hospitalized patients (pts). METHODS: A total of 150 pts from neurological, endocrinological and cardiac units one of Moscow city hospital were enrolled into the survey (50 pts in each unit). The pts were interviewed during the I-II days of the hospitalization. A special questionnaire was developed in­ cluding socio-demographic and clinical indicators, open questions on the awareness of traditional cardiovascular RFs and their target values. RESULTS: Pts of three units did not differ in gender and age. The range of diagnoses corresponded to the profile of the unit. The survey revealed an extremely low awareness of major cardiovascular RFs of pts in all 3 units: almost none of them pointed to elevated cholesterol (0%, 4% and 0%, respectively) and blood pressure (2%, 2% and 0%) respectively) as RF of cardiovascular diseases. The pts of the three units most often referred to stress (64%, 56% and 66%, respectively) and unhealthy diet (50%, 56% and 64%, respectively) as the main cardiovascular RFs. On average, pts in three units correctly indicated only 2 RFs. CONCLUSION: The survey revealed a low awareness of cardiovascular RFs in different types of medical pts, including cardiac pts, at time of hospital admission.


Asunto(s)
Enfermedades Cardiovasculares/epidemiología , Conocimientos, Actitudes y Práctica en Salud , Hospitalización , Humanos , Moscú , Factores de Riesgo , Encuestas y Cuestionarios
6.
Kardiologiia ; 59(9): 29-39, 2019 Sep 17.
Artículo en Ruso | MEDLINE | ID: mdl-31540574

RESUMEN

PURPOSE: to assess efficacy of correction of anxiety states by anxiolytic drug fabomotizole in ambulatory patients with arterial hypertension (AH) and / or ischemic heart disease (IHD). MATERIALS AND METHODS: In the framework of multicenter cross-sectional study with participation of patients aged ≥55 years with verified AH / IHD we conducted the therapeutic part of the COMETA program in which we included patients with comorbid anxiety state (≥11 points on the Hospital Anxiety and Depression Scale Anxiety [HADS-A] and clinically expressed anxiety state) without clinically expressed depressive symptoms (<11 points on the HADS-Depression). Participants were randomized into main and control groups. Patients in the main group in addition to therapy prescribed because of AH / IHD were given a recommendation to take fabomotizole (10 mg thrice a day), patients of control group received standard therapy. Efficacy of therapy was evaluated by HADS and visual analog scale after 6 and 12 weeks of observation. RESULTS: We included 182 and 104 in the main and control groups, respectively. Most patients in main and control groups had AH (97.3 and 95.2 %, respectively, about one third had IHD (36.8 and 30.8 %, respectively). Social-demographic, clinical characteristics, and recommended for AH / IHD treatment of participants of both groups were similar. Portion of patients with complete reduction of anxiety symptoms (<8 points on HADS-A) was significantly higher already after 6 weeks of fabomotizole therapy (37.9 and 19.2 %, respectively, p<0.001). Analogous picture was noted by the end of observation (66.9 and 32 %, respectively; p<0.001). Mean estimate of chronic psychoemotional stress in the main group decreased by 25 % after 6 weeks (from 6.45±2.20 to 5.05±1.96 points; р<0.001) and by 40 % after 12 weeks (from 6.45±2.20 to 3.98±1.99 points; р<0.001). In the control group it also decreased but degree of lowering was 2 times less than in the main group (11.1 % vs. 25 % after 6 weeks, р=0.016; and 20 % vs. 40 % after 12 weeks, р<0.001, respectively). CONCLUSION: The use of fabomotizole by patients with AH / IHD provided improvement of psychological status (reduction of anxiety symptoms and lowering of the level of chronic psychoemotional stress).


