scholarly journals Group and individual patients’ training impact on effectiveness of controlling cardiovascular risk factors

2019 ◽  
Vol 26 (1) ◽  
pp. 61-71
Author(s):  
G. S. Isayeva ◽  
L. A. Reznik ◽  
M. M. Vovchenko ◽  
O. O. Buryakovska ◽  
N. Yu. Emelyanova
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Lipid Metabolism ◽  
Life Quality ◽  
Density Lipoprotein ◽  
Behavioral Risk ◽  
High Cardiovascular Risk ◽  
Steps Per Day ◽  
Very High

The aim – to compare the effectiveness of group versus individual patients’ training of the medical basics to control the essential cardiovascular risk factors. Materials and methods. The study included 210 patients with high and very high cardiovascular risk. The first group comprised 75 patients who studied in Health Schools «Basics of Healthy Life Style». The second group comprised 75 patients who were offered individual consulting. 60 patients were representatives of the control group. Patients of both experimental groups were examined before the beginning and at the end of the training course. General clinical examination was carried out, anthropometric indicators were identified (body weight, height, body mass index, waist circumference, hip circumference, body build), blood pressure, glucose content, cholesterol and its fractions in blood. Results and discussion. In both groups of patients reliable reduction of blood pressure values was observed. For example, at the beginning of the study the number of patients with blood pressure target values was 31 persons (41.8 %) among the patients of the first group and 46 persons (60.9 %) among the patients of the second group. In the first group the average indicators of lipid metabolism did not show reliable change. However, in the second group the reliable reduction of total cholesterol by 21.1 % (р=0.031), low density lipoprotein cholesterol by 20.1 % (р=0.04) and the rise of the high-density lipoprotein cholesterol by 11 % (р=0.03) were found. Such behavioral risk factors as smoking, alcohol and table salt consumption did not reliably change in both groups of patients. Physical activities, assessed by the number of steps per day, did not reliably change in the first group 2311.6±1672.4 m steps per day and 2033.33±1980.27 steps per day (р=0.205), but it rose in the second group – from (2346.67±1845.54) m steps at the beginning of the study to 2654.67±1922.08 m at the end of the study (р=0.007). In the first group the life quality indicators, assessed by the data from questionnaires using SF-36 Health Status Survey, did not reliably change (58.66±16.21 and 62.54±16.39, р=0.062), in the second group it rose significantly – from 58.16±9.88 to 67.21±14.34 (р=0.008). Conclusions. The results of our research demonstrated higher effectiveness of the individual education compared to the group training. Group training of the patients with high and very high cardiovascular risk in the Health Schools «Basics of Healthy Life Style» encourages better control of blood pressure, but it does not significantly influence behavioral risk factors and lipid metabolism indicators in the patients with high and very high cardiovascular risk. Individual training of the patients with high and very high cardiovascular risk leads to significant reduction of blood pressure values, improves lipid metabolism indicators, increases physical activity and enhances life quality indicators.

scholarly journals The neurological level of spinal cord injury and cardiovascular risk factors: a systematic review and meta-analysis

Spinal Cord ◽  
2021 ◽  
Author(s):  
Peter Francis Raguindin ◽  
Gion Fränkl ◽  
Oche Adam Itodo ◽  
Alessandro Bertolo ◽  
Ramona Maria Zeh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Blood Pressure ◽  
Spinal Cord ◽  
Cardiovascular Risk ◽  
Meta Analysis ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Low Density ◽  
Cord Injury

Abstract Study design Systematic review and meta-analysis. Objective To determine the difference in cardiovascular risk factors (blood pressure, lipid profile, and markers of glucose metabolism and inflammation) according to the neurological level of spinal cord injury (SCI). Methods We searched 5 electronic databases from inception until July 4, 2020. Data were extracted by two independent reviewers using a pre-defined data collection form. The pooled effect estimate was computed using random-effects models, and heterogeneity was calculated using I2 statistic and chi-squared test (CRD42020166162). Results We screened 4863 abstracts, of which 47 studies with 3878 participants (3280 males, 526 females, 72 sex unknown) were included in the meta-analysis. Compared to paraplegia, individuals with tetraplegia had lower systolic and diastolic blood pressure (unadjusted weighted mean difference, −14.5 mmHg, 95% CI −19.2, −9.9; −7.0 mmHg 95% CI −9.2, −4.8, respectively), lower triglycerides (−10.9 mg/dL, 95% CI −19.7, −2.1), total cholesterol (−9.9 mg/dL, 95% CI −14.5, −5.4), high-density lipoprotein (−1.7 mg/dL, 95% CI −3.3, −0.2) and low-density lipoprotein (−5.8 mg/dL, 95% CI −9.0, −2.5). Comparing individuals with high- vs. low-thoracic SCI, persons with higher injury had lower systolic and diastolic blood pressure (−10.3 mmHg, 95% CI −13.4, −7.1; −5.3 mmHg 95% CI −7.5, −3.2, respectively), while no differences were found for low-density lipoprotein, serum glucose, insulin, and inflammation markers. High heterogeneity was partially explained by age, prevalent cardiovascular diseases and medication use, body mass index, sample size, and quality of studies. Conclusion In SCI individuals, the level of injury may be an additional non-modifiable cardiovascular risk factor. Future well-designed longitudinal studies with sufficient follow-up and providing sex-stratified analyses should confirm our findings and explore the role of SCI level in cardiovascular health and overall prognosis and survival.

scholarly journals Clinical profiles and quality of care of subjects with type 2 diabetes according to their cardiovascular risk: an observational, retrospective study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Basilio Pintaudi ◽  
Alessia Scatena ◽  
Gabriella Piscitelli ◽  
Vera Frison ◽  
Salvatore Corrao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Quality Of Care ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Cardiovascular Risk Factors ◽  
High Cardiovascular Risk ◽  
Very High

Abstract Background The European Society of Cardiology (ESC) recently defined cardiovascular risk classes for subjects with diabetes. Aim of this study was to explore the distribution of subjects with type 2 diabetes (T2D) by cardiovascular risk groups according to the ESC classification and to describe the quality indicators of care, with particular regard to cardiovascular risk factors. Methods The study is based on data extracted from electronic medical records of patients treated at the 258 Italian diabetes centers participating in the AMD Annals initiative. Patients with T2D were stratified by cardiovascular risk. General descriptive indicators, measures of intermediate outcomes, intensity/appropriateness of pharmacological treatment for diabetes and cardiovascular risk factors, presence of other complications and overall quality of care were evaluated. Results Overall, 473,740 subjects with type 2 diabetes (78.5% at very high cardiovascular risk, 20.9% at high risk and 0.6% at moderate risk) were evaluated. Among people with T2D at very high risk: 26.4% had retinopathy, 39.5% had albuminuria, 18.7% had a previous major cardiovascular event, 39.0% had organ damage, 89.1% had three or more risk factors. The use of DPP4-i markedly increased as cardiovascular risk increased. The prescription of secretagogues also increased and that of GLP1-RAs tended to increase. The use of SGLT2-i was still limited, and only slightly higher in subjects with very high cardiovascular risk. The overall quality of care, as summarized by the Q score, tended to be lower as the level of cardiovascular risk increased. Conclusions A large proportion of subjects with T2D is at high or very high risk. Glucose-lowering drug therapies seem not to be adequately used with respect to their potential advantages in terms of cardiovascular risk reduction. Several actions are necessary to improve the quality of care.

Assessment of the carotid artery intima-media complex through ultrasonography and the relationship with Pathobiological Determinants of Atherosclerosis in Youth

2015 ◽  
Vol 26 (7) ◽  
pp. 1333-1342 ◽  
Author(s):  
Thacira D. A. Ramos ◽  
Tatianne M. E. Dantas ◽  
Mônica O. S. Simões ◽  
Danielle F. Carvalho ◽  
Carla C. M. Medeiros
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
Cardiovascular Risk ◽  
Carotid Artery ◽  
High Density Lipoprotein ◽  
High Density Lipoprotein Cholesterol ◽  
Density Lipoprotein ◽  
High Density ◽  
Z Score ◽  
High Cardiovascular Risk

