The influence of social support on risk of acute cardiovascular diseases in female population aged 25–64 in Russia

Objective. To study the prevalence of social support (SS) and its influence on the relative risk (RR) of myocardial infarction (MI) and stroke in the female population aged 25–64 in Russia. Materials and methods. Under the third screening of the WHO “MONICA-psychosocial” programme, a random representative sample of women aged 25–64 (n=870) were surveyed in Novosibirsk. SS was measured according to the methods of the Berkman–Sym test [indices of close contacts (ICC) and index of social network (SNI)]. From 1995 to 2010, women were followed for 16 years to observe the incidence of MI and stroke. Results. The prevalence of low levels of ICC and SNI in women aged 25–64 was 57.1 and 77.7%, respectively. Low levels of ICC and SNI were associated with poor self-rated health and awareness about their health, adverse behavioural habits, high job strain and family stress. Rates of MI and stroke development were higher in married women with low ICC and SNI who were being in class “hard manual work”. Over a 16-year study period, the RR of MI in women with low ICC compared to those with high ICC was 4.9 times higher, and the risk of stroke was 4.1 times higher. Low level of SNI increased MI risk in 2.9 times, risk of stroke in 2.7 times. Conclusions. Majority of women aged 25–64 years in Russia have low social support which is associated with poor self-rated health, low awareness about the health that increases the risk of MI and stroke in 2.7–4.9 times in groups of “married” and “hard physical work”

Biological Determinants of Sleep Disorders

The purpose of the study is to research the effect of polymorphism of genes such as CLOCK, ARNTL, PER2, NPAS2, DRD4, DAT, TNF-α, and NPSR1 on sleep disorders in an open population of 25–64-year-old men. We conducted screening studies of representative samples of men aged 25–64 years. The general examination was carried out according to the standard methods included in the WHO MONICA-Psychosocial Program (MOPSY). Carriers of the C/T genotype of the CLOCK gene more often than others reported having “satisfactory” or “poor” sleep. Carriers of the C/T genotype of the ARNTL gene were more likely to experience anxiety dreams, and they woke up exhausted. Carriers of the A/A genotype of the PER2 gene were more likely to wake up two or more times per night, a total of four to seven times per week. In the population, C/T and T/T genotypes of the NPAS2 gene were significantly more common in individuals with 7-hour sleep. Genotype 4/6 of the DRD4 gene and genotype 9/9 of the DAT gene were significantly associated with sleep disturbances. Carriers of the heterozygous A/G genotype of the TNF-α-308 gene, compared with carriers of all other genotypes, more often rated sleep as “satisfactory” (30%) than “good.

Biological Determinants of Hostility

Our aim was to study the association of hostility with the DRD4, DAT, MAOA genes in an open male population of 25–64 years old. A representative sample of men aged 25–64 years (n = 657 men, average age 44.3 ± 0.4 years) was examined in 1994–1995 and 45–64 years old (n = 781 men, average age - 56.48 ± 0.2 years) in 2003–2005 using the methods proposed by the WHO international program “MONICA-psychosocial” and “HAPIEE”. All respondents completed the hostility questionnaire on their own. Genotyping of the DRD4, DAT and MAOA gene polymorphisms was carried out. It was established that the level of hostility in the male population was 76.9% in the group of 25–64 years old and 60.3% in the group of 45–64 years old. Genotypes 4/6, 4/7 of the DRD4 gene are reliably associated with a high level of hostility; the genotype 4/4 of the DRD4 gene is associated with an average and lower level of hostility. There was no association of individual genotypes and VNTR alleles of DAT gene polymorphism with different levels of hostility. It was found that among individuals with low-active alleles of the MAOA-L gene (alleles 2 and 3), a high level of hostility was more common - 50.9%. The results of constructing a logistic regression model showed that the presence of low-active alleles (2; 3) of the MAOA gene increases the likelihood of hostility OR = 2.103 (95% CI 1.137–3.889, p = 0.018). Based on the received data we can assume that the long alleles of the DRD4 gene and the low-level allele of the MAOA-L gene are associated with hostility

Association of Personal Anxiety with Dopamine Receptor D4 (DRD4), DAT Genes Polymorphism

Modern studies in the world have attached high priority to the role of genetics in human psychosocial stress. People who have strong biochemical responses to stress are more inclined to develop acute and posttraumatic stress disorders. Why do such unusually strong biological reactions occur in certain people? Psychogenetics focuses on many aspects: personality traits that can affect human behavior directly. Their individual variability has been found to be a genetic trait. At present we already know a number of genes, certain allelic variants and genotypes associated with some neuropsychological characters. Among these are genes encoding intracellular and plasma protein neurotransmitter transporters and their receptors; to date, there are only several dozen genes. Of particular interest are dopaminergic system genes. However, information about the polymorphism of known genes associated with personality traits is quite limited and contradictory for open population. Under these circumstances, the chapter is devoted to the association of polymorphisms of candidate genes of the dopaminergic system with anxiety in the open population

