Heart Disease In Men Research Articles

Risk factors in females with ischemic heart disease

Ischemic heart disease has been proved to be one of the most actual sociomedical problems of today. According to the World Health Organization, the ischemic heart disease is ranked first in the world in terms of morbidity and mortality among men and women. In recent years, mortality due to ischemic heart disease in men tends to decrease, whereas in women it remains stable. Analysis of scientific literature has allowed to conclude that the prevalence of risk factors in women as compared to men, and their importance in different age groups is not the same. In women, the risk factors are identified on average 10 years later than in men, but their negative impact on women's health is much stronger, which is manifested by higher death rates due to ischemic heart disease in women as compared to men.

Prospective Study of Dietary Patterns, Bone Lead Levels and Risk of Incident Coronary Heart Disease in Men

Introduction: Cumulative lead exposure has been associated with cardiovascular outcomes. Previous studies have examined individual nutrients known to affect lead toxico-kinetics and toxico-dynamics. Instead of individual nutrients, we examined whether overall dietary pattern derived from a food-frequency questionnaire can modify the association between cumulative lead exposure and incident coronary heart disease (CHD). Methods: We examined 588 men from the VA Normative Aging Study who had bone lead levels measured by K-shell-X-ray fluorescence and were free of CHD at the time of measurement. Dietary patterns were identified from a FFQ with 40 predefined food groups using factor analysis. Diet scores were dichotomized to examine effect modification. Cox proportional hazard models were used to compute hazard ratios and 95% confidence intervals for incident CHD (from 1991 to 2011; median follow-up time=10 years). Results: We derived two major dietary patterns. The ‘prudent’ pattern was identified with high intakes of fruit, whole grains, vegetables, legumes, poultry and seafood; while, the ‘Western’ pattern was characterized by high intakes of red meat, processed meat, refined grains, high-fat dairy products, fries, butter and eggs. After adjustment for age, smoking, body mass index, education, and ratio of total cholesterol to high-density lipoprotein, the HR of CHD was 1.42 (95%CI: 1.12-1.81) with a 2-fold increase in patella lead levels, among participants with lower prudent pattern score. Whereas the HR of CHD was 1.09 (95%CI: 0.87-1.37) among higher prudent pattern score participants (p for interaction=0.10). In contrast, subjects with lower western pattern score had a HR of 1.08 (95%CI: 0.85-1.36); while those with higher western pattern score had an HR of 1.43 (95%CI: 1.12-1.81) (p for interaction=0.09). Conclusion: Our findings provide suggestive evidence that diet patterns may play important roles in individual vulnerability to lead-related CHD risk.

Overuse and Underuse of Aspirin for Primary Prevention of Cardiovascular Events in Primary Care

Background/Aims: The U.S. Preventive Services Task Force (USPSTF) currently recommends aspirin for primary prevention of coronary heart disease in men 45–79 years old and strokes in women 55–79 years old when the potential cardiovascular disease benefit outweighs the potential harm of gastrointestinal hemorrhage. The complexity and time required to assess risks and benefits for primary prevention can be a barrier for providers to giving patients USPSTF-consistent recommendations, resulting in potential overuse and underuse.

Women’s Heart Health: Differences in Heart Disease in Women Compared to Heart Disease in Men

Women’s Heart Health: Differences in Heart Disease in Women Compared to Heart Disease in Men

Background, Principles, Implementation, and General Experiences of the North Karelia Project.

The extremely high mortality of cardiovascular diseases in the 1960s in Finland, particularly in the Eastern Province of North Karelia and especially that of coronary heart disease in men, caused great concern among the local population. Action to reduce the problem was demanded in a petition signed in 1971 by the representatives of the population. In response, the North Karelia Project was launched in 1972 to carry out a comprehensive preventive project, first only in North Karelia as a national pilot (1972 to 1977), and thereafter continuing in North Karelia but at the same time transferring the experiences to a national level. The intervention was based on the at-that-time relatively new scientific information on the main causal risk factors. A comprehensive population-based intervention was carried out, aiming especially at the reduction of the high levels of serum cholesterol, blood pressure, and tobacco use, emphasizing general dietary changes and smoking reduction. A comprehensive monitoring and evaluation program was designed and implemented to learn from the experience in preparation for national and international use. Presented here are the background, principles, and general experiences of this project, which has made major contributions both to the contemporary public health work for the prevention and control of heart disease and noncommunicable diseases and for research in the area.

