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Pogosova NV, Badtieva VA, Ovchinnikova AI, Sokolova OY. [New treatments and technologies in cardiac rehabilitation programs]. VOPROSY KURORTOLOGII, FIZIOTERAPII, I LECHEBNOI FIZICHESKOI KULTURY 2022; 99:50-57. [PMID: 35700376 DOI: 10.17116/kurort20229903150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The article presents a review of literature data reflecting the relevance and modern views on the effectiveness and expediency of using various options for rehabilitation programs for cardiovascular diseases. The issues of the history of the development of cardiac rehabilitation both abroad and in Russia are consecrated. The article also presents alternative models for conducting cardiac rehabilitation, in particular, using remote and telemedicine technologies. The widespread use of smartphones and high-speed Internet access contributed to the further introduction and use of telemedicine technologies in cardiac rehabilitation. The article discusses the possibilities of telerehabilitation of cardiological patients and shows its comparable effectiveness with traditional cardiac rehabilitation.
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Affiliation(s)
- N V Pogosova
- National Medical Research Center of Cardiology, Moscow, Russia
| | - V A Badtieva
- Moscow Scientific-Practical Center of Medical Rehabilitation, Restorative and Sports Medicine, Moscow, Russia
| | - A I Ovchinnikova
- Moscow Scientific-Practical Center of Medical Rehabilitation, Restorative and Sports Medicine, Moscow, Russia
| | - O Yu Sokolova
- National Medical Research Center of Cardiology, Moscow, Russia
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Pogosova NV, Boytsov SA, Ausheva AK, Sokolova OY, Arutyunov AA, Osipova IV, Pozdnyakov YM. Drug Therapy and Adherence in Patients With Coronary Heart Disease: Results of the Russian Part of the EUROASPIRE V International Multicenter Study. KARDIOLOGIYA 2021; 61:4-13. [PMID: 34549688 DOI: 10.18087/cardio.2021.8.n1650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 05/12/2021] [Indexed: 11/18/2022]
Abstract
Aim To study the practice of drug treatment of ischemic heart disease (IHD) and the consistency of this practice with the established guidelines.Material and methods Results of the Russian part of the EUROASPIRE V study were compared with the general European population of the study. At ≥6 mos. and <2 years after the discharge from the hospital, patients were invited to visit the site for an interview. The drug therapy recommended upon discharge and taken by patients in the long-term as well as the patients' compliance with the treatment were analyzed. In Russian centers, 699 patients were registered, and 399 of them visited the centers for the interview.Results Upon discharge from the hospital, patients of the Russian cohort and of the entire study population were prescribed acetylsalicylic acid or other antiplatelet drugs (99.2% and 94.1%, respectively); beta-blockers (87.2 and 81.6%, respectively); angiotensin-converting enzyme (ACE) inhibitors (69.9% and 61.1%, respectively); sartans (16.5% and 14.2 %, respectively); calcium channel blockers (19.3 and 19.4 %, respectively); nitrates (8.0% and 22.5 %, respectively); diuretics (31.1 and 32.5 %, respectively); statins (98.0% and 85.0 %, respectively); and anticoagulants (6.6 and 8.3 %, respectively). For the long-term treatment, patients of the Russian cohort and of the entire study population took antiplatelets (94.7 % and 92.5 %, respectively); beta-blockers (83.2% and 81.0 %, respectively); ACE inhibitors (60.2% and 57.3 %, respectively); sartans (19.3% and 18.4 %, respectively); calcium antagonists (21.1% and 23.0 %, respectively); nitrates (9.0% and 18.2 %, respectively); diuretics (31.8% and 33.3 %, respectively); statins (88.2% and 80.8 %, respectively); and anticoagulants (8.8% and 8.2 %, respectively). High intensity hypolipidemic therapy was prescribed to 54.0 % of patients in Russian centers and 60.3 % of patients in the entire study. Both Russian and international patients evaluated their compliance with the prescribed medication as high.Conclusion According to results of the EUROASPIRE V study as compared to earlier studies, the practice of drug therapy in Russian patients with IHD has significantly approached European indexes. Further optimization is possible by a more extensive use of high intense hypolipidemic treatment and antidiabetic drugs with a documented positive effect on prognosis of cardiovascular diseases.
