rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2011-7-4-463-467rpcardio-862Research ArticleORIGINAL STUDIESОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯGENDER DIFFERENCES IN THE EFFICACY OF RISK FACTORS CORRECTION AND TREATMENT COMPLIANCE IN PATIENTS AFTER ACUTE CORONARY SYNDROMEГЕНДЕРНЫЕ РАЗЛИЧИЯ В ЭФФЕКТИВНОСТИ КОРРЕКЦИИ ФАКТОРОВ РИСКА И ПРИВЕРЖЕННОСТИ ПРИЕМУ РЕКОМЕНДОВАННОЙ ЛЕКАРСТВЕНОЙ ТЕРАПИИ СРЕДИ БОЛЬНЫХ, ПЕРЕНЕСШИХ ОСТРЫЙ КОРОНАРНЫЙ СИНДРОМЕфановА. Ю.EfanovA. Y.

 

очный аспирант кафедры госпитальной терапии

efan_8484@mail.ruНизамоваД. Ф.NizamovaD. F.

очный аспирант  кафедры госпитальной терапии

ДородневаЕ. Ф.DorodnevaE. F.

д.м.н., профессор кафедры госпитальной терапии 

МедведеваИ. В.MedvedevI. V.

д.м.н., член-корр. РАМН, профессор, заведующая  кафедрой госпитальной терапии 

ШалаевС. В.ShalaevS. V.

д.м.н., профессор, заведующий кафедрой кардиологии

Тюменская Государственная Медицинская АкадемияРоссияTyumen State Medical AcademyRussian Federation20111901201674463467Copyright © Efanov A.Y., Nizamova D.F., Dorodneva E.F., Medvedev I.V., Shalaev S.V., 20162016Ефанов А.Ю., Низамова Д.Ф., Дороднева Е.Ф., Медведева И.В., Шалаев С.В.Efanov A.Y., Nizamova D.F., Dorodneva E.F., Medvedev I.V., Shalaev S.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/862

Aim. To compare the efficacy of correction of modifiable risk factors for ischemic heart disease (IHD), and treatment compliance within 6 months of observation in group of men and group of women after acute coronary syndrome (ACS). Material and мethods. Patients (n=147: 100 men and 47 women) aged under 70 years who underwent ACS were examined. Prevalence of cardiovascular risk factors and frequency of basic drugs taking were evaluated at baseline and after 6 months. The efficacy of risk factors correction in men was compared with this in women. Results. A general number of patients with effective blood pressure (BP) control as well as patients who reached the target levels of total cholesterol (TC) <4.5 mmol/l and cholesterol of low>density lipoproteins (LDC) <2.5 mmol/l after 6 months increased significantly in comparison with this before observation. Taking of drugs from all main groups left unsatisfactory and did not>reach the advisable values. Women have better antihypertensive treatment compliance, but worse lipidemia level control; they more often have glucose metabolism disorders, arterial hypertension and obesity. Men smoked more often, but have better BP, TC and cholesterol LDC control. Conclusion. The high prevalence of cardiovascular risk factors requires intensification of preventive activity regarding IHD onset and progression among both men and women.

Цель. Оценить эффективность коррекции модифицируемых факторов риска (ФР) ишемической болезни сердца (ИБС), а также приверженность лекарственной терапии через 6 мес наблюдения в группе мужчин в сравнении с группой женщин, среди пациентов, перенесших острый коронарный синдром (ОКС). Материал и методы. Обследована группа из 147 пациентов (100 мужчин, 47 женщин) в возрасте до 70 лет, перенесших ОКС. Оценена исходная распространенность ФР заболевания, а также частота приема основных лекарственных препаратов. Через 6 мес наблюдения пациенты обследованы повторно. Оценена эффективность коррекции ФР в группе мужчин в сравнении с группой женщин. Результаты. Через полгода наблюдения в общей популяции больных было достоверно больше пациентов, эффективно контролирующих артериальное давление (АД), а также больных, достигавших уровень общего холестерина (ОХС) <4,5 ммоль/л и холестерина липопротеидов низкой плотности (ХС ЛПНП) ><2,5 ммоль/л. Прием лекарственных пре-паратов всех основных групп оставался неудовлетворительным и достоверно меньше рекомендованных значений. При оценке гендерных различий женщины были более при->вержены применению антигипертензивной терапии, хуже контролировали уровень липидемии, чаще страдали нарушениями углеводного обмена, артериальной гипертонией и ожирением. Мужчины же чаще курили, но лучше контролировали АД, уровень ОХС, ХС ЛПНП.  Заключение. Высокая распространенность ФР ИБС говорит о необходимости интенсификации профилактических мероприятий в отношении развития и прогрессирования заболевания как среди мужской, так и среди женской популяции.

