Clinical and pathogenetic features of the development of non-communicable diseases depending on the degree of comorbidity, the stage of cardiovascular continum

Abstract

The article is devoted to the clinical study of the clinical and pathogenetic features of the development of non-communicable diseases, depending on the degree of comorbidity and the stage of the cardiovascular continuum.The aim was to determine the clinical and pathogenetic features of the development of non-communicable diseases, depending on the degree of comorbidity and the stage of the cardiovascular continuum, and to improve the methodology of patient management, taking them into account accordingly.Material and methods. 439 people were examined in an open, non-randomized, controlled study. 253 people were sick with non-communicable diseases (main group) and 186 people were functionally healthy respondents (control group). All participants in the study underwent a retrospective assessment of medical records, with the calculation of the history of diseases, assessment of the degree of comorbidity and determination of the stage of the cardiovascular continuum.Results. It was found that the principle of diagnostic monism is not an adequate methodological approach for all patients with non-communicable diseases since there were no people with one verified diagnosis among them. A significant increase in the average number of diagnoses was noted between the subgroups of the control group and the main group. An increase in the level of comorbidity in terms of CIRS, Charlson index, SCORE was noted between the control subgroups and subgroup 1 of the main group (p <0.0001), between subgroup 1 and other subgroups of the main group (p <0.0001), between subgroup 2 and subgroups 3 and 4 (p <0.0001).
 Conclusions. Comorbidity is a characteristic feature of non-communicable diseases, a manifestation of the systemic progression of metabolic disorders. It significantly increases with the age of patients and it has a significant increase in the number of diagnoses and the risk of death from cardiovascular diseases in the development of the cardiovascular continuum with the maximum number of diagnoses at the stage of its complication. The cardiovascular continuum plays a key role in increasing comorbidity, the risk of death. It determines the prognosis and is an integral part of the overall continuum in non-communicable diseases and has a comorbid relationship with diseases of the upper gastrointestinal tract as the basis of the metabolic pattern. Comorbidity should be taken into account in the management of patients as a manifestation of the systemic progression of metabolic disorders and the general continuum in non-communicable diseases.