[An increased risk of death from ischemic heart disease in men with low blood concentrations of total cholesterol and low-density lipoprotein cholesterol]. / O povyshennom riske smerti ot ishemicheskoi bolezni serdtsa u muzhchin s nizkoi kontsentratsiei v krovi obshchego kholesterina i kholesterina lipoproteidov nizkoi plotnosti.

A number of epidemiological surveys have recently established that in populations with the lowest levels of total cholesterol (TC) and LDL cholesterol (LDLC) death rates grow due to both malignant and cardiovascular diseases. The results of a detailed study on multifactor prevention of coronary heart disease (CHD) in an open population of Moscow males aged 40-59 to elucidate the relations between TC, HDL cholesterol, LDLC and CHD mortality demonstrated that low levels of TC are markers, but not a factor of CHD and sudden death risk in low-educated subjects free of CHD symptoms. When planning mass measures to primarily prevent CHD, subjects with low cholesterol levels should be given a special care as well as those with hypercholesterolemia.

[Long-term results of the program for preventing ischemic heart disease in Moscow (10-year follow-up study)]. / Otdalennye rezultaty provedeniia programmy mnogofaktornoi profilaktiki ishemicheskoi bolezni serdtsa v Moskve (10-letnee nabliudenie).

The paper provides the results obtained from implementation of the programme on multifactorial prevention of coronary heart disease (CHD) in Moscow, which provided strong evidence for a reduction in the levels of major risk factors and mortality from cardiovascular diseases, including coronary heart disease. The efficiency of comprehensive prophylactic measures in persons with clinical signs of CHD showed up at year 3 of their implementation and retains in subsequent years. At the same time in persons without CHD signs a mortality reduction starting at years 4-5 of the follow-up virtually came to an end when a further active intervention ceased. The impact of aftereffect of active prophylactic measures after intervention cessation turned out to be different in the examinees at various baseline risk factor levels, which suggests that continuous prophylaxis should be done, on the one hand, and it requires a differential approach, on the other. The reduction in the extent and mean levels of major risk factors, which had been achieved during a 5-year prophylactic intervention, retained, though it was less pronounced and 10 years later. However, this was followed by an increase in the mortality from myocardial infarction and stroke and their incidence in the population that had undergone active prophylactic measures, though the value of these parameters was lower at the end of the tenth year than in the controls.

[Prognostic significance of body weight and the possibility of dietary correction of obesity in male Moscow residents aged 40-59 years]. / Prognosticheskaia znachimost' massy tela i vozmozhnost' dieti- cheskoi korrektsii izbytochnoi massy tela u muzhchin 40-59 let, zhivushchikh v Moskve.

Males, aged from 40 to 59, were followed up during 5 years after a standard epidemiological investigation. Their mortality rate and incidence of new cases of myocardial infarction and cerebral stroke were studied against the background of active preventive program (group I), and during routine treatment (group II). Hinh prognostic importance of body mass value has been shown in respect to common mortality rate, mortality rate due to cardiovascular diseases, incidence of myocardial infarction and its lethal outcomes. Difficulties in the correction of nutrition habits in middle-age subjects for decreasing their body mass, and relations between the nutrition habits and body mass were noted. Regardless of the body mass growth degree, a tendency was observed to the lowering of common and cardiovascular disease-induced mortality rates. The incidence rate of myocardial infarction in patients with excessive body mass significantly decreased. Body mass correction has been recommended in subjects aged from 40 to 49 years with body mass index 29.

[Diagnosis of myocardial infarct with fatal outcome within the framework of multifactorial prevention of ischemic heart disease in Moscow]. / Diagnostika infarkta miokarda so smertel'nym iskhodom v ramkakh programmy mnogofaktornoi profilaktiki ishemicheskoi bolezni serdtsa, provedennoi v Moskve.

The death diagnosis of myocardial infarction (including acute heart failure) was recorded and verified on the basis of standard criteria during a 5-year implementation of the Program on Multifactorial Prevention of Coronary Heart Disease among males aged 40-59 years. The analysis demonstrated that the hyperdiagnosis of acute heart failure as a death cause was observed in 29.0% of cases, death being due to acute alcohol intoxication in 43% of all the inconsistent diagnoses.

[Prognostic significance of total blood cholesterol level and the possibility of dietary correction of hypercholesterolemia in the population]. / Prognosticheskaia znachimost urovnia obshchego kholesterina v krovi i vozmozhnost dieticheskoi korrektsii giperkholesterinemii v populiatsii.

In a population of males aged 40-59 years, a routine epidemiological survey was performed, which was followed by a 5-year follow-up to examine the mortality rates and incidence of myocardial infarction and stroke treated by an active prophylactic measure program (Group 1) and conventional regimen (Group 2). The total cholesterol levels of 260 mg/dl or more were found to be of highly prognostic value to death from all causes, largely cardiovascular diseases, to development of myocardial infarction, stroke, and to higher risk of fatal cases of the diseases. It was ascertained that it was difficult to modify the dietary habits in subjects of mature age. By the end of the fifth follow-up year, the examined patients from Group 1 showed a reduction in the mean level of total cholesterol and hypercholesterolemia rates, following by a decrease in total and cardiovascular mortality by 6.5 and 5.7%, respectively, the incidence of myocardial infarction and stroke and the risk of death from these complications becoming lower.

[Prognostic significance of arterial blood pressure levels and the effectiveness of the treatment of arterial hypertension in a non-organized male population 40-59 years of age in Moscow]. / Prognosticheskaia znachimost' urovnia arterial'nogo davleniia i éffektivnost' meropriiatii po lecheniiu arterial'noi gipertonii v neorganizovannoi populiatsii muzhchin 40-59 let Moskvy.

Isolated working rat hearts were subjected to a 3-hour ischemia followed by reperfusion. The defense effects of the heart cooling to 6-7 and 12-15 degrees C were assessed according to the degree of postischemic recovery of hemodynamic (arterial pressure, heart rate, coronary flow, cardiac output) and biochemical (ATP, phosphocreatine, Pi, and lactate content) characteristics and electron microscopic evidence. The energy resources of the myocardium and its cellular structures were effectively preserved during one-hour ischemia at 12-15 degrees C. At 6-7 degrees C, the energy resources of the hearts were better preserved in long-term ischemia, where the functional characteristics were recovered to the same extent as in the 12-15 degrees C hypothermia, but some cell damage was observed. The obtained findings suggested that the temperature of 12-15 degrees C should be the temperature of choice for heart cooling in cardiosurgery.

[Approaches to the secondary prevention of arterial hypertension among the population (data from a cooperative study on the multifactorial prevention of ischemic heart disease)]. / Podkhody k vtorichnoi profilaktike arterial'noi gipertonii sredi naseleniia (dannye kooperativnogo issledovaniia po mnogofaktornoi profilaktike ishemicheskoi bolezni serdtsa).

A cooperative study has reviewed the prevalence of arterial hypertension (AH) among 40- to 59-year-old male residents of three cities (Moscow, Minsk and Kaunas) and the possibility of organizing a long-term outpatient treatment of newly-detected AH cases as well as the efficiency of the latter. Of 16,703 individuals screened, AH was detected in 27.9%. Evidence is obtained that preventive and therapeutic procedures for hypertensive patients are in need of an improvement. In a middle-aged population, moderate AH is prevalent (nearly 67.7%). Coronary risk factors, such as hyperlipoproteinemia and excessive body weight, were more frequent in AH patients, as compared to the general population, an argument in favor of the need for an improved combined approach to AM control in the population. Active combined treatment of the recognized cases over 5 years proved effective as it brought arterial blood pressure back to normal. Patient participation in the treatment and its contribution to treatment efficiency are reviewed.