Objective measurement of physical activity in a random sample of Saint-Petersburg inhabitants

Background: World Health Organization (WHO) experts listed physical inactivity in leading risk factors for global mortality. Current research shows that only objective measurement of physical activity may provide accurate information on this parameter. The aim of our study was to assess the 7-day physical activity monitoring using triaxial accelerometers in a random sample of Saint-Petersburg inhabitants. Material and methods: As a part of all-Russian epidemiology survey ESSE-RF there was involved random sampling of 1600 Saint-Petersburg inhabitants (25–65 years) stratified by age and sex. After that a random sub-population of 100 subjects was selected. All subjects filled in questionnaire regarding physical activity, occupation, education and nutrition. Anthropometry (weight, height with body-mass index calculation, waist circumference) was performed. Actigraph GT3X+ (Actigraph LLC, USA) accelerometer and physical activity diary were used in order to evaluate physical activity monitoring for 7 days. Adequate levels of physical activity (PA) were defined as more than 10 000 steps/day and at least 150 minutes/week of moderate and vigorous physical activity (MVPA) in bouts of 10 minutes or more. Results: 1/2 of subjects were physically active according to steps, and 1/3 according to MVPA time criteria. No gender, occupation or body composition differences were revealed in physically active and inactive subjects. Almost 50% of physically active subjects had balanced workweek-weekend PA profile, and the same criterion is true only for 13% of subjects in inactive group. In both groups the same peaks of MVPA were revealed — at 8.00–9.00 and 18.00–19.00, which are typical transportation time, but in active group these peaks were significantly higher. According to PA diaries, in most of cases physical inactivity was related to the usage of private or public transport. Conclusion: Triaxial PA-monitoring shows, that 40–60% of subjects were physically inactive, and 150-min MVPA goal can easily be achieved by only increasing walking time during transportation peaks. The physical inactivity was not determined by the type of occupation, sex or age, instead it was mainly influenced by the usage of cars in the morning and evening transportation time, rather than walking

Is self-reported insomnia a risk factor for subclinical carotid atherosclerosis?

Background. Insomnia is considered an additional cardiovascular (CV) risk factor (RF). However, the data on itsassociation with vascular damage is controversial. We analyzed the relation between self-reported insomnia andcarotid atherosclerosis in the population-based sample. Material and methods. We selected 985 (males — 38%; mean age 45.2 ± 11.6 years) participants of the St Petersburgpopulation-based sample (the ESSE-RF study) who did not have previously known CV events. All subjectsunderwent a structured interview (lifestyle, medical history). Insomnia was diagnosed when complaints occurred≥ 3 times/week (the questions: “How often did you have difficulties in falling asleep for > 30 min after going tobed in the last month?”, “How often did you have difficulties in falling asleep after midnight awakening in the lastmonth?”). Subclinical atherosclerosis was assessed by carotid intima-media thickness (IMT): normal ≤ 0.9 mm,increased IMT 0.9–13 mm, IMT > 13 mm indicated an atherosclerotic plaque. Results. In total, 209 subjects reported at least one insomnia complaint; 79 participants (8%) reported both sleeponsetand sleep-maintenance problems. IMT thickening was found in 142 subjects (14.4%). IMT values were higherin those with frequent nocturnal awakenings vs. non-insomniacs (0.75 ± 0.18 vs. 0.71 ± 0.17 mm, p = 0.006). Theyalso showed greater prevalence of thickened IMT (χ2 = 4.6, p = 0.026). Mean IMT weakly correlated with insomniacomplaints (ρ = 0.10, p = 0.002), but the association was no longer significant after adjustment for age, BP andtotal cholesterol level. Conclusion. We demonstrated an association between insomnia complaints and subclinical carotid atherosclerosis,although we assume it to be weak compared to the common CV RF

Sleep duration and cardiovascular risk: results of the large-scale epidemiology study ESSE-RF

Background. The recent data suggest that sleep disorders are associated with cardiovascular diseases. We assessedthe relation between self-reported sleep duration and cardiovascular and metabolic disorders in the large-scale epidemiological study. Material and methods. The ESSE-RF is a population-based cross-sectional study involving 22,258 participants aged 25–64 years from 13 regions of the Russian Federation. In 2012–2014, all subjects underwent a structured interview including questions about average daily sleep duration, lifestyle, complaints and diseases. The current analyses considered the associations with the following disorders: obesity, hypertension, coronary artery disease, myocardial infarction, stroke (cerebral thrombosis or hemorrhage) and diabetes mellitus. Results. Altogether 20,359 respondents were included in the final analysis. The mean self-reported sleep duration was 7.0 h per night: 23.3% participants reported sleeping less than 6 h while 4.5% subjects slept more than 9 h. We found both short and long sleep duration to be associated with self-reported cardiovascular diseases. The association was independent of age, sex, body mass index, blood pressure, lipids and glucose levels. The multivariable odds were higher for obesity in short-sleepers compared to those sleeping 7–8 h. In the meanwhile, the association was U-shaped for coronary artery disease. A J-shaped relation was found for myocardial infarction. No relation was found for hypertension, diabetes mellitus or stroke. Conclusions. Differences in sleep duration may have health consequences given associations between short and long sleep duration and cardiometabolic outcomes

Transgenerational and intergenerational effects of early childhood famine exposure in the cohort of offspring of Leningrad Siege survivors

Famine exposure during early life development can affect disease risk in late-life period, yet, transmission of phenotypic features from famine-exposed individuals to the next generations has not been well characterized. The purpose of our case–control study was to investigate the association of parental starvation in the perinatal period and the period of early childhood with the phenotypic features observed in two generations of descendants of Leningrad siege survivors. We examined 54 children and 30 grandchildren of 58 besieged Leningrad residents who suffered from starvation in early childhood and prenatal age during the Second World War. Controls from the population-based national epidemiological ESSE-RF study (n = 175) were matched on sex, age and body mass index (BMI). Phenotypes of controls and descendants (both generations, children and grandchildren separately) were compared, taking into account multiple testing. Comparison of two generations descendants with corresponding control groups revealed significantly higher creatinine and lower glomerular filtration rate (GFR), both in meta-analysis and in independent analyses. The mean values of GFR for all groups were within the normal range (GFR less than 60 mL/min/1.73 m2 was recorded in 2 controls and no one in DLSS). Additionally, independent of the creatinine level, differences in the eating pattern were detected: insufficient fish and excessive red meat consumption were significantly more frequent in the children of the Leningrad siege survivors compared with controls. Blood pressure, blood lipids and glucose did not differ between the groups. Parental famine exposure in early childhood may contribute to a decrease in kidney filtration capacity and altered eating pattern in the offspring of famine-exposed individuals.</p

Case Report : Supernormal Vascular Aging in Leningrad Siege Survivors

Age-related changes in the vascular system play an important role in the biological age and lifespan of a person and maybe affected from an early age onward. One of the indicators of changes in the vascular system is arterial wall stiffness and its main measure, i.e., carotid-femoral pulse wave velocity (cfPWV). We examined arterial wall stiffness in a sample of 305 Leningrad Siege survivors to assess how hunger and stressful conditions during fetal development and early childhood affected the state of the cardiovascular system at a later age and what factors may neutralize the negative impact sustained in early childhood. Here, we presented an evaluation of two unique patients with supernormal vascular aging (SUPERNOVA) phenotype from this cohort and described the details of congruence between hereditary resistance and practiced lifestyle yielding slower biological aging rate.Peer reviewe

May Measurement Month 2018: a pragmatic global screening campaign to raise awareness of blood pressure by the International Society of Hypertension

Aims Raised blood pressure (BP) is the biggest contributor to mortality and disease burden worldwide and fewer than half of those with hypertension are aware of it. May Measurement Month (MMM) is a global campaign set up in 2017, to raise awareness of high BP and as a pragmatic solution to a lack of formal screening worldwide. The 2018 campaign was expanded, aiming to include more participants and countries. Methods and results Eighty-nine countries participated in MMM 2018. Volunteers (≥18 years) were recruited through opportunistic sampling at a variety of screening sites. Each participant had three BP measurements and completed a questionnaire on demographic, lifestyle, and environmental factors. Hypertension was defined as a systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg, or taking antihypertensive medication. In total, 74.9% of screenees provided three BP readings. Multiple imputation using chained equations was used to impute missing readings. 1 504 963 individuals (mean age 45.3 years; 52.4% female) were screened. After multiple imputation, 502 079 (33.4%) individuals had hypertension, of whom 59.5% were aware of their diagnosis and 55.3% were taking antihypertensive medication. Of those on medication, 60.0% were controlled and of all hypertensives, 33.2% were controlled. We detected 224 285 individuals with untreated hypertension and 111 214 individuals with inadequately treated (systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg) hypertension. Conclusion May Measurement Month expanded significantly compared with 2017, including more participants in more countries. The campaign identified over 335 000 adults with untreated or inadequately treated hypertension. In the absence of systematic screening programmes, MMM was effective at raising awareness at least among these individuals at risk

NOTCH1 Mutations in Aortic Stenosis: Association with Osteoprotegerin/RANK/RANKL

Background. The NOTCH pathway is known to be important in the pathogenesis of calcific aortic valve disease, possibly through regulators of osteoprotegerin (OPG), receptor activator of nuclear factor κB (RANK), and its ligand (RANKL) system. The purpose of the present study was to search for possible associations between NOTCH1 gene mutations and circulating levels of OPG and soluble RANKL (sRANKL) in patients with aortic stenosis (AS). Methods. The study was performed on 61 patients with AS including 31 with bicuspid and 30 with tricuspid aortic valves. We applied a strategy of targeted mutation screening for 10 out of 34 exons of the NOTCH1 gene by direct sequencing. Serum OPG and sRANKL levels were assessed. Results. In total, 6 genetic variants of the NOTCH1 gene including two new mutations were identified in the study group. In an age- and arterial hypertension-adjusted multivariable regression analysis, the serum OPG levels and the OPG/sRANKL ratio were correlated with NOTCH1 missense variants. All studied missense variants in NOTCH1 gene were found in Ca(2+)-binding EGF motif of the NOTCH extracellular domain bound to Delta-like 4. Conclusion. Our results suggest that the OPG/RANKL/RANK system might be directly influenced by genetic variants of NOTCH1 in aortic valve calcification

Subclinical target organ damage in subjects with different components of metabolic syndrome

Background: To assess the association of metabolic syndrome (MS) and its components with target organ damage in a follow-up study of relatively healthy bank employers. Methods: Out of 1600 random samples of office workers in Saint Petersburg (Russia), a group of 383 participants with at least one component of MS and without cardiovascular complications was selected (mean age 46.6 ± 9.0 years, 214 females (64.6%)). Follow-up visit was performed in 331 subjects. Target organ damage (TOD) was assessed by echocardiography, carotid ultrasound, applanational tonometry, brachial–ankle index, and urine albumin excretion measurements. Anthropometry, vital signs, and biochemistry were performed according to standard protocols. Results: Presence of MS was not associated with higher probability of TOD. Multiple linear regression revealed significant association of all markers of TOD with older age. Hypertension was a significant predictor of left ventricular hypertrophy (LVH), increased arterial stiffness, and early signs of carotid atherosclerosis in logistic regression adjusted for age and gender. During follow-up, proportion of patients with LVH significantly decreased (from 46.7% to 32.9%, р = 0.003) and prevalence of patients with IMT > 0.09 сm increased (from 24.5% to 44.1%, p < 0.001) accompanying by significant declining of office blood pressure (BP) and total cholesterol. Conclusions: MS per se is not related to increased probability to TOD. Hypertension, female gender, and older age are main determinants of subclinical changes. After 2-years follow-up, significant LVH and renal damage regression was observed probably owing to BP reduction. Alternatively, early signs of carotid atherosclerosis increase with aging despite decreasing of the prevalence of hypercholesterolemia