Aim. To evaluate the economic burden of cardiovascular diseases (CVD) in the Russian Federation (RF) in 2016, including the direct costs and the economic losses caused by reduced productivity. Material and methods. Main data sources: data of the Federal state statistics service, data of state statistical reporting (forms №14, №141, №12 and №16-VN), and data of State Guarantee Program of Free Medical Care to the Citizens of the RF, statistical data of CVD, ischemic heart disease (IHD), myocardial infarction, cerebrovascular diseases, stroke. The direct medical costs were calculated based on the number of hospitalizations, including daycare center, emergency calls and outpatient visits due to CVD using the costs of the State Guarantee Program. The amount of disability benefits payments was calculated based on the number of disabled persons from each group and by the amount of the disability allowance. Indirect costs (economic losses) included a shortage of gross domestic product (GDP) due to premature mortality and disability in economically active age and loss of earnings due to temporary incapacity for work. The potential years of life lost (PYLL) were calculated using the number of life years not reached in economically active age due to premature death. Losses associated with premature mortality in the economically active age included unproduced GDP due to lost life years in the corresponding age group due to deaths from CVD, meaning the population' employment rate. Statistical analysis was performed by Microsoft Excel 10.0. Results. PYLL due to premature death from CVD-4.5 million years of potential life in economically active age, mostly men (3.3 million PYLL). Among almost 50% of men PYLL were due to ischemic heart disease. Economic burden because of CVD in 2016 in the RF reached 2.7 trillion ₽, which is equivalent of 3.2% of GDP for this year. In the structure of burden among all blood circulatory system diseases, IHD was in the first place (over 1 trillion ₽). In the burden structure, direct costs were only 8.1%, losses in the economics-91.9% of the total burden. In the cumulative burden of CVD, IHD determined as 39.8% (over a trillion ₽), cerebrovascular diseases-fifth part (560 billion ₽); strokes and heart attacks-424 billion ₽ and 213.1 billion ₽, respectively. Conclusion. The economic burden because of CVD in the RF in 2016 was 2.7 trillion ₽ (3.2% of GDP). Economic losses caused by premature mortality of people in economically active age prevailed in the structure of the burden (over 90%). Such the significant economic burden is a weighty argument for increasing investments in the prevention and treatment of CVD.

В России утвержден приоритетный проект «Формирование здорового образа жизни», одна из задач которого-мониторинг приверженности здоровому образу жизни населения (ЗОЖ) на популяционном уровне. Цель исследования-на основе отечественных данных разработать интегральный показатель-индекс приверженности ЗОЖ (ИПЗОЖ), оценить его распространенность в России и ассоциацию со смертностью от всех причин и сердечно-сосудистой. Материал и методы. В анализ включены результаты обследования представительных случайных выборок населения регионов России 25-64 лет, вошедшие в исследовании ЭССЕ-РФ. Отклик составил приблизительно 80%. Проанализированы социально-демографические параметры, поведенческие факторы, привычки питания с использованием стандартных эпидемиологических методов и критериев. Среднее время наблюдения за смертностью и сердечно-сосудистой заболеваемостью составило 4,5 года, число случаев смерти-240, в том числе от сердечно-сосудистых заболеваний (ССЗ)-188, общая сердечно-сосудистая конечная точка-771. Статистический анализ проведен с применением SAS, версия 6.12описательная статистика, модель пропорционального риска Кокса. Результаты. Для оценки доли граждан, приверженных ЗОЖ, был предложен ИПЗОЖ, включающий следующие компоненты: отсутствие курения, потребление овощей и фруктов ежедневно не менее 400 г, физическая активность (не менее 150 мин умеренной или 75 мин интенсивной физической нагрузки в неделю), нормальное (не выше 5 г/ст) потребление соли, употребление алкоголя до 168 г чистого этанола в неделю для мужчин, до 84 г-для женщин. Степени приверженности ЗОЖ: 1) удовлетворительная-отсутствие курения и наличие одного любого компонента ЗОЖ; 2) высокая-отсутствие курения при наличии всех компонентов. Удовлетворительный ИПЗОЖ выявляется в популяции у 49,6%, у женщин существенно выше, чем у мужчин (p<0,001). Индекс высокой приверженности отмечен у 16,7%, у женщин выявляется в 2 раза чаще (p<0,001). Был проведен анализ ассоциаций удовлетворительного ИПЗОЖ со смертностью от всех причин и от ССЗ, а также с фатальными и нефатальными сердечнососудистыми событиями. При удовлетворительной приверженности ЗОЖ смертность от всех причин ниже на 39% (р=0,0003), от ССЗ-на 36% (р=0,0035) и общие сердечно-сосудистые события-на 19% (р=0,0058). Заключение. На основе отечественных данных были отобраны ФР, сформировавшие ИПЗОЖ для взрослого населения России. Использование данного индекса позволит изучить степень приверженности населения ЗОЖ на популяционном уровне. Кроме того, наличие и характер изменений ИПЗОЖ в ответ на профилактическое воздействие важны в оценке эффективности проведения приоритетного проекта «Формирование здорового образа жизни». Ключевые слова: здоровый образ жизни, ЗОЖ, хронические неинфекционные заболевания, приоритетный проект «Формирование здорового образа жизни», курение, недостаточное потребление овощей и фруктов, низкая физическая активность, избыточное потребление соли, злоупотребление алкоголем.

