With the increase in life expectancy, there is an increase in the number of elderly people among the population, therefore, an important task for Russian health care is to ensure healthy aging. An examination of a group of centenarians can help in studying the factors and causes that contribute to a long life without development or with the later development of age-associated diseases. In many ways, the long life expectancy and better health of such people are genetically determined. At the same time, longevity, as a complex sign, is influenced by many genetic polymorphisms, often with a small individual effect. Identification of hereditary determinants and their effects on the mechanisms of aging is necessary to identify the foundations of healthy longevity and to find protector mechanisms and targets by which it is possible to prevent the occurrence or slow the progression of age-related diseases.

The pathology of the cardiovascular system is the most significant of the diseases associated with aging, since it is the leading cause of mortality according to world statistics. Thus, cardiovascular aging is an important factor in determining a person’s life expectancy.

This article examines the methodological aspects of studies involving centenarians, and also provides an overview of genes that affect both life expectancy and longevity, as well as the development and course of cardiovascular diseases.

The metabolic needs of the brain largely depend on the intensity of the functioning of its various departments, which requires constant regulation of the level of local blood flow. The importance of accurate and timely regulation of cerebral blood flow is enhanced by the lack of substrate stores for autonomous energy production in nervous tissue. In this case, the state of systemic hemodynamics can have a significant effect on organ blood flow. At the same time, given the significant importance of the central nervous system in providing all physiological processes, the regulation of organ cerebral blood flow is aimed at minimizing the possible adverse consequences of the influence of disorders of systemic hemodynamics. In this regard, the regulation of cerebral blood flow is based on multiple and complex physiological mechanisms at various levels. The basic level of regulation of cerebral blood flow is myogenic response, which provides the phenomenon of autoregulation of blood flow in the brain. The review focuses on the physiological mechanisms underlying myogenic regulation as well as the change in this regulation in various diseases.

Objective. To evaluate gender differences in the profile of a wide range of risk factors (RF) among men and women aged 65 years and older and its associations with cardiovascular and all-cause mortality. Design and methods. The present study was the part of the Survey on Stress, Aging, and Health in Russia. The sample size was 1,243 participants aged 65 years and older. Thirty RF were included in the analysis, including social, cardiometabolic, behavioural, physical and cognitive functioning, inflammation, and neuroendocrine biomarkers, as well as coronary heart disease (CHD), myocardial infarction, arterial hypertension, and acute stroke. The mean follow-up was 12 years, during which 534 participants died from various causes, including 324 from cardiovascular diseases (CVD). Results. Multivariate analysis showe that elevated heart rate, smoking, excessive alcohol consumption, elevated interleukin‑6, elevated leukocyte levels, reduced cognitive function (for CVD mortality), CHD and history of acute stroke contributed to allcause and CVD mortality among men 65 years and older. Elevated blood pressure and elevated high-sensitive C-reactive protein, impaired cognitive function, reduced muscle strength, reduced dehydroepiandrosterone sulfate levels, absence of children, and a history of acute stroke were associated with all-cause and CVD mortality among women 65 years and older. Conclusions. The present study identified gender difference in survival and RF profile for both total and CVD mortality in population of men and women aged 65 years and older. Aamong more than 30 RF and several CVD, 8 indicators were found to affect mortality in men and 7 RF affected mortality in women.

Objective. The aim of the study was to investigate the content of fatty acids (FA) in the blood plasma of Novosibirsk men (“ESSE-RF3” in the Novosibirsk region) with established and newly diagnosed arterial hypertension (HTN). Design and methods. Within the framework of the multicenter single-stage epidemiological study ESSE-RF3 in the Novosibirsk region, 1200 residents of Novosibirsk (men — 600, women — 600) aged 35–74 years were examined. The random number study included 340 men with an average age of 54,63 ± 11,34 years, of which 156 people with established HTN, 49 had AH for the first time, and 135 people without HTN. In the blood plasma, the fatty acid spectrum of blood, including omega‑3,-6,-9 FA, was determined by highperformance liquid chromatography. Results. The level of alpha-linolenic and gamma-linolenic FAs was 1,21 (p = 0,005) and 1,39 times higher (p = 0,013) in the group of men with established HTN (who did not reach the target values of blood pressure against the background of therapy), respectively. The content of gammalinolenic acid was 1,46 times higher in the group of men with the first ever detected HTN (p = 0,038) when compared with the group of men without HTN. The relative chance of HTN in men, regardless of risk factors, is directly associated with an increase in the level of gamma-linolenic FA, and inversely associated with the level of hexadecenoic FA in blood plasma. Conclusions. Thus, from the studied FA in blood plasma, an increase in the level of gamma-linolenic FA can serve as an additional informative biomarker indicating a high probability of developing HTN in men.

