Diagnosis, treatment, and medical examination of military personnel with familial hypercholesterolemia



Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription Access

Abstract

The probable number of military personnel of the Armed Forces with a heterozygous form of familial hypercholesterolemia is more than 2 thousand people. This pathology requires an interdisciplinary approach and the introduction of a universal algorithm of treatment and prophylactic measures for patients with familial hypercholesterolemia, taking into account the peculiarities of the activities of military medical organizations, as well as adapting the requirements of national recommendations for the diagnosis and treatment of familial hypercholesterolemia in military health practice. The basis of its successful treatment is the correction of atherosclerosis risk factors and lifestyle modification, categorical smoking cessation (both active and passive), elimination of excess body weight under the supervision of a specialist, blood pressure control, dosed and accessible physical activity (30-minute walk, cycling at least five times a week) under the control of heart rate and blood pressure and in the absence of contraindications. Survey of military personnel must be carried out, taking into account the severity of atherosclerotic lesions of the arteries and the functional state of the organs supplied to them by blood, compensation for impaired lipid metabolism with available lipid - lowering drugs. Expert opinion on the category of fitness for military service is made during the development of clinical manifestations of atherosclerosis.

Full Text

Restricted Access

About the authors

B. V Pomogaibo

413th Military Hospital of the Ministry of Defense of the Russian Federation

Email: to413vg@yandex.ru
Volgograd, Russia

E. V Kryukov

The N.N.Burdenko Main Military Clinical Hospital of the Ministry of Defense of the Russia Federation

Moscow, Russia

A. L Chaplyuk

The Main Center for Military Medical Examination of the Ministry of Defense of the Russian Federation

Moscow, Russia

I. V Sergienko

National Medical Research Center for Cardiology, Ministry of Health of the Russian Federation

Moscow, Russia

M. V Ezhov

National Medical Research Center for Cardiology, Ministry of Health of the Russian Federation

Moscow, Russia

S. A Chernov

The N.N.Burdenko Main Military Clinical Hospital of the Ministry of Defense of the Russia Federation

Moscow, Russia

P. G Shakhnovich

The N.N.Burdenko Main Military Clinical Hospital of the Ministry of Defense of the Russia Federation

