CURRENT TREATISE OF RISK FACTORS FOR CIRCULATORY DISEASES ASSOCIATED WITH ATHEROSCLEROSIS

V.l. Kharcherko, O.B. Joffina, Ye.B. Cooperberg, A.S. Akopyan, N.I. Osipov
Russian State Medical University, Scientific Center of Cardiovascular Surgery, Russian Academy of Medical Sciences, Moscow Clinical Central Basin Hospital,
Moscow, Russia

Based on the reported data and their own experience the authors suggest the systemiwtion of risk factors for circulatory diseases (RFCD) associated with atherosclerosis by classifying them with 4 groups.

1. Classic RF CD revealed primarily in the course of Freminham studies and data processing:

unchangeable factors: sex, age, heredity – close relatives suffering from coronary artery disease (CAD) or other diseases associated with atherosclerosis in men under 55 years and in women under 65 years*), familial hyperlipidemia;
changeable factors: hyperlipidemia, arterial hypertension, tobacco-smoking, diabetes mellitus;
other RF the influence of which on CAD development is less documented: psychosocial factors, hyperuricemia, alcohol abuse, soft drinking water, sedentary life (hypokinesia), the use of oral contraceptives, etc.

2. Risk factors of the new generation revealed over recent time in the course of studies into new components of atherosclerosis: Apo-A, Apo-B, Apo-E; HDL-2, HDL-3; impairment of homocysteinemetabolism, lipidperoxidation, antioxidant blood capacity, the lack or density reduction of receptors pertinent to cholesterol removal from vessel wall and so forth.

3. Russian RF – risk factors for CD having the greatest importance in up-to-date Russia: deterioration of the living standards; psychoemotional factors, unhealthy way of life (alcohol abuse, tobacco-smoking, violation of work standards hygiene, malnutrition), unavalability of drug medical services as well as underfinancing of medical institutions and the lack of the universal planned dispensary system for population.

4. Local RF (intimal thickening and/or arterial stenosis) leading to an increase of the risk for thrombosis and occlusions of arteries alongside other factors (the rise of blood viscosity, red blood cell and platelet counts, platelet aggregation, blood coagulation, reduced fibrinolytic activity). Information on the presence and intensity of these RF can be obtained with the aid of up-to-date noninvasive exploration methods (different types of Doppler, duplex scanning) and angiography.

The authors hold that the systemization of RF CD associated with atherosclerosis suggested by them may be helpful in the design of more effective measures aimed at these factors elimination under conditions of modem Russia.

* According to the data of Russian researchers, in men under 50 and in women under 60 years.

P. 145

« Back