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Affiliation(s)
- N V Pogosova
- National Medical Research Center of Cardiology of the Ministry of Health of Russian Federation, Moscow
| | - S A Boytsov
- National Medical Research Center of Cardiology of the Ministry of Health of Russian Federation, Moscow
| | - A K Ausheva
- National Medical Research Center of Cardiology of the Ministry of Health of Russian Federation, Moscow
| | - O Y Sokolova
- National Medical Research Center of Cardiology of the Ministry of Health of Russian Federation, Moscow
| | - A A Arutyunov
- National Medical Research Center of Cardiology of the Ministry of Health of Russian Federation, Moscow
| | - I V Osipova
- Krai government-owned publicly funded health care institution "Regional clinical hospital", Barnaul
| | - Yu M Pozdnyakov
- Budgetary Public Health Facility of the Moscow Region "Zhukovsky city clinical hospital", Zhukovsky
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Cook S, Hopstock LA, Eggen AE, Bates K, Iakunchykova O, Kontsevaya A, McKee M, Schirmer H, Voevoda M, Kudryavtsev AV, Malyutina S, Leon DA. Pharmacological management of modifiable cardiovascular risk factors (blood pressure and lipids) following diagnosis of myocardial infarction, stroke and diabetes: comparison between population-based studies in Russia and Norway. BMC Cardiovasc Disord 2020; 20:234. [PMID: 32430002 PMCID: PMC7236339 DOI: 10.1186/s12872-020-01513-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 05/10/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) mortality is substantially higher in Russia than in neighbouring Norway. We aimed to compare blood pressure- and lipid-lowering medication use and proportion meeting treatment targets between general population samples in the two countries in those with CVD and diabetes. METHODS The study population was adults aged 40-69 years reporting a diagnosis of myocardial infarction (MI), stroke and/or diabetes participating in cross-sectional population-based studies in Russia (Know Your Heart (KYH) 2015-18 N = 626) and Norway (The Tromsø Study 2015-16 (Tromsø 7) N = 1353). Reported medications were coded according to the 2016 WHO Anatomical Therapeutic Chemical Classification system. Treatment targets were defined using the Joint European Societies guidelines for CVD prevention in clinical practice (2016). RESULTS Age- and sex-standardized prevalence of use of lipid-lowering medications was higher in Tromsø 7 for all three conditions with a disproportionately large difference in those reporting MI (+ 48% (95% CI 39, 57%)). Proportion meeting treatment targets for LDL cholesterol was poor in both studies (age- and sex-standardized prevalence of control KYH vs Tromsø 7: MI 5.1% vs 10.1%; stroke 11.6% vs 5.8%; diabetes 24.9% vs 23.3%). Use of antihypertensive medication was higher in KYH for stroke (+ 40% (95% CI 30, 50%)) and diabetes (+ 27% (95% CI 19, 34%)) groups but approximately equal for the MI group (- 1% (95% CI -1, 1%)). Proportion meeting blood pressure targets was lower in KYH vs Tromsø 7 (MI 51.8% vs 76.3%; stroke 49.5% vs 69.6%; diabetes 51.9% vs 63.9%). CONCLUSIONS We identified different patterns of medication use in people with CVD and diabetes. However despite higher use of lipid-lowering medication in the Norwegian study treatment to target for total cholesterol was poor in both Russian and Norwegian studies. In contrast we found higher levels of use of antihypertensive medications in the Russian study but also that less participants met treatment targets for blood pressure. Further work should investigate what factors are responsible for this seeming paradox and how management of modifiable risk factors for secondary prevention could be improved.
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Affiliation(s)
- Sarah Cook
- Department of Community Medicine, UiT The Arctic University of Norway, 9037, Tromsø, Norway.
| | - Laila A Hopstock
- Department of Community Medicine, UiT The Arctic University of Norway, 9037, Tromsø, Norway
| | - Anne Elise Eggen
- Department of Community Medicine, UiT The Arctic University of Norway, 9037, Tromsø, Norway
| | - Katie Bates
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.,Department of Medical Statistics, Informatics and Health Economics, Medical University of Innsbruck, Schöpfstraße 41/1, A-6020, Innsbruck, Austria
| | - Olena Iakunchykova
- Department of Community Medicine, UiT The Arctic University of Norway, 9037, Tromsø, Norway
| | - Anna Kontsevaya
- National research center for preventive medicine, Moscow, Russian Federation, 101990
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Henrik Schirmer
- Akershus University Hospital, 1478, Lørenskog, Norway.,Institute of Clinical Medicine, University of Oslo, 0318, Oslo, Norway
| | - Michael Voevoda
- Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russian Federation, 630090
| | - Alexander V Kudryavtsev
- Department of Community Medicine, UiT The Arctic University of Norway, 9037, Tromsø, Norway.,Northern State Medical University, Arkhangelsk, Russian Federation, 163000
| | - Sofia Malyutina
- Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russian Federation, 630090.,Novosibirsk State Medical University, Russian Ministry of Health, Novosibirsk, Russian Federation, 630091
| | - David A Leon
- Department of Community Medicine, UiT The Arctic University of Norway, 9037, Tromsø, Norway.,Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
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