Associations of ECG Signs of Ischemic and Non-Specific Signs of Metabolic Changes in the Myocardium With Unfavorable Cardiovascular Prognosis in a 7-Year Prospective Follow-Up of Young People Under 45 Years.

AIM: To study ischemic and/or nonspecific ECG signs of metabolic changes in the myocardium and to determine their relationship with unfavorable cardiovascular prognosis in a 7-year prospective observation of young people under 45 years of age. MATERIAL AND METHODS: A cross-sectional population survey of a random sample aged 25-44 years (n=1363) was conducted in Novosibirsk. The survey program used the standardized epidemiological Rose questionnaire. Biochemical tests were used to measure blood concentrations of total cholesterol (C), triglycerides (TG), low- and high-density lipoprotein cholesterol (LDL-C, HDL-C), and fasting blood plasma glucose. Systolic and diastolic BP (SBP, DBP), the presence of arterial hypertension (AH), body mass index (BMI), waist circumference (WC), and smoking status were assessed. ECG was recorded at rest in 12 standard leads followed by interpretation according to the Minnesota Code. The presence of ischemic and/or nonspecific ECG signs of metabolic changes in the myocardium was determined. Subjects with ECG signs of ischemic changes in the myocardium were selected for long-term follow-up and additional examination by cardiologists. Then the whole cohort was monitored for 7 years, and cardiovascular events were recorded, including using data from the WHO Myocardial Infarction Registry in Novosibirsk. For statistical analysis of the results, cardiovascular events were combined into a composite endpoint. RESULTS: During 7 years, 40 people (27 men and 13 women) had an unfavorable cardiovascular prognosis. Multivariate regression analysis showed that a 7-year unfavorable cardiovascular prognosis in people younger than 45 years was associated with signs of ischemic myocardial alterations identified on the background ECG (OR 5.319, 95% CI: 1.543-18.342, p=0.008) and nonspecific ECG signs of metabolic changes in the myocardium (OR 2.978, 95% CI: 1.216-7.216, p=0.017) regardless of age, gender, the presence of arterial hypertension (AH) and type 2 diabetes mellitus (DM2). CONCLUSION: In young people under 45 years of age, not only ECG signs of ischemic changes in the myocardium, but also nonspecific ECG signs of metabolic changes in the myocardium are associated with an unfavorable cardiovascular prognosis, directly and independently on age and gender, in a long-term, 7-year period.

[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.

[The relationship between the relative length of leukocyte telomeres and mtDNA copy number and acute coronary syndrome in a 15-year follow-up.]

We studied the relationship between the leucocyte telomere length (LTL) and the copy number of mitochondrial DNA (CNmtDNA) and the development of acute coronary syndrome during 15 years of follow-up. A random population sample was examined at baseline in 2003-2005 (n=9 360, men and women 45-69 years old, Novosibirsk, the HAPIEE project) and followed-up for 15 years. In the frame of nested case-control design, we selected cases - incident myocardial infarction/acute coronary syndrome (MI/ACS) among those free from baseline CVD (n=256) and sex- and age-stratified control among those free from baseline CVD and cancer and alive by the end of follow-up (n=799). The relative LTL and CNmtDNA were assessed using quantitative real-time PCR. Results. The carriers of shorter telomeres had increased 15-year risk of MI/ACS with adjusted OR=1,87 (95% CI 1,70-2,06) per 1 LTL decile independent of other factors. Fewer CNmtDNA was associated with increased risk of MI/ACS with adjusted OR=1,19 (95% CI 1,12-1,26) per 1 CNmtDNA decile. The identified associations were confirmed in tertile analysis and in stepwise analysis with continuous variables of both biomarkers. All associations persisted after adjusting for gender, age, and traditional CVD risk factors. Conclusion. The LTL and CNmtDNA were independent predictors of the 15-year risk of MI/ACS in the middle- and elderly Siberian (Caucasoid) population cohort. These findings highlight the need for further research to elucidate the mechanisms by which LTL and mtDNA copy number may affect human health.

[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.

[Prevalence of ischemic heart disease depending on factors of psychoemotional stress among men of mature age (epidemiological study)].

