Prevention of Cardiovascular Diseases
Development and Introduction of Early Diagnostics and Prevention of Cardiovascular Diseases Programs into Atomic Industry Enterprises
Tech Area / Field
3 Approved without Funding
VNIITF, Russia, Chelyabinsk reg., Snezhinsk
- John Hopkins University / Bloomberg School of Public Health, USA, MD, Baltimore\nNational Public Health Institute, Finland, Helsinki\nPublic Health Agency of Canada, Canada, ON, Ottawa
Project summaryThe aim of the project is to develop and introduce the evaluation program (inpidual program after making a diagnostics) of total risk for fatal cases of cardiovascular diseases (CVD) for employees of atomic industry enterprises for the period of 10 years with the use of SCORE scale (Systematic Coronary Risk Evaluation).
CVD are major reasons of morbidity, disability and mortality of people all over the world. About 1.3 mln of people die every year in Russia because of CVD. A number of epidemiological studies performed both in Russia and abroad proved that it is possible to prevent premature morbidity and mortality from CVD. The early diagnostics of CVD plays an important role. It will help to decrease the consequences of the disease, mortality from myocardial infraction and cerebral stroke by monitoring ischemic heart disease, hypertension, and risk factors.
A lot of different methods and models have been developed for the evaluation of total CVD risk. Framingham Heart Study was the first prospective epidemiological research which obtained data for the evaluation of risk factors influence on development of fatal and non-fatal CVD. At the same time the authors of Framingham risk scale warned that the results should be carefully extrapolated on other populations.
In 2003 the SCORE scale developed on the basis of European researches was introduced by the experts of European Society of Cardiologists. This scale determines total and mortality risk of CVD development. It was marked that the evaluation of total risk with the help of SCORE scale has to be adapted to national conditions, recourses and priorities because it accounts heterogeneity of CVD and mortality in different European populations. SCORE scale should be considered as a basis, in which some necessary corrections can be added depending on local economic, social and medical conditions.
Computer program HeartScore is the realization of the SCORE scale is currently existing and developing. It is a good tool for a practicing doctor in forecasting of CVD.
The results of cardiological studies of the staff conducted by cardiologists in 1991-2004 on the basis of Nuclear Center VNIITF demonstrated that CVD appear to be an often pathology among these people. It will be impossible to reach substantial improvement of the situation without essential increase of medical service effectiveness. It looks like the situation will be the same for another sampling of atomic industry staff in Russia and other countries.
Therefore, it is necessary to resolve such problems as improvement of medical examination methods, diagnostics, prevention and treatment of inpiduals subject to different risk factors specific for atomic industry companies. It is of great scientific importance to compare the results of this study to similar researches performed for other industries in Russia and other countries.
The peculiarity of this project is that people living in closed cities, in particular, personnel of atomic industry companies, have population, biological, social, and psychophysiological status differences. Therefore, it seems rational to determine the significance of risk factors in order to correct and more precisely forecast possible diagnostics methods in comparison with the SCORE scale.
It is common knowledge that there is a connection between intermediate and terminal points (indices) of last ventricle hypertrophy, changes of electrical stability of myocardium and the increase of CVD risk That is why the determination of intermediate and terminal points can be included into more complicated models of cardiovascular risk estimation in addition to SCORE scale.
Within the project it is planned to find correlation dependencies between the factors used in SCORE tables and the above indicators. Detection of such stable dependences will give the opportunity to estimate more accurately risk in presence of all indices and risk without some of them.
SCORE scale-based new model of total risk estimation for the personnel of nuclear industry companies will be presented in this research. It will be based upon the results of studies performed at VNIITF in different years and forecast the risk of fatal CV diseases.
The majority of epidemiological and clinical researches held in Russia have a significant drawback: control groups either too small to extrapolate data on the population or do not relate to population under research, or methods of data collection and examination are not standardized.
The team of researches working in the project possesses data of cardiological studies which were developed and being refilled over the last 15 years by scientific manager of the project Dr. Natalia Dyatlova, M.D., and other cardiologists. These data contain the results of examination of out-patients and in-patients (1700 patients of different age).
The cumulated results were successfully used in a number of scientific studies. For example, in the dissertation of Natalia Dyatlova: “The Significance of Early Complex Diagnostics of CV Diseases in the Nuclear Industry, Issues of Prevention and Forecasting”.
The further use of these data is connected with the estimation of additional criteria for expansion of SCORE tables and possible application thereof for study of diseases at nuclear industry companies, as well as for performance of early complex diagnostics for prevention and forecasting of CV diseases. Member of the Russian Academy of Medical Sciences, Dr. Rafael Oganov agreed to assist in these questions.
The project procedures will be conducted in the following spheres:
- Assimilation of computer program HeartScore;
- Development of the system for accumulation and analysis of initial data of population studies for filling the existing data bank and more precise definition of risk factors;
- Statistical analysis of correlation dependencies between risk factors;
- Comparison of risks predicted by SCORE scale and observed by research results, taking into account possible influence of radiation on development of CV diseases;
- Implementation of the improved HeartScore program into clinical practice (for the time for the staff of nuclear industry companies only);
- Development of medical programs aimed at health strengthening and prevention among the staff of nuclear industry companies.
The best practicing cardiologists from Snezhinsk, Moscow State Scientific and Research Center of Preventive Medicine and specialists from VNIITF are attracted for this project.
Cooperation with foreign collaborates will include the exchange of methods and results of analog studies conducted in Europe, Canada and the United States. Joint scientific seminars are planned.
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