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Authors: Bulich E.G., Muravov I.V.

Pages: 1-21


The problem of chronic pathological conditions and chronic diseases (CD) in a paradoxical way combine both opposed and mutually exclusive points of view. The development of chronic pathological conditions is considered to be the greatest danger to the life of the population or protective reaction. The absence of the reliable epidemiological methods to assess CD significantly interferes with the description of the problem.

The suggested analysis allowed justifying the assessment method of development of chronic diseases based on the use of known epidemiological indicators. The proposed indicators allowed quantitatively evaluating the correlation between sub-populations "adapted" and "unadapted" among the population. The indicators could evaluate the ability of the population to separate the disease preserving the life span.

The assessment method was approved at one of the most mass illnesses CD – ischemic heart disease (IHD). We explained the protective influence of the development of chronic IHD in people of working age. That influence was not the passive "extension" of the pathological process but the active mechanism of danger resistance that favored reduction of mortality. Although the development of chronic pathological conditions become a biological process, but its implementation at various diseases may differ importantly.

Keywords:epidemiology, chronicpathologicalstates, morbidity, morbidityrate, mortality, protectiveeffect, pathogenesis, ischemicheartdisease.       

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  1. OganovRG,MaslennikovaGYa,ShalnovaSA,DeyevAD.[Cardiovascular and other chronic noninfectious diseases: situation and possibilities of prevention in Russia]. Intern. 2003;1:16
  2. Beaglehole R, Bonita R, Kjellstrom T. [Basic epidemiology]. Lodz:
  3. Preventing chronic diseases: a vital investment. Geneva: WHO, 2005, 200 p.
  4. Zatonski W. Nowotwory złośliwe w Polsce [Malignant tumours in Poland]. Warszawa: Centrum onkologii Publ., 1993, 206 p. (in Polish)
  5. Sant M, Allemani C, Santaquilani M, Knijn A, Marchesi F, Capocaccia R; EUROCARE Working Group. EURUCARE-4. Survival of cancer patients diagnosted in 1995-1999. Results and commentary. Eur J Cancer. 2009;45(6):931doi: 10.1016/j.ejca.2008.11.018
  6. WojciechowskaU, Didkowska J, Zatonski W. Wskazniki przezyc chorych na nowotwory zlosliwe w Polsce zdiagnozowanych w latach 2000-2002. [Survival of canser patients diagnosed in 2000–2002]. Warszawa: the Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology Publ., 2009, 72 p. (in Polish)
  7. WojciechowskaU, Didkowska J, Zatonski W. Nowotwory złośliwe w Polsce – wskażniki 5-letnich przeżyć według wojewodstw zdiagnozowanych w latach 2000-2002 [Cancer in Poland five-year survival rates by regions]. Warszawa: the Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology Publ., 2010, 55 p. (in Polish)
  8. Dawydowski IW. Zagadnienie przyczynowosci w medycynie (etiologia) [Issues of diease cause in medicine: etiology]. Warszawa: PZWL Publ., 1965, 215 p. (in Polish)
  9. Bien B.Opieka zdrowotna nad ludzmi w starszym wieku. Stan a potrzeby w perspektywie starzenia się ludności Polski. Biuletyn 53. Warsaw: Rzadowa Rada Ludnosciowa Publ., 2008, pp. 128
  10. Frackiewicz L. Potrzeby społeczne starzejącego się społeczeństwa. Biuletyn 53. Warsaw: Rzadowa Rada Ludnosciowa Publ., 2008, pp. 26
  11. Hopman WM, Harrison MB, Coo H.Friedberg E, Buchanan M, VanDenKerkhof EG. Associations between chronic disease, age and physical and mental health status.Chronic Dis Can. 2009;29(2):108
  12. Kane R, Onslander J, Abrass I, Resnick B, editors. Essentials of clinical geriatrics. New York: McGraw-Hill Medical, 2009, 576 p.
  13. Prystupa E, Prystupa L, Opimakh O, Dytko V. [Association between obesity and osteoporosis]. Zdrowie i Społeczenstwo. 2011;1(1):131–153.
  14. Jasmer RM, Nahid P, Hopewell PC. Clinical practice. Latent tuberculosis infection.N Engl J Med. 2002;347(23):1860
  15. Global tuberculosis control. WHO Report Geneva: WHO, 2011, 258 p.
  16. Feshchenko YuI, Melnik VM, Turchenko LV, Lirnyk SV. Tuberkuloz: orhanizatsiia, diagnostyka, likuvannia, profilaktyka ta control za smertnistiu [Tuberculosis: organization, diagnosis, treatment, prevention and monitoring of mortality]. Kyiv: Zdorovia Publ., 2010, 447 p.