Email: p-shakhnovich@mail.ru
Moscow, Russia

References

  1. Бойцов С.А., Марцевич С.Ю., Кутишенко Н.П. и др. Регистры в кардиологии. Основные правила проведения и реальные возможности // Кардиоваскулярная терапия и профилактика. - 2013. - Т. 12, № 1. - С. 4-9.
  2. Ежов М.В., Сергиенко И.В., Рожкова Т.А. и др. Российские рекомендации по диагностике и лечению семейной гиперхолестеринемии // Атеросклероз и дислипидемии. - 2016. - № 4. - С. 21-29.
  3. Ежов М.В., Сергиенко И.В., Аронов Д.М. и др. Диагностика и коррекция нарушений липидного обмена с целью профилактики и лечения атеросклероза: Рос. рекоменд., VI пересмотр // Атеросклероз и дислипидемии. - 2017. - № 3. - С. 5-22.
  4. Кухарчук В.В. Этиология и патогенез атеросклероза: Руководство по атеросклерозу и ишемической болезни сердца / Под ред. Е.И.Чазова, В.В.Кухарчука, С.А.Бойцова. - М.: Медиа Медика, 2007. - 736 с.
  5. Мешков А.Н., Малышев П.П., Кухарчук В.В. Семейная гиперхолестеринемия в России: генетическая и фенотипическая характеристика // Тер. архив. - 2009. - Т. 81, № 9. - С. 23-28.
  6. Пономарева А.И., Компаниец О.Г., Линчак Р.М. и др. Фармакоэпидемиология статинов у пациентов с гипертонической болезнью и дислипидемией // Кардиология. - 2015. - Т. 55, № 10. - С. 25-31.
  7. Постановление Правительства РФ от 04.07.2013 г. № 565 «Об утверждении Положения о военно - врачебной экспертизе» http://www.consultant.ru/document/cons_ doc_LAW_149096/
  8. Приказ министра обороны РФ от 18.06.2011 г. № 800 «Об утверждении Руководства по диспансеризации военнослужащих в Вооруженных Силах Российской Федерации».
  9. Сафарова М.С., Сергиенко И.В., Ежов М.В. и др. Российская научно - исследовательская программа по своевременной диагностике и лечению больных семейной гиперхолестеринемией: обоснование и дизайн российского регистра семейной гиперхолестеринемии (РоСГХС) // Атеросклероз и дислипидемии. - 2014. - № 3. - С. 7-15.
  10. Сергиенко И.В., Аншелес А.А., Кухарчук В.В. Атеросклероз и дислипидемии: современные аспекты патогенеза, диагностики и лечения. - М.: ООО «Патис», 2017. - 142 с.
  11. Соколов А.А., Александрова О.Ю., Кашталап В.В. и др. Методические рекомендации по организации медицинской помощи больным с наследственными атерогенными нарушениями липидного обмена в субъектах Российской Федерации // Кардиологич. вестн. - 2017. - № 2. - С. 3-8.
  12. Чумаков А.В., Черкашин Д.В., Кутелев Г.Г. и др. Проблема кардиологического обследования водолазного состава военно - морского флота при проведении военно - врачебной экспертизы в условиях современного стационара // Морская медицина. - 2015. - Т. 1, № 1. - С. 41-44.
  13. Baigent C., Blackwell L., Collins R. et al. Aspirin in the primary and secondary prevention of vascular disease: collaborative meta - analysis of individual participant data from randomised trials // Lancet. - 2009. - Vol. 373, N 9678. - P. 1849-1860.
  14. Boekholdt S.M., Hovingh G.K., Mora S. et al. Very low levels of atherogenic lipoproteins and the risk for cardiovascular events: a meta - analysis of statin trials // J. Am. Coll. Cardiol. - 2014. - Vol. 64, N 5. - P. 485-494.
  15. Cannon C.P., Blazing M.A., Giugliano R.P. et al. Ezetimibe Added to Statin Therapy after Acute Coronary Syndromes // N. Engl. J. Med. - 2015. - Vol. 372, N 25. - P. 2387-2397.
  16. Catapano A.L., Graham I., De Backer G. et al. 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias // Eur. Heart J. - 2016. - Vol. 37, N 39. - P. 2999-3058.
  17. Ershova A.I., Meshkov A.N., Bazhan S.S. et al. The prevalence of familial hypercholesterolemia in the West Siberian region of the Russian Federation: A substudy of the ESSE-RF // PLoS One. - 2017. - Vol. 12, N 7. - P. e0181148.
  18. Familial hypercholesterolaemia: identification and management. NICE guideline, 2008. https://www.nice.org.uk/guidance/cg71/resources /familial - hypercholesterolaemia - identifi cation - and - management - pdf - 975623384005.
  19. Giugliano R.P., Keech A., Murphy S.A. et al. Clinical Efficacy and Safety of Evolocumab in High-Risk Patients Receiving a Statin: Secondary Analysis of Patients With Low LDL Cholesterol Levels and in Those Already Receiving a Maximal-Potency Statin in a Randomized Clinical Trial // J.A.M.A. Cardiol. - 2017. - Vol. 2, N 12. - P. 1385-1391.
  20. Hopkins P.N., Toth P.P., Ballantyne C.M. et al. Familial hypercholesterolemias: prevalence, genetics, diagnosis and screening recommendations from the National Lipid Association Expert Panel on FamilialHypercholesterolemia // J. Clin. Lipidol. - 2011. - Vol. 5, Supp. 3. - P. S9-S17.
  21. Hovingh G.K., Raal F.J., Dent R. et. al. Long - term safety, tolerability, and efficacy of evolocumab in patients with heterozygous familial hypercholesterolemia // J. Clin. Lipidol. - 2017. - Vol. 11, N 6. - P. 1448-1457.
  22. Jansen A.C., van Aalst-Cohen E.S., Tanck M.W. et al. The contribution of classical risk factors to cardiovascular disease in familial hypercholesterolaemia: data in 2400 patients // J. Intern. Med. - 2004. - Vol. 256, N 6. - P. 482-490.
  23. Maeda K., Noguchi Y., Fukui T. The effects of cessation from cigarette smoking on the lipid and lipoprotein profiles: a meta - analysis // Prev. Med. - 2003. - Vol. 37, N 4. - P. 283-290.
  24. Merino-Ibarra E., Castillo S., Mozas P. et al. Screening of APOB gene mutations in subjects with clinical diagnosis of familialhypercholesterolemia // Hum. Biol. - 2005. - Vol. 77, N 5. - P. 663-673.
  25. Nordestgaard B.G., Chapman M.J., Humphries S.E. et al. Familial hypercholesterolaemia is underdiagnosed and undertreated in the general population: guidance for clinicians to prevent coronary heart disease: consensus statement of the European Atherosclerosis Society // Eur. Heart J. - 2013. - Vol. 34, N 45. - P. 3478-3490.
  26. Page M.M., Bell D.A., Hooper A.J. et al. Lipoprotein apheresis and new therapies for severe familial hypercholesterolemia in adults and children // Best Pract. Res. Clin. Endocrinol. Metab. - 2014. - Vol. 28, N 3. - P. 387-403.
  27. Scott M., Arai H., Barter P. et al. An International Atherosclerosis Society Position Paper: global recommendations for the management of dyslipidemia - full report // J. Clin. Lipidol. - 2014. - Vol. 8, N 1. - P. 29-60.
  28. Shaw K., Gennat H., O’Rourke P. et al. Exercise for overweight or obesity // Cochrane Database Syst. Rev. - 2006. - Vol. 4. - CD003817.
  29. Suаrez Bagnasco M. Psychological issues and cognitive impairment in adults with familial hypercholesterolemia // Fam. Pract. - 2017. - Vol. 34, N 5. - P. 520-524.
  30. Thorogood M., Seed M., De Mott K. Management of fertility in women with familial hypercholesterolaemia: summary of NICE guidance // Br. J. Obstet. Gynaecol. - 2009. - Vol. 116, N 4. - P. 478-479.
  31. Watts G.F., Gidding S., Wierzbicki A.S. et al. Integrated guidance on the care of familial hypercholesterolaemia from the International FH Foundation // Int. J. Cardiol. - 2014. - Vol. 171, N 3. - P. 309-325.

Copyright (c) 2021 Eco-Vector

СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: № 01975 от 30.12.1992.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies