Trigger factors of obliterating atherosclerosis of the arteries of the lower extremities

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Introduction. Every year, 17.9 million people die from diseases of the cardiovascular system in the world, which is 31% of all deaths worldwide. According to WHO, by 2030, the number of deaths will approach 23.6 million. This statistic is related to the fact that atherosclerosis is the main link in the pathogenesis of diseases such as myocardial infarction and cerebral stroke. Important risk factors for the development of atherosclerosis are genetic predisposition, diabetes mellitus, stress (psychoemotional and physical overload), smoking, excessive alcohol consumption, non-compliance with food hygiene rules, leading mainly to obesity [1, 2].
Nicotine use is one of the many currently existing methods of its administration, and in particular, smoking, is a leading factor in the development of atherosclerosis. Speaking about the contribution of nicotine to the development of atherosclerosis, it is worth mentioning that it contributes to damage to the vascular wall by increasing the concentration of very low-density lipoproteins, low-density lipoproteins, basic cholesterol and increased blood pressure [3, 4].
Alcohol consumption contributes to a violation of lipid metabolism, or rather saturated fatty acids, which leads to a decrease in the activity of enzymes involved in lipid oxidation. For this reason, in combination with other factors, excessive alcohol consumption exacerbates the course of cardiovascular diseases [5]. According to statistics, alcohol is also closely related to smoking. The percentage of smokers among alcoholics is about 90%, as neurobiological mechanisms of sensitization to nicotine and alcohol are formed [6].
Food hygiene is important to maintain the integrity of our body. When analyzing this aspect, it is necessary to take into account the quantitative and qualitative composition of the food entering the body. With regular and prolonged consumption of unhealthy food, the whole body suffers, as immunity decreases, and the mechanisms of protection against the influence of harmful factors weaken. In particular, the vessels become susceptible to the influence of the above-mentioned lipid and cholesterol compounds, the content of which increases in the blood [7].
Food hygiene is also closely related to obesity, which develops as a result of overeating. In the future, a metabolic syndrome occurs – a violation of carbohydrate, lipid and purine metabolism. The main criterion is hypertrophy of adipocytes of visceral adipose tissue and an increase in the synthesis of vasoconstrictor and procoagulation compounds contributing to endothelial damage [8].
Hypodynamia can be added separately to the list of risk factors, since as a result of a decrease in activity, metabolic processes slow down and, as a result, abdominal obesity develops. It, in turn, provokes the appearance of other risk factors listed above [9].
The aim of the study is to identify the trigger factors of obliterating atherosclerosis of the arteries of the lower extremities.
Materials and methods of research. In the course of this work, an anonymous survey was conducted using a questionnaire that contained 28 questions. During the work, 250 people were interviewed, among them 157 women (62.8%) and 93 men (37.2%), who made up 4 age groups: 18-24 years old – 170 people (68%), 25-44 years old – 23 people (9.2%), 45-59 years old – 32 people (12.8%), 60-74 years old – 22 people (8.8%), 75-90 years old – 3 people (1.2%). The study was conducted on respondents aged 18-74 years due to the representativeness of these age groups.
The results of the study. During the study, the indicators of height and body weight were evaluated. Based on the presented data, the average BMI values for Ketla were calculated in accordance with the WHO BMI classification (1997). On average, 11.8% of men and 10.1% of women had a body weight disorder. Upon detailed examination, the following results were obtained: among women, 1.9% are underweight, 4.5% are overweight, and obesity of the 1st and 2nd degrees is passed by 2.5% and 1.3%. In men, body weight deficiency was observed in 1.1%, overweight in 7.5%, obesity in the 1st and 2nd in 3.2% and 0.0%, respectively. The normal body weight is 12.9% of men and 14.6% of women.
The highest percentage of body weight disorders was observed in the 45-59 age group, and the most adequate body weight was typical for the 18-24 age group. However, there was an increase in body weight with age and a further decrease in indicators. In the 18-24 year old group, the percentage of obesity of the 1st degree is 3.8%, in the 25-44 group - 26.3% decrease to 22.7% already in the 45-59 year old group and in the 60-74 group – 4.5%
The analysis of physical activity showed the following results: 36 men (38.7%) and 48 women (30.6%) attended the gym, while the group from 18 to 24 years old showed the greatest activity in both sexes (50.0% and 39.6%, respectively). 32 men (34.4%) and 43 women (27.4%) were engaged in playing sports. The greatest enthusiasm for playing sports among men was found in the 18-24 year old group. With age, there was a decrease in this indicator from 43.3% to 11.1% - from 18 to 74 years old. Women showed a similar picture: the highest rate is typical for the same age group, 18-24 years old, with a similar decrease in the indicator with an increase in age from 33.0% to 15.4% - from 18 to 74 years
53 men (57.0%) and 86 women (54.7%) took walks every day. The level of activity in age groups depends on gender. So, among men, the age group 18-24 (65.0%) was the most frequent hiking, and among women – the age group 45-59 years (62.5%). This question was not mandatory.
Women tend to prefer hiking with age. Jogging during the week was arranged by 18 (19.3%) men and 18 (11.5%) women. According to 56 men, their activities are predominantly sedentary (60.2%), 126 women (80.3%) believe the same. In the 18-24 year old group, 75.0% of men describe their work as sedentary, in the 25-44 year old group (25.0%), respondents in the 45-59 year old group (100.0%) and the 60-74 group (22.2%). The women had similar results. 61 men (65.6%) and 60 women (38.2%) rated their lifestyle as active, the percentage ratio in all age groups is about the same, slightly more than 50% for both sexes. A smaller proportion of respondents can work stationary for less than 2 hours (23 men and 35 women), from 2 to 4 hours - 29 men and 44 women. In the case of such work, 74 (79.6%) men and 117 women (74.5%) prefer to do a warm-up, the age group of 25-44 years had the most responses.
In the study of the respondents' food hygiene, the following data were obtained. 34 men (36.6%) and 65 women (41.4%) followed a healthy diet. When both 59 men (63.4%) and 92 women (58.5%) did not adhere to proper nutrition. The group of men aged 18-24 and 25-44 preferred to give up proper nutrition (61.7% and 87.5%, respectively). In women aged 18-24 and 25-44, they did not adhere to the principles of a healthy diet (63.2% and 57.9%, respectively). Then, in groups 45-59, the indicators were equalized in both sexes. Men observed 3-4 meals a day for 57 people (61.3%) to a greater extent, whereas 1-2 meals a day and 5-6 meals a day only 29 (31.2%) and 7 (7.5%), respectively. Among women, 68 people (43.3%) had 3-4 meals a day, 52 people (33.1%) had 1-2 meals a day, and only 37 people (23.6%) had 5-6 meals a day. The percentage of people who do not consume fast food is higher in the 45-59 and 60-74 groups in men slightly more than half (62.5%) and (66.7%), in women (75.0%) and (84.6%), respectively. Confirmed diabetes mellitus only among 5 men (5.4%) and 8 women (5.1%)
Only 17 men (18.3%) observed a regular increase in blood pressure, and 34 people (36.6%) do not monitor blood pressure, whereas 18 women (11.5%) observed an increase in blood pressure and 56 (35.7%) women do not monitor blood pressure, while the percentage of people who monitor blood pressure increases with age It's growing. 42 men (45.2%) and 83 women (52.9%) do not register an increase in blood pressure.
Among the men surveyed, slightly less than half of 44 people (47.3%) smoke, of which only 3 people smoke more than one pack per day. Women smoke about half as much as men, 32 people (20.4%). Among women who smoke, no one consumes more than one pack.
66 men (71.0%) consumed alcohol, the age groups 45-59 and 60-74 years old most often consumed alcohol (75.0% and 77.8%, respectively). 27 men (29.0%) do not drink alcohol. Men are more likely to drink alcohol several times a month 28 people (30.1%). The percentage of drinkers among women is lower than among men, 86 people (54.8%). Similarly, alcohol is consumed more by the 45-59 and 60-74 year old groups. Men prefer strong alcoholic beverages such as vodka, tincture (39.5%). Women, on the contrary, prefer lighter drinks wine, sparkling wine (60.7%). With age, there is an increase in the proportion of strong drinks from the total amount of alcohol.
A study was conducted on the symptoms of atherosclerosis. Pain or burning in the lower extremities, which disappear after rest, was felt by 16.1% of men. In women, this percentage is slightly higher than 29.2%, respondents in the 60-74 year group complained about this symptom. Complaints of frequent cold in the lower extremities were noted by 21.5% of men, when in women this percentage is much higher than 53.9%, respondents from 25 to 74 years old noted this symptom more often. Only 9.7% of men observed frequent goosebumps in their legs, women noted this symptom in 18.2%. Numbness of the lower extremities was observed in 11.8% of men and 19.5% of women. Seizures were reported by 28% of men and 47.4% of women.