Asunto(s)
Ansiedad , Hipertensión , Estudios Transversales , Humanos , Persona de Mediana Edad , Atención Primaria de Salud , Federación de Rusia
7.
Kardiologiia ; 59(8): 54-63, 2019 Aug 08.
Artículo en Ruso | MEDLINE | ID: mdl-31397230

RESUMEN

BACKGROUND: Psychosocial risk factors (RFs) play a major role in the development and progression of cardiovascular diseases (CVDs). AIM: The COMET study aimed to obtain current data on psychosocial RFs in outpatients with arterial hypertension (AH) and/or coronary heart disease (CHD) seen in primary care facilities in 30 cities of Russia. METHODS: In 2016-2017, a multicenter cross-sectional study was carried out involving 325 physicians from community primary care facilities who enrolled 2,775 patients with AH and/or CHD ≥ 55 years of age. However, only 73 CHD patients (2.6%) were not hypertensive, therefore, these patients were excluded from the analyses. As a result, current paper is based on the comparison of AH patients (n=1687) vs. participants with both CHD and AH (AH+CHD; n=1015). We collected patients' socio-demographic data, clinical features, traditional and psychosocial RFs, such as anxiety and depression, stress level, type D personality, and treatment adherence. RESULTS: The study population (women, 72%; mean age ± SD, 66.7 ± 7.9 years) had a significant prevalence of psychosocial RF. 43.8% of AH patients and 45.5 % of participants with AH+CHD rated their income as low or very low, a low educational level was reported in 21.6% and 26.0%, respectively (both p=n/s). Social isolation was uncommon, but it occurred more frequently in AH+CHD patients (8.3% vs. 5.2%, p<0.01). Nevertheless, 40.2% of AH patients and 39.4% of AH+CHD were not married, and 26.0% and 24.6% were living alone, respectively. Elevated stress level was prevalent in more than 60% of patients (67.9% in AH patients vs. 67.7% in AH+CHD patents, p=n/s), and 63.3% and 64.8% of patients, respectively, reported stressful life events in the preceding year (p=n/s). Type D personality was more common in AH+CHD patients (41.2% vs. 35.8%; p<0.01). Clinically significant anxiety symptoms were prevalent in 24.7% ofAH patients and in 27.4% ofAH+CHD patients (p=n/s), and clinically significant depressive symptoms were identified in 13.9% and 20.9%, respectively (p<0.001). CONCLUSION: We obtained current data on psychosocial RFs prevalence in outpatients with the most common CVDs in primary care setting. At the moment, their prevalence remains significant.


Asunto(s)
Enfermedades Cardiovasculares , Enfermedad de la Arteria Coronaria , Hipertensión , Anciano , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Federación de Rusia
8.
Kardiologiia ; (10): 34-44, 2018 Oct.
Artículo en Ruso | MEDLINE | ID: mdl-30359215

RESUMEN

PURPOSE: to assess the impact of preventive counseling with focus on diet modification on lipid and metabolic parameters in patients with high / very high cardiovascular (CV) risk who visited Health centers. MATERIALS AND METHODS: This was a prospective randomized controlled study of patients aged 40 to 65 years with high/very high CV risk (≥5% according to the Systematic Coronary Risk Evaluation scale [SCORE]) and any 2 criteria for metabolic syndrome. Patients were 1:1 randomized into 2 groups. The intervention group (n=50) received comprehensive preventive counseling with focus on diet modification followed by remote preventive counseling by phone every two weeks for the first 3 months after enrollment (a total of 6 sessions). The control group (n=50) received usual care in Health centers which also included basic preventive counseling. RESULTS: A total of 100 patients (women 82%, age 59.74±4.66 years) were randomized. At baseline 81% of patients had high and 19% - very high CV risk. The groups were well balanced according to demographic and clinical features. At 1 year of follow-up patients from the intervention group experienced significant improvement of metabolic parameters compared with controls: their diastolic blood pressure (BP) decreased by 5.62±7.7 mm Hg, total and low-density lipoprotein cholesterol (TC and LDL-C) - by 0.5±0.83 and 0.46±0.62 mmol/l, respectively. Both groups experienced statistically and clinically significant decreases in systolic BP (intervention, - 17.76±16.2 mm Hg, control, - 13.44±15.6 mm Hg; both groups p.


