Европейский конгресс кардиологов: фокус на питание

The relationship between nutrition and cardiovascular health has emerged over the past two decades. European Society of Cardiology has become a leading platform for discussion. This article encompasses the main findings of a multitude of studies presented at ESC. The assessment of population dietary patterns should include the data on the profile of food and nutrients as well as their lifestyle, socio-economic status, the quality of products, and macronutrients replacement. The study design aimed at assessing dietary patterns nutrition should be a prospective long-term study focusing on collecting the data on ethnic and socio-economic components as well as the data suggesting the adherence to a particular dietary pattern.Последние десятилетия проблема связи характера питания и сердечно-сосудистого здоровья населения является предметом пристального изучения и обсуждения. Очередной Европейский конгресс кардиологов не стал исключением. Данная статья посвящена обсуждению основных вопросов, озвученных на этом мероприятии. Изучение рациона питания населения должно включать не только сбор данных о фактическом питании, но и анализ образа жизни, социально-экономического положения населения, качества продуктов, а также факт замены макроэлементов. Дизайн исследований, посвященных изучению питания, должен включать долгосрочный крупномасштабный проект, учитывающий как этническую, так и социально-экономическую составляющую жизни населения, а также вопросы приверженности тому или иному стереотипу питания

Polymorphic variants of ACE, AGT, AGTR1, MTHFR and NOS3 candidate genes connected with arterial hypertension as part of the metabolic syndrome among the shor people

Background: The problem of high blood pressure in the framework of metabolic syndrome (MS) is one of the most important for modern medicine in connection with the predicted increase in the incidence in the future and an increase in the mortality rate from cardiovascular disease.Aims: the aim of the study is to examine the frequency of arterial hypertension (AH) as part of the MS among the members of the indigenous population of the Mountain Shoria and to state the degree of the interconnection between the expression level of the candidate genes ACE, AGT, AGTR1, MTHFR and NOS3 and certain health problem.Materials and methods: The sample included 901 members of the indigenous population living in the settlements of the Mountain Shoria region. All experimental subjects had their blood pressure measured, anthropometry (measurements of height, body weight, waist circumference) taken according to standard procedures, fasting blood taken to determine the lipid spectrum and glucose level, morning urine dose taken and albumin level detected. All the patients with hypertension underwent duplex scanning of the brachycephalic arteries and examination of the structural and functional state of the myocardium was performed using echocardiography. Gene polymorphisms ACE (I/D, rs4340), AGT (c.803T>C, rs699), AGTR1 (A1166C, rs5186), MTHFR (c.677C>T, Ala222Val, rs1801133) and NOS3 (VNTR, 4b/4a) were tested using polymerase chain reaction.Results: Among the indigenous population of the Mountain Shoria, the frequency of hypertension combined with abdominal obesity and any other additional component of MS was 28.2%. In the group of the patients with, organ changes in the form of left ventricular myocardial hypertrophy and an increase in the thickness of the intima-media complex were more common than in the group of patients with AH alone: 58.0% versus 45.1%, p = 0.029 and 81.9% versus 67 , 0%, p = 0.007, respectively. The high risk of hypertension within the framework of MS was determined by the D allel of the ACE gene [OR = 2.45; 95% CI (1.05-5.72)].Conclusions: The high frequency of the spread of high blood pressure within MS confirms that hypertension is less frequently manifested as an isolated disease, more often combined with other components of MS — abdominal obesity or disorders of carbohydrate and lipid metabolism. Stated genetic predisposition to hypertension within the MS in a specific small cohort of the Shors will undoubtedly help in the development and implementation of the health programs

Unresolved issues of increasing physical activity after myocardial infarction

The review presents the results of studies on the problems of increasing the efficiency of rational  physical  activity  within the concept of comprehensive secondary  prevention of myocardial  infarction. The aspects of insufficient adherence of specialists and patients to rehabilitation methods were discussed; possible safe exercise modes after infarction and available monitoring methods were given. We also described the potential characteristics of physical training, taking into account the initial clinical severity  and completeness of revascularization after myocardial infarction. In addition, the need for socio-economic,  as well as informational support of the state and healthcare system has been updated