Objective – to study the incidence and risk factors of atrial fibrillation (AF) in patients with obstructive sleep apnea syndrome (OSA), verified according to screening respiratory monitoring during sleep, performed during hospitalization in a therapeutic hospital. Design and methods. The study performed a retrospective analysis of 291 case histories of patients hospitalized in a therapeutic clinic in 2021-2022. All patients underwent overnight respiratory monitoring as part of the initial screening examination for sleep-disordered breathing. Results. Obstructive sleep apnea syndrome was identified in 216 patients, mild severity – in 27,8%, moderate severity – in 20,3%, severe severity – in 26,1% of patients. The incidence of atrial fibrillation in patients with diagnosed OSA was 28,7% and was significantly higher in patients with severe apnea compared to patients with mild apnea (p=0,043). According to the results of the analysis of the reasons underlying the development of AF in patients with verified apnea, arterial hypertension was identified in 96,8% of patients, chronic heart failure in 72,6%, coronary heart disease in 51,6%, thyrotoxicosis in 6,5%, sick sinus syndrome in 4,8% of patients, 19,4% of patients without structural heart damage. In severe apnea, the permanent form of AF was more common (p=0,008), and in mild OSA, paroxysmal AF was more common (p=0,024). It was found that the volumes of the left and right atria in patients with AF and severe OSA are greater than in patients with mild apnea. Conclusion. AF in OSA often occurs in patients without organic heart disease. The most common risk factors for AF in patients with OSA were arterial hypertension, found in 96,8% of subjects, as well as obesity (in 74,2%). The incidence of AF in patients with severe apnea is higher than in patients with mild apnea. The permanent form of AF is detected more often, and atrial volumes are larger in patients with severe OSA compared to patients with mild sleep-disordered breathing.

Objective. To study feasibility of atherosclerotic plaque (AP) detection in individuals working in the Arctic via rotating shifts (ARS) regarding sex, arterial hypertension (HTN), immune inflammation. Design and methods. In Yamburg village (68° 21’ 40” N), 99 males (M) and 81 females (F) with HTN 1,2 stages and normotensive individuals, comparable in age, work experience in ARS, office blood pressure (BP) were examined. Ultrasound examination of carotid arteries, biochemical blood test was performed. Statistica 8,0 (Stat Soft, USA), IBM SPSS Statistics 23 (IBM, USA). Results. Analysis was conducted in M and F groups with AP (n = 98) / without AP (n = 82): among them 57 M (58%), 41 F (51%) were with AP, Рχ2 = 0,6116; with/without HTN. In HTN M, more often than in normotensive M, AP was visualized in carotid arteries lumen: 72% (44 out of 61) vs 34% (13 out of 38), Рχ2 = 0,0209. Probability of AP in M was associated with highly sensitive C-reactive protein (p = 0,052), level of very low density lipoprotein cholesterol (VLDL CH) (p = 0,038), C-peptide (p = 0,004), interleukin IL‑6 (p = 0,048); with level of VLDL CH (p = 0,052) in F only. In M with AP, strong association with mean daily BP parameters was found. Conclusions. Carotid AP associated with HTH in ARS was frequently detected in M. Regardless of PB, AP in M was associated with systemic inflammation, raise of pro-inflammatory cytokines and increase in VLDL CH level. According to logistic regression data in W, lipid metabolism disorders, hormonal changes and metabolic changes, but not immune inflammation, increased the chance of AP imaging in carotid arteries. In HTN M and F, AP was associated with systemic inflammation, pro-inflammatory cytokines due to HTN presence.

Background. The effect of physical activity (PA) on the state of the cardiovascular system and quality of life in patients with hypertension (HTN) remains insufficiently studied, while there is no data on the effect of PA and rehabilitation programs on cardiometabolic parameters, according to duration and recurrence of their effect in women with a history of HTN during pregnancy. Objective. To compare cardiometabolic parameters in women with a history of HTN during pregnancy versus women without HTN during pregnancy and measure the effects of an exercise program on their dynamics changes. Design and methods. The study included 66 women divided into two groups: group 1 — 33 women with a history of HTN during pregnancy. The distribution of different HTN disorders of pregnancy was the following: 75% — gestational HTN; 12,5% — chronic HTN; 12,5% — preeclampsia. Group 2 — 33 women with a history of normotension during pregnancy. Walking for at least 150 min per week (30 min a day, 5 times a week) for 9 months was a mandatory component of the physical training program in group 2. Women in group 2 continued clinical follow-up without physical training program. All participants filled in a specially designed questionnaire. Anthropometric, clinical, and biochemical parameters were evaluated, including PA level, quality of life (short questionnaire SF‑36), and serum leptin and adiponectin concentrations. Results. A PA training program for 9 months in women with a history of HTN during pregnancy led to a decrease in waist circumference and body mass index, a decrease in serum leptin levels and an increase in serum adiponectin levels, an increase in PA levels and an improvement in quality of life for account of the general physical and spiritual components.

