Given the high prevalence of chronic kidney disease (CKD) at the present time, as well as a number of shortcomings of traditional parameters of kidney function estimation, in the last few years more and more attention is paid to the search for new renal injury markers for earlier and accurate diagnosis of the onset of CKD. This paper reviews the available evidence on traditional markers of renal injury in comparison with the new biochemical markers, reflecting mainly tubulointerstitial kidney injury that occurs in the earlier stages of kidney disease. Moreover, we discuss the potential of a number of biomarkers, such as neutrophil gelatinase-associated lipocalin, kidney injury molecule‑1, cystatin C, and liver fatty acid binding protein for early diagnosis of both acute and chronic kidney disease, including hypertensive nephropathy.

Objective. To estimate the prevalence, awareness, treatment and control of arterial hypertension (HTN) among adult inhabitants of Krasnoyarsky territory based on the data from Russian multicenter epidemiological study ESSE-RF.

Design and methods. The study included 1603 subjects 25 to 64 years old selected by the systemic multistage stratified randomization among urban and rural inhabitants of Krasnoyarsky territory. Office blood pressure (BP) was measured twice by the automatic tonometer “Omron” on the right hand in the sitting position. HTN was defined as systolic BP ≥ 140 mm Hg and/or diastolic BP ≥ 90 mm Hg or self-reported previously elevated BP or use of antihypertensive treatment (HTNT). Treatment efficacy was defined as proportion of achieved target BP among individuals who received HTNT, and BP control was assessed as proportion of achieved target BP level among all hypertensives.

Results. The gender distribution was 653 males (40,7%) and 951 females (58,3%). The median level of systolic BP was 133,4 ± 0,5 mm Hg, diastolic BP— 82,9 ± 0,3 mm Hg. The median prevalence of HTN was estimated at 49,4% and appeared to be higher as compared with average Russian parameter 44% (based on the date of 10 regions from the ESSE-RF study). The median prevalence of HTN was estimated at 56,3% in men and 43,7% in women. The HTN prevalence in rural community was significantly higher as compared with urban community (63,4 ± 2,4 vs. 44,2 ± 1,5%, p < 0,01). The median rate of HTN awareness in Krasnoyarsky territory was 77,9% (average rate in Russia based on the ESSE-RF study results was 73,1%). The median rates of HTNT, treatment efficacy and BP control in Krasnoyarsky territory was estimated at 59,5%, 31,6% and 18,8%, respectively. Target BP level was achieved significantly more often among female, than male hypertensives, except those aged 25–34 years.

Conclusions. Thus, estimated prevalence of HTN in Krasnoyarsky territory is higher than average Russian indices based on the data of ESSE-RF study from 10 regions. The median HTN prevalence among men is higher than in women. The rural inhabitants are more likely to have HTN compared with urban inhabitants. Despite high rates of HTN awareness and HTNT, the treatment efficiency in Krasnoyarsky territory appeared to be lower as compared with average Russian ESSE-RF indices.

Objective. To evaluate the relationship of pre-diabetes and diabetes mellitus (DM) with arterial stiffness assessed by cardio-ankle vascular index (CAVI).

Design and methods. Cross-sectional study in the framework of a multicenter epidemiological study “Epidemiology of cardiovascular diseases and their risk factors in the Russian Federation” (ESSE-RF) from March to October 2013. The object of the study was a random population sample of the Kemerovo region of males and females aged 25–64 years. Each participant provided written informed consent to the survey. Standard research protocol ESSE-RF extended by further study of peripheral arterial stiffness using VaSeraVS‑1000 (Fukuda Denshi, Japan) with automatic measurement of CAVI. The CAVI ≥ 9,0 was considered as pathological. Two patients with type 1 DM were excluded from a total sample of 1619 people. The remaining 1617 people were divided into three groups: Group 1 — patients with type 2 DM (n = 272), Group 2 — patients with prediabetes — impaired fasting glucose, impaired glucose tolerance or their combination (n = 44), Group 3 — persons without any confirmed carbohydrate metabolism disorder (n = 1301). Medical history and laboratory data and indicators of volume sphygmography (VaSera VS‑1000) were analyzed in groups depending on the presence of carbohydrate metabolism disorders.