Risk factors for ischemic events in residents of Kemerovo and Kemerovo region at 3-year follow-up (results of the urban rural epidemiology study)

The aim of the study was to identify risk factors for ischemic events in residents of Kemerovo and Kemerovo region at 3-year follow-up. Material and methods. The study included participants (n = 638, ages 35 to 70 years), permanently residing in Kemerovo or the Kemerovo region of the prospective epidemiological study conducted at the Research Institute for Complex Issues of Cardiovascular Diseases from 2015 to 2020. The exclusion criteria were prior myocardial infarction (MI), angina pectoris and/or diagnosed peripheral artery disease. The main socio-economic and behavioral characteristic and health status of participants were determined by means of questionnaire, data of some participants were collected from medical records (case history, patient discharge summary, results of laboratory and instrumental examinations). Food Frequency Questionnaire was used to capture an individual`s usual food consumption. International Questionnaire on Physical Activity was used to measure health-related physical activity of participants. Data regarding the end points (all-cause death or death due to cardiovascular events, de novo angina, MI, stroke) were collected at 3-year follow-up. Results. Out of 638 participants, death was reported for 22 cases (of which 4 deaths were due to cardiovascular events), 6 developed non-fatal MI, 45 had de novo angina, and 12 had a non-fatal stroke at 3-year follow-up. A composite endpoint (CE) developed in 80 study participants during 3 years of follow-up. Logistic regression analysis revealed a significant association between CE and the following factors: obesity at the beginning of the study (odds ratio (OR) 2.09, 95 % confidence interval (95 % CI) 1.03–4.26) (an adjusted OR (AOR) 2.17, 95 % CI 1.06–4.44)), regular (at least once a month) alcohol consumption at the time of the survey (OR 2.33, 95 % CI 1.23–4.42 (AOR 2.29, 95 % CI 1.21–4.34)), participants stating that they have been thinking about death during previous month (OR 3.22, 95 % CI 1.54–6.76 (AOR 3.74, 95 % CI 1.73–8.07)). The following factors had the weakest association with the risk of ischemic events at 3-year follow-up: disability due to injury and occupational diseases (OR 0.19, 95 % CI 0.07–0.51 (AOR 0.21 (0.08–0.57)), taking medication for a month (OR 0.37, 95 % CI 0.17–0.81 (AOR 0.36, 95 % CI 0.16–0.80)), in particular, antihypertensive drugs (OR 0.43, 95 % CI 0.22–0.81 (AOR 0.43, 95 % CI 0.22–0.82)) and lipid-lowering drugs as a part of primary prevention (OR 0.33, 95 % CI 0.15–0.70 (AOR 0.33, 95 % CI 0.15–0.73)). Moreover, low physical activity associated with the use of transport in daily travels (car, bicycle) proved to be conditionally protective in relation to CE (OR 0.48, 95 % CI 0.25–0.94) (AOR 0.49, 95 % CI 0.25–0.96)). Conclusions. The identification of a number of significant «non-conventional» risk factors for development of ischemic events in residents of Kemerovo and Kemerovo region without prior atherosclerotic cardiovascular diseases at 3-year follow-up allows to consider them as additional modifiable risk factors within the framework of primary prevention

