O.N. Osipova’s scientific contributions

To study trends in prevalence, risk factors (RF) and mortality of ischemic heart disease (IHD), contribution of RF to risk of death due to IHD and other cardiovascular diseases (CVD) among male population of Yakutsk; to determine characteristics of atherosclerosis among native male population and migrants. A clinicopathological epidemiological trial covered male population of Yakutsk. It was performed by standard techniques within the scope of the cooperative program. The analysis of the trends for the last 10 years demonstrates a marked rise in the incidence rates of arterial hypertension (AH), overweight and hypercholesterolemia. CVD mortality reached 38.4% of overall mortality. Such factors as AH, smoking, IHD, ischemic ECG changes and overweight contribute much to the integral risk of CVD death. A comparative morphometric analysis of atherosclerosis development in 1965-1968 and 1985-1988 showed accelerated development of atherosclerosis both among native population and migrants in 1985-1988. There are population differences in development of atherosclerosis in males from native population and migrants. The effects of trace elements on formation of atherosclerosis components in the Far North were evaluated. Present-day epidemiological situation in relation to IHD and other CVD necessitates further monitoring of the situation, activation of primary and secondary IHD prevention among population of the Far North.

Prevalence of ischemic heart disease, its main risk factors, as well as their relationship were assessed in a cross-sectional epidemiological study of a random representative sample of professional car drivers aged 20-59 years. Prevalence of hypertension, smoking, hypercholesterolemia and hypo-alphacholesterolemia was found to be high. Prevalence of hypertension, excess body mass and ischemic heart disease were positively related with age. Ischemic heart disease was more frequent in the presence of hypertension, excess body weight, hypertriglyceridemia and hypo-alphacholesterolemia. High level of risk factors of ischemic heart disease morbidity and mortality among professional car drivers requires implementation of preventive measures.

Prevalence of hypertension among men aged 20-54 years in 17 cities of different regions was related to risk factors and ischemic heart disease mortality. The latter was recorded during the period of 6 years. Overall prevalence of hypertension was 33,6% however three groups of populations were distinguished: with low (25,2%), medium (33,7%) and high (44,8%) prevalence of hypertension. Body mass, age, alcohol, smoking, and dyslipoproteinemia contributed significantly to the prevalence of hypertension. Mortality increased with elevation of blood pressure. Relative risk of death was higher in populations with high and medium compared with low prevalence of hypertension.

Cardiovascular disease (CVD) is the main reason of death among the population of Eastern Siberia (Yakutia). Monitoring of epidemiological situation of coronary heart disease (CHD) and other CVD allows to make goal-directed preventive programs in region of extreme conditions. Methods: Two casual representative cohorts of men at the ages of 20-54 years during 1985-87 and 1997-99 (n=2666 and n=831, approximately) was examined. The study was carried out according to WHO standard methods. The men formerly examined in 1985-87 were objects of follow-up observation for registration of "end points". Results: The prevalence of high blood pressure was 26.7%, obesity - 23.2 %, smoking - 43.7 %. At the analysis of the lipid spectrum of blood serum was established, that the prevalence of hypercholesterolemia, hypertriglyceridemia and hypoHDLcholesterolemia was 21.5 %, 6.8 % and 3.9 % approximately. The prevalence of CHD was 18.7 %, myocardial infarction - 2.6 %, angina - 7.1 %. Authors established the middle levels of total cholesterol (228.3 mg/dL), tryglicerides (119.1 mg/dL) and HDL cholesterol (55.8 mg/dL). During a 10-year follow-up interval 133 men have died. Age-adjusted rate of total mortality was 4.9 per 1000 person-years, including CVD mortality - 1.9 per 1000 person-years. At an estimation of mortality in quintiles of systolic blood pressure (SBP) direct relation between SBP level and total mortality incidence is detected. Curves of CHD mortality and CVD mortality by their characters reminded "J"-shaped relation. Curves of total mortality and CVD mortality in quintiles of body mass index reminded "U"-shaped relation. CHD, CVD and total mortality were associated with the status of smoking. Relative risk (RR) of CHD, CVD and total mortality sharply grew in 2-3 times at smoking up to 20 cigarettes/day (p<0.01). RR of CHD mortality was 4.7 times higher in those who smoked more than 20 cigarettes/day, then in never smokers (p<0.01). Multivariate (Cox regression model) estimation of relative risk total mortality showed, that the essential contribution to risk of death is made by such variables as raised SBP [OR 1.02, 95%CI (1.01-1.03)], smoking [OR 2.81, 95%CI (1.58-5.00)], age [OR 1.05, 95%CI (1.02-1.08)], presence of angina [OR 2.28, 95%CI (1.14-4.55)]. Conclusion: For last 10 years in Eastern Siberia the epidemiological situation of CHD has worsened. In republic Sakha (Yakutia) the concept of reorganization of public health with a priority of prevention of the basic not infectious diseases is introduced.