Results. The type 2 DM was diagnosed in 16,6% patients, pre-diabetes — in 2,7%. Patients with DM and prediabetes were comparable for most indicators, but significantly different from patients without carbohydrate metabolism disorders. The prevalence of coronary heart disease, hypertension, obesity, stroke, kidney disease, dyslipidemia was higher among DM and pre-diabetic patients. The CAVI in patients with pre-diabetes and DM were higher (7,7 and 7,6) than in those without the carbohydrate metabolism disorders (7,2; p = 0,009 and p < 0,001, respectively). The incidence of pathologic CAVI (> 9,0) was higher among patients with DM and prediabetes (15,9% and 16,8%) compared with those with normoglycaemia (9,0%, p < 0,001 for trend). The CAVI positively correlated with age (r = 0,526, p < 0,001), male gender (r = 0,111, p < 0,001), type 2 DM (r = 0,128, p < 0,001), prediabetes (r = 0,071, p = 0,002), total cholesterol (r = 0,190, p < 0,001), triglycerides (r = 0,108, p < 0,001), low-density lipoprotein cholesterol (r = 0,186, p < 0,001), uric acid (r = 0,085, p < 0,001). The CAVI negatively correlated with the glomerular filtration rate GFR CKD-EPI (r = –0,461, p < 0,001). The regression analysis showed that CAVI values were associated with the presence of DM (odds ratio (OR) 1,185 with an increase in the CAVI for each unit, 95% confidence interval (CI) 1,100–1,276; p < 0,001), and pre-diabetes (OR 1,179, 95% CI 1,008–1,380; p = 0,044).

Conclusions. Prediabetic and DM patients have similar prevalence of cardiovascular risk factors, including increased stiffness of arteries. In a community sample of Western Siberia increase in CAVI was associated with both type 2 DM and prediabetes.

Objective. To determine the gender differences regarding the impact of sleep disturbances on the risk of arterial hypertension (HTN) in the open population aged 25–64 years in Russia/Siberia.

Design and methods. As part of the screening program III WHO “MONICA-psychosocial”, we surveyed a random representative sample of the population of both sexes aged 25–64 years in Novosibirsk in 1994 (men: n = 657, mean age — 44,3 ± 0,4 years, the response — 82,1%; women: n = 689, mean age — 45,4 ± 0,4 years, the response — 72,5%). The screening survey program included registration of social and demographic data, the assessment of sleep disorders (Jenkins test). During 16‑year follow-up we identified 229 cases of new-onset HTN in women and 46 cases in men. The “chi-squared” (χ 2 ) Pearson criterion was used to assess the differences between groups. To assess the risk (HR — hazard ratio) we used univariate and multivariate regression model of Cox proportional hazards (Cox-regression). The reliability in all kinds of analysis was adopted at the level of significance p ≤ 0,05.

Results. In an open population (aged 25–64 years), 48.6% men and 65.9% women had sleep disturbances. The following characteristic features were identified: marital status does not differ, but widowhood was associated with greater risk of HTN greater in men (HR = 14.6) than in women (HR = 5.6). Low level of education was stronger associated with sleep disordersin women (83.3%) than in men (53.7%). Women of following professions reported sleep disorders more often than men: middle managers (78.3% and 48.9%, respectively) and technical workers (63.2% and 42.1%, respectively). The risk of developing HTN at 5-, 10‑and 16‑year follow-up was higher in men (HR = 5.4, 2.68 and 1.2) with sleep disorders than in women (HR = 4.35, 2.3 and 1.05).

Conclusions. Our analysis showed that in Russian population sleep disorders are more common in women than in men. However, in 5–16 years men with sleep disorders have higher risk of developing HTN than women.