Sex Variations in the Effects of Arthritis and Activity Limitation on First Heart Disease Event Occurrence in the Canadian General Population: Results From the Longitudinal National Population Health Survey.

To estimate sex-specific effects of arthritis and activity limitation on incident heart disease in a nationally representative, Canadian longitudinal population-based survey. Information on sociodemographic variables, self-reported physician-diagnosed chronic conditions (including arthritis and heart disease), activity limitations, and traditional risk factors was collected every 2 years from 1994-1995 through 2010-2011 as part of the longitudinal Canadian National Population Health Survey. Deaths due to ischemic heart disease (International Classification of Diseases, Tenth Revision [ICD-10] codes I20-I25) and heart failure (ICD-10 codes I50.0-I50.9) were confirmed against the Canadian Vital Statistics Database. Discrete-time survival analysis stratified by sex was used to estimate effects of arthritis and activity limitation on first heart disease event occurrence. The study included 12,591 participants with no prior history of heart disease and 1,783 incident heart disease events. After adjusting for common risk factors, arthritis was associated with a significant increased risk of incident heart disease in women (adjusted odds ratio [OR] 1.58, 95% confidence interval [95% CI] 1.23-2.02). Even higher risks were reported in women with arthritis and activity limitation (OR 2.19, 95% CI 1.61-2.97). Arthritis was not associated with incident heart disease in men, except for when also reported with activity limitation (OR 1.60, 95% CI 1.14-2.26). Women with arthritis, and men with arthritis and activity limitation, have significant excess risks for developing heart disease in the general population. These findings point to the need for improved access to arthritis care, cardiovascular prevention strategies, particularly in women with arthritis, and directed interventions toward prevention of activity limitation.

Частота выявления интактных коронарных артерий и факторы, ассоциированные с необструктивной ишемической болезнью сердца у мужчин и женщин

Частота выявления интактных коронарных артерий и факторы, ассоциированные с необструктивной ишемической болезнью сердца у мужчин и женщин

Risk of Coronary Heart Disease in Men With Poor Emotional Control: A Prospective Study.

Many psychosocial factors have been associated with coronary heart disease (CHD), including hostility, anger, and depression. We tested the hypothesis that these factors may have their basis in emotion regulation abilities. Our aim was to determine whether poor emotional control predicted long-term risk of CHD. This Swedish national study includes 46,393 men who were conscripted for military service in 1969 and 1970. The men were aged 18 to 20 years at the time of conscription. Psychologists used a brief semistructured interview to retrospectively assess the conscripts' level of emotional control in childhood and adolescence. The outcome measure was a first fatal or nonfatal event of CHD. We calculated hazard ratios (HRs) and 95% confidence intervals (CIs) for poor and adequate versus good emotional control. After 38 years of follow-up (1971-2009), 2456 incident cases of CHD had occurred. Poor emotional control increased the risk of CHD (HR = 1.31, 95% CI = 1.18-1.45), adjusting for childhood socioeconomic position, anxiety, depression, and parental history of CHD. Further adjustment for life-style-related factors, for example, smoking and body mass index, attenuated the HR to 1.08 (95% CI = 0.97-1.21). In stratified analyses, the fully adjusted association between poor emotional control with CHD remained significantly elevated among men with a parental history of CHD (HR = 1.49, 95% CI = 1.11-2.01, p interaction = .037). In the overall study population, poor emotional control had no direct effect on CHD beyond life-style-related factors. However, in men with a parental history of CHD, poor emotional control in adolescence remained significantly predictive of long-term CHD risk even when adjusting for life-style-related factors.

Pessimism and the risk for coronary heart disease among middle-aged and older Finnish men and women: a ten-year follow-up study.

BackgroundDespite the growth in knowledge about coronary heart disease (CHD) risk factors, and the advances made in preventing and treating them, the incidence of CHD is still notably quite high. Research has concentrated on the physiological factors that present risks for CHD, but there is an increasing amount of evidence for the connection of mental health, personal traits and CHD. Data on the connection of disposition (optimism or pessimism) and CHD are relatively scarce. The aim of this study was to investigate the long-term connection between optimism, pessimism and the risk for having CHD.MethodsThis was a ten-year prospective cohort study on a regional sample of three cohorts aged 52–56, 62–66 and 72–76 years at baseline (N = 2815). The study groups were personally interviewed four times (in 2002, 2005, 2008 and 2012). The revised Life Orientation Test (LOT-R) was completed at the first appointment to determine the level of dispositional optimism or pessimism. During the ten-year follow-up, the incidence of new cases of coronary heart diseases was measured. The association between dispositional optimism/pessimism and the incidence of CHD during the follow-up was studied with logistic regression.ResultsThose who developed coronary heart disease during the ten-year follow-up were significantly more pessimistic at baseline than the other subjects. Using multivariate logistic regression models separately for men and women, we noticed no elevated risk for CHD in the pessimistic women compared to the non-pessimistic women. However, among men in the highest quartile of pessimism, the risk for CHD was approximately four-fold (OR 4.11, 95 % CI 1.68–11.04) that of the men in the lowest quartile. Optimism did not seem to have any role in the risk for developing CHD.DiscussionOur main finding is that pessimism seemed to be a clear risk factor for coronary heart disease in men even after adjusting for classical well-known risk factors while optimism did not seem to be a protective factor. Connection between pessimism and coronary heart disease was not detectable among women. Similar gender differences between psychosocial factors and overall well-being have been noticed in some earlier studies, too. The mechanism of this gender difference is not fully understood. Differences between men and women in somatic responses to stress found in earlier studies may at least partly explain this phenomenon.The impact of optimism and pessimism on cardiovascular disease has been studied earlier and several possible mechanisms have been discovered but it seems clear that they cannot fully explain the association. For example, optimists have healthier lifestyles which lowers the risk for coronary heart disease, but pessimism was established to be a risk factor for cardiovascular disease in our study even in logistic regressions including the best known classical risk factors, e.g. smoking and high level of blood glucose. According to our study it is important to pay attention also to the psychosocial components in addition to the well-known risk factors when planning the prevention of coronary heart disease. Measuring pessimism is quite easy and it consumes very little time. Once the amount of pessimism is ascertained, it is easier to define who is in the greatest need of preventive actions concerning coronary heart disease.ConclusionsPessimism seems to be a substantial risk factor for CHD, and as an easily measured variable it might be a very useful tool together with the well-known physiological risk factors to determine the risk for developing CHD, at least among men.

The placenta is the center of the chronic disease universe

Over the past quarter century it has become clear that adult onset chronic diseases like heart disease and type 2 diabetes have their roots in early development. The report by David Barker and colleagues showing an inverse relationship between birthweight and mortality from ischemic heart disease was the first clear-cut demonstration of fetal programming. Because fetal growth depends upon the placental capacity to transport nutrients from maternal blood, it has been a suspected causative agent since the original Barker reports. Epidemiological studies have shown that placental size and shape have powerful associations with offspring disease. More recent studies have shown that maternal phenotypic characteristics, such as body mass index and height, interact with placental size and shape to predict disease with much more precision than does birthweight alone. For example, among people in the Helsinki Birth Cohort, who were born during 1924–1944, the risk for acquiring colorectal cancer increased as the placental surface became longer and more oval. Among people in whom the difference between the length and breadth of the surface exceeded 6 cm, the hazard ratio for the cancer was 2.3 (95% CI 1.2–4.7, p=0.003) compared with those in whom there was no difference. Among Finnish men, the hazard ratio for coronary heart disease was 1.07 (1.02–1.13, P =0.01) per 1% increase in the placental weight/birthweight ratio. Thus, it appears that the ratio of birthweight to placental weight, known as placental efficiency, predicts cardiovascular risk as well. Babies born with placentas at the extremes of efficiency are more vulnerable for adult onset chronic diseases. Recent evidence suggests that placental growth patterns are sex specific. Boys’ placentas are, in general, more efficient than those made by girls. Another recent discovery is that the size, shape and efficiencies of the placenta can change over years of time with very narrow confidence limits. This suggests that the growth of the placenta within a population of women is strongly affected by their nutritional environment. Even though it is known that an individual placenta can expand to improve its nutrient acquisition capacity in the first 2/3rd of gestation, the mechanisms by which placentas grow in response to a specific nutritional environment are not known. Discovering those mechanisms is the task of the current generation of scientists. While it may seem obvious that good nutrition is highly important for women who are pregnant because it supports optimal placentation and fetal development, more research is needed to determine the mechanisms by which maternal nutrition, placenta growth and fetal health are related.