Asunto(s)
Enfermedades Cardiovasculares , Adulto , Anciano , LDL-Colesterol , Consejo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores de Riesgo
9.
Kardiologiia ; 58(9): 47-58, 2018 09.
Artículo en Ruso | MEDLINE | ID: mdl-30295199

RESUMEN

BACKGROUND: More than 10 years passed since conduction of the first clinical-epidemiological study of prevalence of psychosocial risk factors (PSRF) in patients with arterial hypertension (AH) an/or ischemic heart disease in Russian Federation. PURPOSE: to assess current prevalence of PSRF in patients with AH/CHD and their relationship with traditional risk factors. MATERIALS AND METHODS: Patients with verified AH and/or CHD aged ≥55 years were included into this cross-sectional study in 30 cities of Russia representing 7 federal districts according to the following procedure. In each city we selected 2-5 federal clinics - providers of primary medical care; in each of these clinics we at random invited 2-5 physicians to take part in this study. Each of these physicians for 1-2 days included 10 consecutive patients with AH and/or CHD. Information collected from patients comprised social demographic and clinical characteristics, risk factors, adherence to therapy; Hospital Anxiety and Depression Scale (HADS) was applied for detection of symptoms of anxiety and depression. Obtained information was used for analysis of prevalence of cardiovascular risk factors and their association with symptoms of depression and anxiety in a framework of Pearson linear and Kendall rank correlation analysis. RESULTS: Symptoms of anxiety of various severity (HADS-A≥7) were detected in 42.2% of patients with AH and/or CHD, in 25.5% they were clinically significant (HADS-A≥11). Symptoms of depression of various severity (HADS-D ≥7) were detected in 42.5% of patients with AH and/or CHD, in 16.3% they were clinically significant (HADS-D≥11). We also observed several significant associations of symptoms of depression and anxiety with traditional cardiovascular risk factors: low level of physical activity, elevated systolic and diastolic arterial pressure, level of total cholesterol, abdominal obesity; some unhealthy nutritional habits. CONCLUSIONS: Prevalence of symptoms of anxiety and depression was found to be high among ambulatory patients with AH and/or CHD. However, in this study it was lower compared with that reported by previous studies in Russia.


Asunto(s)
Hipertensión/epidemiología , Isquemia Miocárdica/epidemiología , Ansiedad/complicaciones , Ansiedad/epidemiología , Presión Sanguínea , Estudios Transversales , Depresión/complicaciones , Depresión/epidemiología , Humanos , Hipertensión/complicaciones , Hipertensión/psicología , Persona de Mediana Edad , Isquemia Miocárdica/complicaciones , Isquemia Miocárdica/psicología , Pacientes Ambulatorios , Prevalencia , Factores de Riesgo , Federación de Rusia
10.
Kardiologiia ; 58(11): 5-16, 2018 Nov 23.
Artículo en Ruso | MEDLINE | ID: mdl-30625073

RESUMEN

BACKGROUND: Psychosocial (PS) risk factors (RF) make a substantial contribution in populational burden of cardio-vascular diseases (CVD) and their complications. PURPOSE: The KOMETA (Comet) study was directed to obtaining actual information on PSRF among ambulatory patients with arterial hypertension (AH) and / or ischemic heart disease (IHD) in 30 cities of Russian Federation. MATERIALS AND METHODS: This multicenter cross-sectional study was conducted in 2016-2017. Doctors participating in the study (n=325) recruited in state polyclinics 2775 patients aged ≥55 years with AH and / or IHD. Information collected from these patients comprised social-demographic and clinical characteristics, data on RF, adherence to therapy. Assessment of PSRF was carried out with consideration of levels of anxiety, depression and stress, presence of personality type D. RESULTS: Population of patients studied (72 % women) was characterized by considerable prevalence of PSRFs. Low levels of education and income were found in 24.5 and 44.2 % of patients, respectively; 25.2 % of patients reported living alone, 6.3 % - felt social isolation. Elevated, extremely high levels of stress, type D personality were detected in 67.8, 10, and 37.6 % of patients, respectively; clinically significant symptoms of anxiety and depression were found in 25.5 and 16.3 %, respectively. Most RFs were significantly more often detected in women, and older people. One third of patients (33.1 %) during a year preceding inclusion took some psychotropic drugs mainly herbal or barbiturate-containing (27.1 %). Moreover, 30 % of patients had lowering of cognitive functioning. CONCLUSION: In this large-scale study we revealed high prevalence of PSRFs among ambulatory patients with AH and / or IHD in Russia. Despite positive dynamics of prevalence of states of anxiety and depression relative to earlier studies in this country their negative impact on prognosis of CVD and quality of life of affected patients requires optimization of efforts for organization of adequate care and directed to timely diagnosis and correction of these states.


