[Efficacy of 3-year prophylaxis of coronary heart disease risk factors in an organized population]. / Effektivnost' 3-letnei profilaktiki faktorov riska ishemicheskoi bolezni serdtsa v organizovannoi populiatsii.

An organized community numbering 1563 men aged 20 to 59 years engaged in scientific activity were entered into an experimental and prophylactic study. The intervention measures were exercised in a high risk group with dyslipoproteinemia, borderline hypertension and coronary heart disease (CHD), mainly at the expense of alterations in nutrition. The three-year prophylaxis resulted in a 7-percent decrease in blood plasma cholesterol and a 13-percent fall in triglycerides. The prevalence of arterial hypertension declined by 3 and the excess body weight by 3.7 percent, which led to a 33-percent decrease in CHD risk development calculated with the aid of the R. P. Prochorskas risk logistic function. Advantages of the individual strategy of CHD prevention are discussed.

[Nutritional and risk-factor dynamics of ischemic heart disease during a 3-year prophylactic intervention in an organized population]. / Dinamika pitaniia i faktorov riska ishemicheskoi bolezni serdtsa v techenie 3-letnego profilakticheskogo vmeshatel'stva v organizovannoi populiatsii.

An experimental and prophylactic study was performed in an organized population of 1563 men aged 20-59 years engaged in scientific work. Intervention was realized in a group at high risk, mainly at the expense of changes in nutrition. After 3 years the main group demonstrated the lowering of the total caloricity of nutrition, consumption of food cholesterol and refined sugar together with the rise of animal protein, poly- and monounsaturated fatty acids (PUFA and MUFA) and complex carbohydrates consumption, leading to reduction of risk factors for coronary disease. After 3 years the control group manifested a decrease of sugar and a rise of complex carbohydrates consumption, which was not associated with changes in risk factors. It has been established using a multiple step-by-step regression analysis that the greatest effect on the drop of blood plasma cholesterol was produced by body weight reduction and diminution of the content of SFA in the diet whereas the decrease of arterial pressure by body weight reduction and the rise of the PUFA portion in the diet.

[Effect of diet on major risk factors in an organized population]. / Vliianie diety na uroven' osnovnykh faktorov riska v organizovannoi populiatsii.

In the organized population, 364 male subjects aged 20-59 years (those with dyslipoproteinemias and borderline hypertension and patients with coronary heart disease) were on diet for 6 months, which resulted in a significant drop in plasma cholesterol, triglycerides, systolic and diastolic blood pressures, and body weight by 7.7%, 17%, 3%, 3.7%, and 5.3%, respectively. The portion of fat in the diet was reduced from 40% to 36% of total caloric value and that of sugar was decreased from 13% to 10%, at the same time complex carbohydrates and protein were increased from 8% to 12% and from 15% to 17%, respectively. A multiple stepwise regression analysis was used to define whether different variables were significant in lowering the risk factors.

[Features of the epidemiologic characteristics of ischemic heart disease among scientific research workers]. / Osobennosti épidemiologicheskoi kharakteristiki ishemicheskoi bolezni serdtsa u nauchnykh rabotnikov.

The peculiarities of prevalence of coronary heart disease (CHD), its main risk factors and their interrelationships were studied on the basis of the results of epidemiological surveys of an organized population of men aged 20 to 59 engaged in research, and an unorganized male population in one of Moscow districts. A similar CHD frequency was revealed in both populations (10.5 and 9.5%), however the prevalence of possible CHD was significantly higher among the research workers. In this group more unfavorable epidemiological conditions were noted with relation to such CHD risk factors as hypercholesterolemia, disturbed glucose tolerance, a low physical activity, with practically the same prevalence of excess body mass and lower frequency of arterial hypertension and smoking. The results obtained formed the basis for a design of measures on primary and secondary CHD prevention among research workers.

[Age-related dynamics of the prevalence of ischemic heart disease and arterial hypertension and the mean level of basic risk factors in men 20 to 69 related to the nature of their nutrition]. / Vozrastnaia dinamika rasprostranennosti ishemicheskoi bolezni serdtsa i arterial'noi gipertonii i srednii uroven' osnovnykh faktorov riska u muzhchin v vozraste 20--69 let v sviazi s kharakterom pitaniia.

Analysis of the data derived in the course of examination of men aged 20 to 69 years demonstrates a distinct rise of the prevalence of CHD and AH with age. The level of the total cholesterol also increases with advancing age, reaching a maximum at 40 to 49 years as does the level of Tg (maximal at 50 to 59 years). The body weight also shows a linear increase. Emphasis should be placed on a high alpha-cholesterol content in persons aged 30 to 39 years. Analysis of the nutrition pattern of the male population aged 20 to 69 years revealed an atherogenic nature of nutrition marked by a high quota of fat, saturated fatty acids, low ratio of polyunsaturated to saturated fatty acids, and high cholesterol consumption with food. The highest consumption of energy sources and animal products was noted in persons aged 30 to 39 years. The same age demonstrated the lowest consumption of products of vegetable origin. Persons aged 50 to 59 years showed a reduction in consumption of protein of animal origin and essential polyunsaturated fatty acids as well as an increase in consumption of readily available sugars, which may lead to the development of obesity and hypertriglyceridemia and therefore to a higher risk of CHD development.

