DYNAMICS OF CARDIOVASCULAR RISK FACTORS IN RAILWAY CREWS

Abstract

Aim. To assess the prevalence of cardiovascular risk factors (RF) and dynamics over 4 years in locomotory crews.Material and methods. One hundred train drivers and assistants aged 25-59 y.o. (mean age — 43,8±10,3 y.) were investigated in-patient with 24 hour blood pressure (BP) monitoring, ultrasound Doppler of brachiocephalic arteries, standard biochemistry. Fifty three persons were assessed prospectively from 2013 to 2017 y.Results. BP increase (essential hypertension of I-II grades with mild or moderate hypertension) was found in 78 persons, with the mean duration — 10,4±4,3 years, and age of onset — 37,0±8,5 y.o. Most commonly, the dyslipidemiaswerefound:hypertriglyceridemiain59%,hypercholesterolemia in 44%. Smokers — 39%, overweight — 37%, obese — 41%. Correlational analysis revealed significant direct correlation of triglycerides with body mass index (r=0,35), with glucose tolerance disorder (r=0,22) and hypertension (r=0,22), however there was negative correlation with smoking status (r=-0,25). In patients with hypertension, aged 25-39 (n=18), comparing to the group with the none (n=22), there were significantly higher: body mass index, cholesterol level, triglycerides level and low density lipoproteideslevelwiththeabsenceofdifferenceinhighdensitylipoproteides, smoking prevalence and family anamnesis of cardiovascular diseases. In prospective follow-up the negative dynamics of lipid profile was found in males of 25-39 y.o., and morphological presentation — lesions in brachiocephalic arteries, at the age 40-49 y. with stabilization of parameters at the age 50-59 y.o. Mean group levels of systolic and diastolic BP at daytime and at night in both timepoints were within normotension range in all groups, corresponding to “non-dipper” type.Conclusion. Most prevalent RF in railway crews were dyslipidemia and obesity. The adequacy of therapy prescribed in all age strata makes it to regard the raise of BP as modifiable RF.