AbstractObjectiveTo evaluate the presence of carotid thickening and its relationship with the Pathobiological Determinants of Atherosclerosis in Youth score.MethodsWe carried out a cross-sectional study involving 512 brazilian adolescents. Variables such as sex, body mass index, concentrations of non-high-density lipoprotein and high-density lipoprotein cholesterol, blood pressure, blood glucose and glycated haemoglobin A1c levels that make up the score, and carotid thickening through the intima-media complex measured by ultrasound were evaluated. We adopted two cut-off points to evaluate carotid thickening, being considered altered for those higher or equal to the z-score 2+ and ⩾75th percentile. The association was assessed using the χ2 test and univariate and multivariate logistic regression analyses.ResultsHigh cardiovascular risk was present in 10.2% of the adolescents; carotid thickness was present in 4.3% determined by the z-score 2+ and in 25.0% determined by the 75th percentile. When measured by the z-score, carotid thickening was associated with high systolic blood pressure (p=0.024), high-non-high density lipoprotein cholesterol (p=0.039), and high cardiovascular risk assessed by the score and by the 75th percentile, with body mass index >30 (p=0.005). In the multivariate analysis, high cardiovascular risk was found to be independently associated with the presence of carotid thickness evaluated by the z-score, with risk four times greater (p=0.010) of presenting with this condition compared with individuals with low risk, and this fact was not observed when factors were analysed alone.ConclusionThe presence of high cardiovascular risk in adolescents assessed by the Pathobiological Determinants of Atherosclerosis in Youth score was associated with marked thickening of the carotid artery in healthy adolescents.

scholarly journals Gender Difference in Blood Pressure Control and Cardiovascular Risk Factors with Diagnosed Hypertension

2021 ◽  
pp. 275-280
Author(s):  
Tarique Shahzad Chachar ◽  
Ummama Laghari ◽  
Ghullam Mustafa Mangrio ◽  
Abdul Ghaffar Dars ◽  
Ruqayya Farhad ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Pressure Control ◽  
Health Sciences ◽  
Low Density Lipoprotein Cholesterol ◽  
Male And Female

Objective: Our study was designed to compare the gender difference in Blood Pressure Control and Cardiovascular Risk Factors in patients of Liaquat University of Medical and Health Sciences Jamshoro Pakistan. Methodology: This cross-sectional study was conducted in  Liaquat University of Medical and Health Sciences Jamshoro Pakistan from December 2019 to December 2020. Blood pressure was measured twice by trained physicians using aneroid sphygmomanometers after a standardized protocol. Patients were asked to sit with both feet on the floor for ≥5 minutes before the first BP measurement. Both the two BP measurements were taken 60 seconds apart.  For this research we defined hypertension as systolic BP ≥140 mm Hg, diastolic BP ≥90 mm Hg. Results:  We conducted a comparison between Hypertensive and nonhypertensive participants of the male and female groups. High blood pressure increased the level of uric acid in both male and female groups (351 ± 92 vs 303 ± 75). We observed that the hypertensive male population reported a high prevalence of cardiovascular risk factors due to  increase amount of total cholesterol level, triglyceride and low-density lipoprotein cholesterol (5.45 ± 1.01, 1.42 ±  0.85,  2.56 ± 0.70) than females (5.15 ± 0.91, 1.29 ± 0.87, 2.30 ± 0.63). Conclusion: Our results concluded that the male hypertensive population is more prone to future cardiovascular risk due to increased amount of total cholesterol levels, triglycerides, and low-density lipoprotein cholesterol, and sex hormones (androgens).

scholarly journals Patterns of care of subjects with type 1 and type 2 diabetes according to their cardiovascular risk

2021 ◽  
Vol 24 (1) ◽  
pp. 30
Author(s):  
Pintaudi, B.
Keyword(s):  
Risk Factors ◽  
Quality Of Care ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Quality Indicators ◽  
High Cardiovascular Risk ◽  
Very High

AIM OF THE STUDY To explore the distribution by cardiovascular risk groups according to the classification promoted by the ESC (European Society of Cardiology) of subjects with type 1 (T1D) and type 2 (T2D) diabetes cared for by Italian diabetologists and to describe the quality indicators of care, with particular regard to cardiovascular risk factors. DESIGN AND METHODS The study is based on data extracted from electronic medical records of patients treated at the 258 diabetes centers participating in the Annals AMD initiative and active in the year 2018. Patients with T1D or T2D were stratified by cardiovascular risk, in accordance with the recent ESC guidelines. General descriptive indicators and measures of intermediate outcomes, intensity/appropriateness of pharmacological treatment for diabetes and cardiovascular risk factors, presence of other complications and overall quality of care were evaluated. RESULTS Overall, 29,368 adults with T1D and 473,740 subjects with T2D were evaluated. Among subjects with T1D: 64.7% were at very high cardiovascular risk, 28.5% at high risk and the remaining 6.8% at moderate risk. Among subjects with T1D at very high-risk: 54.7% had retinopathy, 29.0% had albuminuria, 7.3% had a history of major cardiovascular event, 47.3% had organ damage, 48.9% had three or more risk factors, and 70.6% had a diabetes duration of over 20 years. Among subjects with T2D: 78.5% were at very high cardiovascular risk, 20.9% at high risk and the remaining 0.6% at moderate risk. Among those with T2D at very high risk: 39.0% had organ damage, 89.1% had three or more risk factors, 18.7% had a previous major cardiovascular event, 26,4% had retinopathy, 39.5% had albuminuria. With regard to the glucose-lowering drugs: the use of DPPIV-i increased markedly as cardiovascular risk increased; the use of secretagogues also increased and, although within low percentages, also the use of GLP1-RA tended to increase. The use of SGLT2-i is also still limited, and only slightly higher in subjects with very high cardiovascular risk. In both types of diabetes, the overall quality of care, as summarized by the Q score values, tended to be lower as the level of cardiovascular riskincreased. CONCLUSIONS The analysis of a large population such as that of the AMD Annals database allowed to highlight the characteristics and quality indicators of care of subjects with T1D and T2D in relation to cardiovascular risk classes. A large proportion of subjects appear to be at high or very high risk. Glucose-lowering drug therapies seem not to be adequately used with respect to the potential advantages in terms of reduction of cardiovascular risk of some drug categories (GLP1-RA and SGLT2-i) and, conversely, with respect to the potential risks related to the use of other pharmacological classes (sulfonylureas). Several actions are necessary to optimize care and improve the quality of care for both subjects with T1D and T2D. KEY WORDS type 1 diabetes; type 2 diabetes; cardiovascular risk; quality indicators of care.

scholarly journals Age at period cessation and trajectories of cardiovascular risk factors across mid and later life

Heart ◽  
2020 ◽  
Vol 106 (7) ◽  
pp. 499-505 ◽  
Author(s):  
Linda Marie O'Keeffe ◽  
Diana Kuh ◽  
Abigail Fraser ◽  
Laura D Howe ◽  
Debbie Lawlor ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Later Life ◽  
Glycated Haemoglobin ◽  
Lipoprotein Cholesterol ◽  
The Impact

ObjectiveTo examine the association between age at period cessation and trajectories of anthropometry, blood pressure, lipids and glycated haemoglobin (HbA1c) from midlife to age 69 years.MethodsWe used data from the UK Medical Research Council National Survey of Health and Development to examine the association between age at period cessation and trajectories of systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI) and waist circumference (WC) from 36 to 69 years and trajectories of triglyceride, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and HbA1c from 53 to 69 years.ResultsWe found no evidence that age at period cessation was associated with trajectories of log triglyceride, LDL-C and HDL-C from 53 to 69 years and trajectories of SBP or DBP from 36 to 69 years, regardless of whether period cessation occurred naturally or due to hysterectomy. While we found some evidence of associations of age at period cessation with log BMI, log WC and log HbA1c, patterns were not consistent and differences were small at age 69 years, with confidence intervals that spanned the null value.ConclusionHow and when women experience period cessation is unlikely to adversely affect conventional cardiovascular risk factors across mid and later life. Women and clinicians concerned about the impact of type and timing of period cessation on conventional cardiovascular intermediates from midlife should be reassured that the impact over the long term is small.

Modification of Cardiovascular Risk Factors during Antihypertensive Treatment: A Multicentre Trial with Quinapril

1993 ◽  
Vol 21 (1) ◽  
pp. 15-25 ◽  
Author(s):  
E Manzato ◽  
A Capurso ◽  
G Crepaldi
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Diastolic Blood Pressure ◽  
Enzyme Inhibitor ◽  
Density Lipoprotein ◽  
Diabetic Patients ◽  
Intent To Treat

A large multicentre study involving 6003 [3044 males, 2959 females; mean (± SD) age 59 ± 11 years] mild-to-severe hypertensive patients was carried out to evaluate the effects of the angiotension converting enzyme inhibitor quinapril on blood pressure and on metabolic cardiovascular risk factors during 3 − 6 months' treatment (mean follow-up 90.4 days). The study population included 551 elderly [mean (± SD) age 71.9 ± 9.3 years] patients, 1314 subjects with diabetes mellitus and 154 non-diabetic patients with hyperlipaemia; 4% of patients were lost to follow-up. Diastolic blood pressure decreased from 102 to 87 mmHg (intent-to-treat analysis) and 62% of patients were normalized (diastolic blood pressure below 90 mmHg) at the last evaluable visit. Overall, serum lipids were favourably affected during quinapril treatment; when corrected for changes in body weight, a significant improvement in total, low- and high-density lipoprotein cholesterol, and triglycerides was detected. Quinapril treatment in elderly patients was efficacious and well tolerated, and quinapril appears to be an effective antihypertensive drug devoid of untoward effects on metabolic risk factors for cardiovascular disease.

scholarly journals THE RELATIONSHIP BETWEEN DAILY STEPS AND CARDIOVASCULAR RISK FACTORS AMONG TEACHERS IN CENTRAL REGION, MALAYSIA

2020 ◽  
Vol 9 (2) ◽  
Author(s):  
Shafiqah Mohd Radhi ◽  
Nur Zakiah Mohd Saat ◽  
Nor Farah Mohamad Fauzi ◽  
Siti Aishah Hanawi
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Waist Circumference ◽  
Cardiovascular Risk Factors ◽  
Diastolic Blood Pressure ◽  
Blood Sugar ◽  
School Teachers ◽  
Steps Per Day

Physical activity is an important component of cardiovascular health. The fact that physical activity is also associated with a substantial number of cognitive and academic benefits, therefore schools teachers can be an important role model in promoting a physically-active lifestyle in school children. The aim of this study is to examine the levels of physical activity (PA) and its association with cardiovascular risk factors in a sample of school teachers. Forty-nine (n=49) teachers from primary and secondary schools around Klang Valley urban areas were recruited. The PA level was determined using pedometer, worn for three consecutive days. Anthropometric measurements and blood samples were collected to determine cardiovascular risk factors. Findings showed that the school teachers recorded an overall mean (± SEM) of 7707 ± 490 steps/day, which is below the recommended target of 10 000 steps per day. According to pedometer-determined physical activity indices proposed by Tudor-Locke and Bassett (2004), 20.83% of the sample were classified as ‘sedentary’ (<5000 steps/day), 35.40% were ‘low active’ (5000 – 7499 steps/day) and only 18.70% achieved more than 10 000 steps/day. According to Asian BMI cut-off points, 43% of the teachers were categorized as overweight and obese (>23 kg/m2). The mean values for waist circumference, fasting blood sugar, and cholesterol level, systolic and diastolic blood pressure were 83.96 ± 1.90 cm, 5.41 ± 0.26 mmol/l, 4.64±0.26 mmol/l, 118.90 ± 1.72 mmHg and 72.40±1.58 mmHg respectively. Fisher Exact Test shown that there were significant association between daily step and age category. Daily steps weakly negative correlated with systolic blood pressure (r = -0.024, p > 0.05) as well as blood sugar levels (r = -0.061, p> 0.05), diastolic blood pressure (r = -0.079, p> 0.05), body mass index (r = -0.271, p> 0.05), waist circumference (r = -0.196, p> 0.05), as well as blood cholesterol levels (r = -0.037, p> 0.05). In conclusion, there were weak negative correlations between steps per day and cardiovascular risk factors. Generally, the level of physical activity in the sample of teachers needs to be improved. Interventions aimed at promoting PA among school teachers may be warranted in the future.

Abnormalities in protein С system and atherosclerosis of peripheral arteries in patients with high and very high risk of cardiovascular complications

2019 ◽  
Author(s):  
В.В. Генкель ◽  
В.А. Сумеркина ◽  
И.И. Шапошник
Keyword(s):  
Cardiovascular Risk ◽  
Relative Risk ◽  
Lower Limb ◽  
Protein C ◽  
Carotid Arteries ◽  
Density Lipoprotein ◽  
Cardiovascular Complications ◽  
Peripheral Arteries ◽  
High Cardiovascular Risk ◽  
Very High

Цель исследования: изучить частоту встречаемости нарушений в системе протеина С у пациентов высокого и очень высокого риска сердечнососудистых осложнений (ССО), а также выявить взаимосвязи данных нарушений и тяжести атеросклеротического поражения периферических артерий. Материалы и методы. В исследование были включены 165 пациентов высокого и очень высокого риска ССО. Скрининг нарушений в системе протеина С проводили с использованием набора реагентов Парустест (ООО ТехнологияСтандарт, Россия). Резистентность фактора Va к активированному протеину С определяли с использованием набора реагентов Фактор VPCтест (ООО ТехнологияСтандарт, Россия). По полученным данным рассчитывали нормализованное отношение (НО). Всем пациентам проводили ультразвуковое дуплексное сканирование артерий каротидного бассейна и артерий нижних конечностей (АНК). Результаты. Медиана НО протеина С составляла 1,20 0,801,60. Снижение НО менее 0,7 было выявлено у 16 (9,69 ) пациентов. Резистентность к АПС была установлена у 1 (0,61 ) больного. По результатам корреляционного анализа снижение НО протеина С ассоциировалось с увеличением степени стенозирования сонных артерий и АНК. По результатам полиномиального логистического регрессионного анализа снижение НО протеина С менее 0,7 с поправкой на такие факторы как пол, возраст, курение, артериальная гипертензия, сахарный диабет 2го типа, скорость клубочковой фильтрации и содержание липопротеинов низкой плотности ассоциировалось с увеличением относительного риска выявления тяжелого сочетанного поражения периферических артерий с их стенозированием более 50 в 10,8 раз (95 ДИ 1,8363,8 p 0,009). Заключение. У пациентов высокого и очень высокого риска ССО нарушения в системе протеина С выявлялись в 9,69 случаев. Снижение НО протеина С ассоциировалось с увеличением тяжести атеросклеротического поражения периферических артерий. Наличие у пациента нарушений в системе протеина С ассоциировалось с увеличением относительного риска выявления тяжелого сочетанного поражения периферических артерий в 10,8 раза. Aim: to study frequency of protein C system abnormalities in patients with a high and very high cardiovascular risk and to reveal the relationship of these disorders and the severity of atherosclerosis of peripheral arteries. Materials and methods. The study included 165 patients at high and very high cardiovascular risk. Screening of abnormalities in the protein C system was carried out using Parustest (OOO TechnologyStandard, Russia). Resistance factor Va to APS was determined using Factor VPCtest (OOO TechnologyStandard, Russia). The obtained data were used to calculate the normalized ratio (NO). All patients underwent ultrasound duplex scanning of carotid arteries and lower limb arteries. Results. The median NO of protein C was 1.20 0.801.60. A decrease in NO less than 0.7 was diagnosed in 16 (9.69 ) patients. Resistance to APC was established in 1 (0.61 ) patient. A decrease in the NO of protein C was associated with an increase in the degree of stenosis of carotid arteries and lower limb arteries. According to the results of the polynomial logistic regression analysis, the decrease in the NO protein C less than 0.7, adjusted for factors such as sex, age, smoking, hypertension, type 2 diabetes mellitus, glomerular filtration rate and low density lipoprotein content was associated with an increase in the relative risk of identifying severe combined atherosclerosis of peripheral arteries in 10.8 times (95 CI 1.8363.8 p 0.009). Conclusion. In patients with a high and very high cardiovascular risk abnormalities of the protein C system were detected in 9.69 of cases. Reduction of the normalized ratio of protein C was associated with an increase in the severity of peripheral arteries atherosclerosis. The presence of abnormalities in the protein C system was associated with a 10.8fold increase in the relative risk of detecting a severe combined atherosclerosis of peripheral arteries.

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