Asunto(s)
Hipertensión , Isquemia Miocárdica , Ciudades , Estudios Transversales , Depresión , Femenino , Humanos , Masculino , Persona de Mediana Edad , Calidad de Vida , Factores de Riesgo , Federación de Rusia
11.
Kardiologiia ; 57(S1): 333-344, 2017.
Artículo en Ruso | MEDLINE | ID: mdl-29276906

RESUMEN

RELEVANCE: Evaluation of the effectiveness of risk management in persons with high cardiovascular risk is an important element in reducing the death rate of the population from cardiovascular diseases (CVD). AIM: Analysis of the prevalence and level of risk factors control in patients with high CV risk CVD from the Russian centers of the primary care unit of the EUROASPIRE IV study in comparison with the general population of the study. MATERIALS AND METHODS: In this cross-sectional study, 14 European countries, including the Russian Federation, participated. Patients aged 18 to 79 years were included in the study, without clinical manifestations of atherosclerosis, who were prescribed antihypertensive therapy and/or lipid lowering therapy and/or treatment for diabetes between the ages of ≥6 months and.


Asunto(s)
Aterosclerosis/complicaciones , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/prevención & control , Prevención Primaria , Anciano , Antihipertensivos/uso terapéutico , Niño , Estudios Transversales , Complicaciones de la Diabetes/complicaciones , Diabetes Mellitus/tratamiento farmacológico , Europa (Continente) , Femenino , Humanos , Hipolipemiantes/uso terapéutico , Lactante , Masculino , Prevalencia , Factores de Riesgo , Federación de Rusia
12.
Kardiologiia ; 57(S4): 47-52, 2017 04.
Artículo en Ruso | MEDLINE | ID: mdl-29466182

RESUMEN

Patients with coronary heart disease (CHD) and abdominal obesity (AO) are a priority group for the most active implementation of secondary prevention efforts. The paper focuses on most challenging issues of cardiovascular risk factors (RFs) correction via comprehensive cardiac rehabilitation (CR) programs in patients with CHD and AO. Based on large randomized clinical trials results, intensive behavioral interventions in the form of counselling are beneficial for such patients especially during the long-term support stage. They produce small but important changes in health behaviors (which translate into weight reduction, more healthy nutrition and higher physical activity) and improve selected intermediate clinical endpoints.


Asunto(s)
Enfermedad Coronaria/complicaciones , Enfermedad Coronaria/terapia , Consejo , Obesidad Abdominal/complicaciones , Rehabilitación Cardiaca , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto , Factores de Riesgo , Prevención Secundaria
13.
Kardiologiia ; 57(S3): 5-16, 2017 03.
Artículo en Ruso | MEDLINE | ID: mdl-29466184

RESUMEN

BACKGROUND: The picture of primary prevention obtained from real-life practice makes possible scheduling measures for prevention improvement. AIM: To analyze features of drug and non-drug therapy aimed at decreasing cardiovascular risk in Russian patients with a high risk (HR) of CVD compared with the study general population. MATERIALS AND METHODS: 14 European countries, including the Russian Federation, participated in this cross-sectional study. The study included patients aged 18-80 without clinical signs of atherosclerosis who have received antihypertensive and/or lipid-lowering therapy and/or therapy for diabetes mellitus (DM) within >6 to.


Asunto(s)
Aterosclerosis/complicaciones , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/prevención & control , Prevención Primaria , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Antihipertensivos/uso terapéutico , Aterosclerosis/epidemiología , Aterosclerosis/terapia , Enfermedades Cardiovasculares/epidemiología , Estudios Transversales , Europa (Continente) , Humanos , Hipoglucemiantes/uso terapéutico , Persona de Mediana Edad , Factores de Riesgo , Federación de Rusia , Adulto Joven
14.
Kardiologiia ; 57(12): 34-42, 2017 Dec.
Artículo en Ruso | MEDLINE | ID: mdl-29466209

