[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.

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.

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.

[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.

[The Results of the Method Percutaneous Intracoronary Intervention in Patients of Both Male and Female].

OBJECTIVE: To assess gender differences among patients subjected to percutaneous coronary intervention (PCI) according to data of the "Register of performed operations of percutaneous transluminal coronary angioplasty (PTCA)". MATERIALS AND METHODS: The Register was conducted from 1996 to 2012 years and comprised 4890 patients (4121 men and 769 women). RESULTS: Women compared to men were older (58.2+/-8.6 vs 53.4+/-8.3 years; <0.001), had higher body mass index (31.4+/-5.3 vs 29.0+/-4.4 kg/m2; <0.001), level of total cholesterol (5.6+/-1.5 vs 5.3+/-1.3 mmol/l%; <0.001), systolic (141.1+/-22.2 vs 135.1+/-20.8 mmHg, <0.001) and diastolic blood pressure (86.5+/-11.8 vs 85.4+/-12.0 mmHg; =0.014). Compared to male cohort females more often had diabetes mellitus (22.5% vs 10.0%; <0.001), arterial hypertension (92.1 vs 75.6%; <0.001), family history of ischemic heart disease (IHD) (31.3 vs 23.4%; <0.001). Moreover, severe functional classes of effort angina (class III-IV 62.8 vs 50.0%; <0.001) and heart failure (NYHA class III-IV 28.1 vs 13.4%; <0.001) were more often detected in women. In men more frequent were smoking (45.4 vs 9.9%; <0.001), alcohol consumption (26.6 vs 9.0%; <0.001) and history of myocardial infarction (51.8 vs 40.2%; <0.001). Linear heart dimensions were larger in men. Men had more severe left ventricular (LV) asynergy (15.9+/-15.1 vs 13.7+/-14.7%; <0.001) and lower LV ejection fraction (54.5+/-8.7 vs 55.4+/-8.6 %; =0.03). As compared with men, portion of women subjected to primary PTCA was higher (14.3 vs 9.2%; <0.001), likewise coronary stenting was more often performed in women (93.6 vs 88.5%; <0.001). Optimal angiographic results were more frequently achieved in women (97.9 vs 96.4%; =0.04). Incidence of post-punctional hematoma was higher in female cohort (15.0 vs 4.6%; <0.001). There were no significant differences between men and women in post-operative mortality and rate of major adverse noncardiac events after primary and planned PTCA. CONCLUSION: Despite the detected clinical, functional, and echocardiographic gender differences both for men and women PCI was safe and highly efficient method of IHD treatment.

[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.

[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%).

[Associations of the prevalence of cardiovascular diseases with a high level of depression in the open population of an average urbanized Siberian town].

AIM: To reveal an association of the prevalence of coronary heart disease (CHD) and metabolic syndrome (MS) with a high level of depression in the open population of 25-64-year-old men in an average urbanized Siberian town. SUBJECTS AND METHODS: The survey was conducted on a representative sample formed from the voting list of 25-64-year-old men in one of the administrative districts of Tyumen. The standard WHO MONICA-psychosocial questionnaire was used to study associations of the prevalence of CHD and MS with a high level of depression within cardiologic screening. RESULTS: The age-adjusted prevalence of depression was 4.6% (a high rate) and 19% (a moderate rate) in the 25-64-year-old men of the average urbanized town of West Siberia. With advancing age, the high level of depression increased, peaking in a 55-64-year-old group. In high depression and CHD in the 25-64-year-old men, the odds ratio (OR) was 21.07 for high depression and 39.84 for a definite CHD form. High depression was significantly more common in MS patients in the open population of 25-64-year-old people of the average urbanized Siberian town and in the 55-64 year old age group. An association was found between high depression and a combination of MS components: a concurrence of abdominal obesity, hypertriglyceridemia, and lower high-density lipoprotein cholesterol (OR 13.13). CONCLUSION: The epidemiological criteria revealed by standardized survey methods for psychosocial factors, depression in particular, should be used during the preventive examinations of a male population and during the selection of able-bodied people with cardiovascular disease to undergo in-depth examination and follow-up.

[Risk of cardiovascular death in relation to blood pressure levels in Tyumen men and women: results of a 12-year prospective study].