Objective. To estimate the epidemiology of smoking as one of the risk factors of arterial hypertension during 18 years among Tyumen pupils in order to develop preventive measures.

Design and methods. Two crosssectional epidemiology studies among Tyumen pupils were performed. The pupils were randomly selected. The first selection was performed in 1986–1987 (within the cooperative program); 3704 pupils aged 7–15 (1836 boys and 1866 girls) were examined (93% response). The second selection was performed in 2005–2006 by the same method and estimation of blood pressure (BP): 2640 pupils (1308 boys and 1332 girls) aged 7–17 were enrolled (response 87,7%). Attitude to smoking was estimated by anonymous questionnaire.

Results. Incidence of smoking among Tyumen boys aged 7–17 is 7,6%, among Tyumen girls — 3,1%; 30,5% boys and 21,2% girls have tried smoking. Incidence of smoking in pupils grows in older groups. Thus, every 5th boy and every 10th girl smoke by 17 years old. Boys have more positive attitude to smoking and more uncertainty of smoking in future than girls. Also, passive smoking among children is frequent. Modern children show interest to smoking in the early age. Boys frequently smoke. The second survey showed significant growth of smoking rates among girls (р < 0,05). An association between active and passive smoking and BP among boys and girls was found.

Conclusions. We determined epidemiology status and dynamics of smoking incidence in Tyumen pupils. High rate of smoking among pupils requires immediate implementation of efficient preventive measures.

Objective. To study the features of the lipid and carbohydrate metabolism, hemostasis and the level of adipokines in young patients with abdominal obesity (AO) and arterial hypertension (HTN) in different age subgroups (younger and older than 35 years).

Design and methods. The study included both males and females aged 20 to 45 years (group 1 — control, group 2 — patients with isolated AO, group 3 — patients with metabolic syndrome (MS), group 4 — patients with HTN). Patients of each group were divided into 2 subgroups: patients aged 20 to 35 years and patients aged 36 to 45 years. Laboratory parameters of carbohydrate and lipid metabolism, hemostasis and levels of leptin and adiponectin were assessed.

Results. Lipid and carbohydrate metabolism parameters differed between young patients with AO and the control group. Levels of leptin and D-dimer were increased compared to the group 1. Dyslipidemia was found in patients with MS 20–45 years old, and it was characterized by increased total cholesterol, low-density lipoprotein cholesterol and triglyceride levels and decreased high-density lipoprotein cholesterol compared to the control group. Insulin and HOMAIR value were higher than in group 1. Leptin level was higher in patients with MS compared to controls, and the adiponectin level was reduced. The hemostasis in group 3 was characterized by increased concentration of fibrinogen, decreased plasminogen activity, increased concentration of soluble fibrin monomer complex, D‑dimer, plasminogen activator inhibitor type 1, as well as the activation of anticoagulant systems. HTN patients showed changes in lipid and carbohydrate metabolism compared to the control group as following: increased total cholesterol, low density lipoprotein cholesterol and glucose. The level of D‑dimer was higher compared to the group 1.

Conclusions. Serum leptin level was higher in young patients with AO compared to patients without MS. Patients with MS aged 20–35 years showed insulin resistance. The levels of total cholesterol, low density lipoprotein cholesterol, triglycerides and leptin were comparable in young patients older the 35 with HTN and with MS. Young patients with isolated AO and isolated HTN demonstrated the activation of coagulation and fibrinolytic systems, and patients with MS showed the activation of coagulation, fibrinolytic and anticoagulant systems. Patients aged 36–45 years with MS have increased concentration of fibrinogen and decreased plasminogen activity compared to patients younger than 35 years.

Background. In oncohematology, microcirculatory disorders in patients with coexistent myeloproliferative diseases and arterial hypertension (HTN) are poorly understood.

The aim of study was to investigate changes in microcirculation in patients with polycythemia vera (PV) and HTN by laser Doppler flowmetry.

