[Disorders of glucose tolerance and ischemic heart disease]. / Narushenie tolerantnosti k gliukoze i ishemicheskaia bolezn' serdtsa.

The incidence of impaired glucose tolerance, the relation of blood glucose levels to the prevalence of risk factors for coronary heart disease (CHD) and to myocardial infarction morbidity and mortality were studied over 15 years among males aged 45-59 years, excluding patients with diabetes mellitus. The data analysis was made in quintils of glucose levels. Impaired glucose tolerance was detected in 20.6% of the males. In the fifth versus the first quintil, there was an increase in the prevalence of systolic and diastolic arterial hypertension (p less than 0.001), obesity (p less than 0.001), low physical activity and hypercholesterolemia (p less than 0.05). As compared with the first, the fifth quintil showed higher total mortality rates and higher myocardial infarction morbidity and cardiovascular disease and CHD morbidity rates. But for age, and major risk factors, the risk for CHD, total and cardiovascular mortality increase at low and high blood glucose concentrations.

[Detection of ischemic heart disease in a survey of a male population 40-59 years of age (data of cooperative studies performed in Moscow, Kaunas, Kiev and Kharkov)]. / Vyiavlenie ishemicheskoi bolezni serdtsa pri obsledovanii muzhskogo naseleniia 40-59 let (dannye kooperativnogo issledovaniia v Moskve, Kaunase, Kieve, Khar'kove).

The authors analyzed the prevalence of coronary heart disease (CHD) and its various types detected by routine epidemiological methods among the examinees in four cities (Moscow, Kaunas, Kiev, and Kharkov). The results were obtained in the collaboration study, adhering to the rigid standardization of all the procedures applied. Examination of 17, 168 males aged 40-59 years revealed signs of CHD in 13.8%; 3.3% had a history of myocardial infarction; 5.3% suffered from exertional angina without prior myocardial infarction; 5.2% showed a painless course of CHD. The analysis demonstrated that simultaneous use of the standard epidemiological methods is the only way of ensuring a more complete detection of CHD. In different cities, from 36.4 to 60.8% were not aware of the presence of the disease. Secondary preventive measures should involve methods for identifying the major risk factors and eliminating the latter.

[Prevalence of risk factors and indicators of mortality among males 40-59 years of age with various forms of ischemic heart disease (data of a 5-year prospective study)]. / Rasprostranennos't faktorov riska i pokazateli smertnosti u muzhchin 40-59 let s razlichnymi formami ishemicheskoi bolezni serdtsa po dannym prospektivnogo nabliudeniia).

A collaborative study was undertaken to assess the efficacy of multifactor prevention of myocardial infarction and cerebral stroke. A representative group of 5951 males aged 40-50 years was examined in Kaunas. Coronary heart disease (CHD) was detected in 11.1%, including 2.7% who had a history of myocardial infarction, 2.5% had exertional angina, its painless type was found in 5.9%. In males with CHD, arterial hypertension, hypercholesterolemia, obesity were more common and smoking was more infrequent than in those without the disease. The results of the 5-year follow-up showed that CHD males had higher total and cardiovascular mortality and myocardial infarction morbidity rates than males without CHD. Males with prior MI and pain-free CHD significantly differed from those from the control group in total and cardiovascular mortality rates. No statistically significant difference was found in MI mortality and morbidity rates between male patients with exertional angina and controls.

[Comparative evaluation of mortality and incidence of ischemic heart disease among participants and non-participants in a population study]. / Sravnitel'naia otsenka smertnosti i zabolevaemosti ishemicheskoi bolezn'iu serdtsa sredi uchastnikov i neuchastnikov populiatsionnogo issledovaniia.

The groups of participants (5946 males) and nonparticipants (2626 males) in a population study, carried out in Kaunas, were compared on the basis of a 4.5-year follow-up, making use of the acute myocardial infarction register and the mortality register. The total mortality rate, as well as the rates of mortality due to cardiovascular diseases, traumas and accidents were higher in nonparticipants, as compared to the participants. The detectability of recent coronary disease was also higher among those who refused to participate in the study: 5.46 vs. 4.41, respectively, per 1000 people per year (p less than 0.05). It is demonstrated that particular attention must be paid to individuals avoiding preventive screening programs.

[Intermittent claudication and risk factors among men 40 to 59 years of age based on the data of a prospective population study]. / Peremezhaiushchaiasia khromota i faktory riska sredi muzhchin 40--59-letnego vozrasta po dannym prospektivnogo populiatsionnogo issledovaniia.

A study was made of the prevalence of intermittent claudication (IC) and risk factors among men aged 40 to 59 years and of the acute myocardial infarction lethality and incidence during ten years of the follow up. Using standard techniques a representative group of 6117 men were examined. The prevalence of IC amounted to 0.89% in the group under study (standardized according to age). Analysis of the relationship between the prevalence of IC and risk factors has demonstrated the presence of the significant correlation only among men with hypercholesterolemia and tobacco smokers. In men who suffered myocardial infarction, the rate of IC was higher than in men with angina pectoris of effort, painless coronary disease or without coronary disease. Analysis of the acute myocardial infarction lethality and incidence has shown that they are significantly higher among men with IC than in those without this pathology.

Standardized Minnesota coding of electrocardiographic findings for purposes of cooperative research on ischaemic heart disease.

For purposes of cooperative research on multifactorial prevention of ischaemic heart disease, a standardization system was elaborated in the USSR for classification of ECG findings according to the Minnesota code. The system includes instruction about the coding rules, experimental coding, analysis of faulty codings, and finally a control test consisting in encoding several series of 200 ECG findings each. For assessing the encoder's qualification the criterion was accepted of less than 20% cases of discordance with the standard code of "ischaemic" ECG changes. It was found that after the initial instructive course it was necessary to gain experience with encoding at least 1 000 ECG to qualify the candidate for the specified expert level. The necessity is emphasized of continual surveillance of the quality of ECG classification by the encoders in different centres, and the possibility of reaching a satisfactory level of unification is declared.