Conclusions. Upon detailed consideration of each trigger factor, it can be noted that men of the age groups 45-59 and 60-74 years old are more susceptible to obliterating atherosclerosis of the arteries of the lower extremities, since these age groups statistically account for a greater number of trigger factors. However, it can already be said that a healthy lifestyle, food hygiene, abstinence from smoking and alcohol, timely medical examination significantly reduce the risk of developing obliterating atherosclerosis of the lower extremities and have a positive effect on the standard of living.

About the authors

Matvey Aleksandrovich Uzhov

Tver State Medical University

Email: ammorozovv@gmail.com
ORCID iD: 0009-0006-3550-821X
Russian Federation, 170100, Russia, Tver, Sovetskaya str., 4

Ekaterina Andreevna Fisyuk

Tver State Medical University

Email: ammorozovv@gmail.com
ORCID iD: 0009-0000-0582-7398
SPIN-code: 2392-8968
Russian Federation, 170100, Russia, Tver, Sovetskaya str., 4

Anastasia Antonovna Utkina

Tver State Medical University

Email: ammorozovv@gmail.com
ORCID iD: 0009-0006-8695-3444
Russian Federation, 170100, Russia, Tver, Sovetskaya str., 4

Artem Мihailovich Morozov

Tver State Medical University

Author for correspondence.
Email: ammorozovv@gmail.com
ORCID iD: 0000-0003-4213-5379
SPIN-code: 6815-9332

Candidate of Medical Sciences, Associate Professor, Associate Professor of the Department of General Surgery

Russian Federation, 170100, Russia, Tver, Sovetskaya str., 4

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