[Non-traditional view on traditional risk factors of cardiovascular diseases in seniors.]

The article reveals little-known scientific data on the traditional risk factors of cardiovascular diseases in relation to social groups of the elderly, old people and centenarians. Some of metabolism associated signs of ageing are considering. In the article some biochemical markers in seniors are evaluated (lipids, fibrinogen, uric acid etc.). Some particularities about atherosclerotic lesions of coronary arteries in seniors are discovering, as well as relationships between coronary heart disease (CHD) and fatty liver degeneration. One more topic of the article is the lipid spectrum characteristics in senior patients with different types of heart diseases and psychological features and behavioral personality types of the seniors with cardiovascular pathology. Special attention payed on so-called preventive paradox in men older than 60 years with different forms of CHD, when the influence of traditional risk factors is critically decreased, and as important prognostic factors low levels of high-density lipoprotein cholesterol, reduced APO-A1, an increasing of APO-B/APO-A1 ratio and low physical activity play a significant role.

[ACTIVITY ACTUAL INTESTINAL ENZYMES OF PANCREATIC ENZYMES AND ISCHEMIA OF THE SMALL INTESTINE (EXPERIMENTAL STUDY)]

THE PURPOSE OF THE STUDY

To study the activity of carbohydrase in model experimented on dogs.

MATERIAL AND METHODS

The research was carried out on 20 adult mongrel dogs of both sexes weighing from 12 before 22 kg and consisted of two series of experiments. The first one was 12 animals with 50% wrap-retirement stenosis of the celiac trunk. In the second series of experiments consisted of 8 animals with 50% compression stenosis of the cranial brizee Noi artery. The activity of amidalas and sucrase were determined to wrap-retirement narrowing of the arteries and through 114-173 after stenosis.

RESULTS

In conditions of chronic ischemia of the small intestine revealed as an increase in the activity of one, and unchanged levels of other Carbo-hydras: in biopsies of the mucosa of the proximal small intestine experienced dogs activity of pancreatic alpha-amylase stress-Valas is on average 13 times the original values, the activity of one membrane enzymes--gamma-amylase was increased by 4 times, the activity of another membrane enzyme sucrase remained without changes.

[Specifics of the use of NSAIDs in senior age]

Nonsteroidal anti-inflammatory drugs (NSAIDs) have a strong analgesic and anti-inflammatory effects and are widely used in clinical practice. Patients with chronic disorders of the joints, in particular the spine, are main consumers of NSAIDs. However, risk factors for side-effects should be taken into consideration in the treatment with NSAIDs, especially in patients of old age. The careful control of treatment taking into account the risk of developing gastrointestinal and cardiovascular events is needed.

[FATTY LIVER AND DEVELOPMENT OF ATHEROSCLEROSIS IN ELDERLY AND SENILE AGE]

Search for scientific information on the relation fatty liver with the development of atherosclerotic lesions of arteries. Currently fatty liver regarded as hepatic manifestation of metabolic syndrome, regardless of the presence or absence of traditional risk factors and components of metabolic syndrome, fatty liver is associated with a greater degree of atherosclerotic vascular disease. In addition fatty liver may occur long before the development of metabolic problems, thus creating preconditions for the development of possible metabolic disorders in the human body.

[Genotype and allele frequencies of UCP and PPAR gene families in residents of besieged Leningrad and in the control group]

Genotype and allele frequencies of uncoupling proteins 2 and 3 genes (UCP2 and UCP3) and peroxisome proliferator-activated receptors genes (PPARA, PPARD and PPARG) were studied in 206 residents of the siege and in 139 individuals of more than 69 years old (control group). Studied polymorphisms included UCP2 (Ala55Val), UCP3 (C-55T), PPARA (G/C), PPARD (+294T/C), and PPARG (Pro12Ala). The G allele and the G/G genotype (PPARA) were overrepresented in the group of survivors and C/C (UCP3) genotype prevailed in the women of besieged Leningrad compared to relevant control groups of the persons of the same age who did not suffered hungry disaster. Feasible protective effects of PPARA gene allele G and C allele of UCP2 genes are briefly discussed.