Design and methods. We examined 76 patients with PV, among them 49 patients had coexistent PV and HTN. Microcirculatory disorders were assessed by laser Doppler flowmetry. The survey was carried out by a standard procedure, which included three methods: laser Doppler flowmetry, optical tissue oximetry and pulse oximetry. The level of endothelin‑1 (ЕТ‑1) was determined by enzyme immunoassay.

bET‑1 level was higher (p < 0,05) in PV + HTN patients than in the control group (2,40 ± 0,49 and 1,52 ± 0,50 fmol/ml, respectively). The spastic type of microcirculation was found in PV patients. Correlation analysis demonstrated relationship of ET-1 level with the parameter I in patients with PV and HTN (r = 0,67, p = 0,025). The correlation between endothelin‑1 and the parameter I in patients with PV and HTN evidences that the indicator I is a diagnostic criterion of endothelial dysfunction in PV.

Conclusions. ET‑1 level and parameters of laser Doppler flowmetry reflect the PV-related change in the microvasculature, as well as concomitant HTN. Moreover, it also provides insights into the mechanism of these changes.

Background. Cerebrovascular diseases are the major medical and social problem, since they take one of the first places in the structure of total mortality and disability in Russia.

Objective. The objective of our study was to assess the demographics, structure and risk factors of stroke based on the territorial population stroke Komi Register.

Design and methods. We analyzed 15,496 cases of stroke included in the geographically-stroke population register within 83 months by the method of a cross-sectional study.

Results. Women are predominant in this group. Among patients with acute cerebrovascular disorders the majority of patients were hospitalized in spring. The distribution by the months showed significant differences — the largest number of patients were hospitalized in the Republic of Komi in January. The most frequent risk factor is arterial hypertension (HTN), with significant predominance of women among HTN patients. However, HTN patients are significantly older than normotensive subjects. Similar trend was found for other cardiac pathology. Ischemic stroke occurs 10 times more often than hemorrhagic stroke. Mortality related to hemorrhagic stroke is 5-fold higher than the mortality rate from ischemic stroke.

Conclusions. The number of strokes, identified in the Komi Republic is gradually reducing. The mortality rate associated with stroke is slowly falling.

Background. The prevalence of sleep-disordered breathing varies from 9% to 24% in adult population and is higherin some somatic diseases contributing to the worse outcomes. Early diagnostics of sleep-disоrdered breathing (SDB) might be beneficial for the management of somatic diseases.

Objective. To assess the predictive value of the routine screening tests for the SDB diagnostics.

Design and methods. Target population included residents of St Petersburg, who participated in the epidemiological study ESSE-RF. Out of 1417 participants, 136 individuals signed informed consent for additional sleep evaluation. The following tools were used to assess the presence of SDB: questionnaire of sleep quality, Epworth sleepiness scale; Pittsburgh questionnaire. Full in-lab polysomnography (Embla N7000, Natus, USA) was performed in 49 subjects.

Results. Based on polysomnography, SDB was diagnosed in 17 of 49 patients. When compared to objective data, predictive values for SDB detection was 1,28 (χ 2 = 1,67; p = 0,19) for the question about snoring; 3,9 (χ 2 = 6,4; p = 0,011) for the question about sleep apnea; 3,9 (χ 2 = 9,3; p = 0,002) for the high risk of sleep apnea defined by the Berlin questionnaire; 2,9 (χ2 = 3,3; p = 0,07) for complaints of snoring by the Pittsburgh questionnaire; 1,2 (χ 2 = 0,05; p = 0,8) for the question about napping; 1,2 (χ 2 = 1,4; p = 0,2) for excessive sleepiness and 7.0 (χ 2 = 4,93; p = 0,026) for moderate to severe daytime sleepiness assessed by the Epworth sleepiness scale.

Conclusions. Self-reported (subjective) questionnaires aimed to the assessment of SDB, are suitable to define further diagnostic strategy. However, they cannot be used for the differential diagnosis.