2026-01-22
K. S. Samatova, N. G. Gumanova, A. I. Korolev, N. L. Bogdanova, A. Yu. Gorshkov, A. R. Kiselev, O. M. Drapkina
Aim. Тo conduct a preclinical trial of the effect of beetroot powder (Beta-NO-BOOST), as an exogenous source of nitrate and nitrite ions (NOx), on blood pressure (BP) and arterial stiffness in patients with arterial hypertension (AH). Material and methods. The pilot preclinical study included 22 male volunteers (49±10 years) with AH who completed the protocol. Participants took Beta-NOBOOST beetroot powder, developed for the National Research Center for Therapeutic and Mechanics, at a dose of 20 g/day, equivalent to 650-700 mg NOx, orally for a week in addition to prescribed therapy. Blood pressure was monitored by 24-hour BP monitoring and volumetric sphygmography, which included measuring blood pressure in all four limbs and calculating the cardio-ankle vascular index (CAVI) and ankle-brachial index before and after beetroot powder intake. Blood was collected to analyze the total concentration of nitrate and nitrite ions (NOx, μM) using a colorimetric method based on the Griess reaction with single-step reduction of nitrate to nitrite using a vanadium (III) chloride solution in 1N hydrochloric acid. Results. Serum NOx concentrations increased by an average of 2.7 times after completing the Beta-NO-BOOST beetroot powder regimen, confirming adherence to the study protocol. No significant difference in BP levels was observed before and after Beta-NO-BOOST, but a significant decrease of 0.3 units in the arterial stiffness index (CAVI) was noted. Furthermore, after a week of Beta-NO-BOOST regimen, negative correlations were found between NOx concentrations and blood pressure parameters, with a high r coefficient reaching -0.66. Conclusion. This preclinical trial demonstrated that increased NOx concentrations in the blood were associated with decreased arterial stiffness. Based on the significant negative correlations between serum NOx levels and blood pressure, it is demonstrated that the NOx in beetroot powder contributes to lowering blood pressure. The results of the preclinical trial support the feasibility of a randomized crossover controlled clinical trial of the developed beetroot powder, Beta-NO-BOOST, as a therapeutic nutritional supplement for patients with AH.
2026-01-21
O. M. Drapkina, Yu. A. Balanova, S. A. Shalnova, V. A. Kutsenko, G. E. Svinin, A. E. Imaeva, A. V. Kapustina, S. E. Evstifeeva, G. A. Muromtseva, L. I. Gomanova, S. A. Maksimov, B. M. Nazarov
Aim. To validate the European SCORE2 scale for assessing the 10-year risk of fatal and non-fatal cardiovascular events in the Russian population and to develop an adapted local version of the scale (SCORE2-RF) with defined thresholds for risk stratification. Material and methods. The analysis was performed on data from the prospective follow-up of the Russian cohort of the ESSE-RF study (2012-2014, 10 regions). The final sample included participants aged 40-64 years without a history of cardiovascular disease (CVD) or diabetes mellitus. The median follow-up was 11.5 years. The combined endpoint included death from cardiovascular causes, non-fatal myocardial infarction, and/or stroke. Data collection involved questionnaires, anthropometry, and laboratory tests. Тo assess the associations of risk factors with the combined cardiovascular endpoint, a Fine–Gray competing risks model with stratification by region and type of settlement was used. The calculated hazard ratios were converted into absolute probabilities. The prediction accuracy of the original and adapted scales was assessed using Bland–Altman plots and calibration coefficients. Results. The Fine–Gray model confirmed a statistically significant association with the combined endpoint for most SCORE2 components (age, systolic blood pressure, total cholesterol, smoking) in men. In women, smoking did not show a significant association (HR 1.18; 95% CI: 0.73-1.91). Validation showed that the original SCORE2 scale satisfactorily predicted risk for Russian men, slightly overestimating it (by 0.96 percentage points or by a factor of 1.11), but the prognosis for women was significantly overestimated – on average by 3.12 percentage points or by a factor of 1.72. Based on the constructed Fine–Gray model, an adapted SCORE2-RF scale was developed. To avoid shifting most of the population into the high-risk category when using the original SCORE2 thresholds, new stratification criteria were proposed, based on the percentile distribution of risk within each age-sex group (low/moderate, high, very high risk). Conclusion. The adapted SCORE2-RF scale, developed based on Russian population data and using new threshold values, is a more accurate and practical tool for risk stratification and clinical decision-making in the Russian healthcare setting.
