Polypathy: searching for etiopathogenetic risks factors
The article provides an overview of the literature on the actual problem of diseases - polypathy. The review focuses problematic aspects of comorbid states, the scatter of their definitions, the incidence in different countries according to the international scientific community, the frequency of use of comorbid indices, the influence of racial and ethnicity in polypathies, risk factors for the development of combined diseases both at the level of an individual’s genes and aspects of a person’s lifestyle and the environment, options for their pathogenetic development with examples of nodal chains and their effects (nodules), examples of countries with modified risk factors to reduce mortality according to the approved action plan World Health Organization for the Prevention of Chronic Noncommunicable Diseases. The review focuses on factors contributing to the development of polypathy, in particular connective tissue dysplasia. The problems of diagnosing the external signs of connective tissue dysplasia in comorbid patients according to accepted diagnostic criteria and the frequency of their occurrence abroad and in Russia. An analogy is drawn between the concept of cardiovascular continuum and the development of polypathy in the patient’s body with connective tissue dysplasia of varying severity. There is analyzed the experience of treating patients with comorbid pathology of both the international scientific society of comorbidity (2010) and the Russian recommendations on comorbidity (2016). There is raised the development of COVID-19 in different patients with polypathy in China and other countries.