Choline and Betaine Intakes Are Not Associated with Cardiovascular Disease Mortality Risk in Japanese Men and Women1–3

Background: Dietary intakes of betaine and choline may reduce the risk of cardiovascular disease; however, epidemiologic evidence is limited. Seafood is a rich source of betaine and is a popular traditional food in Japan.Objective: We examined the associations of betaine and choline intakes with cardiovascular disease mortality in a population-based cohort study in Japan.Methods: Study subjects were 13,355 male and 15,724 female residents of Takayama City, Japan, who were aged ≥35 y and enrolled in 1992. Their diets were assessed by a validated food frequency questionnaire. Deaths from coronary heart disease and stroke were identified from death certificates over 16 y. Multivariable-adjusted HRs were computed by using Cox regression models.Results: During follow-up, we documented 308 deaths from coronary heart disease and 676 deaths from stroke (393 from ischemic and 153 from hemorrhagic strokes). Compared with the lowest quartile, the second, third, and highest quartiles of betaine intake were significantly associated with a decreased risk of mortality from coronary heart disease in men after controlling for covariates. The HRs were 0.58 (95% CI: 0.36, 0.93), 0.62 (95% CI: 0.39, 0.998), and 0.60 (95% CI: 0.37, 0.97), respectively. The trend was not statistically significant (P = 0.08). There was no significant association between betaine intake and the risk of mortality from ischemic stroke. In women, betaine intake was unrelated risk of mortality from coronary heart disease and stroke (P = 0.32 and 0.73, respectively, for interaction by sex). There was no significant association between choline intake and cardiovascular disease mortality risk in men or women.Conclusion: Overall, we found no clear evidence of significant associations between choline and betaine intakes and cardiovascular disease mortality risk in Japanese men and women.

Testosterone and cardiovascular disease risk

Ageing is accompanied by a reduction in circulating testosterone and progressive accumulation of medical morbidities. There is an intense debate whether low testosterone contributes to ill-health as opposed to being a biomarker for its presence. Prescriptions for testosterone are rising on a background of concern over potential adverse effects. This review examines evidence relating androgens to cardiovascular risk in older men. Observational studies show lower risk of cardiovascular events in older men with higher testosterone, and lower mortality from ischaemic heart disease in men with higher concentrations of its more potent androgenic metabolite dihydrotestosterone. However, randomized controlled trials of testosterone supplementation have been underpowered for the outcome of cardiovascular events. Recent meta-analyses have reached contrasting conclusions regarding cardiovascular adverse events associated with testosterone therapy. Retrospective studies of prescription databases have produced controversial and conflicting results. Additional randomized controlled trials are required to clarify the role of testosterone supplementation in older men in the absence of pituitary or gonadal disease. Pending such studies, testosterone therapy should be considered in androgen-deficient men, with evaluation of potential benefits and risks.

Correlation of androgenetic alopecia and early onset coronary heart disease in men.

Correlation of androgenetic alopecia and early onset coronary heart disease in men.