2026-01-21
V. M. Gorbunov, T. S. Ilina, M. M. Loukianov, Ya. N. Koshelyaevskaya, O. M. Drapkina
Aim. To assess the prognostic value of in-hospital 24-hour blood pressure monitoring (BPM) data in patients with arterial hypertension (AH) and other cardiovascular diseases (CVD) within the hospital registry of a multidisciplinary medical center. Material and methods. This study was conducted as part of the REKVAZA-CLINICA NMIC TPM hospital registry. The final analysis included 358 patients with a mean age at hospitalization of 72.9±12.0 years (median 74.0 [28.7; 97.6] years). Over a mean prospective follow-up period of 9.4±2.3 years (median 10.2 [0.4; 11.5] years), the primary endpoint (PE; all-cause mortality) was recorded in 77 (21.5%) patients. The secondary composite endpoint (SCE) — composing non-fatal acute myocardial infarction and/or non-fatal acute cerebrovascular accident and/or pulmonary embolism and/or relevant surgical interventions and/or hospitalization for concomitant CVD — was identified in 160 (44.7%) patients. Results. Multivariate analysis in the patient group aged <75 years (n=197) showed that the risk of PE was associated with the presence of concomitant CVD (HR=3.25; 95% CI=1.14-9.22; p=0.027), higher average real variability of systolic BP (HR=1.19; 95% CI=1.01-1.41; p=0.038), and higher mean 24-h pulse pressure (PP) (HR=1.05; 95% CI=1.02-1.09; p=0.001). In the group of patients aged ≥75 years (n=161), PE was associated only with age (HR=1.17; 95% CI=1.12-1.23; p<0.001). In the overall patient cohort (n=358), PE was associated with the riser BP pattern (HR=3.93; 95% CI=1.44-10.73; p=0.008). The SCE was associated with the presence of concomitant CVD (HR=1.88; 95% CI=1.35-2.62; p<0.001) and higher mean daytime PP (HR=1.14; 95% CI=1.08-1.20; p<0.001). Conclusion. In patients with AH, 24-h BPM parameters obtained in a hospital setting retain their prognostic value, despite the significant impact of cardiovascular comorbidity and age on outcomes.
2026-01-21
E. P. Кalaydzhian, S. Yu. Martsevich, N. P. Kutishenko, O. M. Drapkina
Aim. To assess the impact of treatment adherence on long-term outcomes over a ten-year period in patients with acute myocardial infarction (MI) based on data from the prospective PROFILE-MI registry. Material and methods. The prospective PROFILE-IM registry included 160 patients attended a cardiologist at Moscow City Polyclinic No. 9 or one of its two branches in the period from March 1, 2014 to December 31, 2015. The vital status of patients was assessed 10 years after their discharge from the hospital. Results. Analysis of the results of the NODF Adherence Scale survey made it possible to identify three categories of patients (n=158, two patients refused to fill out the questionnaire): committed – 98 (62%), non-committed – 16 (10%), partially committed – 44 (28%). The life status was analyzed after 1.5 and 10 years in patients of these groups, with a 95% response rate. At 1.5 years from the start of observation, fatal outcomes were recorded in 16 (10%) patients. After ten years of follow-up, the number of deaths increased to 43 (26.9%) patients. Patients who developed primary endpoint (PEP) were significantly older than those without it – 70.3±11.1 vs 58.6±10.5 years, p<0.001. According to multivariate analysis, the risk PEP developing during a ten-year follow-up was 2.7 times higher in non-adherent patients compared to adherent and partially adherent patients (p=0.027). The ten-year monitoring data indicate that the probability of PEP increases by 8.6% every year of the patient’s life. Conclusion. The results of the study demonstrate that insufficient treatment adherence increases the likelihood of an adverse outcome during the ten-year followup period. Long-term monitoring of patients with insufficient treatment adherence is of particular importance in the context of secondary prevention.