[Time-related changes in prevalence of chronic heart failure and diabetes mellitus in Nizhny Novgorod Region between 2000 and 2017].

AIM: To determine time-related changes in prevalence, morbidity, and all-cause mortality of patients with CHF depending on the presence of DM in a representative sample of Nizhny Novgorod Region. MATERIALS AND METHODS: In 1998, a representative sample of Nizhny Novgorod Region was created, which included 1922 respondents. From 2000 through 2017, this sample was evaluated three times. Patients with CHF and DM were studied. RESULTS: For 17 years, prevalence of NYHA FC IV CHF increased from 6.88 to 9.1 % (р=0.04). Prevalence of NYHA FC III-IV CHF increased considerably from 1.2 % to 4.8 % (р.

[The notion of CHF course stability: Is it acceptable for Russian practice?]

AIM: To evaluate preparedness of physicians in real clinical practice to strive for stabilizing the course of CHF by control of clinical and hemodynamic indexes both in prevention of admission for decompensated CHF and following discharge from the hospital. MATERIALS AND METHODS: The study included 750 CHF patients with any NYHA FC who were admitted in emergency for decompensated CHF. All patients with CHF were followed up for a year after discharge from the hospital. Medical records of inpatients (MRIP) and outpatients (MROP) were analyzed including determination of clinical symptoms and administered doses of medicines. Changes in clinical parameters during a year were recorded. RESULTS: CHF decompensation was evident as pulmonary edema in 1.6% of cases and acute left ventricular failure in 18.5% of cases. All the rest of decompensated CHF cases included ascites or hyposarca (21.1%), or increased edema syndrome with unstable hemodynamics (58.5%). In MROPs, weight control was presented for 1.2% of patients. The composite index of effectively achieved control of hemodynamics and body weight was only 0.2%. Treatment effectiveness decreases due to absence of drug titration and switching therapies, which considerably impairs prognosis for patients. CONCLUSION: Outpatient physicians lack alertness for development of CHF decompensation, and control of hemodynamics and body weight of patients remains ineffective. Physicians are not prepared to achieve recommended doses of medicines, which provokes high risk of fatal outcome and/or rehospitalization.