AIM: To evaluate the effect of blood pressures (BP) on the risk of cardiovascular death (CVD) in a Tyumen open population through a 12-year prospective follow-up study. SUBJECTS AND METHODS: Standard methods were used to make a cardiac screening of a representative sample of 25-to-64-year-old Tyumen citizens in 1996. The response rate was 80.4% or 1608 persons. CVD cases were recorded in 85 (10.69%) men and 33 (4.06%) women during the 12-year subsequent prospective follow-up study. The Cox regression model was used to assess the relative risk (RR) for CVD. Survival rates were analyzed with the Kaplan-Meier method. RESULTS: In the men, RR for CVD statistically significant increased from the 4th quintile of the distribution of systolic blood pressure (SBP) (2.88) and from the 3rd quintile of that of diastolic BP (DBP) (2.33). The women showed a statistically significant increase i RR for CVD only in the 5th quintile both of SBP and DBP (11.0 and 7.95%, respectively). Analysis of the absolute risk showed that SBP made a greater contribution to CVD that DBP in both the men and women (52.8 and 46.9% for the men and 92 and 83.8% for the women, respectively). CONCLUSION: The open population from Tyumen was ascertained to have a high RR for CVD starting with a SBP of > or = 141 mm Hg and a DBP > or = 86 mm Hg for the men and with a SBP of > or = 152 mm Hg and a DBP of > or = 95 mm Hg for the women, which determined a lower survival in the population with elevated SBP and elevated DBP.

[Association of ischemic heart disease with some psychosocial risk factors in male population aged 25-64 years].

Aim of the study was elucidation of association between prevalence of ischemic heart disease (IHD) with high levels of psychosocial risk factors in open male population aged 25-64 years. We examined a representative sample of men aged 25-64 years formed from electoral lists in one of administrative districts in Tyumen. In a framework of cardiological screening we studied prevalence of IHD and levels of psychosocial risk factors - personality anxiety and depression - using standard WHO questionnaire MONICA-psychosocial. IHD prevalence among men aged 25-64 years in Tyumen was 12.4%. Among men of this age high levels of psychosocial risk factors were more frequent - in men with IHD than in men without IHD. In men with high levels of psychosocial risk factors we observed increase of risk of development of acute (A)IHD. Increases of risk of AIHD and IHD in the presence of personal anxiety or depression were characteristic for age categories 55-64 and 45-64 years, respectively.

[Risk of cardiovascular death in relation to blood lipid composition in male inhabitants of Tyumen: results of a 12-year prospective study].

AIM: To evaluate the impact of the blood levels of lipoproteins, such as total cholesterol (TC), high-density lipoproteins (HDL), triglycerides (TG), on the risk for cardiovascular death in an open Tyumen male population on the basis of a 12-year prospective follow-up study. SUBJECTS AND METHODS: Standard methods were used to conduct an epidemiological study of a representative sample of Tyumen males aged 25-64 years in 1996. The cardiological screening response rate was 79.5% (n = 795). Eighty-five cardiovascular deaths (CVD) were registered in the male cohort during 12 years of the prospective follow-up study. The Cox proportional hazard regression model was employed to assess the relative risk (RR) of CVD. Survival rates were analyzed with the Kaplan-Meier method; the significance of lifespan differences in two groups was estimated using the log-rank test. RESULTS: In the male cohort, a statistically significant increase in the RR of CVD occurred, starting with a TC level of > or = 230 mg/dl. The lowest survival rates were noted in the males with hypercholesterolemia (HC). The statistically significant increase in the RR of CVD depending on the levels of TG was found in its 5th quintile (138 mg/dl or more). Lower survival rates were stated in the males with hypertriglyceridemia (HTG) than in those with normal blood TG levels. There were neither statistically significant results in the assessment of RR and survival rates in relation to the level of low-density lipoprotein cholesterol, no data on the effect of the level of HDL cholesterol on the RR of CVD in the males. CONCLUSION: According to the data of a 12-year cohort study, the open Tyumen male population was found to have a high RR of CVD in those who had TC levels > or = 230 mg/dl and TG levels > or = 138 mg/dl, which determined the lowest survival rates in males with HC and HTG.

