Vol 15, No 2 (2024)

BACKGROUND: The study of senile preasthenia gravis as a possible additional risk factor for falls in patients with arterial hypertension (AH) may complement existing ideas in this field.

AIM: To analyze risk factors for falls in patients aged ≥60 years.

MATERIALS AND METHODS: This open single-center, single-stage, continuous method study included 94 outpatient patients (2 men, 92 women) aged 72.0±5.6 years with a history of falls. Physical examination, clinical and biochemical blood tests, screening of senile asthenia (“Age is not a hindrance” questionnaire), risk (get up and go test), and fear of falls (short falls efficacy scale and falls efficacy scale), cognitive functions (Montreal scale of cognitive assessment), and daily monitoring of blood pressure were collected.

RESULTS: Concomitant diseases were registered in 95% of patients, two or more diseases in 88%, and AH in 78%. Orthostatic hypotension was observed in 30% of people with AH. Preasthenia gravis was detected in every third patient who had a history of falls, regardless of the presence or absence of AH (p=0.915). A relationship has been established between probable preasthenia gravis in individuals with AH and the fear of falls (odds ratio [OR] 9.66, 95% confidence interval [CI] 1.22–76.77, p=0.032), decreased cognitive function in the MoSa test (OR 4.29, CI 1.65–11.11, p=0.003), and orthostatic hypotension (OR 2.92, CI 1.03–8.32, p=0.045). AH in patients who had a history of falls correlated with reduced functional activity as evidenced by the results of the get up and go test (OR 4.65, CI 1.00–21.63, p=0.050), fear of falls according to the short falls efficacy scale (OR 2.87, CI 1.00–8.21, p=0.050) and falls efficacy scale (OR 5.07, CI 1.08–14.26, p=0.002), and decreased cognitive functions (OR 4.43, CI 1.43–13.11, p=0.009). An association was established between fractures and the number of falls (OR 3.9).

CONCLUSION: Senile preasthenia was associated with predicted risk factors for falls (cognitive decline, fear of falling, and orthostatic hypotension); thus, preasthenia can be considered a possible independent correctable risk factor for falls.

BACKGROUND: The analysis of the long-term consequences of acute coronary syndrome (ACS) revealed a high incidence of complications and their probable relationship with defects in secondary prevention, which allows us to determine the direction of elimination of such defects.

AIM: To assess the long-term consequences of ACS and the effectiveness of secondary prevention.

MATERIALS AND METHODS: The study included 255 patients who were sequentially hospitalized in the Regional Vascular Center of Petrozavodsk for ACS in 2009–2010. In the period from October 2021 to February 2022, electronic medical record data were retrospectively analyzed to assess the effects of ACS and the effectiveness of secondary prevention.

RESULTS: Data from 155 patients were analyzed, among whom men predominated (n=113, 72.9%). The mortality rate was high, with a significant prevalence of adverse effects of ACS. The 12-year mortality was 42.6% (66 people), and the average age of the deceased was 62.1±6.8 years. Chronic heart failure was diagnosed in 50 (32.3%) patients. Thirty-five of them had stage IIa (72.9% among 48 patients with a known stage), and 26 had functional class II (FC; 68.4% among 38 patients with a known FC). Stable angina pectoris was diagnosed in 41 patients (26.5%), 26 (66.7% among 39 patients with known FC) had symptoms of FC II, and 31 (20%) had recurrent ACS. Percutaneous intervention was performed in 65% of cases (n=20). Cardiac arrhythmias and conduction disorders were recorded in 41 (26.5%) patients: 15 of them (36.6%) were diagnosed with ventricular extrasystole of high grade (grade IV according to Ryan), and atrial fibrillation/flutter developed in 22 (14.2% of all observed) patients. Data indicate a lack of commitment to the principles of secondary prevention for both patients and doctors, except for quitting smoking. Six patients (3.9%) continued to smoke. Moreover, increased body weight persisted in 33 patients (21.3%). The prescription rate for necessary medications was low; acetylsalicylic acid was prescribed to 61 (39.4%) patients, blockers of the renin–angiotensin–aldosterone system to 74 (47.7%), beta-blockers to 74 (47.7%), and statins to 69 (44.5%), which does not allow achieving the target levels of therapy. The target blood pressure was achieved only in 68 patients (43.9%), heart rate in 23 (14.8%), and lipid spectrum in 2 (1.3%).

CONCLUSION: This study revealed the high incidence of adverse effects of ACS in the long-term period, which, apparently, is a consequence of low adherence to lifestyle modifications and drug correction of risk factors.

BACKGROUND: At present, the Arctic receives special attention as a strategic region of great importance for the future of the whole country. In the Arctic region, the human body is subjected to the complex effects of negative natural and climatic factors associated with the proximity of the Arctic Ocean. In the process of evolution, two genophenotypes of adaptive response to natural stress factors occurred, namely, “stayers” or “hyporeactors” and “sprinters” or “hyperreactors.”

AIM: To determine the psychoemotional state and quality of life of individuals with arterial hypertension working on a shift basis in the Arctic region.

MATERIALS AND METHODS: Participant recruitment was conducted at the New Port field of Gazpromneft-YAMAL LLC, in the Arctic region. The research protocol was registered in ClinicalTrials.gov as NCT05839028. In this group, daily blood pressure monitoring and questionnaire surveys (Hospital Anxiety and Depression Scale, Symptom Checklist-90-Revised, Short-Form-36) were conducted in the first 3 days after arrival in the Arctic regions.

RESULTS: In the assessment of shift workers in the first 3 days after arrival in the Arctic region, blood pressure tended to rise in the daytime. The duration of this period was examined, as people adapt to the climate relative to their permanent place of residence.

CONCLUSION: The physical and role functioning of individuals are associated with indicators of SMAD, such as daily diastolic and systolic blood pressure and blood pressure variability. Obesity as a risk factor positively affects functioning in the Arctic watch, reducing the severity of psychopathological symptoms. However, the reasons for this observation require further study. In shift workers, obsessive-compulsive symptoms decrease with increasing age.

Diet optimization is considered an effective strategy for preventing chronic noncommunicable diseases, as a necessary component of rehabilitation and, in general, as a preventive direction of healthy aging. The article discussed the different accents of the diet of older people. The main causes of the inferiority of such diet were considered. The review presented age-related physiological features of the changes in energy and nutrient requirements. Data on the features and criteria of formulating a diet, taking into account dietary diversity, are presented, including recommendations on the choice of food products. The basic principles of dietary correction in the presence of an alimentary-dependent risk factor in older people are described. The MIND diet was analyzed. The analysis revealed that diet must be optimized to prevent cognitive impairment.