Компоненты здорового образа жизни у студентов высших учебных заведений Кемерова

Highlights. The results of an online survey of Kemerovo students regarding nutrition, physical activity, smoking, drinking alcohol, and maintaining a healthy lifestyle are presented.University students do not always follow the principles of healthy living due to poor nutrition, low physical activity and high consumption of tobacco and alcohol products.Aim. To evaluate dietary habits and modifiable cardiovascular risk factors in tertiary students in Kemerovo.Methods. The pilot study included 136  university students (aged 20-21  years)  residing in Kemerovo who filled out online questionnaires. The questionnaires were comprised of questions about the preferred diet, lifestyle, level of physical activity, the presence of behavioral risk factors for non-communicable diseases (smoking, drinking alcohol). Additionally, the respondents` subjective opinion about their own healthy lifestyle (HLS) was evaluated.Results. The obtained data demonstrates a high prevalence of meat and sausage consumption (60%) and a low frequency of vegetables and fruits consumption (26%) among tertiary students. Simultaneously, most of the respondents have restricted the intake of savory snacks and consumption of sweet carbonated drinks. Almost a third of students skip breakfast and regularly visit fast food restaurants. Most of the respondents do not consider replacing red meat with fish or poultry, or using more low-fat dairy products and fruits instead of confectionery in their diet. A third of young people (33%) aged 20-21 have smoked or are currently smoking cigarettes, and more than half (63%) have consumed or regularly consume alcohol. Moreover, a very low percentage of students (7%) devote their time to regular physical activity. The analysis of the respondents` subjective opinion of their lifestyle has revealed that most students do not fully comprehend the concepts   of “healthy lifestyle” and “healthy diet”, because their answers did not meet the criteria of healthy lifestyle. Only 57.7% of respondents who believe their lifestyle to be healthy are actually correct.Conclusion. Tertiary students in Kemerovo do not always follow the rules of healthy lifestyle. It has been illustrated by their poor nutrition, low physical activity and frequent alcohol and tobacco use. Students associate healthy diet exclusively with not consuming sugary drinks, savory snacks, fast food, and having proper breakfast, which could be caused by the lack of general knowledge about a proper balanced diet.Основные положения. Представлены результаты онлайн-опроса студентов Кемерова о характере питания, физической активности, распространенности табакокурения и употреблении алкогольных напитков, соблюдении здорового образа жизни.Учащиеся вузов не всегда следуют принципам здорового образа жизни ввиду нерационального питания, низкой физической активности и высокого уровня потребления табачной и алкогольной продукции.Цель. Оценить пищевые привычки и модифицируемые факторы сердечно-сосудистого риска у студентов высших учебных заведений Кемерова.Материалы и методы. В пилотном исследовании проанализировано 136 оригинальных онлайн-опросников, заполненных студентами высших учебных заведений Кемерова в возрасте 20–21 года. Анкеты включали вопросы, характеризующие привычное питание, образ жизни, уровень физической активности, наличие поведенческих факторов риска неинфекционных заболеваний (табакокурение, прием алкогольных напитков). Наряду с этим оценено субъективное мнение респондентов о соблюдении ими здорового образа жизни (ЗОЖ).Результаты. Исследование продемонстрировало высокую распространенность употребления студентами мясоколбасных изделий (60%) и низкую частоту потребления овощей и фруктов (26%). При этом большая часть опрошенных ограничивали прием пикантных закусок и сладкой газированной воды. Почти треть студентов игнорировали завтраки и регулярно посещали заведения фастфуда. Большая часть респондентов не стремились заменять красное мясо на рыбу или птицу, употреблять обезжиренные молочные продукты, фрукты взамен кондитерских изделий. Треть молодых людей (33%) в возрасте 20–21 года курили ранее или курят в настоящее время, а более половины (63%) употребляли или употребляют алкогольные напитки. Обращает внимание и низкий процент студентов (7%), ежедневно уделяющих время физической активности. Анализ субъективного мнения о соблюдении ЗОЖ показал, что зачастую студенты не знают, что включают понятия «здоровый образ жизни», «здоровое питание», так как последующие ответы не соответствовали критериям ЗОЖ. Только 57,7% лиц, относящих себя к приверженцам ЗОЖ, действительно являлись таковыми.Заключение. Учащиеся вузов Кемерова не всегда придерживаются ЗОЖ вследствие нерационального питания, низкой физической активности и частого употребления табачной и алкогольной продукции. Студенты ассоциируют здоровое питание исключительно с неупотреблением газированных сладких напитков, пикантных закусок, непосещением заведений фастфуда, наличием регулярных завтраков, что, возможно, связано с недостаточной осведомленностью о сбалансированной диете

