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Solodenkova K.S.
Sechenov University
Osadchuk M.A.
I.M. Sechenov First Moscow State Medical University
Balashov D.V.
Sechenov University
Cardiovascular risk in a comorbid patient. A comparative analysis considering traditional risk factors
Journal: Russian Journal of Preventive Medicine. 2023;26(5): 52‑62
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To cite this article:
Solodenkova KS, Osadchuk MA, Balashov DV. Cardiovascular risk in a comorbid patient. A comparative analysis considering traditional risk factors. Russian Journal of Preventive Medicine.
2023;26(5):52‑62. (In Russ.)
https://doi.org/10.17116/profmed20232605152
The issue of comorbidity in recent decades has become one of the most urgent in medicine and healthcare due to objective demographic processes and the high prevalence of cardiovascular, metabolic, and immune-mediated disorders. Cardiovascular events determine the prognosis in most comorbid patients, indicating the importance of correct assessment of cardiovascular risk (CVR).
To perform a comparative analysis of the rate of traditional cardiovascular risk factors in patients with cardiovascular disorders (chronic ischemic heart disease (CIHD), hypertension, metabolic disorders (type 2 diabetes mellitus (DM), metabolic syndrome (MS), and obesity) and immuno-inflammatory conditions (rheumatoid arthritis — RA), depending on the presence of comorbidity and its type.
The study included 160 patients with a verified CIHD, 132 patients with type 2 DM, 124 patients with verified RA, 94 patients with obesity (O) and/or MS, 60 patients with hypertension, and 40 apparently healthy individuals (HI). In each main group, subgroups were formed depending on the presence or absence of comorbidities. In the formed subgroups, demographic, anthropometric, and the most significant traditional CVR factors were compared; the correlation of risk factors (RF) and the Charlson comorbidity index (CI) was analyzed.
In the cohorts of comorbid patients, a high rate of traditional CVR factors was noted: the average number of RF ranged from 7.21 (CIHD +T2DM) to 3.86 (RA+O/MS) and statistically significantly exceeded the values in hypertension and HI groups. The cumulative CVR assessment using SCORE for individuals without CIHD and type 2 DM showed high risk in the RA+O/MS subgroup: the average score was 7.12±2.25%, with statistical significance versus hypertension and HI groups. When comparing the mean number of RFs in the comorbid and non-comorbid groups, statistically significant differences were found in the combination of CIHD and type 2 diabetes and the combination of CIHD and obesity or MS. Strong statistically significant correlation was established between Charlson CI and age, HDL-C decrease, the total number of traditional FR and the CVR degree. A moderate correlation was found between CI and BMI, total cholesterol, low-density lipoprotein cholesterol, and triglyceride levels.
The combination of cardiovascular and metabolic or immuno-inflammatory disorders was characterized by more pronounced lipid profile disorders, a greater range of traditional risk factors, and a higher total cardiovascular risk. The comorbidity index correlated with individual risk factors, their number and degree of cardiovascular risk.
Keywords:
Authors:
Solodenkova K.S.
Sechenov University
Osadchuk M.A.
I.M. Sechenov First Moscow State Medical University
Balashov D.V.
Sechenov University
Received:
07.10.2022
Accepted:
03.03.2023
List of references:
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