Considering the number of patients affected by SARS-CoV-2, the World Health Organization declared a pandemic on 11 March 2020. A number of publications regarding the course of COVID-19 infection and its relation to comorbidities have appeared since December 2019, when the first cases of atypical pneumonia were diagnosed in China. There is evidence of the higher susceptibility and higher risk of unfavourable outcomes in comorbid patients, including those with hypertension. We summarize the available data on the association with the COVID-19 infection and arterial hypertension, and discuss potential risks, e.g. the risks and benefits of antihypertensive therapy (in particular, related to the blockers of renin-angiotensin-aldosterone system) and the management approaches.

Regarding prevention of cardiometabolic diseases, we often rely on the concepts of risk and disease, rather than the possibility of prevention. The concept of “vascular age” is developed to assess the biological state of arteries and to present cardiovascular risk in years for better understanding by the doctor and patient. Early vascular aging (EVA) syndrome has been studied for more than 10 years to determine the optimal diagnostic criteria and treatment approaches. In 2019, leading experts in the area of vascular stiffness suggested the opposite concept of supernomal vascular aging (SUPERNOVA), in which patients have extremely low vascular stiffness rates for their age and gender. This review discusses new data about factors that accelerate or slow vascular aging.

The problem of the widespread prevalence of noncommunicable diseases (NCDs) and their risk factors (RF) has not lost its relevance already for many years. In 2017, World Health Organization (WHO) published cost-effective solutions and other recommended interventions for the prevention and control of NCDs. For each behavioral RF and category of disease, measures are listed with an assessment of their cost-effectiveness. In this review, the measures presented by WHO are analyzed in terms of their application at three out of the six levels identified by the authors: community, family, medical specialist. Human health is known to be only 1015 % dependent on medical support. However, medical specialists are completely responsible for some types of prevention, as well as the management of NCDs. At the same time, only a small number of novel studies on the prevention and management of NCDs are devoted to activities carried out at the level of communities or families. To date, it is necessary to take these levels into account when developing comprehensive preventive measures of the “life-long cycle”. The review provides examples of preventive programs aimed at combating unhealthy diet and lack of physical activity, consumption of alcohol and salt. It also examines the relationship of infectious and non-communicable diseases by the example of human papillomavirus infection. Possible criteria that increase the effectiveness of modern preventive measures have been identified.

Hypertension (HTN) is one of the most common diseases and a risk factor leading to disabling and fatal complications. Large-scale epidemiological studies in all countries convincingly prove the need for early prevention and treatment of this pathological condition. In conditions of rapid urbanization, it is necessary to look for individual measures for the prevention and treatment. In addition to the main risk factors for HTN, such as low physical activity and increased body weight, smoking, alcohol abuse, as well as sex and age, there is convincing evidence that the level of education, economic status, professional affiliation, living conditions are also potential predictors of HTN. The review presents an analysis of the main socio-economic risk factors for HTN and the mechanisms of their influence on blood pressure. The article discusses each factor, its impact on blood pressure and the body as a whole, as well as approaches for the identification of these factors.

Preeclampsia (PE) is one of the most common and serious complications of pregnancy. In women with a history of PE the risk of cardiovascular disease is increased, and atherosclerosis can be induced even during fetal development. The exact mechanisms by which PE increases future cardiovascular risk are unknown, although multiple similarities between mechanisms responsible for cardiovascular disease and PE are reported. Risk factors for PE, such as obesity, insulin resistance, thrombophilia, changes in the lipid spectrum are similar to those for atherosclerosis, which allows us to compare these two conditions to clarify the specifics and is important for understanding the pathogenesis of both pathologies. PE, as well as atherosclerosis, manifests as endothelial dysfunction, abnormal immune function, oxidative stress, activation of inflammation, changes in lipid metabolism. Recent studies have provided a broader understanding of the problem, although there are still many open questions. The etiology and pathogenesis of these diseases, their possible relationship are not fully understood. The article provides a summary of possible common mechanisms of PE and atherosclerosis.

Background. Arterial stiffness, which is a marker of vascular damage and cardiovascular disease independent predictor, can be used as an indicator of vascular aging. Vascular changes may occur in some individuals earlier than it comes according to chronological age (early vascular aging syndrome) or later (healthy aging). SUPERNOVA (supernormal vascular aging) is a new protective phenotype in which very low arterial stiffness values are recorded regardless of the level of risk factors exposure.