RESUMEN

OBJECTIVE: to study medical awareness of cardiovascular risk factors (FR) in hospitalized patients of the cardiac and internal medicine units (CU and IMU). MATERIALS AND METHODS: A total of 100 patients from CU (n=50) and IMU (n=50) of a Moscow city hospital were included into the survey. The patients were interviewed during the I-II days of hospital stay. A special questionnaire was developed including socio-demographic and clinical indicators, open questions on the knowledge of traditional cardiovascular RFs and their target values. RESULTS: Patients of both units did not differ in gender and age. The survey revealed an extremely low awareness of major cardiovascular RFs of patients in both units: practically none of them indicated as RFs for cardiovascular disease elevated cholesterol (0 and 2 %, respectively, p>0.05) and blood pressure (0 % and 2 %, respectively, p>0.05). The majority of patients in both units (74 and 68 %, respectively, p>0.05) reported only 1-2 RFs. Patients in both units often believed that stress is the main cardiovascular RF (66 % and 50 %, respectively, p>0.05). CONCLUSION: The survey revealed a low awareness of cardiovascular RFs in different types of medical patients at time of hospital admission.


Asunto(s)
Enfermedades Cardiovasculares , Presión Sanguínea , Conocimientos, Actitudes y Práctica en Salud , Humanos , Moscú , Factores de Riesgo , Encuestas y Cuestionarios
16.
Kardiologiia ; 56(11): 18-26, 2016 12.
Artículo en Ruso | MEDLINE | ID: mdl-28290815

RESUMEN

The purpose of the study "Invasive Techniques for the treatment of atherosclerosis: the effectiveness of secondary preventive intervention" (IMLA-TRAC) - long-term efficacy of single preventive counseling of patients with coronary heart disease (CHD) in a stationary treatment for percutaneous coronary intervention (PCI). MATERIAL AND METHODS: In a prospective, randomized, controlled trial included 160 patients with coronary artery disease who underwent PCI between the ages of 38 to 87 years (mean age 59,43+/-8,94 years, 81.9% male). Included in the study, patients were randomized in a ratio of 1: 1 into 2 groups - the primary (n=80) and control (n=80). Patients in both groups received standard hospital treatment and hospital doctors recommendations. In addition to these patients of the main group carried out a preventive educational program After being discharged from hospital patients in both groups were followed for 12 months. RESULTS: The study showed that a single prevention counseling, conducted in patients with coronary heart disease at the stage of hospital treatment over a planned or emergency PCI, does not provide a stable positive dynamics of the main risk factors and has no effect on mortality and combined end point. There is only a small positive dynamics of individual indicators, for example, significantly lower intake of saturated fats, an increase in adherence to treatment, in particular, receive aspirin. CONCLUSION: Further studies are needed to determine the most effective models for preventive intervention in patients with coronary artery disease, which can start in a hospital, but should continue on an outpatient or remote formats.


Asunto(s)
Atención Ambulatoria , Enfermedad Coronaria/fisiopatología , Enfermedad Coronaria/cirugía , Intervención Coronaria Percutánea , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Prospectivos , Distribución Aleatoria , Factores de Riesgo , Resultado del Tratamiento
17.
Kardiologiia ; 56(8): 66-72, 2016 08.
Artículo en Ruso | MEDLINE | ID: mdl-28290884

RESUMEN

Quality of life (QL) of patients with ischemic heart disease (IHD) is a combination symptoms of the disease, physical state, emotional status, and social-laboring functioning. Until recently there were no universal questionnaire allowing to perform comparative analysis of QL of patients with effort angina (EF), survivors of myocardial infarction (MI) and chronic heart failure (CHF). Therefore, European Association of Cardiovascular Prevention and Rehabilitation conducted a study with the aim of developing universal questionnaire for assessment of QL in patients with IHD - HeartQol. The study enrolled 6384 patients with angina, MI, or CHF across 22 countries (315 in Russia). Patients completed a battery of questionnaires and Mokken scaling analysis was used to identify most important guestions for assessment of QL questions to be included into the HeartQoL questionnaire.


