Introduction. The economic well-being of the country depends on the size of the able-bodied population. The maximum possible preservation of labor potential is an essential task of public health in any country. The complexity and diversity of factors affecting the population’s mortality make the problem of studying this index considered one of the most urgent. The purpose of the study is to analyze the dynamics of mortality of Russia’s able-bodied population from the circulatory system’s diseases. Material and methods. as the research materials, the Single Interdepartmental Information and Statistical System’s official information. Results. During the past ten years, the mortality rate of the able-bodied population of Russia has been reduced by 1,7 times from all causes. The life expectancy at birth has increased by six years, and the proportion of non-disabled people has decreased by 7% in the population structure. The leading causes of mortality of Russia’s able-bodied population in 2016 were diseases of the circulatory system (DCS) and external causes in the presence of significant differences between Russia’s federal districts. Ischemic heart disease (IHD) and cerebrovascular disease occupy a vital place in the mortality structure of Russia’s able-bodied population. There were significant regional differences in the mortality rate of Russia’s able-bodied population from IHD (2.7 times). In regions with a high mortality rate of the able-bodied population from the DCS, a mortality rate of the able-bodied population from IHD was high. In all areas of Russia, the mortality rate of working-age men is higher than that of women. Conclusion. High mortality rates of Russia’s able-bodied population from DCS determine significant social and economic losses in the country. It put the task of optimizing existing and developing additional activities to study the causes of regional and gender differences, creating and improving organizational and medico-social technologies to improve the demographic situation.

The association of non-alcoholic fatty liver disease (NAFLD) and cardiovascular risk is currently one of the actively studied areas. The incidence of non-alcoholic fatty liver disease continues to grow worldwide. In the structure of mortality rate of patients with non-alcoholic fatty liver disease, the first place is occupied by cardiovascular events: stroke and myocardial infarction. Studies have shown that the presence of severe liver fibrosis (F3-4) in NAFLD not only increases the risk of cardiovascular diseases (CVD), but also increases the risk of overall mortality by 69% due to mortality from cardiovascular causes. The degree of increased risk is associated with the degree of activity of non-alcoholic steatohepatitis (NASH). Despite the large number of works on this topic, we do not have a clear opinion on the impact on cardiovascular risk, interaction and the contribution of various factors, as well as algorithms for managing patients with non-alcoholic fatty liver disease to reduce the risk of cardiovascular diseases. This article describes the pathogenetic factors of formation of cardiovascular risks in patients with non-alcoholic fatty liver disease, proposed the idea of stratification of cardiovascular risks in these patients, taking into account changes in the structure of the liver (fibrosis) and function (clinical and biochemical activity) and also it describes the main directions of drug therapy, taking into account the common pathogenetic mechanisms for non-alcoholic fatty liver disease and cardiovascular diseases. The role of obesity, local fat depots, adipokines, and endothelial dysfunction as the leading pathogenetic factors of increased cardiovascular risk in patients with NAFLD is discussed. Among pathogenetically justified drugs in conditions of poly and comorbidity, hypolipidemic (statins, fibrates), angiotensin II receptor antagonists, beta-blockers, etc. can be considered. According to numerous studies, it becomes obvious that the assessment of cardiovascular risks in patients with NAFLD will probably allow prescribing cardiological drugs, selecting individualized therapy regimens, taking into account the form of NAFLD, and on the other hand, building curation taking into account the identified cardiovascular risks.

We discussed about the term intestinal permeability like as the mucosal barrier a single structural and functional conception that includes the layer of mucus, the indigenous microbiota and the epithelium of the mucosa in this publication. Information was presented about the role of the microbiota, the composition of intestinal mucus, epithelial cells and proteins of tight junctions which lead to various metabolic diseases. The complex pathogenetic interactions are formed between the intestinal mucosal barrier, metabolic disorders such as non-alcoholic fatty liver disease and cardiovascular diseases. The complex researches and modification of this interactions will allow to create personalized approaches and to prevent of these diseases.

Modern lifestyle in developed countries significantly impacts the incidence of metabolic disorders and, consequently, many chronic non-communicable diseases. These disorders are often due to chronic low-intensity inflammation caused by the activation of various molecular pathways, such as nuclear factor kappa B (NF-κB), mitogen-activated protein kinase (MAPk), rapamycin complex 1 (TORC1), cyclooxygenase-2 (COX-2). Numerous interventional studies have shown that lifestyle changes help reduce inflammation and improve health. It can be attributed to the concept of real-life risk modeling, as humans are constantly exposed to dietary factors in small doses and complex combinations (e.g., polyphenols, fiber, polyunsaturated fatty acids). A balanced diet, combined with caloric restriction, modulates molecular mechanisms such as mTOR, NRF2, IKK/JNK, and JAK/STAT, eventually leading to a significant decrease in inflammatory markers and an improvement in metabolic parameters. Healthier diets at the individual level and in public institutions can improve population health, reduce the financial burden on the healthcare system and increase society’s resilience to epidemics that mainly affect people with metabolic diseases.

Arterial hypertension (HTN) remains a global medical and social problem, significantly affecting cardiovascular morbidity and mortality. Detailed study of mechanical and functional changes in the arterial wall associated with age has led to the development of the concepts of Early Vascular Aging (EVA syndrome), Healthy Vascular Aging (HVA) and SUPERNOrmal Vascular Aging (SUPERNOVA). Identification of predictors and pathogenetic mechanisms of the phenotypes formation, as well as determinants of arterial stiffness progression, allows developing preventive and therapeutic strategies to reduce mortality from cardiovascular diseases. At the same time, it is no less important to isolate patients with already formed arterial rigidity and, as a consequence, isolated systolic arterial hypertension (ISAH) into a separate group due to the need to optimize the treatment of this cohort in order to slow down the processes of increasing arterial stiffness and minimize the undesirable effects of hypoperfusion. Thus, the purpose of this literature review was to systematize the accumulated knowledge about the possibilities of slowing down the processes of vascular aging, as well as tools to improve the effectiveness and safety of treatment in the group of patients with ISAH. The article presents a clinical observation of 44 patients with ISAH who were treated at the Omsk Region Budgetary Healthcare Institution “Clinical Cardiology Dispensary” and received a fixed combination of amlodipine/indapamide. By the end of the observation period, high adherence, tolerability and effectiveness of this therapy were observed, as well as a trend towards a decrease in arterial stiffness, assessed by the cardio-ankle vascular index (CAVI). However, there is a need for further studies to stratify patients in order to identify cohorts that can potentially benefit more from the use of preventive interventions.