Sex Differences in Long-Term Trends of Psychosocial Factors and Gender Effect on Risk of Cardiovascular Diseases: Arterial Hypertension, Myocardial Infarction and Stroke

Introduction: The study aimed to determine gender differences in the prevalence and dynamics of affective states over a long period, i.e., 23 years, and to establish their effect on the risk of cardiovascular diseases (CVD), i.e., arterial hypertension (AH), myocardial infarction (MI), and stroke among the population aged 25–64 in Russia / Siberia. Methods: Between 1994 and 2017, we conducted 4 screening surveys of representative samples (totalling 4,815 people) under the international programs MONICA and HAPIEE in Russia / Siberia. To determine the sex differences in cardiovascular risk from 1994 to 2010, we observed cohorts formed from the screened individuals without CVD and diabetes mellitus (DM). Results: High levels of affective states in the period from 1994 to 2003, especially in women, were replaced by a downward trend in 2013. At the same time, there was a reduction in the gender gap in terms of frequency of depression lower 1%, and men in the younger age groups reported higher levels of personal anxiety (49.3% vs 46.1% in adults aged 35-44y) and vital exhaustion (16.9% vs 15.6%) than women in 2017. We found that men with unfavourable levels of affective states have a 3–5 fold higher risk of hypertension and stroke, while women have a higher risk of myocardial infarction (p for all < 0.05). Hostility in men is associated with a negative risk of myocardial infarction and stroke (HR=0.3 and HR=0.29, respectively; p for all < 0.05). However, this was levelled out by unfavourable social characteristics. Conclusions: The downward trends in prevalence of psychosocial factors were unstable and associated with reduced gender gap for affective states. It had a significant impact on the gender magnitude of cardiovascular risk

Prevalence of ischemic heart disease depending on factors of psychoemotional stress among men of mature age (epidemiological study)

Aim. To establish associations of the prevalence of ischemic heart disease (IHD) and factors of psychoemotional stress in men of the open urban population in the age group 4564 years after two decades of life. Materials and methods. A cross-sectional epidemiological study using a model of the city of Tyumen was conducted on a representative sample of the population among males of mature age (4564 years). Based on standard epidemiological methods, IHD was established according to strict epidemiological criteria definite IHD. The study of the factors of psycho-emotional stress (depression, hostility, life exhaustion) was carried out according to the algorithms of the World Health Organization program MONICA-psychosocial. When calculating the odds ratio for the development of IHD, a low level of psycho-emotional stress factors was regarded as the absence of a sign, a combination of medium and high levels as a presence. Results. The prevalence of ischemic heart disease in the open population (on the model of Tyumen) according to strict epidemiological criteria in men aged 4554 years was 8.2%, at the age of 5564 years 19.2%, a predominance of painless form of ischemic heart disease was revealed. According to the levels of factors of psychoemotional stress in mature men, mainly the average level of depression and life exhaustion, a high level of hostility were established. In men of an open population (on the model of Tyumen), depending on the psychoemotional stress, a high risk of developing a certain coronary heart disease was established in the age categories 4554 and 5564 years old in the presence of depression, at the age of 5564 years in the presence of hostility or life exhaustion. Conclusion. Consequently, the data obtained indicate the importance of further studying the factors of psychoemotional stress in men of mature age in Siberian populations, their relationships with conventional risk factors for coronary artery disease, as well as the advisability of preventive measures aimed at weakening the influence of not only conventional risk factors, but also factors of psycho-emotional stress. among the Russian population

Association of the dopamine receptor (DRD4, DAT) gene polymorphisms with vital exhaustion in an open population among 25—64-year-old men (Novosibirsk): Epidemiological study according to the WHO MONICA-psychosocial program

Objective: to study the association of the DRD4, DAT genes with vital exhaustion in an open 25—64-old-year male population. A random representative sample of 657 men aged 25—64 years, living in one of the Novosibirsk districts was examined within the WHO MONICA project in 1994. The MONICA-MOPSY test was used to estimate the level of vital exhaustion. The examined DRD4, DAT gene Polymorphisms were genotypes in the Laboratory of Molecular Genetic Studies, Therapy Research Institute, Siberian Branch, Russian Academy of Medical Sciences (Novosibirsk). Results. The genotype containing allele 7 in the dopamine receptor subtype 4 (DRD4) gene, as well as genotype 9/9 in the dopamine-transporter protein (DAT) gene are significantly associated with the high level of vital exhaustion. Conclusion. The vital exhaustion is significantly associated with certain DRD4, DAT gene polymorphisms in the open 25—64-year-old male population of Novosibirsk

Attitude to the health in the open population of a medium-urbanized city of Western Siberia, association with the prevalence of CHD: gender features

The validity of the use of a subjective-objective indicator of health as a significant indicator of its association with the prevalence of coronary artery disease is shown in both domestic and foreign scientific literature. At the same time, the subjective-objective indicator of health, and first of all, the attitude to one's health, is recognized as an indicator of a lifestyle that establishes the interpretation of conventional risk factors for coronary artery disease and interest in preventive measures at the population level. Purpose: to determine the attitude towards one's health in the age range and in groups with and without coronary artery disease in an open population of a medium-urbanized city of Western Siberia in terms of gender. Material and methods. Cross-sectional studies were carried out in the framework of two cardiac screenings on unorganized subpopulations of men and women 2564 years old in Tyumen (with responses 85.0 and 70.3 %, respectively). The isolation of various forms of coronary heart disease was carried out on the basis of standard epidemiological methods, the comparison group was defined as the absence of coronary heart disease. The attitude of the population to their health was established using a rigidly standardized WHO questionnaire MONICA-psychosocial «Knowledge and attitude to the health». Results. In the open population of a moderately urbanized city of Western Siberia, with a predominance among women, a low level of attitude towards their health was established, the prevalence of low responsibility for their health in the gender aspect took place in the third, fourth and sixth decades of life. Negative attitudes towards their health among persons of both sexes were determined mainly in groups with CHD; in women, the tendency towards a decrease in responsibility for their health was more pronounced than in men. Conclusion. When planning a preventive program for the population of a medium-urbanized city of Western Siberia, taking into account the priority impact on the subjective-objective indicator of population health, the implementation of the population strategy will probably not be enough. Taking into consideration the obtained regularities of the growth of negative attitudes towards their health among women, especially in groups with the presence of coronary heart disease, along with the population strategy, it would be optimal to use a high-risk strategy

Global variations in heart failure etiology, management, and outcomes

Importance: Most epidemiological studies of heart failure (HF) have been conducted in high-income countries with limited comparable data from middle- or low-income countries. Objective: To examine differences in HF etiology, treatment, and outcomes between groups of countries at different levels of economic development. Design, Setting, and Participants: Multinational HF registry of 23 341 participants in 40 high-income, upper–middle-income, lower–middle-income, and low-income countries, followed up for a median period of 2.0 years. Main Outcomes and Measures: HF cause, HF medication use, hospitalization, and death. Results: Mean (SD) age of participants was 63.1 (14.9) years, and 9119 (39.1%) were female. The most common cause of HF was ischemic heart disease (38.1%) followed by hypertension (20.2%). The proportion of participants with HF with reduced ejection fraction taking the combination of a β-blocker, renin-angiotensin system inhibitor, and mineralocorticoid receptor antagonist was highest in upper–middle-income (61.9%) and high-income countries (51.1%), and it was lowest in low-income (45.7%) and lower–middle-income countries (39.5%) (P &lt; .001). The age- and sex- standardized mortality rate per 100 person-years was lowest in high-income countries (7.8 [95% CI, 7.5-8.2]), 9.3 (95% CI, 8.8-9.9) in upper–middle-income countries, 15.7 (95% CI, 15.0-16.4) in lower–middle-income countries, and it was highest in low-income countries (19.1 [95% CI, 17.6-20.7]). Hospitalization rates were more frequent than death rates in high-income countries (ratio = 3.8) and in upper–middle-income countries (ratio = 2.4), similar in lower–middle-income countries (ratio = 1.1), and less frequent in low-income countries (ratio = 0.6). The 30-day case-fatality rate after first hospital admission was lowest in high-income countries (6.7%), followed by upper–middle-income countries (9.7%), then lower–middle-income countries (21.1%), and highest in low-income countries (31.6%). The proportional risk of death within 30 days of a first hospital admission was 3- to 5-fold higher in lower–middle-income countries and low-income countries compared with high-income countries after adjusting for patient characteristics and use of long-term HF therapies. Conclusions and Relevance: This study of HF patients from 40 different countries and derived from 4 different economic levels demonstrated differences in HF etiologies, management, and outcomes. These data may be useful in planning approaches to improve HF prevention and treatment globally