Objective. To assess the prevalence of SUPERNOVA phenomenon and risk factors in St Petersburg population-based sample.

Design and methods. The survey of 1600 St Petersburg residents aged 24-65 years was performed in terms of the epidemiological observation study ESSE-RF (2012-2013). Anthropometry and fasting blood sampling for lipids and glucose detection and blood pressure measurement according to standard methods were performed. Pulse wave velocity (PWV) assessed by SphygmoCor (Australia) was performed in 524 people. 485 participants were selected without cardiovascular complications history. The participants were divided by age into 5 groups: persons under 30 years, 30-39 years, 40-49 years, 50-59 years, 60 years and older. PWV < 10th percentiles for healthy individuals PWV (Reference Values for Arterial Stability’s Collaboration, 2010) was detected as SUPERNOVA phenomenon in each age group. Mathematical and statistical data analysis was implemented using IBM SPSS Statistics 20.0.

Results. SUPERNOVA phenomenon prevalence was 9,8 % (48 participants): 11,9 % women (32 participants) and 7,4 % men (16 participants). Among women systolic blood pressure (SBP) levels (p = 0,01) and body mass index (BMI) (p = 0,055) were significantly lower. Subjects with SUPERNOVA showed significantly lower SBP and diastolic blood pressure (DBP), BMI, glucose, triglycerides and lower prevalence of arterial hypertension (HTN), obesity, hypercholesterolemia and hypertriglyceridemia. In participants younger 30 years only obesity prevalence was significantly lower in respondents with SUPERNOVA, based on BMI criterion (p = 0,046). Participants aged 30-39 years showed no significant differences. In the group aged 40-49 years BMI (p = 0,02), abdominal obesity prevalence (p = 0,05), as well as SBP levels (p = 0,03) and DBP (p = 0,05) was significantly lower in individuals with SUPERNOVA. In the group aged 50-59 with SUPERNOVA significantly lower HTN prevalence (p = 0,03), glucose levels (p = 0,005) and BMI (p = 0,04) were found. In the older age group of 60-65 years subjects with SUPERNOVA have significantly lower levels of SBP (p = 0,014) and DBP (p = 0,014), as well as significantly lower prevalence of HTN (p = 0,03).

Conclusions. At population level the phenomenon of supernormal vascular aging occurs in about 10 % without significant gender prevalence. HTN, obesity and metabolic factors are the determining factors of vascular aging. Ideal vascular health is associated with age-specific features.

Objective, To establish the prevalence of psychoemotional stress factors among young and middle-aged women in an open population of the mid-urbanized Siberian city.

Design and methods. A cross-sectional epidemiological study was conducted among working-age women in the Central Administrative District of Tyumen in 2015-2016. A representative sample was formed from the election lists among women of 25-64 years using the “random numbers” method — 1000 people (250 people each in the decades of life 25-34, 3544, 45-54, 55-64 years), the response was 70,3 %. We used the algorithms of the WHO program “MONICA-psychosocial” to determine psychosocial risk factors — personal anxiety, depression, hostility, life exhaustion.

Results. Among women in an open population of a moderately urban Siberian city, medium and high levels of personal anxiety were evenly distributed, the average level of depression and life exhaustion prevailed over a high level, while high level of hostility prevailed over average level. The prevalence of high levels of personal anxiety, depression, hostility was comparable among young and middle-aged women, an increase in the high level of life exhaustion in middle age was found. In young women of an open urban population, the age trend in the prevalence of psychosocial risk factors was due to the increased high level of hostility in the fourth decade of life. In middle-aged women, the age trend in the prevalence of psychosocial risk factors was due to the increased high levels of vital exhaustion in the fifth and sixth decades of life.

Conclusions. Thus, the data obtained within evidence-based prevention programs with the use of novel technologies of differentiated impact on age-dependent psycho-emotional stress factors are highly relevant and correspond to the European and international experience in conducting preventive measures using population strategies and high risk strategies in female populations.

Objective. The purpose of this study was to assess the prevalence and risk factors for atrial fibrillation (AF), to analyze the rates of administration of antiarrhythmic and anticoagulant therapy.

