Cardiovascular disease is a major cause of death worldwide and a global socio-economic problem. To date, there are numerous studies focused on finding new biomarkers of cardiovascular diseases. High-technological methods such as mass spectrometry (MS), high-performance liquid chromatography (HPLC), and nuclear magnetic resonance (NMR) spectroscopy enable us to record thousands of metabolites of organs and tissues. Studying organisms at a molecular level contributes to an in-depth understanding of preclinical conditions of various diseases. Metabolomics reflects the dynamics of metabolism distribution, including environmental influences, allowing us to create a metabolic profile of the patient. The aim of this review was to analyze current data on metabolomic and proteomic biomarkers in the diagnosis of cardiovascular diseases. The search databases were used to select studies on the potential clinical and diagnostic application of proteomic and metabolomic markers in cardiology. The selected sources were subjected to qualitative and thematic analysis. All biomarkers were grouped according to the pathophysiological process (inflammation, blood coagulation and lipid metabolism disorders, myocardial necrosis, etc.). The association of changes in metabolomic and proteomic profiles with the activation of pathogenic processes in the cardiovascular system was demonstrated. The use of these multivariate markers, individually or in combination, will increase the accuracy of early diagnosis and the effectiveness of treatment. This article also highlights the limitations of the method and possible ways to solve them.

Background: Poor adherence to antihypertensive therapy is a major barrier to effective blood pressure control, particularly in countries with a high burden of non-communicable diseases. In Kazakhstan, improving adherence is a key objective of the “Densaulyk” State Health Program (2020–2025). Objective: To assess medication adherence among patients with arterial hypertension in Kazakhstan and identify associated socio-demographic and clinical factors. Methods: A cross-sectional survey was conducted among outpatient hypertensive patients at a major urban medical center. Adherence was measured using the 8-item Morisky Medication Adherence Scale (MMAS-8). Socio-demographic characteristics, disease duration, and the number of prescribed medications were analyzed in relation to adherence levels. Results: Adherence was significantly associated with age, ethnicity, education, marital and financial status, disease duration, and treatment complexity. A notable share of participants demonstrated low to moderate adherence. The use of self-reported data may have introduced bias. Conclusions: Medication adherence in Kazakhstan is influenced by multiple interrelated factors. Targeted and culturally appropriate interventions—such as simplified regimens, digital tools, and broader access to subsidized drugs—are essential to improve long-term outcomes in hypertension management.

Cardiorespiratory fitness (CRF) is a strong predictor of cardiovascular morbidity and mortality. This study aimed to describe age- and sex-specific reference values for CRF in healthy adults in Kazakhstan and to examine age-related changes in key physiological parameters, including peak heart rate and body mass index. The research included 3271 nonsmoking adults aged 20 to 59 years, free of health issues, who performed symptom-limited incremental cardiopulmonary exercise testing on a cycle ergometer between 2018 and 2025. The highest 30-s average value from exercise testing defined peak oxygen uptake (VO₂ peak). VO₂ peak were lower in older age groups in both sexes. In men, VO₂ peak values was 43.4 ± 7.41 mL/kg/min during ages 20-29 and 38.3 ± 6.32 mL/kg/min during ages 50-59. In women, corresponding VO₂ peak values were 39.2 ± 6.49 and 30.8 ± 5.78 mL/kg/min. Peak heart rate also was lower in older ages (men: 174 ± 11 to 142 ± 8 bpm; women: 179 ± 10 to 143 ± 11 bpm). Simple linear regression results showed that age was a significant predictor of VO₂ peak, BMI, and peak heart rate in both men and women (p < .001). This study provides the first nationally relevant descriptive data on CRF reference values for Kazakh adults.

Background. Patients with atrial fibrillation commonly experience decreased exercise tolerance, lower peak oxygen uptake (VO₂peak), and reduced overall physical activity levels, which negatively affect quality of life and cardiovascular outcomes. Catheter ablation has become an effective rhythm-control strategy, with growing evidence demonstrating improvements in functional capacity and cardiopulmonary efficiency after restoration of sinus rhythm. Methods. A systematic search was conducted in PubMed, Scopus, Web of Science, and Google Scholar for studies published between 2000 and 2025. Keywords included “atrial fibrillation,” “catheter ablation,” “exercise capacity,” “cardiorespiratory fitness,” and “reference values.” After screening 160 records, 48 peer-reviewed articles were included for qualitative analysis. Results. The reviewed studies consistently report that atrial fibrillation significantly reduces VO₂peak, exercise duration, and physical activity tolerance due to impaired cardiac output and rhythm irregularity. Catheter ablation is associated with significant improvements in cardiopulmonary performance, exercise capacity, and patient-reported quality of life. However, the extent of recovery varies among individuals. Importantly, the literature reveals a lack of population-specific reference values for cardiorespiratory fitness in Central Asian and Kazakh populations. Conclusion. Evidence supports the detrimental impact of atrial fibrillation on functional capacity and the beneficial role of catheter ablation in improving cardiorespiratory performance. Nevertheless, the absence of regional normative data represents a major limitation for clinical interpretation, highlighting the need for population-based studies in Kazakhstan and Central Asia.