AIM: To establish associations of the prevalence of ischemic heart disease (IHD) and factors of psychoemotional stress in men of the open urban population in the age group 4564 years after two decades of life. MATERIALS AND METHODS: A cross-sectional epidemiological study using a model of the city of Tyumen was conducted on a representative sample of the population among males of mature age (4564 years). Based on standard epidemiological methods, IHD was established according to strict epidemiological criteria definite IHD. The study of the factors of psycho-emotional stress (depression, hostility, life exhaustion) was carried out according to the algorithms of the World Health Organization program MONICA-psychosocial. When calculating the odds ratio for the development of IHD, a low level of psycho-emotional stress factors was regarded as the absence of a sign, a combination of medium and high levels as a presence. RESULTS: The prevalence of ischemic heart disease in the open population (on the model of Tyumen) according to strict epidemiological criteria in men aged 4554 years was 8.2%, at the age of 5564 years 19.2%, a predominance of painless form of ischemic heart disease was revealed. According to the levels of factors of psychoemotional stress in mature men, mainly the average level of depression and life exhaustion, a high level of hostility were established. In men of an open population (on the model of Tyumen), depending on the psychoemotional stress, a high risk of developing a certain coronary heart disease was established in the age categories 4554 and 5564 years old in the presence of depression, at the age of 5564 years in the presence of hostility or life exhaustion. CONCLUSION: Consequently, the data obtained indicate the importance of further studying the factors of psychoemotional stress in men of mature age in Siberian populations, their relationships with conventional risk factors for coronary artery disease, as well as the advisability of preventive measures aimed at weakening the influence of not only conventional risk factors, but also factors of psycho-emotional stress. among the Russian population.

[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.

Levels of depression and life exhaustion in the open population of the middle urbanized Siberian city: gender differences.

AIM: The aim of the study was to determine the levels of depression and life exhaustion in men and women of the open urban population in the age range. MATERIALS AND METHODS: A single-stage epidemiological study was conducted among people of both sexes aged 25-64 in Tyumen. A representative sample was formed from the electoral lists of citizens by the method of "random numbers" - 2000 men and women with a response among men 85.0%, among women - 70.3%. The study of depression was conducted according to the algorithms of the program of the world health organization "MONICA-psychosocial". RESULTS: The prevalence of depression in the Tyumen population and in the age and sex groups showed a predominance of the average level over the high, in the age categories 25-34 and 35-44 years - significantly higher prevalence of high levels of depression in women. The higher prevalence of the average level of men and women IN the open population was determined to be relatively high. The average level of LIFE significantly prevails in women in the older age categories and in the population as a whole, the high level of LIFE - at the age of 25-34 years in women and at the age of 55-64 years in men. CONCLUSION: Therefore, in the open population of the middle-urbanized Siberian city there is a need to form an integrated approach to the prevention of non-infectious diseases, especially cardiovascular diseases, as it is established that prevention programs lead to a reduction in the burden of depression and, and effective approaches to the prevention of psycho-emotional States at the level of individual communities include school-oriented programs to teach positive thinking among the population, starting from a young age.

[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.

Stress in the family - association with prevalence of cardiovascular diseases in men of the open city population.

AIM: The aim of the study was to establish associations of the prevalence of coronary artery disease (CAD), metabolic syndrome (MS) and arterial hypertension (AH) with family stress in open male population of Tyumen aged 25-64 years. MATERIALS AND METHODS: Cross-sectional epidemiological survey was conducted on representative sample of 1000 individuals (250 in every 4 decades: 25-34, 35-44, 45-54, 55-64 years) formed from the election list of males in one of the administrative districts of Tyumen. The response to cardiac screening was 85.0% - 850 patients. Different types of CAD were defined based on standard methods in epidemiological surveys. "Certain" CAD and "possible" CAD were determined according to extended epidemiological criteria. IDF criteria (2005) were used for the MS assessment, AH was considered as a component of the MS. A questionnaire of WHO MONICA «Knowledge and attitude to health¼ was used to analyze stress in families. RESULTS: The results of the study showed that more than 80% of males in open urban population, mostly older individuals, had a stable marital status last twelve months, while one-third of the male population had conflicts in their families and the fifth part did not have the opportunity to relax at home. Male patients with CAD had family stress more frequently during last 12 months on extended epidemiological criteria. In the open male population aged 25-64 years with MS and AH there was found more stable marital status versus comparison groups. CONCLUSION: Standardized methods and the accumulated database should be used to continue objective monitoring of the epidemiological situation of cardiovascular diseases and psychosocial risk factors in open urban population during regional preventive program.

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.

[Blood Levels of Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) in Men from Different Population Groups and Its Relation to Unfavorable Long-Term Prognosis].

AIM: of the study was to investigate blood levels of proprotein convertase subtilisin/kexin type 9 (PCSK9) in men from different population subgroups, their associations with cardiovascular risk factors and with unfavorable 7-years long-term prognosis. MATERIAL AND METHODS: The study included three subgroups of men from a population sample of residents of Novosibirsk, 44-73 years old, not receiving lipid-lowering drugs: subgroup of population proper (183 men), subgroup with hypercholesterolemia (46 men), and subgroup with hypocholesterolemia (18 men). Blood level of PCSK9 was determined by ELISA using the test-systems "Human Proprotein Convertase 9/PCSK9 Immunoassay". Study endpoints (myocardial infarction, cardiovascular death) were registered during 7 years after baseline examination of subgroups using the data of the Registers of myocardial infarction and cardiovascular mortality. RESULTS: Distribution of PCSK9 protein in subgroups with hyper- and hypocholesterolemia was normal. In the subgroup of population proper it was abnormal with leftward shift. PCSK9 protein concentration in the subgroup with hypercholesterolemia was 1.2 times higher than in the population subgroup. PCSK9 protein level correlated significantly with blood levels of total cholesterol (CH), low density lipoprotein (LDL) CH, and glucose. Only 15% of PCSK9 variability was due to the influence of other factors (R Square=0.155, p<0.001). Factors with significant influence on blood level of PCSK9 protein were levels of high density lipoprotein CH (=0.238, p=0.023), triglycerides (=0.253, p=0.049) and LDL CH (=0.751, p=0.009). Multivariate regression analysis revealed significant independent association of PCSK9 protein levels with cardiovascular death during period of registration (7-years) (p=0.048, OR=1.01). This result indicates that in men increase of blood level of PCSK9 protein by 1ng/ml independently of other parameters increases relative risk of cardiovascular death during following 7 years by 1%.