[Risk of cardiovascular death and social status in the Tumen cohort: results 12 years prospective study].

In an open Tumen population we assessed associations of relative risk (RR) of death of cardiovascular diseases with characteristics of social status: level of education, occupation, and marital status. Risk of cardiovascular death in female and male population was the highest among persons with low level of education, persons belonging to heavy manual labor occupational group, as well as in business executives in female population. According to marital status RR was high among single, widowed, and divorced men. No conclusive data were obtained on association of marital status and RR of cardiovascular death in female population.

[Some behavioral risk factors of cardiovascular diseases in middle-aged males].

AIM: To study prevalence and instensity of smoking in middle-aged male population of Tyumen, follow-up changes in smoking during monitoring, fat and cholesterol content in diet. MATERIAL AND METHODS: Two cardiological screenings were performed during 5-year monitoring of Tyumen population: basic smoking study in 25-64-year old males and second screening with 24-hour diet control in the groups of 35-54 year old males. RESULTS: Smoking prevalence in Tyumen males was moderate while intensity was high in all age groups. The proportion of males who quitted smoking was small. For 5 years the number of nonregular smokers in 45-54 year old males, of those who never smoked, hard smokers rose, while number of persons who smoked a small number of cigarettes diminished. Diet of the studied population was non-rational with mean caloric value but animal fat excess. CONCLUSION: The diet of the examinees contained high amount of fat, saturated fatty acids, mono- and polyunsaturated fatty acids, food cholesterol. The proportion of smokers was high.

[The cardiovascular mortality in Tiumen' cohort depending on social gradient].

The study was carried out on two representative samples from electoral roll of citizen aged from 25 to 64 years of the Central administrative okrug of the city of Tyumen. The procedures of mail survey and cardiological screening were applied. In the process of prospective monitoring of the mentioned investigated cohort during the last seven years the detection of cases of death from cardiovascular diseases on the basis of Tyumen administration registry office was analyzed. The relative risk of death from cardiovascular causes had unilateral increase in males and females paralleled by the increase of education level. The significant relationship of the relative risk of death from cardiovascular diseases with the professional involvement was established in the group of toil workers. Depending of the marital status relative risk of death from cardiovascular causes among persons of different gender had disdirectional trend. It increased among family status females as compared with single females and, on the contrary, significantly decreased among married males as compared with divorced, single and widowed males.

[Dynamics of prevalence of ischemic heart disease and risk of cardiovascular death in open population of Tiumen].

Prevalence of ischemic heart disease (IHD) has been repeatedly studied in 3 sex and age stratified representative samples of Tyumen citizens. Prevalence of IHD in Tyumen open population is 11.7 among men and 13.2% among women. Prevalence of definite IHD is 7.1 and 8.4%, respectively. Studies conducted with 5 years interval demonstrated rise of prevalence of IHD defined according to soft criteria among women at the account of its probable forms. Relative risk of cardiovascular death rose in middle aged and elderly men and in elderly women.

Prostacyclin and thromboxane A2 levels in children and adolescents with an inherited predisposition to coronary heart disease: a family study.

BACKGROUND: The aim of this study was to trace the possible mechanisms of premature atherosclerosis in its early stages and to expand our knowledge of the genetic structure of an inherited predisposition to coronary heart disease (CHD) by monitoring of TXA2 and PGI2 levels in the children of fathers who have suffered a premature myocardial infarction. METHODS: Prostacyclin (PGI2) and thromboxane A2 (TXA2) levels were estimated by radioimmunoassay in 90 children (aged 7-18 years) of fathers who had suffered premature infarction and in both their parents (the 'main' group, n = 191), and in 59 of their healthy contemporaries with no family history of ischaemic events, hypertension, or diabetes, and both their parents (the 'control' group, n = 110). RESULTS: Sons of early infarction patients presented an average TXA2 level of 158.94 +/- 16.60 pg/ml (versus 86.88 +/- 12.71 pg/ml in the control group, P < 0.001), and daughters presented an average TXA2 level of 230.13 +/- 33.68 pg/ml (versus 69.67 +/- 14.99 pg/ml in the control group, P < 0.001). This hyperproduction was independent of the children's sex and could not be attributed to health problems. A significant increase (two-fold) of PGI2 in the boys but not in the girls of the main group was noted. Daughters of infarction patients had significantly higher levels of TXA2 than PGI2. The wives of early infarction patients presented a significantly higher level of both TXA2 and PGI2 (two and three times the level in the control group, P < 0.02 and P < 0.05, respectively). CONCLUSIONS: Spontaneous TXA2 hyperproduction is intrinsic among children with an inherited propensity for CHD and is strongly determined by genetic factors, which is evident from the structure of in-family phenotypic correlations of PGI2 and TXA2 levels.