  17. Szczuka I. [Tubercolosis in Poland in 2007]. Przegl. Epidemiol. 2009;63(2):281
  18. Caminero JA. Treatment of multidrug-resistant tuberculosis: evidence and controversies. . 2006;10(8):829–837.
  19. Madariaga MG, Lalloo UG, Swindells S. Extensively drug-resistant tuberculosis. Review. Am. J. Med. 2008;121(10):835–844. doi: 10.1016/j.amjmed.2008.04.015
  20. Caminero JA. Multidrug-resistant tuberculosis: epidemiology, risk factors and case finding. Int J Tuberc Lung Dis. 2010;14(4):38290.
  21. Reaven GM. The metabolic syndrome: requiescat in pace. Clin. Chem. 2005;51:931938.
  22. Zimmet P, Shaw J, Alberti G. Preventing type 2 diabetes and the dysmetabolic syndrome in the real world: a realistic view. Diabetic medicine. 2003;20(9):693
  23. Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, McQueen M, Budaj A, Pais P, Varigos J, Lisheng L; INTERHEART Study Investigators. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364(9438):937–52.
  24. Lakka HM, Laaksonen DE, Lakka ТА, et al. The metabolic syndrome and total cardiovascular disease mortality in middle -aged men. JAMA. 2002;288:2709
  25. Chen W, Berenson GS. Metabolic syndrome: definition and prevalence in children. J Pediatr. 2007;83(1):1–3.
  26. Moreira SR, Ferreira AP, Lima RM, Arsa G, Campbell CSG, Simoes HG, Pitanga FJ, França NM. Predicting insulin resistance in children: anthropometric and metabolic indicators. J Pediatr. 2008;84(1):47–52. doi:10.2223/JPED.1740
  27. Hirschler V, Roque MI, Calcagno ML, Gonzalez C, Aranda C. Maternal waist circumference and the prediction of children's metabolic syndrome. Arch Pediatr Adolesc Med. 2007;161(12):1205–10.
  28. Ford ES, Chaoyang The Journal of Pediatrics. 2008;152(2):160–164.
  29. Ferreira AP, Oliveira CE, Franca NM. Metabolic syndrome and risk factors for cardiovascular disease in obese children: the relationship with insulin resistance (HOMA-IR). J Pediatr. 2007;83(1):21
  30. Bulicz E, Murawow I. [Do preventive measures lead to health?]. Radom: PR Publ., 2007, 207. (in Polish)
  31. McDonagh TA, Gardner RS, Clark AL, Dargie H, editors. Oxford textbook of heart failure. Oxford: Oxford University Press, 2011, 664.
  32. Andersson B, Waagstein F. Spectrum and outcome of congestive heart failure in a hospitalized population. Am Heart J. 1993, 126:632–640.
  33. Bonneux L, Barendregt JJ, Meeter K, Bonsel GJ, van der Maas PJ. Estimating clinical morbidity due to ischemic heart disease and congestive heart failure: future rise of heart failure. Am J Public Health. 1994;84:20–28.
  34. Koelling TM, Chen RS, Lubwama RN, L'Italien GJ, Eagle KA. The expanding national burden of heart failure in the United States: the influence of heart failure in women. Am Heart J. 2004;147:74–78.
  35. Fang J, Mensah GA, Croft JB, Keenan NL. Heart failure-related hospitalizationin the, 1979to2004. JAmCollCardiol. 2008;52:428434.
  36. BelenkovYuN, AgeevFT, MareevVN [Meetdiastolicheartfailure].Terapevtucheskiiarkhiv. 1994;9:3
  37. McMurray JJ, Stewart S. Epidemiology, aetiology, and prognosis of heart failure. Heart. 2002;83:596602.
  38. AgeevFT, ArutiunovGP, BelenkovYuN, etal. Khronicheskaia serdechnaia nedostatochnost [Chronic heart failure]. Moscow: GEOTAR-Media Publ., 2010, 336 p.
  39. 2009 Focused Update: ACCF/AHA guidelines for the diagnosis and management of heart failure in adults: a report of the American College of Cardiology Foundation. J Am Coll Cardiol. 2009;53:1343
  40. Cheorghiade M, Filippatos G. Roassessing treatment of acute heart failure syndromes: the ADHERE Registry. Eur. Heart J. 2005;7(B):1318.
  41. Lloyd-Jones D, Adams R, Carnethon M, De Simone G, Ferguson TB, Flegal K, Ford E, Furie K, Go A, Greenlund K, Haase N, Hailpern S, Ho M, Howard V, Kissela B, Kittner S, Lackland D, Lisabeth L, Marelli A, McDermott M, Meigs J, Mozaffarian D, Nichol G, O'Donnell C, Roger V, Rosamond W, Sacco R, Sorlie P, Stafford R, Steinberger J, Thom T, Wasserthiel-Smoller S, Wong N, Wylie-Rosett J, Hong Y; American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics–2009 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2009;119(3):4806.doi: 10.1161/CIRCULATIONAHA.108.191259
  42. Pang PS, Gheorghiade M. A review of phase II acute heart failure syndromes clinical trials. Heart Fail Clin. 2011;7(4):441450.
  43. Liao L, AllenLA, WhellanEconomic burden of heart failure in the elderly. Pharmacoeconomics. 2008;26:44762.
  44. Cowie MR, Mosterd A, Wood DA, Deckers JW, Poole-Wilson PA, Sutton GC, Grobbee DE. The epidemiology of heart failure. Europ. Heart J. 1997;18:208225.
  45. Noor L, Adnan Y, Khan SB, Shah SS, Sawar S, Qadoos A, Arif M, Awan ZA. Inpatient burden of heart failure in the cardiologyunits of tertiary care hospitals in Peshawar. Pak. J. Phisiol. 2012;8(1):3
  46. ErtlG, AngermannCE. Therapy of chronic left heart failure. Internist. 2007;48(1):59
  47. Cleland JG, McDonagh T, Rigby AS, Yassin A, Whittaker T, Dargie HJ; The national heart failure audit for England and Wales 2008-2009. Heart. 2011;97(11):876
  48. Franciosa JA, Wilen M, Ziesche S, Cohn JN. Survival in men with severe chronic left ventricular failure due to either coronary heart disease or idiopathic dilated cardiomyopathy. AmJCardiol. 1983;51:831836.
  49. ProshchaievKI, IlnitskiiAN, ZhernakovaNI. Khronicheskaia serdechnaia nedostatochnost [Chronic heart failure in the elderly]. Saint Petersburg, 2009, 67 p.
  50. Hsu DT, Pearson GD. Advances in heart failure. Heart failure in children. Part I: History, Etiology, and Pathophysiology. Circulation: Heart Failure. 2009a;2:63
  51. Hsu DT, Pearson GD. Advances in heart failure. Heart failure in children. Part II: Diagnosis, Treatment, and Future Derections. Circulation: Heart Failure. 2009b;2:490
  52. Massin MM, Astadicko I, Dessy H. Epidemiology of heart failure in a Tertiary Pediatric Center. Clinical Cardiology. 2008;32(8):388
  53. Dilman VM. Ageing, metabolic immunodepression and carcinogenesis. Mech. Ageing and Develop. -1978;8:153
  54. Foreman KE, Tang J. Molecular mechanisms of replicative senescence in endothelial cells. Exp. Gerontol. 2003;38(1112):1251
  55. Bulicz E., Murawow I. [Health status and diagnosis. Effects of physicala activities]. Radom: PR Publ., 2002, 207 p. (in Polish)
  56. AkhaladzeNG, EnaLM. [Correlationsbetweencertaintypeschronicpathologiesandbiologicalage]. Problemystareniiaidolgoletiia. 2009;18(2):187199.
  57. KorkushkoOV, ShatiloVB. [Risk factors and approaches to the prevention of accelerated ageing]. Problemystareniiaidolgoletiia. 2008;17
  58. Menec VH, Lix L, MacWilliam L. Trends in the health status of older Mannitobans. Can. J. Aging. 2005;24(1):5
  59. Frolkis VV, Bezrukov VV, Kulchitsky OK. The aging cardiovascular system: Physiology and pathology. New York: Springer Publ. Comp., 1996, 238р.
  60. Hayflick L. The future of aging. Nature. 2000;408(6809):267269.
  61. Bengtons V, Gaus D, Putney N, Silverstein M, editors. Handbook of theories of aging.New York: Springer, 2009, 790 p.
  62. AnisimovVN. [Agingandage-relateddiseases]. Klin. gerontol. 2005;11(1):42
  63. KomarovFI. [General issues of internal diseases chronization]. Terapevticheskiiarkhiv. 1987;5(1):3
  64. Lebedev KA, Poniakina ID, Kozachenko NV. [Physiology of chronic inflammatory processes and their treatment]. Fiziologiia cheloveka. 2005;31(5):100113.
  65. Kaunitz H. Adaptive changes in aging and arteriosclerosis role of cholesterol. Mech Ageing Dev. 1988;44(1):3543.
  66. Kaunitz H. Is arteriosclerosis a life prolonging, adaptive process?Mechanisms of Ageing and Development. 1991;57(139–144.