Factors Determining the Three-Year Dynamics of Lipid Metabolism Indicators in Residents of a Large Industrial Region of Siberia

Aim. To assess the contribution of traditional and socio-economic factors to the development and dynamics of dyslipidemia based on the results of an epidemiological study in a large region of Siberia.Material and methods. Clinical and epidemiological prospective study of the population 35-70 years old was carried out. At the basic stage, 1600 participants were examined, including 1124 women and 476 men, the prospective stage included 807 respondents (the response was 84.1%). A survey was carried out to find out the state of health (presence of diseases, taking medications), socio-economic status (level of education and income, marital status) and the presence of behavioral risk factors (tobacco and alcohol use).Results. The proportion of people with hypercholesterolemia increased 1.2 times, low LDL – 1.1 times, and hypertriglyceridemia and low HDL – 1.7 times. In persons with hypertriglyceridemia, the frequency of detected obesity and hypertension decreased by 7.9% and 4.6%, respectively (p = 0.046). Obesity was associated with an increased risk of developing hypercholesterolemia (OR = 1.49, CI: 1.0-2.2), hypertriglyceridemia (OR = 2.14, CI: 1.5-3.0), high LDL cholesterol (OR = 2.16, CI: 1.3-3.6) and low HDL cholesterol (OR = 2.07, CI: 1.5-2.9). The presence of hypertension - with an increased risk of developing hypertriglyceridemia (OR = 2.19, CI: 1.5-3.1) and low HDL (OR = 2.49, CI: 1.8-3.5). Among people with low HDL levels, the number of smokers and drinkers decreased (by 7.0% and 5.7%, respectively), as well as those with obesity by 8.6%. The prevalence of dyslipidemia increased in all socioeconomic groups.Conclusion. Over 3 years of follow-up, there was a statistically significant increase in the proportion of persons with dyslipidemia in all socio-economic groups. There was a significant decrease in such risk factors as obesity, hypertension, smoking, alcohol consumption and an increase in the number of respondents taking lipid-lowering therapy

Sex and age specificities of the dynamics of anthropometric indicators characterizing obesity (according to a prospective epidemiological research)

Background. Overweight and obesity significantly increase the risk of premature death and the development of chronic diseases. Many anthropometric indices have been developed to verify obesity, although the best among them still remains undetermined.The aim. To determine the sex and age specificities of the dynamics of anthropometric indicators characterizing obesity.Materials and methods. The program was implemented in the period from 2015 to 2020. It provided for the implementation of a sample research. The baseline research included 1,124 women and 476 men. The average age was 54.9 ± 9.75 years and 52.6 ± 10.0 years, respectively. To identify gender specificities, all participants were divided into three age groups: 35–49 years old, 50–59 years old, and 60–70 years old. The observation period was 3 years. To determine the level of visceral fat, the VS-532 fat mass analyzer (Tanita Health Equipment HK Ltd., Hong Kong) was used. Body mass index (BMI), waist-hip index (WV/HV), visceral obesity index (VOI) were also calculated. Statistical processing of the results was carried out using the program Statistica 6.0 (StatSoft Inc., USA).Results. New cases of obesity developed in 30.6 % of the surveyed. There was an increase in the prevalence of obesity according to the criteria of WV (by 8.9 %) and VFL (by  5.4  %) and a  decrease in the number of people who are obese according to WV/HV – by 4.2 %. Of all the indicators, only VOI showed a statistically significant decrease in the mean values over the observed period, while BMI, WV and VFL showed an increase.Conclusions. It is necessary to apply various criteria for the diagnosis of obesity, since individual indices are not able to fully reflect the gender and age specificities of the distribution of fat in the bod

Parameters of the Infrastructure of the Residential Area and Their Relationship with Cardiovascular Risk Factors

Aim. This study determined the level of public satisfaction with neighborhood design features in Kemerovo Oblast and their connection to cardiovascular disease risk factors.Subjects and methods. The study population included 1,598 respondents aged between 35 and 70, with 491 living in rural areas and others living in Kemerovo (1,221 women and 477 men). The assessment of neighborhood environment was done according to residents' subjective opinions about infrastructural features (the Neighborhood Environmental Walkability Scale). Depending on how participants responded to the questionnaire, some of these parameters were identified as adverse.Results. The residents of Kemerovo and rural areas of Kemerovo Oblast identified the following neighborhood design features as adverse: the lack of interesting places in neighborhood environment, the remote location of parks and restaurants, the absence of pavement, busy traffic, and a long distance between home and workplace. In the city, arterial hypertension prevalence was high among men, when grocery, fruit and clothing stores were distant, and among women, when banks, public transport stops were distant and the traffic was heavy. Lipid metabolism disorders were more common among women in urban areas, when there were no interesting places around. Obesity prevalence was high among urban female population, when the following adverse factors were present: the remote location of grocery stores, fruit stores, bank, pharmacy and public transport stops and the absence of pavement. Among rural male population, this risk factor was common when there were no pavements. The highest rate of carbohydrate metabolism disorders was found among women living in villages where the traffic is heavy and public transport stops are far away.Conclusion. The impact of infrastructure on the health status of the living population is a new direction of scientific research. Epidemiological studies in different geographic areas and population groups show significant differences in health status, morbidity and mortality from chronic noncommunicable diseases. To reduce the risks of developing diseases of the cardiovascular system, the formation of a socially comfortable health-saving environment is of great importance

Anthrax in the Territory of Dagestan

The aim of the study is to investigate anthrax epizootiologic and epidemiologic situation in the Republic of Dagestan over the period of 1944–2010. Anthrax morbidity has been registered in 38 regions and Makhachkala. All in all 1001 anthrax cases and 3128 sick rural animals have been registered. Determined are 420 anthrax specified potentially hazardous areas (SPHA), the majority of them (77.4 %) have formed before 1969. Regions of the republic have been checked against the level of risk connected with anthrax infecting over the last 40 years. Therewith, they have been classified into three groups: with low, medium, and high epizootiological-and-epidemiological potential. 15 regions with high epizootiological-and-epidemiological potential have been marked as potentially hazardous on a regular basis. These regions occupy 31 % of the republic`s territory and 52.5 % of the SPHA territory. 84 % of patients and 88 % of fallen animals have been registered there for the past 40 years

Impaired complex I repair causes recessive Leber's hereditary optic neuropathy

Leber's hereditary optic neuropathy (LHON) is the most frequent mitochondrial disease and was the first to be genetically defined by a point mutation in mitochondrial DNA (mtDNA). A molecular diagnosis is achieved in up to 95% of cases, the vast majority of which are accounted for by 3 mutations within mitochondrial complex I subunit-encoding genes in the mtDNA (mtLHON). Here, we resolve the enigma of LHON in the absence of pathogenic mtDNA mutations. We describe biallelic mutations in a nuclear encoded gene, DNAJC30, in 33 unsolved patients from 29 families and establish an autosomal recessive mode of inheritance for LHON (arLHON), which to date has been a prime example of a maternally inherited disorder. Remarkably, all hallmarks of mtLHON were recapitulated, including incomplete penetrance, male predominance, and significant idebenone responsivity. Moreover, by tracking protein turnover in patient-derived cell lines and a DNAJC30-knockout cellular model, we measured reduced turnover of specific complex I N-module subunits and a resultant impairment of complex I function. These results demonstrate that DNAJC30 is a chaperone protein needed for the efficient exchange of complex I subunits exposed to reactive oxygen species and integral to a mitochondrial complex I repair mechanism, thereby providing the first example to our knowledge of a disease resulting from impaired exchange of assembled respiratory chain subunits