[Comparative study of drug and dietary correction of dyslipoproteinemias among the population]. / Sravnitel'noe izuchenie medikamentoznoi i dieticheskoi korrektsii dislipoproteidemii v populiatsii.

A comparative study of diet and drug correction of dyslipoproteinemias in individuals with stable hypercholesterolemia showed that following a month of diet treatment of groups selected for the therapy with probucol and ascorbic acid there was a clear-cut decrease in the level of plasma cholesterol. The administration of probucol in combination with the diet therapy decreased cholesterol by 33.6%, triglycerides by 32.8% and high density lipoprotein cholesterol (HDLC) by 19.7% as compared with the baseline values. Ascorbic acid showed virtually no effect on the lipid spectrum of the blood. Throughout the entire period of treatment, the patients in these groups showed a reduction in the body weight and blood pressure. In the group receiving only drug therapy, probucol use was associated with a statistically significant decrease in both total cholesterol and HDLC, with the HDLC/cholesterol ratio remaining almost unaltered while in the group receiving diet and probucol, the proportion of HDLC with regard to total cholesterol was elevated as against the initial values. The body weight in this group of patients remained actually unaltered.

Detection of heart rhythm disturbances in patients after myocardial infarction, and their prognostic value.

For one year 215 patients were followed up who had been taken into the register of patients with myocardial infarction and had survived three months after the incident. At intervals of 3, 6, 9, and 12 months their electrocardiograms of various durations were recorded. Prolongation of the ECG tracing time eases the assessment of the frequencies and nature of heart rhythm disturbances in patients with ischaemic heart disease. Exercise test helps reveal more complicated types of ventricular extrasystoles better than one-hour recording of resting ECG does. Ventricular ectopic activity is more frequently found in patients with unequivocal ECG changes (p less than 0.025), in patients with enlarged heart volume (p less than 0.05), and in men vs. women (p less than 0.05). Presence of ventricular extrasystoles, especially of complicated ones (polytopic, couplets, early) enhances the risk of death of ischaemic heart disease.

[Incidence and characteristics of cardiac rhythm disorders after myocardial infarct]. / Chastota vyiavleniia i kharakteristika narushenii ritma serdtsa u bol'nykh, perenesshikh infarkt miokarda

In the course of 1 year 130 patients were examined who had survived myocardial infarction and were alive 2 months after the onset of the disease and were included into the Myocardial Infarction Registry. After 2,3,6,9 and 12 months ECG of various duration was recorded. The prolongation of ECG recording permits to give a more precise characteristics of the incidence and nature of the rhythm disorders observed in chronic ischaemic heart disease patients. Repeated heart rhythm examinations at rest during 1 hour, or during physical exercises (bicycle test) permitted to reveal rhythm disorders in 72.2--66.7% of the patients, and among them ventricular extrasystole in 62.6--66.7% of those examined, respectively. The appearance of ventricular extrasystoles correlates with the state of the patients surviving myocardial infarction A higher incidence of ventricular extrasystoles is observed in pateints with distinct tecg changes, with angina pectoris and elevated blood pressure (larger than or equal to140/90mm Hg).

[Results of 2-year study of morbidity of myocardial infarct (according to material of the myocardial infarction registry)]. / Rezul'taty dvukhletnego izucheniia zabolevaemosti infarktom miokarda (pomaterialam registra infarkta miokarda)

The results of a two-year study conducted in accordance with the programme of the Myocardial Infarction Register in the Sokolniky district of Moscow with nearly 164,000 population are presented. The incidence of myocardial infarction in the 20-64 year age group comprises 2.87 and 3.08 among males and 1.52 and 1.44 among females, per 1,000 population for the 1st and 2nd years of the study respectively. The incidence of various clinical forms of myocardial infarction onset and of some complications developing in the acute phase of the disease was established. The typical variant of clinical manifestations is observed in 84.1% of the patients with the onset of myocardial infarction. The most frequently observed complication during the acute period of the disease (nearly in every 5th patient) is cardiac failure. Cardiogenic shock is observed only in 4.4-3.8% of the patients, aged under 64 years. Prior to the development of myocardial infarction 82.3% of the patients suffered angina pectoris, 55-62% arterial hypertension, 29-33% had survived another myocardial infarction earlier.

[Survival and state of patients during the 1st year after myocardial infarct (according to data of epidemiological study - myocardial infarct register)]. / Vyzhivaemost' i sostoianie bol'nykh v techenie 1 goda posle infarkta miokarda (po dannym epidemiologicheskogo issledovaniia - registr infarkta miokarda)

The results of observations conducted in accordance with the programme of myocardial infarction register are presented for 143 patients aged under 65 years, surviving beyond 28 days after the onset of the lesion. In 13.2% of those surviving an acute myocardial infarction a recurrence was found to develop within the first postinfarction year, among them in 11.5% of the cases with a fatal result. Over half (51-54%) of those surviving the infarction retain angina of effort, 16.3-23% have cardiac insufficiency. An examination conducted 3 months following the infarction revealed lipid (57.1%) and carbohydrate (54.3%) metabolism disorders in many patients, as well as disturbances in the blood coagulation and anticoagulation systems. Patients surviving myocardial infarction require differentiated and lasting secondary preventive measures.