High adherence to blood pressure (BP) medical correction determines clinical and socioeconomic efficacy of antihypertensive treatment. Separate components of adherence are to be studied, including regularity of drugs intake and reasons for non-compliance with medical recommendations in different categories of patients. Aim. Evaluation of antihypertensive drugs (AHD) intake regularity (as a component of treatment adherence) and factors it is influenced by in hypertensive patients who had for the first time visited a specialized cardiology center during the 6-month follow-up after the primary consultation. Material and methods. First, a number of hypertensive patients who had visited a cardiologist of one of Moscow's district cardiology clinics for the first time in 2010 (n=1766) had formed a sample of the study participants. The expert cards were filled out in accordance with the primary medical documentation data. The second step was conducted 6 months after the first visit by a phone survey with the completion of questionnaires (n=1419). Results. Majority of respondents (74.9%) had been taking AHD regularly 6 months after the primary consultation and 16.2% of the patients had been using them occasionally. 8.9% of the respondents completely refused to control hypertension with drugs. Respondents of male sex (OR=1.4), with poor BP self-control in home settings (OR=2.5), unable to get drugs under the medicine assistance scheme (OR=1.8), those without coronary heart disease (OR=1.9), with hypertension duration less than 5 years (OR=1.9), with changes in antihypertensive therapy regimen as compared to the one recommended by a cardiologist (OR=1.5), those who had 1-2 drugs in the treatment regimen at the moment of the survey (OR=2.4) and patients who had no fixed drug combinations in the treatment scheme (OR=1.4) were shown to have significantly higher probability of irregular AHD intake or complete treatment refusal. Conclusion. Outpatients of the specialized cardiology center are characterized by rather high treatment adherence by AHD intake regularity. We have revealed a number of factors that significantly correlate with reduced antihypertensive treatment adherence. These factors must be taken into account at treatment regimen selection and patients' follow-up.

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Aim: to study the impact of anti-smoking measures within the Federal Law N 15-FL on the number of hospitalization of patients with acute cardiovascular conditions in the Samara and Arkhangelsk Regions and the Chuvash Republic. Methods: Monthly hospitalization rates for acute myocardial infarction and unstable angina were analyzed usinginterrupted time series by means of the STATA 15.0 software package, which includes the ITS module in three regions of the Russian Federation from 01.01.2012 to 31.12.2017, and by gender (men and women) and age (0-59 years and 60 years and older). Results. Reduction in hospital incidence after each stage of the anti-tobacco policy was obwerved in two of the three regions. In the Samara Region we observed a reductionby 16.3 % in 2013 and by 18.4 % in 2014 for unstable angina and by 10.6 % in 2013 and by 10.5 % in 2014 for acute myocardial infarction, respectively. In the Arkhangelsk Region the number of hospitalizations decreased by 14.3 % in 2013 and by 14.4 % in 2014 for unstable angina, and by 7.5 % in 2013 and by 7.7 % in 2014 for acute myocardial infarction. No significant decrease was observed in the Chuvash Republic. Gender stratification revealed a decrease in the hospital incidence of acute myocardial infarction and unstable angina in women in the Samara and Arkhangelsk Regions, and in men - only in the Samara region. The percentage of reduction in unstable angina was higher than in the acute myocardial infarction. An analysis of age groups in the Samara Region showed a decrease in the number of hospitalizations for acute myocardial infarction and unstable angina in both age groups, and in the Arkhangelsk Region only in people over 60 years of age. Conclusions: anti-tobacco legislation introduced in Russia in 2013 and 2014 is likely to have contributed to a decrease in the number of hospitalizations for acute cardiovascular diseases, but the effect varied across genders and age-groups.