[Prostacyclin-thromboxane system in children and adolescents with a high risk of developing ischemic heart disease]. / Prostatsiklin-tromboksanovaia sistema u detei i podrostkov s vysokim riskom razvitiia ishemicheskoi bolezni serdtsa.

Studies of the prostacyclin-thromboxane system in children and juveniles of 7-18 years old with hereditary ischemic heart disease demonstrated that the hereditary factor proved to be of importance for the system state. Alterations of prostanoids in these children and juveniles were related to atherogenesis development, particularly to hyperproduction of thromboxane A2, whereas patterns of the system studied varied depending on sex and family history.

[The dynamics of the prevalence of the basic risk factors for IHD in men engaged in the expedition--duty-watch form of work at an oil-producing complex in western Siberia]. / Dinamika rasprostranennosti osnovnykh faktorov riska IBS u muzhchin, zaniatykh ékspeditsionno-vakhtovoi formoi truda na neftedobyvaiushchem komplekse Zapadnoi Sibiri.

Monitoring of the main risk factors of ischemic heart disease was conducted in an ordered population of males aged 20-59. The examinees worked in expeditions engaged in oil production at the West Siberia oil fields. The prospective epidemiological survey lasted 3 years for the study population and 2 years for two representative comparison groups. The examination program involved filling WHO risk factor questionnaire, two measurements of arterial pressure, anthropometric examination, total blood cholesterol assay. Systolic pressure was found to increase upon service duration 2.9 and 4.3 years, diastolic pressure rose after 2.9 years of service, body mass index after 4.3 and 5.6 years. It is evident that preventive measures should be taken within 3 years of service in conditions of expedition work schedule.

[Knowledge of cardiovascular disease risk factors in open population of Tyumen and social gradient]. / Informirovannost' o factorakh riska serdechno-sosudistykh zabolevalii v otkrytoi populiatsii tiumeni i sotsial'nyi gradient.

AIM: To study knowledge of cardiovascular disease (CVD) risk factors (RF) in open population of Tyumen with reference to social gradient. MATERIAL AND METHODS: Knowledge of CVD RF was studied in 2248 citizens of Tyumen (men and women, age 25-64 years) by means of mail questionnaire survey. The knowledge was assessed with consideration of education, occupation and marriage status. RESULTS: The examinees with primary education and manual labour workers were found to have little knowledge of the CVD RF while those with university education, engineers and specialists were well informed. Married population, widows and widowers knew about CVD RF more than divorced. CONCLUSION: The results of the study can serve a basis for a large-scale prophylactic program in open population of Tyumen.

[Attitude of urban population to health and knowledge about risk factors of cardiovascular diseases according to postal questionnaire]. / Otnoshenie k svoemu zdorov'iu i informirovannost' gorodskogo naseleniia o faktorakh riska serdechno-sosudistykh zabolevanii po dannym pochtovogo oprosa.

AIM: To elucidate attitude of urban population of Tyumen city to own health and compare the knowledge of cardiovascular disease risk factors in different population groups using postal questionnaire. MATERIALS AND METHODS: 3200 men and women were included into the lists of population selection, 400 subjects in each group according to the age and sex. 71.5% of those on the lists agreed to take part in the survey. RESULTS: The population knew about the risk factors in the following order: hypercholesterolemia (44.6%), arterial hypertension (74.8%), low physical activity (75.2%), smoking (75.7%), obesity (83.7%), stress (93.7%). The knowledge of the risk factors among persons with higher education was greater than among less educated individuals. CONCLUSION: Most respondents worried about their health, especially males, understand the importance of preventive approach to cardiovascular diseases, are aware of the major risk factors but they have low trust in public health service.