Effect of resistive-endurance exercises on myocardial tissue creatine kinase isoenzyme, IL-6 and IL-10 serum changes in male cardiovascular patients

The aim of the present study was to investigate the effects of endurance-resistance (concurrent) training on changes of CKmb, interleukin-6, and IL-10 levels of heart disease in men. For this purpose, 38 patients referred to medical centers Cardiovascular Shahin Shahr city, were selected. The patients were underwent bypass surgery or angioplasty balloon. After, patients filled demographic questionnaire and tests were performed to determine risk factors. Also echocardiography (Simpson) and limited exercise test method (Noughton) were used to determine functional capacity and ejection fraction. Before and after the exercise, anthropometric measurements (weight, waist circumference, hip circumference and subcutaneous fat three regions), blood tests for IL-6, IL-10, CKmb and walk test for 6 min (for determining the physical capacity) were measured. The exercises were performed 3 days a week for 24 sessions, each session was one hour. Results showed that rehabilitation programs reduce CKmb and inflammatory cytokines. Totally, the present study showed rehabilitation program having resistance- endurance (concurrent) training can be appropriate in order to perform functional capacity in patients. This method of training can cause improvement in muscular power, VO 2max and better cardiovascular performance and at last induce quality of life of patients.

Prolonged duration of breastfeeding does not affect lipid profile in adulthood.

The Hertfordshire study suggested that age of weaning and methods of infant feeding may influence adult serum low-density lipoprotein cholesterol (LDL-C) and mortality from ischemic heart disease in men. Although breastfeeding <1 year appeared to be protective compared with formula, prolonged breastfeeding (>1 year) was associated with increased LDL-C and mortality. This study tested the effect of breastfeeding duration on lipid profile in young adults. Adult volunteers whose mothers could recall the age at which their child was weaned were recruited. We excluded patients with known dyslipidemia, dyslipidemia in a first-degree relative, obesity (body mass index [BMI] >30 kg/m(2)), pregnant or within 3 months of a previous pregnancy, subjects taking medications that may affect lipid profile, or subjects with a chronic medical condition. Nutritional questionnaires and number of weekly hours of exercise were recorded. Lipid profiles were obtained after a night fast. The three groups (no breastfeeding, breastfeeding 0-6 months, or breastfeeding >9 months) did not differ in terms of age, gender, BMI, level of education, amount of exercise, and dietary style. By stepwise background multiple regression analysis taking into account exercise, nutritional habitus, age, BMI, gender, and socioeconomic status, blood lipids were not affected by duration of breastfeeding. Duration of breastfeeding does not affect lipid profiles in young adults. These findings do not support negative messages on the long-term effect of prolonged lactation generated by the Hertfordshire study.

Abstract P066: Cortisol/Testosterone and Cortisol/ Sex Hormone Binding Globulin Ratios With Metabolic Syndrome in Women