Asunto(s)
Enfermedad de la Arteria Coronaria , Isquemia Miocárdica , Calidad de Vida , Encuestas y Cuestionarios , Enfermedad de la Arteria Coronaria/psicología , Enfermedad de la Arteria Coronaria/terapia , Humanos , Isquemia Miocárdica/psicología , Isquemia Miocárdica/terapia , Ajuste Social
18.
Kardiologiia ; 55(2): 49-56, 2015.
Artículo en Ruso | MEDLINE | ID: mdl-26164989

RESUMEN

The joint European Registry of patients with cardiovascular diseases participating in cardiac rehabilitation programs (European Cardiac Rehabilitation Database, EuroCaReD) is conducted in collaboration between the ESC and EACPR). It's main goals were to improve the routine use of cardiac rehabilitation, to develop joint standards for cardiac rehabilitation in all European countries and evidence based rehabilitation programs and to monitor any changes. In the EuroCaReD registry participated a total of 44 centers from 13 countries, including 3 centers from Russia, which enrolled 151 patients during 2010-2012. This paper is comparing the baseline demographics, clinical data and risk factors in Russian patients versus the rest of Europe. It was shown that cardiac rehabilitation patients in Russia, as in the whole cohort, are predominantly male. Elderly patients from Russia were 3 times less likely to be referred for rehabilitation than in Europe. Unlike the whole cohort Russian patients were almost never sent to rehabilitation because of heart failure or stable angina. Likewise the whole Europe Russian patients had an average of 3 cardiovascular risk factors before rehabilitation, but with some national differences in their prevalence and severity.


Asunto(s)
Rehabilitación Cardiaca , Enfermedades Cardiovasculares/epidemiología , Conducta Cooperativa , Sistema de Registros , Anciano , Europa (Continente)/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Federación de Rusia/epidemiología
19.
Kardiologiia ; 55(12): 99-107, 2015 12.
Artículo en Ruso | MEDLINE | ID: mdl-28294772

RESUMEN

The results of the Russian part of the EUROASPIRE IV study show that we have a large room for improvement of traditional risk factors management in CAD patients hospitalized for acute myocardial infarction, acute coronary syndromes, PCI or CABG (at average in 1.7 years of follow-up after index events). It is also true for other European countries, although certain differences exist between Russian and whole study population. In some respects, the results of secondary prevention in Russian patients were even more successful: e.g. effective blood pressure control was achieved in 73.4% of our patients taking antihypertensive drugs vs 53.5% in whole study population. In contrast, smoking was more prevalent among Russian patients (22.2% vs 15.0% in other countries). Obviously, it was related to lower frequency of smoking cessation support offered to our patients: only 1.1% were referred to a smoking cessation program, 3.2% were prescribed nicotine replacement therapy, none were prescribed varenicline (vs 18.6, 22.9, 6.2%, respectively, in whole study population). The Russian cohort had the highest rate of overweight and obesity compared to other European countries (93.1 vs 82.1% in whole study population). 74.9% our patients received lipid lowering drugs (vs 86.6% in Europe), although the LDL-C goal was achieved only in 15.9% of our patients taking lipid lowering drugs (vs 21.1% in whole study population).


Asunto(s)
Enfermedad de la Arteria Coronaria/prevención & control , Prevención Secundaria , Antihipertensivos/uso terapéutico , Presión Sanguínea/efectos de los fármacos , Enfermedad de la Arteria Coronaria/epidemiología , Europa (Continente) , Humanos , Hipolipemiantes/uso terapéutico , Obesidad , Intervención Coronaria Percutánea , Factores de Riesgo , Federación de Rusia , Fumar , Cese del Hábito de Fumar
20.
Kardiologiia ; 55(2): 49-56, 2015 Feb.
Artículo en Ruso | MEDLINE | ID: mdl-28294811

RESUMEN

The joint European Registry of patients with cardiovascular diseases participating in cardiac rehabilitation programs (European Cardiac Rehabilitation Database, EuroCaReD) is conducted in collaboration between the ESC and EACPR). Its main goals were to improve the routine use of cardiac rehabilitation, to develop joint standards for cardiac rehabilitation in all European countries and evidence based rehabilitation programs and to monitor any changes. In the EuroCaReD registry participated a total of 44 centers from 13 countries, including 3 centers from Russia, which enrolled 151 patients during 2010-2012. This paper is comparing the baseline demographics, clinical data and risk factors in Russian patients versus the rest of Europe. It was shown that cardiac rehabilitation patients in Russia, as in the whole cohort, are predominantly male. Elderly patients from Russia were 3 times less likely to be referred for rehabilitation than in Europe. Unlike the whole cohort Russian patients were almost never sent to rehabilitation because of heart failure or stable angina. Likewise the whole Europe Russian patients had an average of 3 cardiovascular risk factors before rehabilitation, but with some national differences in their prevalence and severity.

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