сердечно-сосудистые факторы рискаишемическая болезнь сердцапрофилактикагендерные различияприверженность лечениюcardiovascular risk factorsischemic heart diseasepreventiongender differencestreatment complianceReferencesAdes P.A. Cardiac rehabilitation and secondary prevention of coronary artery disease. N Engl J Med 2001; 345: 892–902.Ades P.A. Cardiac rehabilitation and secondary prevention of coronary artery disease. N Engl J Med 2001; 345: 892–902.Balady G.J., Williams M.A., Ades P.A. et al. Core components of cardiac rehabilitation/secondary prevention programs: 2007 update: a scientific statement from the American Heart Association Exercise, Cardiac Rehabilitation, and Prevention Committee, the Council on Clinical Cardiology; the Councils on Cardiovascular Nursing, Epidemiology and Prevention, and Nutrition, Physical Activity, and Metabolism; and the American Association of Cardiovascular and Pulmonary Rehabilitation. Circulation 2007; 115: 2675–2682Balady G.J., Williams M.A., Ades P.A. et al. Core components of cardiac rehabilitation/secondary prevention programs: 2007 update: a scientific statement from the American Heart Association Exercise, Cardiac Rehabilitation, and Prevention Committee, the Council on Clinical Cardiology; the Councils on Cardiovascular Nursing, Epidemiology and Prevention, and Nutrition, Physical Activity, and Metabolism; and the American Association of Cardiovascular and Pulmonary Rehabilitation. Circulation 2007; 115: 2675–2682Wenger N.K. Current status of cardiac rehabilitation. J. Am. Coll. Cardiol 2008; 51: 1619–1631.Wenger N.K. Current status of cardiac rehabilitation. J. Am. Coll. Cardiol 2008; 51: 1619–1631.Clark A.M., Hartling L., Vandermeer B., McAlister F.A. Secondary prevention program for patients with coronary artery disease: a meta-analysis of randomized control trials. Ann Intern Med 2005;143: 659–672.Clark A.M., Hartling L., Vandermeer B., McAlister F.A. Secondary prevention program for patients with coronary artery disease: a meta-analysis of randomized control trials. Ann Intern Med 2005;143: 659–672.Clark A.M., Hartling L., Vandermeer B., Lissel S., McAlister F.A. Secondary prevention programmes for coronary heart disease: a meta-regression showing the merits of shorter, generalist, primary care-based interventions. Eur J Cardiovasc Prev Rehabil 2007; 14: 538–546.Clark A.M., Hartling L., Vandermeer B., Lissel S., McAlister F.A. Secondary prevention programmes for coronary heart disease: a meta-regression showing the merits of shorter, generalist, primary care-based interventions. Eur J Cardiovasc Prev Rehabil 2007; 14: 538–546.Taylor R.S., Brown A., Ebrahim S. et al. Exercise-based rehabilitation for patients with coronary heart disease: a systematic review and meta-analysis of randomized trials. Am J Med 2004; 116:682–697.Taylor R.S., Brown A., Ebrahim S. et al. Exercise-based rehabilitation for patients with coronary heart disease: a systematic review and meta-analysis of randomized trials. Am J Med 2004; 116:682–697.Karoff M., Held K., Bjarnason-Wehrens B. Cardiac rehabilitation in Germany. Eur J Cardiovasc Prev Rehabil 2007; 14: 18–27.Karoff M., Held K., Bjarnason-Wehrens B. Cardiac rehabilitation in Germany. Eur J Cardiovasc Prev Rehabil 2007; 14: 18–27.Leon A.S., Franklin B.A., Costa F. et al. Cardiac rehabilitation and secondary prevention of coronary heart disease: an American Heart Association Scientific Statement from Council on Clinical Cardiology (Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity), in Collaboration with the American Association of Cardiovascular and Pulmonary Rehabilitation. Circulation 2005; 111: 369–376.Leon A.S., Franklin B.A., Costa F. et al. Cardiac rehabilitation and secondary prevention of coronary heart disease: an American Heart Association Scientific Statement from Council on Clinical Cardiology (Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity), in Collaboration with the American Association of Cardiovascular and Pulmonary Rehabilitation. Circulation 2005; 111: 369–376.Rees K., Victory J., Beswick A.D. et al. Cardiac rehabilitation in the UK: uptake among under-represented groups. Heart 2005; 91: 375–376.Rees K., Victory J., Beswick A.D. et al. Cardiac rehabilitation in the UK: uptake among under-represented groups. Heart 2005; 91: 375–376.Suaya J.A., Shepard D.S., Normand S.-L.T. et al. Use of cardiac rehabilitation by Medicare beneficiaries after myocardial infarction or coronary bypass surgery. Circulation 2007; 116: 1653–1662.Suaya J.A., Shepard D.S., Normand S.-L.T. et al. Use of cardiac rehabilitation by Medicare beneficiaries after myocardial infarction or coronary bypass surgery. Circulation 2007; 116: 1653–1662.Denolle T. et al. Effectiveness of a health network in secondary prevention among coronary patients. Arch Mal Coeur Vaiss 2004; 112(4): 1189-96.Denolle T. et al. Effectiveness of a health network in secondary prevention among coronary patients. Arch Mal Coeur Vaiss 2004; 112(4): 1189-96.European guidelines on cardiovascular disease prevention: executive summary. Eur Heart J 2007; 28: 2375 – 2414.European guidelines on cardiovascular disease prevention: executive summary. Eur Heart J 2007; 28: 2375 – 2414.К. Kotseva; D.Wood; et al. EUROASPIRE III: a survey on the lifestyle, risk factors and use of cardioprotective drug therapies in coronary patients from 22 European countries. European Journal of Cardiovascular Prevention & Rehabilitation 2009; 16 (2): 121-137.К. Kotseva; D.Wood; et al. EUROASPIRE III: a survey on the lifestyle, risk factors and use of cardioprotective drug therapies in coronary patients from 22 European countries. European Journal of Cardiovascular Prevention & Rehabilitation 2009; 16 (2): 121-137.Dallongevillle J et al. Gender differences in the implementation of cardiovascular prevention measures after an acute coronary event. Heart 2010; 96(21): 1744-9.Dallongevillle J et al. Gender differences in the implementation of cardiovascular prevention measures after an acute coronary event. Heart 2010; 96(21): 1744-9.

The authors declare that there are no conflicts of interest present.