Background. Controlled arterial hypertension (HTN) does not mean complete regression of preclinical target organ damage. Objective. To study the relationship between indicators characterizing the structural and functional state of the kidneys and retina in middle-aged patients with uncomplicated HTN, receiving combination antihypertensive therapy (AHT) and having office systolic (SBP) and diastolic (DBP) blood pressure levels < 140 and < 90 mmHg. Design and methods. We examined 87 patients (65 males and 22 females, average age 50,5 ± 4,87 years) with stage I and II HTN without clinically significant concomitant pathology taking double combined AHT (group average office level of SBP and DBP 134 ± 12,3 and 84 ± 14,5 mmHg, respectively). For at least the previous 12 months, patients had regularly received voluntary dual combination AHT based on pharmacological blockade of the renin-angiotensin-aldosterone system. HTN patients underwent a comprehensive assessment of the structural and functional state of the kidneys and fundus of the eye. To assess the relationships between biomarkers of kidney and retinal damage in the examined individuals within the entire set of studied parameters, correlation analysis and comparative analysis of the same quantitative (renal or retinal) indicators were used in subgroups of individuals divided according to a conditionally selected qualitative characteristic corresponding to the norm or deviation from the norm (value central retinal arterial equivalent (CRAE ≥ or < 145 μm), central retinal venous equivalent (CRVE ≥ or < 227 μm), albumin-creatinine ratio (ACR ≥ or < 10 mg/g), foveal avascular zone area (FAZ ≥ or < 0,36 mm²). Statistical processing of data was carried out using the Basic Statistics / Tables modules of the application package Statistica for Windows (version 12). The relationship between quantitative renal and retinal indicators was studied using the Pearson r correlation coefficient. Comparative analysis of quantitative parameters within the examined group, conditionally subdivided according to a certain qualitative criterion, was performed using the nonparametric Mann-Whitney U-test. Results. CRVE values directly correlated with ACR (r = 0,30; p = 0,037), FAZ area — with ACR (r = 0,40; p = 0,005), subfoveal choroidal thickness (SCT) — with estimated glomerular filtration rate (eGFR) (r = 0,45; p = 0,001); CRAE values inversely correlated with serum urea (r = –0,34; p = 0,019), SCT — with serum creatinine (r = –0,36; p = 0,011). Patients with ACR ≥ 10 mg/g compared with patients with ACR < 10 mg/g were characterized by significantly lower values of the retinal arteriovenous ratio (0,646 ± 0,09 and 0,689 ± 0,08, respectively, p = 0,016). Patients with FAZ area ≥ 0,36 mm² compared with those with FAZ area < 0,36 mm² had higher proteinuria values (0,101 ± 0,13 and 0,075 ± 0,14 mg/g, respectively, p = 0,01). Conclusions. Middle-aged patients with uncomplicated HTN without clinically significant concomitant pathology, receiving double combined AHT, demonstrate significant associations of indicators characterizing the structural and functional state of the kidneys and retinal microcirculation in terms of their preclinical damage.