  67. BuliczE, MurawowI. [Medical and health education. Theoretical bases of valueology]. Radom: PR Publ, 1997, 283p. (in Polish)
  68. Bulicz E, Murawow I. [From preventive health care to health: strategy and optimization]. Physical training and topical issues of youth behaviour and health conditions. Belarus: Grodno, 2003, pp. 92
  69. Bulicz E, Murawow I. [On the way to grab the sense of health: problems and paradoxes]. Zdrowie i Spoleczenstwo. 2011;1(
  70. Driedger SM, Kothari A, Morrison J, Sawada M, Crighton EJ, Graham ID. Correction: Using participatory design to develop (public) health decision support systems through GIS. Intern. J. of Health Geographics. 2007;6:5364.
  71. Wojtczak A. [Health care. Tasks of health care XXI]. Warsaw: Lekarskie PZWL Publ. 2009, 226 p.
  72. Gebska-Kuczerowska A, Brzega J, editors. [Epidemiology in public health]. Epidemiologia wzdrowiu publicznym [Epidemiology in public health]. Warsaw: Lekarskie PZWL Publ., 2010, pp.1
  73. Zielinski A. [Epidemiology teaches how to think]. Medycyna praktyczna. 2011;14:11.
  74. Olsen J. Epiforum. Epinarium. 2009;4:2
  75. Wlodarczyk C, Pozdzioch S.; Czypryny A, editor. [Concept and spheres of publich health care]. [Public health]. Warsaw: Uniw. Med. "Vesalius" Publ., 2000, pp. 13
  76. Fletcher RH, Fletcher SW, Wagner EH. Clinical Epidemiology. The Essentials. Baltimore:Williams and Wilkins, 1996, 283 p.
  77. Sidorenko GI., Komissarova S. Quantitative assessement for adaptation phenomenon according to preconditioning data. VIII World Congress International Society for adaptive medicine (ISAM). Moscow, 2006, 5253.
  78. Sidorenko GI. [“Reserve of adaptation” – key concepts to analyze the cardiologic syndromes]. Kardiologiia. 2011;51(2):6769.
  79. Valeur N, Clemmensen P, Saunamaki K, Grande P; DANAMI-2 investigators. The prognostic value of pre-discharge exercise testing after myocardial infarction treated with either primary PCI or fibrinolysis: a DANAMI-2 sub-study. Eur. Heart J. 2005;26:119–127.
  80. Kloner RA, Rezhalla SH. Preconditioning, postconditioning and their application to clinical cardiology. Cardiovasc. Res. 2006;70:297
  81. Caugnant DA, Tzanakaki G, Kriz P. Lessons from meningococcal carriage study. FEMS Microbiol. Rev. 2007;31:52
  82. Stephens DS. Conquering the meningococcus. FEMS Microbiol. Rev. 2007;31:3
  83. Yazdarkhan S, Caugant DA. Neisseria meningitisdies; an overview of the carrier date. J. Med. Microbiol. 2004;53:821
  84. Kostiukova NN, Bekhalo VA. [Bacteria-carriers as the form of meningococcus persistence]. J. Mikrobiol. 2009;4:8
  85. ChakhavaOV. Gnotobiotika [Gnotobiology]. Moscow, 1972, 200 p.
  86. Wojtyniak B, Gorynski P, editors; Wojtyniak B, Stokwiszewski J,Gorynski P, Poznanska A. [Life expectancy and mortality among the Polish]. [Health status of the Polish population]. Warsaw, 2008, pp. 31
  87. Brzega J, Gebska-Kuczerowska A, editors; Wysocki MJ, Gromulska L, Car J. [HLY (Healthy Life Years) and other synthetic measures of population health status]. Epidemiologia wzdrowiu publicznym [Epidemiology in public health]. Warsaw: Lek. PZWL Publ., 2010, pp. 46
  88. Gorynski P, Wojtyniak B, Wysocki M. Chorobowość hospitalizowana. Sytuacja zdrowotna ludności Polski [Health status of the Polish population]. Warsaw: Narodowy Instytut Zdrowia Publicznego Publ., 2008, pp. 87
  89. Goliachenko OM, Shulhai AG, Goliachenko AF, Romaniuk LM, Panchyshyn NYa, Smirnova VL, Fedchyshyn NYe, Terenda NO. [Main epidemiological mechanisms of circulatory diseases and hypertension in Ukraine]. Bulletin of social hygiene and healthcare organization of Ukraine.  2010;4:9
  90. Slabkyi GO, Ponomarenko SD, Shatylo BY, et al. [Morbidity of several infectious diseases among population (situation analysis)]. Ukraina. Zdorovia natsii. 2007;1:38
  91. EkhnevaTL, VeselovaVM, NorinskajaCardiovaskularmorbidityandrelateddeathsamongUkraine'spopulationaboveworkableage (1996. Problemy stareniia i dolgoletiia. 2007;16(2):171
  92. 2733rd Employment, Social policy, Health and Consumer Affairs Council meeting (provisional version Luxembourg, 12 June 2006. Retrieved from: