[Prevalence of arterial hypertension and efficacy of long-term multifactor prophylaxis in some regions of Russia].

AIM: To study prevalence of arterial hypertension (AH) in relation to gender, age, profession, risk factors (RF), RF combination; efficacy of active long-term multifactor prevention among the employees of industrial enterprises in some regions of Russia. MATERIAL AND METHODS: 14000 males and 20969 females from industrial enterprises of Cheboksary, Pskov, St-Petersburg were examined. 8974 males and 14515 females worked at enterprises of active intervention (EAI) while 1848 males and 1643 females were employed at comparison enterprises. RESULTS: Correction of RF conducted at six EAI reduced a mean level of systolic blood pressure (SBP) and diastolic blood pressure (DBP), frequency and intensity of smoking, overweight and cases of RF combination, improved ECG parameters, wellbeing of hypertensive patients, increased number of examinees free of risk factors, decreased number of days of temporary disability. Among EAI employees overall mortality, ishemic heart disease mortality and cerebrovascular disorders fell. CONCLUSION: Five- and 10-year active multifactor office prophylaxis resulted in reduction of the rate and intensity of RF, number of temporary disability days by 48%. Arterial hypertention, combination of RF in healthy and hypertensive subjects at the start of the trial significantly promoted high all-causes and cardiovascular mortality at all enterprises studied. Active multifactor prophylaxis reduced those mortalities significantly.

[Prevalence of ischemic heart disease, basic risk factors, and efficacy of long-term multifactorial prophylaxis at work in some regions of Russia]. / Rasprostranennost' ishemicheskoi bolezni serdtsa, osnovnykh faktorov riska ee razvitiia i éffektivnost' mnogoletnei mnogofaktornoi profilaktiki na predpriiatiiakh v riade regionov Rossii.

AIM: To study prevalence of ischemic heart disease (IHD) and its various clinical forms depending on sex, age, profession including risk factors (RF) and their combination and efficiency of long-term multifactorial active prevention programs at enterprises in several regions of the Russian Federation. MATERIAL AND METHODS: 14,000 male and 20,969 female volunteers were observed in organized groups in three Russian cities (Cheboksary, Pskov, St-Petersburg). 8984 males and 14,515 females entered seven groups of outpatient follow-up and active long-term multifactorial prevention during 5-10 years. RESULTS: Risk factor correction produced a significant decrease in mean systolic and diastolic blood pressure, frequency and intensity of smoking, overweight, improved ECG parameters, increased number of the examinees free of risk factors; state of IHD patients improved. Overall mortality, IHD and stroke mortality, number of temporary disability days were significantly less in the prevention group. CONCLUSION: Active multifactorial "in office" prevention for 5 to 10 years reduced RF prevalence and intensity, quantity of days at sick-leave fell by 48.5%. The presence of IHD and risk factors in both groups increased overall mortality rates and cardiovascular (IHD and stroke) mortality rates at the beginning of the study. The multifactorial prevention of IHD and risk factors resulted in a significant reduction of overall mortality rates as well as cardiovascular mortality rates in groups of active prevention.

[Alcohol consumption and its connection with mortality from cardiovascular diseases in 40-59 years old men (data from 21.5 year prospective study)]. / Potreblenie alkogolia i ego sviaz' so smertnost'iu ot serdechno-sosudistykh zabolevanii muzhchin 40-59 let (dannye prospektivnogo nabliudeniia za 21,5 goda).

AIM: To study contribution of alcohol consumption (AC) to mortality of coronary heart disease (CHD), cerebral stroke (CS), cardiovascular diseases (CVD), overall mortality (OM) in a random population of working males. MATERIAL AND METHODS: The results are available of a 21.5 year cohort study of mortality in a random population of 7,815 male citizens of Moscow and St-Petersburg aged 40-59 years. RESULTS: The attributive risk of AC for mortality of CHD, CS, CVD and OM was 16.6, 14.8, 7.7 and 11.9%, respectively. The lowest relative risk to die of CHD, CVD and OM among the cohort studied was observed in males taking alcohol 168.0 ml per week maximum. CONCLUSION: It is necessary to approach differentially to assessment of AC effects on development of many diseases and further investigations are needed to reveal fine mechanisms of action of different alcohol drinks on human organism.