[Frequency of some diseases and conditions in geriatric patients with coronary heart disease and various genotypes of transcription factor 7-like 2 protein]

In 2009-2010, 98 patients diagnosed with the coronary heart disease, but without the expressed metabolic violations, decompensated conditions and diseases were surveyed. Patients of 60-90 years were divided by age into two groups: younger than 75 years--47 people; 75 years and older--51; there were 41 women and 57 men; the ratio between women and men was 1:1.4; average age was 76.0 ± 1.3 years. The average age of women was 76.0 ± 1.8 years, men--76.1 ± 2,0 years. 96.0 ± 2.0% of geriatric patients with CHD complained of steno-cardiac pains in pre-cardiac area; the excess mass of a body was observed in 43.4 ± 5.0% of geriatric patients with CHD, acute myocardial infarction in the anamnesis was noted in 52.5 ± 6.9% (n = 52); hypertensive illness had 98.0 ± 1.4% (n = 97). Patients had the favorable average levels of lipoproteins of high density (not lower than 1 mmol/l). A significant number (79.2 ± 5.6%) of patients had hemodynamically significant narrowing of coronary vessels (75% and more), while the area of myocardial hypokinesia was observed in 41.2 ± 6.9% of patients, sharp violation of brain blood circulation was noted in 14.1 ± 9.8%. Wild type homozygous genotype of TCF7L2 gene was detected significantly more often (77.6 ± 4.7%) in patients of advanced and senile age with CHD, regardless of age group, exis-tence of accompanying diseases and conditions, such as previous myocardial damage, acute disorders of cerebral circulation and fatty degeneration of the liver. However allele of risk T (totally C/Tand T/T) of TCF7L2 gene came to light in 22.4 ± 9.1% of geriatric patients with CHD, that contributes to development of a metabolic syndrome in such patients and reduces term of their life.

[Fatty liver in elderly patients with atherosclerotic coronary artery disease (according to autopsy data)]

In article it is a question of morphological research of fragments of tissue of a liver at 143 elderly and old patients with atherosclerosis of the coronary arteries which have died on offices of the S-Petersburg hospital for veterans of wars in 2006-2010. Average age of the died patients was defined in the range from 61 till 98 years and made 82.3 ± 1.3 years. It is established that at geriatric patients with atherosclerotic defeat of coronary arteries fatty regeneration of a liver was observed in 25.9 ± 7.3%; more than at 2\3 geriatric patients with atherosclerosis of coronary arteries it was noted cteatogpatit with the minimum degree of the activity, thus specified degree of activity came to light at the surveyed patients with fatty regeneration of a liver (77.8 ± 8.0% against 60.7 ± 6.1% in group without fatty regeneration of a liver) more often. Cardiovascular diseases caused death of patients with atherosclerosis of coronary arteries and fatty regeneration of a liver, than in group of patients without a fatty degeneration of a liver (91.7 ± 4.8% of cases and 73.8 ± 4.9% of cases respectively) more often. Patients of senile age with atherosclerosis of coronary arteries and fatty regeneration of a liver died because of cardiovascular diseases, than their contemporaries in group without fatty regeneration of a liver (89.7 ± 6.1% and 71.3 ± 5.7% respectively) more often.

[Starving in childhood and diabetes mellitus in elderly age]

The long-term consequences of the protracted starvation or inadequate nutrition of children is a problem in which considerable interest has been shown in recent decades. Between June 1941 and January 1944 the civilian population of Leningrad was besieged for two and a half years. The non-combatant population of this large European city lived through lengthy periods of starvation or malnutrition against a background of additional complex stress factors (including cold, bombing, death of relatives and acquaintances, and lack of means of transport and communication). It may be assumed that the health in adulthood of those who were children and young people in Leningrad during the siege differed from that of people of the same age who were spared those extreme conditions. Impact of starvation in childhood on prevalence rate of diabetes mellitus in elderly age, time of onset, clinical features of the disease course were studied. The results confirm that insulin-independent diabetes without obesity develops more often and earlier in women who got through the Siege of Leningrad in their childhood. Health status of elderly people who underwent continuous starvation in their childhood is the actual problem, because health status of young people in this country who got through 90's, when one of three children in the age of 2 years starved, suggests developing of medical and social problems because of forthcoming changes in the illness patterns of the population in modern Russia.

[Peculiarities of somatic diseases in people of middle and old age survived Leningrad siege at childhood]

The results of a study on peculiarities of development of some diseases in adult peoples survived the Leningrad siege at childhood are presented. The age- and sex-related differences in an incidence and clinical features of diseases are demonstrated. More frequent incidence of severe arterial hypertension, diabetes mellitus type 2, biliar calculite disease, chronic atrophic pangastritis, terminal stage of kidney failure, more early mortality, clinically unfavorable aortal atherosclerosis development, as well as atherosclerosis of coronary, brain and carotid artheria have been revealed. Specific histological and morphometric changes in kidney tissue of the patients at preclinical stage are demonstrated.