[First Results of Analysis of Russian Part of the European Register on Cardiac Rehabilitation EuroCaReD (European Cardiac Rehabilitation Database)].

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.

[Depressive symptoms worsen cardiovascular prognosis and shorten length of life in patients with arterial hypertension and ischemic heart disease].

UNLABELLED: The KOORDINATA study (clinical epidemiological program of investigation of depression in cardiological practice in patients with arterial hypertension and ischemic heart disease) was a prospective 3 year long multicenter study of effects of depressive and anxiety states on the course and prognosis of ischemic heart disease (IHD) and arterial hypertension (AH). MATERIAL AND METHODS: Patients (n=5038, age more or equal 55 years) with verified IHD and/or AH from 37 cities were included into the study. Symptoms of anxiety and depression were assessed by the HADS scale (Hospital Anxiety And Depression Scale) validated in Russia. RESULTS: Clinically significant symptoms of anxiety ( more or equal 11 HADS) were present in 33 and 38%, of depression - in 30 and 38% of patients with IHD and AH, respectively. Presence of clinically manifested depression at initial examination increased 1.59 times combined risk of nonfatal and fatal cases (odds ratio [OR] 1.59, 95% confidence interval [CI] 1.30-1.96, p=0.0001), 1.64 times - risk of cardiovascular death (OR 1.64, 95% CI 1.20-2.24, p=0.0021), and 1.82 times - risk of death from all causes (OR 1.82, 95% CI 1.41-2.34, p=0.0001). It is known that for somatic patients crossover of anxiety and depression symptoms is typical (simultaneous presence of some symptoms of anxiety and depression). Total HADS score equal to 11 or more increased risk of all cause death (OR 1.41, 95% CI 1.08-1.84, p=0.0111), as well as fatal and nonfatal events (OR 1.33, 95% CI 1.08-1.65, p=0.0089). CONCLUSION: Taking into consideration negative effect of depressive symptoms on prognosis it is recommended to screen patients with IHD in the first place those who have had myocardial infarction and brain stroke with the aim of detection of depression and anxiety depressive symptoms and subsequent their adequate correction.

[Clinical efficacy of citalopram in patients with hypertension and concomitant depression]. / Klinicheskaia éffektivnost' tsitaloprama u bol'nykh arterial'noi gipertoniei s komorbidnoi depressiei.

Patients (n=28) with mild to moderate hypertension and depression were given enalapril (20 mg/day). If target blood pressure was not achieved in 10 days hydrochlorothiazide (12.5 mg/day) was added. These patients were randomized into 2 groups in one of which antihypertensive therapy was supplemented with citalopram (20 mg/day) for 6 weeks. Psychological status was assessed by Beck Depression Inventory (BDI) and Spielberger State-Trait Anxiety Inventory (STAI). Total BDI score in citalopram group decreased 51% (-12.2+/-1.5; p<0.001). Complete reduction of symptoms of depression (BDI score <19) occurred in 86% of patients. There was no significant lowering of BDI score in control group. STAI score among citalopram treated patients with concomitant anxiety (STAI score >50) decreased from initial 62.9+/-2.1 to 46.3+/-3.1 by week 6 (p<0.001). Only minor changes of STAI score took place in control group. According to data of 24-hour monitoring lowering of systolic blood pressure time indexes was somewhat more pronounced in citalopram group than in control group (24 hour -49.8 and -34.4%, diurnal -56.6 and -42%, nocturnal -37.9 and -23%, respectively).