Objective. To identify an associative relationship between inflammatory indicators, hematological indices and left ventricular hypertrophy (LVH) in patients with uncontrolled arterial hypertension (HTN). Design and methods. We examined 130 patients with uncomplicated essential HTN I–II with ineffective blood pressure (BP) control (≥ 140/90 mmHg). All patients underwent a clinical examination with determination of risk factors, indicators of inflammation — high-sensitivity C-reactive protein (hs-CRP), interleukin‑1β (IL‑1β), interleukin‑6 (IL‑6), interleukin‑8 (IL‑8), tumor necrosis factor α (TNF-α), hematological indices — systemic immune inflammation index (SII), the monocyte to high density lipoprotein cholesterol ratio (MHR), the platelet to lymphocyte ratio (PLR), the neutrophil to lymphocyte ratio (NLR), and echocardiography. Results. The positive correlations were found between the indicators of nonspecific inflammation and signs of LVH — MHR and left ventricular myocardial mass index (LVMI) (r = 0,448; p < 0,001), the posterior wall thickness (PWT) of left ventricle (LV) in the diastole (r = 0,256; p = 0,003), the interventricular septum (IVS) thickness in the diastole (r = 0,311; p ≤ 0,001); the level of hs-CRP and the relative wall thickness (RWT) (r = 0,283; p = 0,002), PWT of LV in the diastole (r = 0,202; p = 0,043), IVS thickness in the diastole (r = 0,231; p = 0,011); the level of IL‑6 and the PWT of LV in the diastole (r = 0,215; p = 0,018); SII and IVS thickness in the diastole (r = 0,230; p = 0,009), the RWT (r = 0,205; p = 0,016); NLR and IVS thickness in the diastole (r = 0,227; p = 0,009), PWT of LV in the diastole (r = 0,205; p = 0,029), RWT (r = 0,206; p = 0,016). Using multiple linear regression, independent factors associated with increased LVMI in HTN patients were male sex (β = 0,201), waist circumference (WC) (β = 0,258) and MHR (β = 0,236) (p = 0,029). Independent factors for increasing PWT of LV in the diastole in HTN patients were WC (β = 0,354) and male sex (β = 0,266) (p = 0,003); increase of IVS thickness in the diastole — SII (β = 0,254), WC (β = 0,392) and male sex (β = 0,219) (p = 0,021); and an increase of RWT — hs-CRP (β = 0,333) (p = 0,001). Conclusions. In patients with uncontrolled HTN increased levels of hs-CRP, IL‑6, SII, MHR and NLR were associated with echocardiographic LVH criteria—LVMI, PWT and IVS thickness in the diastole, RWT. Independent factors for increasing LVMI were WC, male sex and MHR; IVS thickness in the diastole — SII, WC and male; RWT — hs-CRP.

Objective. To evaluate central systolic blood pressure (cSBP) and arterial stiffness (AS) in patients admitted with acute decompensated heart failure (ADHF) according to different phenotypes of ejection fraction (EF) and to assess their changes after 6 months of stable guideline-directed medical therapy. Design and methods. In 54 patients (61% males, median age 69,5 (62; 77) years, median EF 51% (interquartile range (IQR) 38; 55%), median N-terminal pro-B-type natriuretic peptide (NTproBNP) 623 (500; 1842) pg/ml; heart failure (HF) with reduced EF in 37%, HF with mildly reduced EF in 13%, HF with preserved EF in 50%), apart from routine tests, we assessed cSBP and AS with applanation tonometry (SphygmoCor). cSBP above individual reference values, central pulse pressure (PP) ≥ 50 mmHg, carotid-femoral pulse wave velocity (cfPWV) > 10 m/s, cfPWV above individual reference values, and aortic-brachial stiffness mismatch (stiffness gradient as cfPWV/carotid-radial (cr)PWV) ≥ 1) were considered abnormal. The statistical analysis was performed in the groups with EF ≥ 50% and < 50% р < 0,05 was considered significant. Results. Brachial systolic blood pressure (bSBP) in the whole group was 117 (106; 130) mmHg; cSBP 109,5 (96; 120) mmHg. Uncontrolled blood pressure was observed in 40%, hypotension — in 3%. There were no differences between groups according to EF. cSBP elevation was observed in 33% (28,5% in EF ≥ 50% and 38,4% in EF < 50%; р > 0,05), and in 27,1% with normal bSBP. There were no significant differences in AS parameters between groups according to EF. Elevation of at least 1 marker of AS was present in 78,5%, cfPWV > 10 ms — in 50%, cfPWV above individual reference values— in 55,5%, central PP ≥ 50 mmHg — in 16,6%, high AS gradient — in 70,3%. Abnormal AS gradient was observed in 48,1% of patients with normal cfPWV. Patients with more severe congestion according to bioimpedance vector analysis (BIVA) had lower cfPWV compared to less severe congestion: 9 (6,7; 10,2) vs 11,6 (6,9; 15,1) m/s, р = 0,04. There was significant correlation between the amount of extracellular fluid by BIVA and cfPWV (r = –0,36, p < 0,05). There was significant increase in cSBP, PP, cfPWV and augmentation index and decrease in PP amplification in the whole group after 6 months. Conclusions. Patients admitted with ADHF have high frequency of cSBP elevation regardless of EF and blood pressure control. The most common marker of AS increase was cfPWV elevation above individual reference values and abnormal stiffness gradient. Patients with less congestion by BIVA had higher cfPWV. After 6 months there was increase in cSBP and parameters of AS.