[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.

[Expert consensus regarding treatment of iron deficiency in stable and decompensated patients with heart failure].

In recent years there has been significant interest in treating iron deficiency (ID) in patients with heart failure (HF) due to its high prevalence and detrimental effects in this population. As stated in the 2020 Russain HF guidelines, Intravenous ferric carboxymaltose remains the only proven therapy for ID.This document was prompted by the results from the recent AFFIRM-AHF trial which demonstrates that treatment of ID after acute HF decompensation reduces the risk of future decompensations. Experts have concluded that in HF patients with acute decompensation, a left ventricular ejection fraction of < 50% and ID, Intravenous ferric carboxymaltose reduces future HF hospitalisations. Patients with stable HF may also benefit from treatment of ID to improve quality of life and alleviate symptoms.  It is, therefore, reasonable to screen for and treat ID in patients with HF.

[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.

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.

[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.

Asymmetric Pauson-Khand reactions using camphor-derived chelating thiols as chiral controllers.

A convenient procedure for the preparation of enantiopure 10-(R-thio)-2-exo-bornanethiols from (1S)-camphor-10-thiol has been developed. The ethynyl derivatives of these thiols gave excellent diastereoselectivities (up to 98:2) in Pauson-Khand reactions with norbornene and norbornadiene through the intermediacy of a chelated dicobalt pentacarbonyl complex. Thermal reaction conditions starting from the preformed chelated complex gave better results than N-oxide-promoted runs with in situ generation of the chelated intermediate. The corresponding adducts have been elaborated through a protocol consisting of conjugate addition, samarium iodide-promoted cleavage of the chiral auxiliary, and retro-Diels-Alder reaction to afford 4-substituted 2-cyclopentenones in high enantiomeric purity.