V.V. Bratus, T.V. Talaeva, V.О. Shumakov. Whether the cholesterol level in blood is the independent cardiovascular risk factor?

Risk factors identification which allows the most adequate appreciation of the pathological state development in one of the most important task of the preventive medicine. It gives the possibility of the timely diagnosis, determination of the character and amount of therapeutic interventions and their efficacy. The verification of the cardiovascular risk factors has special significance since among more that 200 described factors so far the most informative are not yet determined. It was shown that even hypercholecterolemia, which is considered by many investigators the main reason of the ischemic heart disease development and the target for therapeutic and pharmacological interventions is found in patients with myocardial infarction less than in 50 % cases.
Material and methods. The investigation was conducted on patients with osteoarthritis which are characterized by the accelerated development of atherosclerosis, increased severity of cardiovascular pathology and frequency of the end points development. Risk factors were identified in relation to the development of the vascular functional and structural remodeling with the help of paired and multivariate correlation analysis.
Results. It was established that the extend of the vascular damage was in the most strong and direct dependence with systemic inflammation and activation of the renin-angiotensin system; the indexes of the blood lipoprotein profile changes (relation of Tg/HDL cholesterol and apoB/apoA-1) and indexes of their quality changes (atherogenic and immunogenic modification) and changes of glucose metabolism were also in strong correlation with vascular remodeling. However these connections were weakened end even lost after accounting of the systemic inflammation activity, which pointed to its mediated nature. Meanwhile such traditionally used index as the level of LDL cholesterol did not correlated with the severity of the vascular damage, and its connection with the amount of total cholesterol was found only on the background of the systemic inflammation highest intensity.
Conclusion. These data show that the adequate determination of the cardiovascular risk must be based not on one special index, but on the complex analysis of the blood biochemical changes.

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