Design and methods. We performed a retrospective study by analyzing primary medical records of patients referred to cardiologists in a multidisciplinary outpatient clinic.

Results. Based on analysis of 24,215 outpatient records of patients referred to cardiologists of a multidisciplinary outpatient clinic, we found that 1822/24215 (7,5 %) patients had AF, the non-valve form of AF prevailed — 1783/1822 (97,7 %). AF was more common in patients over 60 years of age and in women (58,8 % vs 41,2 % in women and men, respectively, p = 0,001). Important risk factors for AF were advanced age, hypertension (HTN), coronary heart disease (CHD), and diabetes mellitus (DM). HTN, CHD, congestive heart failure (CHF) and DM were more common in patients older than 60 years. Among the methods of rhythm control and restoration, antiarrhythmic therapy 1179/1822 (64,7 %) prevailed, radiofrequency catheter ablation was performed in 93/1822 (5,1 %) patients. According to the CHA₂DS₂VAS_c scale, the risk of thromboembolic complications was the following: ≥ 2 scores (men) and ≥ 3 scores (women) were registered in 1494/1822 (83,8 %) patients, 1 score (men) and 2 scores (women) — in 205/1822 (11,3 %) patients, and HTN was the the only risk factor in 150/205 (73,2 %) subjects. Despite existing indications, anticoagulant therapy was not prescribed in 392/1525 (25,7 %) cases, and among patients with stroke or transient ischemic attack (TIA) — in 28/209 (13,4 %) cases. Non-vitamin K-antagonist oral anticoagulants (NOAC) prevailed and were administered in 1114/1275 (87,4 %) cases. Full-dose NOACs were prescribed in 643/1114 (57,7 %) cases, in a reduced dosage — in 471/1114 (42,3 %) cases. In the apixaban subgroup, the reduced dose was unreasonably prescribed in 164/380 (43,2 %) cases, in the rivaroxaban subgroup — in 196/586 (33,5 %) cases, in the dabigatran subgroup — in 21/148 (14,2 %) cases.

Conclusions. The prevalence of AF in outpatient cardiology practice is 7,5 %. Risk factors for AF are elderly age, HTN, CHD, CHF and DM. Only 5,1 % patients with AF underwent radiofrequency catheter ablation. Anticoagulant therapy was prescribed for the majority of AF patients, but was often not prescribed or recommended in low doses.

Objective. The aim of the study is to identify pathogenetic features of the development of masked hypertension in athletes in the Republic of Sakha (Yakutia).

Design and methods. We enrolled 205 young men and males: 147 athletes with different orientations of training activity (cyclic sports and martial arts) and 58 control individuals without physical activity. All subjects underwent 24-hour blood pressure (BP) monitoring, anthropometry, echocardiography, assessment of central hemodynamics, and a genetic study.

Results. Despite similar sports experience, 40,8 % athletes have masked hypertension, which is more common among athletes with the “master of sports” qualification (χ² = 5,68, df = 1, p = 0,013) and does not depend on sport type (χ² = 2,09, df = 1, p = 0,107). Athletes with masked hypertension showed nocturnal hypertension, decreased myocardial function, and a high rate of left ventricular structural remodeling.

Conclusions. We identified the following genetic and phenotypic features: associations of gene polymorphisms responsible for the development of hypertension, episodes of insufficient nighttime BP decline, nocturnal hypertension, structural remodeling of the heart. These findings suggest that people with masked hypertension show cardiovascular overstrain at rest, which considering excessive physical load can lead to target-organ damage. This pathogenetic factors can be considered as phenogenotypic predictors of hypertension development and require further investigation.

Objective. To study the contribution of the main endothelial vasodilators using different functional tests.

Design and methods. Blood flow in the microvessels of the forearm skin was assessed in 30 healthy volunteers (20-21 years) using high-frequency Doppler ultrasound. Three functional tests were performed: iontophoresis with acetylcholine, a test with reactive hyperemia and a temperature test with local heating of the forearm skin to 42 °C. To analyze the mechanisms of endothelium-dependent vasodilation we carried out iontophoresis of vasoactive substances: L-Nitro-Arginine Methyl Ester (L-NAME) — inhibitor of endothelial NO synthase (eNOS), tetraethylammonium (TEA) — inhibitor of endothelial hyperpolarizing factor (EDHF), diclofenac sodium — inhibitor of cyclooxygenase (COX).

Results. During the test with acetylcholine was characterized by a rapid increase in the volume rate of blood flow for 2 minutes, from 4 minutes there was a slow decrease in the volume rate of blood flow. The blockade of nitric oxide and prostacyclin led to a slowdown in blood flow growth and the blockade of EDHF to accelerate the recovery of the reaction of microvessels to acetylcholine. In postocclusion test changes in blood flow occur only under blockade of nitric oxide, while the blockade of EDHF and prostacyclin showed no effect on reactive hyperemia. Similar results were obtained by local heating of the skin.

Conclusions. Nitric oxide plays a leading role in all tests, including local heat test and flow-mediated dilation. Endothelial hyperpolarizing factor is significant only in the mechanism of acetylcholine-induced vasodilation.

Objective. To study the prevalence of hypertension (HTN), concomitant and associated cardiovascular, metabolic diseases and disorders in people with different levels of blood glucose in the non-diabetic range.

Design and methods. A content analysis of 1503 outpatient maps was carried out with the assessment of age, body weight, body mass index (BMI), fasting plasma glucose (FPG), total cholesterol, low density lipoprotein cholesterol (LDL)), overweight/obesity, HTN, atherosclerotic diseases. The changes in carbohydrate metabolism were classified as following: highnormal FPG (5,6-6,0 mmol/l; n = 141; group 1), normoglycemia (FPG up to 5,5 mmol/l; n = 1227; group 2), previously diagnosed prediabetes (n = 54; group 3) and diabetes mellitus (n = 81).

Results. Group 1 was characterized by higher body mass, BMI, FPG, total cholesterol, higher prevalence of dyslipidemia, atherosclerotic diseases, overweight/obesity, HTN (p < 0,001) compared with group 2. The presence of a “highnormal level of FPG” is associated with an increased risk of dyslipidemia (relative risk: RR 1,579; 95 % confidence interval (CI): 1,348-1,803), atherosclerotic diseases (RR2,095; 95 % CI 1,371-3,832), obesity (RR 1,766; 95 % CI 1,568-1,934), AH (RR 1,697; 95 % CI 1,45-1,93). Groups 1 and 3 did not differ by the general characteristics. HTN patients in group 1 compared with group 2 more often had dyslipidemia (p = 0,034) and overweight/obesity (p = 0,014). In patients with HTN, the presence of “highnormal FPG” is associated with an increased risk of dyslipidemia (RR 1,221; 95 % CI 1,005-1,429), overweight/obesity (RR 1,189; 95 % CI 1,0291,319). HTN patients in groups 1 and 3 did not differ in the frequency of dyslipidemia, atherosclerotic diseases, overweight/obesity.

Conclusions. “Highnormal level of FPG” is associated with an increased risk of dyslipidemia, atherosclerotic diseases, HTN, obesity; among HTN patients—with an increased risk of dyslipidemia, overweight/ obesity. Patients with “highnormal FPG” and patients with prediabetes show similar cardiometabolic status.

In the context of the COVID-19 pandemic and the need to maintain self-isolation, the vast majority of outpatient services are closed, and the inpatient clinics have limited the workload admitting almost only urgent cases. Outpatients, including ones with various sleep disorders, are left without access to the specialized examinations. This will lead to the late diagnosis and untimely therapy prescriptions. In such conditions, it is relevant to take into account new instrumental diagnostic methods that could be used by the patient themselves to register their vital parameters at home. The obtained data can be transmitted via the Internet to the attending physician for further analysis followed by prescriptions when required. One of these methods is bioradiolocation, which allows noncontact recording of breathing patterns, heart rate and movement of a person during sleep, as well as detection of various sleep disorders and determination of sleep stages. This method is easy to use, and can be recommended for home-screening by patients. Sleep has a significant immunomodulating function, and sleep assessment is important in both patients at risk and afflicted with novel coronavirus infection. Thus, the use of bioradiolocation method at home for non-contact sleep monitoring may be relevant in case of closure of outpatient facilities and will provide the doctor with objective data on sleep patterns and patterns of breathing, motor activity, the presence and amount of respiratory disturbances during sleep.