[performance evaluation of the programs aimed at myocardial infraction prevention by relevant mortality rates].

BACKGROUND: Despite implemented measures and general favourable trend, number of patients with myocardial infarction remains high, younger people are increasingly becoming ill and dying. The study purpose: to estimate age-sex mortality dynamics from acute and recurrent myocardial infarction in adults in Moscow compared to Russia's average in 2007-2021 to reveal patterns of mortality change within the implementation period of state prevention programs. MATERIAL AND METHODS: Standardized adult mortality rates for Moscow and Russia, mean expected age at death within interval 20-85 years and gain in life expectancy when eliminating this cause calculated and analyzed. RESULTS: Moscow morbidity rates for acute and recurrent myocardial infarction are twice lower than Russia's, there are higher reduction rates for both diseases - by 16% and 58% respectively. During study period, mortality from myocardial infarction in men was by 45% higher than in women. In 2007 Moscow male-female difference estimated 3% and in 15 years it became 32% due to faster female mortality reduction. Whereas Russia's average age of death from myocardial infarction in 2021 returned to 2010-2011 levels, then in Moscow during 2020-2021 female rates returned to 2008's and male rates fall out the study period. CONCLUSIONS: Since implementation of the first programs on reducing mortality from chronic non-infectious diseases during the 15 years period morbidity and mortality rates from myocardial infarction reduced in Russia and Moscow in all ages. Acute and recurrent myocardial infarction have rejuvenated both in men and women as a negative effect of the pandemic.

[MORTALITY OF THE ADULT POPULATION OF MOSCOW AND THE RUSSIAN FEDERATION FROM OBESITY-ASSOCIATED CAUSES].

BACKGROUND: Currently, obesity is considered one of the most significant health problems, representing a common chronic disease leading to the development of severe comorbidities, accompanied by the loss of disability-adjusted life years and high mortality. Due to the fact that obesity is one of the leading risk factors for a number of non-communicable diseases, such as diseases of the circulatory system, diseases of the endocrine system and malignant neoplasms. AIMS: assessment of adult mortality dynamics from obesity-associated causes in Moscow compared to the Russian Federation in 2011-2020. MATERIALS AND METHODS: data from the analytic package FAISS (internal use program): standardized mortality rates for population of Moscow and the Russian Federation as a whole. RESULTS: Over the 10-year period under study, mortality in the class of diseases of the circulatory system and malignant neoplasms was decreasing, while mortality from diseases of the endocrine system was increasing. Adult mortality from the diseases of the circulatory system in Moscow reduced by 12%, in the Russian Federation - by 25%. It should be noted, that mortality rate in Moscow (302.5 per 100,000) is significantly (by 34%) lower than in Russia (460.3), at the same time, the rate of mortality reduction over a 10-year period is equal and amounts to 23-25%. Myocardial infarction is the most serious obesity-associated disease characterized by high mortality in the class of the diseases of the circulatory system, it has a declining trend in Moscow and in the Russian Federation as a whole. Adult mortality from the diseases of the endocrine system in Moscow increased by 3 times, and in the Russian Federation - by almost 5 times, while the annual increase during the first year of the pandemic was 88% in Moscow and 24% in Russia. In Moscow, more than a half (66%) of deaths from endocrine causes belongs to non-insulin-dependent diabetes mellitus, in the Russian Federation - about 80%. Compared to the Russia's average, in Moscow mortality rates from neoplasms are lower by 8%, but at the same time, the decline happens at a similar rate (11-12%). CONCLUSIONS: Despite the impact of the COVID-19 pandemic, Moscow demonstrates slowdown of growth of mortality rates from obesity-associated diseases compared to the Russian Federation, which could have been positively affected by prevention programs of noncommunicable diseases and promotion of healthy lifestyles.

[ELDERLY CARDIAC PATIENTS: SELF-REPORTED HEALTH STATUS].

INTRODUCTION: Thanks to advances in science and medicine, the threshold age of a patient who can undergo open surgery on the valves of the heart or coronary arteries is increasing every year. Elderly patients constitute a special group in this regard. AIM: Determine how elderly cardiac patients assess their health status and highlight the factors influencing it. MATERIALS AND METHODS: The results of a survey of 107 patients who are in the Department of cardiac rehabilitation of the A. N. Bakulev National Medical Research Center for Cardiovascular Surgery in 2020-2021 after surgical or endovascular treatment of cardiac pathology. The survey is carried out by a cardiologist using a questionnaire that allows you to characterize the patient's health status on the basis of self-esteem. Statistical data processing was carried out in Microsoft Office Excel 2003 and Statistica v. 6.0 programs. RESULTS: The majority of respondents (63.6%) assessed their state of health as satisfactory. No correlation was found between the state of health and the level of education. On average, the patients had 3.7 ± 1.8 chronic diseases. Obesity was observed in 29.4% of men and 68.8% of women. The body mass index did not correlate with the self-reported health status of the respondents, but it did correlate with the number of accumulated diseases (r = 0.42, t-statistic = 2.58). CONCLUSIONS: Recovery of elderly patients after cardiac surgery is progressing rapidly. In women, the recovery process is slower due to the greater number of associated pathologies. Old age is not a direct contraindication for cardiac surgery. When self-assessing their health status, elderly patients do not associate it with risk factors.