[Prevalence of main risk factors for cardiovascular diseases and efficacy of long-term multifactoral prophylaxis]. / Rasprostranennost' osnovnykh faktorov riska serdechno-sosudistykh zabolevanii i éffektivnost' mnogoletnei mnogofaktornoi profilaktiki.

AIM: To study prevalence of cardiovascular disease risk factors (CRF) in relation to sex, age, occupation as well as efficiency of active long-term multifactorial prophylaxis in the groups of active intervention (AI) and observation. MATERIAL AND METHODS: The comparison group consisted of 1848 male and 1643 female volunteers. 8326 males and 13,116 females entered the group of active intervention and observation. RESULTS: Risk factors correction led to lowering of mean systolic and diastolic arterial pressure, smoking intensity, overweight, to improvement of wellbeing of cardiovascular patients. The number of examinees with several risk factors decreased while those free of risk factors increased. There was also a reduction in the number of days of temporary disability. In AI group total mortality, coronary heart disease and cerebral event mortality fell manifold. CONCLUSION: Five- and ten-year active multifactorial "in-office" prophylaxis decreased frequency and intensity of risk factors. Lowering of cardiovascular disease incidence was associated with a 44.4% decrease in the number of days on sick-leave. The presence of cardiovascular diseases, combination of risk factors in healthy subjects and in cardiovascular patients in the beginning of the study significantly increased total mortality, cardiovascular mortality in comparison and active intervention groups. Active multifactor prophylaxis in persons with risk factors and cardiovascular diseases, especially in combination with risk factors, in the beginning of the study reduced total mortality and mortality of cardiovascular disease in active intervention.

[Prevalence of excessive body mass and its relation to mortality from cardiovascular and main chronic noninfectious diseases among urban male population of geographical different regions in Russia]. / Rasprostranennost' izbytochnoi massy tela i ee sviaz' so smertnost'iu ot serdechno-sosudistykh i drugikh khronicheskikh neinfektsionnykh zabolevanii sredi muzhskogo naseleniia v gorodakh raznykh regionov.

The paper contains data on prevalence of low, normal, excessive body mass and obesity among urban male populations aged 20-54 years in different regions. Relative risk of death associated with body mass was estimated on the basis of a twenty years prospective study of sample populations in Moskva and St-Peterburg and level of attributed risk was used for assessment of contribution of body mass to cardiovascular mortality and mortality from other chronic diseases. Levels of main risk factors, smoking intensity and alcohol consumption were studied in deciles of body mass index distribution.

[Incidence of ischemic heart disease: its relation with main risk factors and effectiveness of long-term multifactorial prevention at an industrial enterprise]. / Rasprostranennost' ishemicheskoi bolezni serdtsa. Ee sviaz' s osnovnymi faktorami riska i éffektivnost' mnogoletnei mnogofaktornoi profilaktiki na promyshlennykh predpriiatiiakh.

AIM: To study the prevalence of ischemic heart disease (IHD) and its various clinical forms depending on both sexes, age, profession, risk factors and efficiency of active prevention programs. MATERIAL AND METHODS: 1848 males and 1643 females were inspected as a control group. 8326 males and 13,116 females volunteers were included into the groups of active prevention and observation. RESULTS: Risk factor correction produced a significant decrease in both systolic and diastolic BP mean levels, prevalence of ECG abnormalities together with smoking habits occurrence, overweight and their combination. The general mortality rate, IHD and stroke mortality were significantly less in the group of prevention as well as the number of days of temporary disability. CONCLUSION: Primary and secondary "in office" prevention for 5 to 10 years diminished the prevalence of risk factors and events of IHD. The presence of IHD, risk factors increased general mortality rates and cardiovascular mortality rates in both groups. The multifactorial prevention of IHD contributed to a decline in general mortality rates and cardiovascular mortality rate.

[Prevalence of cardiovascular diseases in organized groups of employees and results of long-term multifactorial prevention]. / Dinamika rasprostranennosti serdechno-sosudistykh zabolevanii i rezul'taty mnogofaktornoi profilaktiki pri mnogoletnikh nabliudeniiakh v organizovannykh kollektivakh.

AIM: Evaluation of cardiovascular diseases (CVD) prevalence and their dynamics after active prevention program. MATERIALS AND METHODS: 1382 male and 155 female volunteers were included into the group of active prevention in their office. 1024 males and 776 females with natural history were compared as a control group. 5-year follow-up was performed in 543 males and 569 females in comparison with 97 males and 119 females. 10-year follow-up covered 82 males and 191 females from the active prevention group and 178 males and 118 females from the referent group. RESULTS: The risk factor correction has resulted in a significant decrease in both systolic and diastolic BP mean levels, prevalence of ECG abnormalities, smoking habits, overweight and combination of the risk factors, general mortality rate, CHD and stroke mortality, number of days of temporary disability. CONCLUSION: The primary and secondary "in office" prevention for 5 to 10 years diminishes the prevalence of the risk factors. The temporary and primary disability rates were connected with the presence of CVD. CVD, in line with other risk factors, significantly increased cardiovascular and general mortality rates.

[Long-term study of the prevalence of arterial hypertension and outcomes of multifactorial prophylaxis in organized groups of employees]. / Dinamika pasprostranennosti arterial'noi gipertonii i rezul'taty mnogofaktornoi profilaktiki pri mnogoletnikh nabliudeniiakh sredi rabochikh i sluzhashchikh organizovannykh kollektivov.

AIM: To evaluate trends in arterial hypertension (AH) and other risk factors and their changes after active prevention program. MATERIAL AND METHODS: 1382 male and 1555 female volunteers were included into the group of active prevention at the workplace vs 1024 male and 776 female controls. 5-year follow-up covered 543 males and 569 females from the prevention group against 97 male and 119 female controls. 10-year follow-up covered 82 males and 191 females, 178 males and 118 females, respectively. RESULTS: Risk factor correction produced a significant decrease in both systolic and diastolic BP levels, prevalence of ECG deteriorations, smoking habits occurrence, overweight. Overall mortality rate, CHD and stroke mortality were significantly less frequent in the prevention group. This group had also less days of temporary disability. CONCLUSION: The primary and secondary "in office" prevention for 5 to 10 years diminishes prevalence of risk factors. The temporary disability rate depends on the presence of arterial hypertension. The latter together with the other main risk facts significantly influences cardiovascular and general mortality rates.

Blood pressure and heart rate response during exercise in men and women in the USA and Russia lipid research clinics prevalence study.

Examination of blood pressure (BP) and heart rate (HR) measurements at rest and during exercise in samples of USA and Russian middle-aged men and women show significant differences between countries for both genders. Russian men had higher resting systolic blood pressure (SBP) than USA men but lower SBP at both stages of exercise. Russian women had significantly higher resting SBP than USA women at rest and also during exercise. Russian men and women had significantly lower HR at rest and during exercise than USA men and women. Differences between countries were also noted for mean body weight, height, lipid levels, percentages of smokers and several other variables, and it was postulated that differences in these factors might be responsible in part for differences in SBP and HR during exercise. After adjustment for these variables, differences in SBP during exercise between USA and Russian men remained, but differences between USA and Russian women disappeared. For both genders, differences in HR during exercise remained after adjustment. Mortality analyses in USA and Russian men indicated that stage 2 SBP response during exercise was generally not a significant mortality risk factor after adjustment for age, BMI, TC, smoking and resting SBP. In a similar model, stage 2 HR response during exercise was also a non-significant risk factor in mortality.

Association of high-density-lipoprotein cholesterol with mortality and other risk factors for major chronic noncommunicable diseases in samples of US and Russian men.

Previous reports from the Russian Lipid Research Clinics (LRC) study showed no association between the level of high-density-lipoprotein (HDL) cholesterol and mortality from coronary heart disease (CHD), while US LRC data indicated a strong negative association between HDL cholesterol and CHD mortality. This report investigated the association of HDL cholesterol and mortality in these same population samples with follow-up extended to 12 years. The association between HDL cholesterol and mortality remained inverse and significant in the US sample. In the Russian sample, high levels of HDL cholesterol were associated with higher risk of all-cause and cancer mortality, although adjustment for known risk factors reduced the strength of the association. The association between HDL cholesterol and CHD mortality was negative in the Russian sample, although the strength of the association was less than that for the US sample. Extended follow-up reduced the difference in the association between HDL cholesterol and mortality between the two countries; however, important differences remained. Further research will be required to clearly determine the cause for their differences.

[The prevalence of arterial hypertension among the organized and unorganized male population based on cardiological screening data]. / Rasprostranennost' arterial'noi gipertenzii sredi muzhskogo organizovannogo i neorganozovannogo naseleniia po dannym kardiologicheskogo skrininga.

Cardiological screening for hypertension has been carried out in two population samples of males. The ordered samples consisted of workers and employees (a total of 1383 subjects) of two institutions. Of them workers made up 64.3%. A random male population comprised 2481 subjects. Of them 1188 (47.88%) were employees. The incidence of hypertension appeared much higher in the random population. It was specific for age and occupation. Hypertension occurred more frequently among workers than employees in both populations. The occurrence of hypertension was associated with body mass excess and age.

[The relation of a number of hormonal indices to risk factors for IHD and its prevalence based on the data from a large population study]. / Sviaz' riada gormonal'nykh pokazatelei s faktorami riska IBS i ee rasprostranennost'iu po dannym krupnogo populiatsionnogo issledovaniia.

Relevance of IHD risk factors and hormone concentrations (insulin, estradiol, testosterone, prolactin, LH, FSH, TTH and hydrocortisone) to IHD incidence was studied in 1200 men. Multivariate statistical analysis demonstrated that only a small number of hormonal indices are associated with main lipid and nonlipid risk factors. The relationships exist between systolic arterial pressure (SAP) and hydrocortisone, between TTH and total cholesterol, SAP and age, estradiol, testosterone and age. Significant independent associations were found between IHD prevalence and age (R = 0.140, 3 = 0.000), SAP (R = 0.130, P.0.001), HDLP cholesterol (R = -0.082, P = 0.007), height (R = -0.078, P = 0.010), insulin (R = 0.067, P = 0.035), standard deviation of estradiol from median value (R = 0.083, P = 0.017). The findings confirm a great role of high SAP in the development of IHD, a significant and independent association of high insulin levels with IHD prevalence, the presence of nonlinear relation of estradiol concentration to IHD occurrence in males.

Correlates of mortality in Russian and US women. The Lipid Research Clinics Program.

Associations between selected risk factors and 7-year all-cause mortality were studied in 2,187 Russian women and 2,146 US women who were screened as part of a US-Russian collaborative program. The US women were screened during the period 1972-1976, while the Russian women were screened from 1978 to 1982. Cigarette smoking and elevated systolic blood pressure were associated with increased mortality in both samples. High density lipoprotein (HDL) cholesterol was inversely related to mortality in US women, but there was no association of HDL cholesterol with mortality in Russian women. Prevalent angina and electrocardiographic abnormalities were associated with mortality in both samples, but the relations achieved statistical significance only in the Russian sample. The problems of cigarette smoking and elevated blood pressure should be addressed with public health measures in both countries. The absence of an association between HDL cholesterol and mortality in the Russian sample should be investigated further.

PIP: Associations between selected risk factors and 7-year all-cause mortality were studied in 2187 Russian women and 2146 US women who were screened as part of the US-Russian collaborative program conducted at 9 sites during the period 1972-1976. Cholesterol and triglycerides were measured in males and females aged birth to 99 years. US women between 40 and 69 years of age were examined during the period 1972-1976. In Russia, women aged 20-69 years were screened on a single occasion during the years 1978-1982. Russian women aged 40-69 years were included in this report. The proportional hazards model was used to assess the associations between mortality and the risk factors. 4% of the Russian women and 22% of the US women reported taking hormones. In the US sample, the only statistically significant interaction was that between hormone use and high density lipoprotein (HDL) cholesterol. Cigarette smoking and elevated systolic blood pressure were associated with increased mortality in both samples. Although the associations of prevalent angina and electrocardiographic abnormalities were similar in magnitude, they were significant only in the Russian sample, while cigarette smoking was significant only in the US sample. The major difference in the 2 samples related to HDL cholesterol, where there was a strong negative association in the US women and no association in the Russian women. Although it was relatively weak, there was also a statistically significant association between triglycerides and mortality in the US sample. HDL cholesterol was inversely related to mortality in US women, but there was no association of HDL cholesterol with mortality in Russian women. The noticeable differences between the samples were the higher systolic blood pressure, body mass index, and prevalence of angina and electrocardiographic abnormalities in the Russian women, and the much higher prevalence of current cigarette smoking in the US women. The respective public health services should address smoking and elevated blood pressure.

[The epidemiology of systolic and diastolic arterial hypertension in relation to risk factors and education among the male population of some cities of Russia, the CIS nations and the Baltic states (a cooperative study)]. / Epidemiologiia sistolicheskoi i diastolicheskoi arterial'noi gipertonii v sviazi s faktorami riska i obrazovaniem sredi muzhskogo naseleniia v nekotorykh gorodakh Rossii, stran SNG i pribaltiiskikh gosudarstv (kooperativnoe issledovanie).

The prevalence of systolic and diastolic arterial hypertension (AH) was studied on a material of random representative samples of male population aged 20-54 years in the cities of Moscow, Saint Petersburg [correction of Sankt-Peterburg], Tallinn, Kiev, Novosibirsk, Alma-Ata, Tashkent and Bishkek. AH was estimated in connection with risk factors (RF) from the standpoint of uni- and multidimensional statistical analysis. It has been established that RF (age, cholesterol and triglycerides concentration, overweight and alcohol use) make more significant contribution into the prevalence of diastolic AH whereas the systolic AH prevalence is largely determined only by age and education. The data obtained are likely to form the basis for the design of a more integral system of prophylaxis of cardiovascular diseases.

[The level of physical development of 14-year-old adolescents--inhabitants of Ulan-Ude]. / Uroven fizicheskogo razvitiia u podrostkov 14 let--zhitelei Ulan-Ude.

Physical development of 2049 Ulan-Ude children aged 14 years was studied. Differences between body size and mass in Buryat and Russian children, girls and boys, were determined. Local standards of children's physical development were set.

Increased risk of coronary heart disease death in men with low total and low-density lipoprotein cholesterol in the Russian Lipid Research Clinics Prevalence Follow-up Study.

BACKGROUND: A continuously increasing risk of coronary heart disease with increasing levels of cholesterol has been reported by many observational and experimental studies. However, this type of association has not been observed in studies in the Russian Lipid Research Clinics. METHODS AND RESULTS: Twelve-year coronary heart disease mortality among 40- to 59-year-old men was analyzed in the Moscow and St Petersburg examines in the Russian Lipid Research Clinics Program. The baseline survey examined 6431 men fasting and free of prevalent coronary heart disease. Lipids and lipoproteins, blood pressure, body mass, education level, alcohol intake, and smoking history were obtained. Mortality follow-up was based on contacts with participants or their relatives or neighbors. Coronary heart disease mortality was analyzed based on risk factor levels and was further divided into rapid and nonrapid deaths. A J-shaped cholesterol-coronary heart disease risk function was present for both total and low-density lipoprotein cholesterol. Further examination showed hypocholesterolemic men to have lower low-density and higher high-density lipoprotein cholesterol, higher alcohol consumption, leaner body mass, and less education than men with normal or high cholesterol levels. When education level was considered, the J-shaped risk function was present only among men with less than a high school education. When deaths were classified into rapid (less than 24 hours after onset of symptoms) and nonrapid, the J-shaped risk function was restricted to rapid deaths. CONCLUSIONS: The results of disclose a sizeable subset of hypocholesterolemics in this population at increased risk of cardiac death associated with lifestyle characteristics.

The association of education with coronary heart disease mortality in the USSR Lipid Research Clinics Study.

There is a strong inverse association between educational attainment and coronary heart disease (CHD) mortality in men in the USSR Lipid Research Clinics (LRC) Study. Less educated men were characterized by higher mean blood pressure, high density lipoprotein cholesterol (HDL-C), cigarettes smoked and by lower mean low density lipoprotein cholesterol (LDL-C) and body mass index (BMI). With respect to nutritional variables, less educated men were characterized by higher mean energy per kg body weight and alcohol intake and by lower mean intake of fat, saturated, mono- and polyunsaturated fatty acids, cholesterol, sucrose, and other sugars. The Keys score closely predicted the differences in plasma cholesterol among the educational groups in the randomly selected sample. In men without CHD at entry, the age and clinic-adjusted relative risk for CHD mortality was 2.4 for the least educated compared with the most educated group; on adjusting for systolic blood pressure, HDL-C, LDL-C, BMI, alcohol intake and number of cigarettes, the relative risk was reduced to 1.9. These data indicate that only 22% of the twofold excess of CHD mortality associated with low education was statistically attributable to the major risk factors. The failure to explain more of the education-CHD mortality gradient in the USSR LRC cohort was similar to observations from cohort studies in Great Britain and the US. Other correlates of low education must be explored to explain the association.

[The epidemiology of the risk factors for cardiovascular diseases and their combination among the male population in the cities of different regions of the CIS Nations and Baltic states. A cooperative study]. / Epidemiologiia faktorov riska serdechno-sosudistykh zabolevanii i ikh kombinatsii sredi muzhskogo naseleniia v gorodakh razlichnykh regionov SNG i pribaltiiskikh gosudarstv. Kooperativnoe issledovanie.

The prevalence of risk factors (RF) to develop cardiovascular disorders alone and in combination has been studied in males aged 20-54 differing by occupation and education. They lived in various cities of CIS and Baltic States. It was established that RF alone and in combination are common among the male population. The risk is the highest in the group of males engaged in hard physical labour (p < 0.05) and in low-education subjects. In subjects with higher education RF are the lowest. RF alone and in combination proved higher in Europeans and Siberians compared to males living in the Central Asia.

[The comparative characteristics of the distribution of the lipid component of the blood and the prevalence of hypercholesterolemia in men 20-54 years old in the cities of the CIS Nations and Estonia (a cooperative study)]. / Sravnitel'naia kharakteristika raspredeleniia lipidnogo sostava krovi i rasprostranennost' giperkholesterinemii u muzhchin 20--54 let v nekotorykh gorodakh SNG i Estonii (kooperativnoe issledovanie).

A comparative study of hypercholesterolemia and lipid distribution in males aged 20-54 randomly selected in one of the districts of Moscow, St. Petersburg, Tallinn, Kiev, Novosibirsk, Tashkent, Alma-Ata and Bishkek has been performed. A comparative interpopulation analysis involved mean values of blood lipid spectrum: total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDLPC), high-density lipoprotein cholesterol (HDLPC). TC, TG, LDLPC in blood were higher in European region and Siberia than in Middle Asia populations. These findings correlated with hypercholesterolemia prevalence. An average of 50% of European population studied need preventive treatment for hypercholesterolemia.