[Associations between high levels of hostility and coronary heart disease in an open urban population among 25-64-year-old men]. / Assotsiatsii vysokogo urovnia vrazhdebnosti i ishemicheskoi bolezni serdtsa v otkrytoi gorodskoi populiatsii sredi muzhchin 25­64 let.

AIM: To establish the associations of the prevalence of coronary heart disease (CHD) with high levels of hostility in the open population of 25-64-year-old men in an average urbanized Siberian town. SUBJECTS AND METHODS: A cross-sectional epidemiological survey was conducted in a representative sample of the electorate of a Tyumen administrative district among 1000 males, with 250 being in each of 4 life decades (25-34, 35-44, 45-54, and 55-64 years). There were 850 (85%) responses. Different forms of CHD were identified by standard methods (the WHO exertional angina questionnaire, resting EEG, and Minnesota coding) used in epidemiological surveys. Definite CHD (DCHD) and possible CHD were identified. A continuous survey method was used by self-filling out the WHO MONICA-psychosocial questionnaire to estimate the levels of hostility. RESULTS: In an average urbanized Siberian town, the prevalence of high levels of hostility among 25-64-year-old men was 46.4% (age-adjusted rate). The high levels of hostility increased with age, peaking in the 55-64-year-old group. In the Tyumen male population aged 25-64-year-old, the odds ratio (OR) for coronary heart disease and high levels of hostility was 2.71; 95% confidence interval (CI), 1.63-4.52 (p<0.05); that for DCHD was almost twice higher (OR, 4.65; 95% CI, 2.14-10.12 (p<0.05). In the older men aged 55-64 years, OR for coronary heart disease and high levels of hostility was 5.42; 95% CI, 2.32-12.66 (p<0.05); that for DCHD was 25.85; 95% CI, 3.30-202.60 (p<0.05). CONCLUSION: Consequently, the epidemiological criteria for psychosocial risk factors, including hostility, which are detected by the standardized survey methods, should be used in prophylactic examinations of a male population and in the selection of able-bodied people with cardiovascular disease to be comprehensively examined and followed up.

[Population characteristics of metabolic syndrome components in 25-64-year-old males of an average urbanized Siberian town].

AIM: To establish the population characteristics of the components of metabolic syndrome (MS) in the age range of 25-64-year-old males in an average urbanized Siberian town. MATERIALS AND METHODS: A cross-sectional epidemiological survey was conducted in a representative sample of the electorate of a Tyumen administrative district among 1000 males, with 250 being in each of 4 life decades (25-34, 35-44, 45-54, and 55-64 years). There were 850 (85%) responses. The IDF criteria (2005) were used to evaluate MS. RESULTS: In the Tyumen open population of 25-64-year-old men, the population characteristics of systolic blood pressure (BP) and waist circumference (WC) were shifted to the right in the normal distribution range, which determined the high prevalence of hypertension and abdominal obesity (AO). In the 25-64-year-old men with the high prevalence of hypertension (a standardized rate of 59.8%) and AO (a standardized rate of 42.6%), the age was positively related to systolic BP in the third to fifth decades of life, diastolic BP, and WC at all ages. CONCLUSION: Examining the epidemiological situation regarding the prevalence of MS components necessitates the elaboration of a scientifically sound prevention program in the specific conditions of an average urbanized Siberian town.

[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.

[Populational characteristics of metabolic syndrome in open male population].

OBJECTIVE: to assess prevalence of various clusters of metabolic syndrome (MS) in open male population aged 25- 64 years. METHODS: This cross sectional epidemiological study was conducted on a representative population sample formed from lists of male voters in one of administrative districts in Tumen. NCEP ATP III (2004) MS criteria were used in analysis. RESULTS: Prevalences of MS were different in various 20 year age intervals. Most frequent 3-component MS variant (5.6%) was combination of arterial hypertension, abdominal obesity, and hyperglycemia; combination of these factors with hypertriglyceridemia was most frequent 4-componet variant (1.5%).