Introduction: The ability to study chronic stress in humans is complicated due to measurement error of questionnaires and the inability of short-term measures of stress hormones to reflect the chronic state. Therefore considerable controversy remains about whether chronic stress influences cardiovascular disease or not. The cortisol/testosterone (C/T) ratio was suggested to be a better predictor of heart disease in men than cortisol alone, as gonadotropin and cortisol are derived from the same biochemical precursor. This ratio has never been studied with metabolic syndrome (MetS) in a U.S. epidemiologic study, especially in women. Study question: Are C/T and C/sex hormone binding globulin (SHBG) ratio associated with MetS in women? Methods: In the Coronary Artery Risk Development in Young Adults (CARDIA) study, 367 women (age range 32 to 51, mean age 40 years old) who had both cortisol from year (Y) 15 and sex hormones from serum specimen Y16 measured are included. Metabolic syndrome (MetS) from Y15, 20, 25 were assessed. Due to the instability and diurnal characteristics of cortisol, area under the curve (AUC) of six samples and slope of 1st (or 3rd) and 6th (or 5th when 6th is not available) sample of salivary cortisol collected over one day were calculated. Ratios of AUC and of slope of cortisol to total testosterone (TT), free testosterone (FT), and sex hormone binding globulin (SHBG) were computed: AUC/TT, AUC/FT, AUC/SHBG, Slope/TT, Slope/FT, and Slope/SHBG. The associations of these variables categorized into tertiles with MetS were assessed cross-sectionally by logistic regression analysis. Model I controlled for age and race. Model II controlled for model I variables plus menopause, oral contraceptive usage, diabetes mellitus, alcohol consumption, and cigarette smoking. Results: MetS was present in 53, 69, and 74 participants at Y15, Y20, and Y25, respectively. The highest tertile of AUC/SHBG ratio was associated with Y15, Y20, and Y25 MetS prevalence in model I (OR 2.17, 3.77, 2.65, 95% CI 1.02-4.61, 1.64-8.44, 1.75-9.20, respectively). This association was slightly stronger in model II (OR 3.72, 4.76, 3.26, 95% CI 1.49-9.30, 2.00-11.34, 1.55-6.85, respectively). The highest tertile of slope/FT ratio was associated with Y20 and Y25 MetS prevalence in model I (OR 2.10, 1.68, 95% CI 1.03-4.26, 0.86-3.31 respectively). This association was slightly stronger in model II (OR 2.32, 2.13, 95% CI 1.09-4.95, 1.03-4.41 respectively). Conclusions: Findings suggest that some indicators of chronic stress are cross-sectionally associated with MetS in women.

Abstract P065: Cross-Sectional and Prospective Associations of the Cortisol/testosterone and Cortisol/ Sex Hormone Binding Globulin Ratios With Atherosclerosis in Women

Introduction: The ability to study chronic stress in humans is complicated due to measurement error of questionnaires and the inability of short-term measures of stress hormones to reflect the chronic state. Therefore considerable controversy remains about whether chronic stress influences atherosclerosis or not. The cortisol/testosterone (C/T) ratio was suggested to be a better predictor of heart disease in men than cortisol alone, as gonadotropin and cortisol are derived from the same biochemical precursor. This ratio has never been studied in a U.S. epidemiologic study, especially in women. Study question: Are C/T and C/sex hormone binding globulin (SHBG) ratio associated with subclinical atherosclerosis in women? Methods: In the Coronary Artery Risk Development in Young Adults (CARDIA) study, 367 women (age range 32 to 51, mean age 40 years old) who had both cortisol from year (Y) 15 and sex hormones from serum specimen Y16 measured are included. Intima-media thickness (IMT) from Y20 was assessed cross-sectionally. Coronary artery calcium (CAC) incidence from Y15-25 was assessed prospectively where available (n=299). Due to the instability and diurnal characteristics of cortisol, area under the curve (AUC) of six samples and slope of 1st (or 3rd) and 6th (or 5th when 6th is not available) sample of salivary cortisol collected over one day were calculated. Ratios of AUC and of slope of cortisol to total testosterone (TT), free testosterone (FT), and sex hormone binding globulin (SHBG) were computed: AUC/TT, AUC/FT, AUC/SHBG, Slope/TT, Slope/FT, and Slope/SHBG. The associations of these variables categorized into tertiles with CAC and IMT were assessed by logistic regression analysis (CAC) and multiple linear regression (IMT). Model I controlled for age and race. Model II controlled for model I variables plus BMI, systolic BP, menopause, oral contraceptive usage, diabetes mellitus, alcohol consumption, and cigarette smoking. Results: The highest tertile of AUC/FT ratio was associated with Y20 carotid bulb IMT max in model I (β=0.07, p=0.031) and model II (β=0.09, p=0.006). This ratio also had moderate OR with incident CAC from Y15 to Y25 in model I (OR 2.22, 95% CI 0.89-5.51) and had significant association in model II (OR 3.45, 95% CI 1.18-10.06). Conclusions: Findings suggest that AUC/FT ratio is cross-sectionally and prospectively associated with subclinical atherosclerosis in women.

Dietary fatty acids and risk of coronary heart disease in men: the Kuopio Ischemic Heart Disease Risk Factor Study.

The epidemiological evidence of the role of dietary saturated fatty acids (SFA) in the development of coronary heart disease (CHD) is inconsistent. We investigated the associations of dietary fatty acids with the risk of CHD and carotid atherosclerosis in men with high SFA intake and high rates of CHD. In total, 1981 men from the population-based Kuopio Ischemic Heart Disease Risk Factor Study (KIHD), aged 42 to 60 years and free of CHD at baseline in 1984 to 1989, were investigated. Food consumption was assessed with 4-day food recording. Multivariate nutrient-density models were used to analyze isocaloric replacement of nutrients. CHD events were ascertained from national registries. Carotid atherosclerosis was assessed by ultrasonography of the common carotid artery intima-media thickness in 1015 men. During the average follow-up of 21.4 years, 183 fatal and 382 nonfatal CHD events occurred. SFA or trans fat intakes were not associated with CHD risk. In contrast, monounsaturated fat intake was associated with increased risk and polyunsaturated fat intake with decreased risk of fatal CHD, whether replacing SFA, trans fat, or carbohydrates. The associations with carotid atherosclerosis were broadly similar, whereas the associations with nonfatal CHD were weaker. Our results suggest that SFA intake is not an independent risk factor for CHD, even in a population with higher ranges of SFA intake. In contrast, polyunsaturated fat intake was associated with lower risk of fatal CHD, whether replacing SFA, trans fat, or carbohydrates. Further investigation on the effect of monounsaturated fat on the CHD risk is warranted.

Оценка смертности населения Тульской области

The article analyzes 183924 case of death of the population in the Tula region from the mortality register from 2007 to 2013. Quantitative assessment of mortality as a percentage of the total number of cases for blocks of three-digit rubric of ICD-X shows that coronary heart disease is 31,507%, cerebrovascular disease – 22,710%, malignant neoplasms of digestive organs – 5,336%, other heart disease – 3,686, liver disease – 2,848%, diabetes – 2,658%, malignant neoplasms, respiratory organs and thorax cells – 2,607%, toxic substances, mainly non-medical purposes (including alcohol) – 2,252%, other and unspecified effects of external causes – 2,069%, chronic diseases of the lower respiratory tract – 1,870%.It is shown that ischemic heart disease was increased until 2010 and thereafter began to decline, reaching approximately the initial level. It is noted that cerebrovascular diseases decrease every year, and malignant neoplasms of digestive organs increase. Coronary&#x0D; heart disease for men is different from women significantly fewer and increased mortality in the age groups 45- 54, 55-64 and 65-74.

Impact of abdominal obesity and systemic hypertension on risk of coronary heart disease in men and women

The objective of our study was to determine the respective contributions of waist circumference and systemic hypertension (HTN) to coronary heart disease (CHD) risk in a large population-based cohort representative of a contemporary European population. A total of 9580 men and 12 250 women aged 45-79 years were followed for 11.4 years. Over the follow-up, 2191 CHD events were recorded. After adjusting for traditional CHD risk factors, individuals with high blood pressure (BP) and high waist circumference were at an increased CHD risk [hazard ratio 3.04; 95% confidence interval (CI) 2.06-4.48 and 2.90 (1.85-4.55) in men and women, respectively], compared with individuals with both low waist circumference and BP. Among individuals with normal BP, those in the top waist circumference tertile were at an increased CHD risk compared with those in the bottom waist circumference tertile (hazard ratio 2.66; 95% CI 1.59-4.45 and 2.11; 95% CI 1.12-3.97 in men and women, respectively). Within each physical activity category, a linear positive association was observed between waist circumference tertiles and both SBP (P for trend <0.001) and DBP (P for trend <0.001). Within each waist circumference tertile, inactive individuals had higher SBP than active individuals (P for trend <0.001). Our results show that abdominal obesity (measured by waist circumference) and HTN had both independent and additive contributions to CHD risk. We also found that physical inactivity and abdominal obesity contribute to elevated BP in primary prevention settings.