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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">clinmed</journal-id><journal-title-group><journal-title xml:lang="ru">Клиническая медицина</journal-title><trans-title-group xml:lang="en"><trans-title>Clinical Medicine (Russian Journal)</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">0023-2149</issn><issn pub-type="epub">2412-1339</issn><publisher><publisher-name>ООО «Медицинское информационное агентство»</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.30629/0023-2149-2021-99-3-234-236</article-id><article-id custom-type="elpub" pub-id-type="custom">clinmed-221</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ДИСКУССИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>DISCUSSION</subject></subj-group></article-categories><title-group><article-title>Двунаправленные связи при коморбидных заболеваниях</article-title><trans-title-group xml:lang="en"><trans-title>Bidirectional associations in comorbid diseases</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2206-8922</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Белялов</surname><given-names>Ф. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Belyalov</surname><given-names>F. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Белялов Фарид Исмагильевич - д-р мед. наук, профессор кафедры геронтологии, гериатрии и клинической фармакологии</p><p>664079, Иркутск</p></bio><bio xml:lang="en"><p>Farid I. Belyalov - MD, PhD, DSc, professor of the Gerontology, Geriatry, and Clinical Pharmacology Department</p><p>Irkutsk, 664079</p></bio><email xlink:type="simple">fbelyalov@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Иркутская государственная медицинская академия последипломного образования - филиал ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Irkutsk State Medical Academy of Postgraduate Education — Branch of the Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2021</year></pub-date><pub-date pub-type="epub"><day>15</day><month>09</month><year>2021</year></pub-date><volume>99</volume><issue>3</issue><fpage>234</fpage><lpage>236</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Белялов Ф.И., 2021</copyright-statement><copyright-year>2021</copyright-year><copyright-holder xml:lang="ru">Белялов Ф.И.</copyright-holder><copyright-holder xml:lang="en">Belyalov F.I.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.clinmedjournal.com/jour/article/view/221">https://www.clinmedjournal.com/jour/article/view/221</self-uri><abstract><p>Двунаправленные связи при коморбидных заболеванияхУвеличение количества пациентов с коморбидными заболеваниями и полифармакотерапией требует поиска оптимальных подходов к лечению. В статье обсуждаются клинические аспекты двусторонних связей между заболеваниями, которые проявляются повышением частоты, тяжести, ухудшением прогноза сочетанных болезней. Общие факторы риска и патофизиологические механизмы заболеваний могут послужить основой для разработки оптимального лечения пациентов c коморбидностью.</p></abstract><trans-abstract xml:lang="en"><p>The increasing number of patients with comorbid diseases with polypharmacotherapy requires the search for optimal approaches to the treatment. The article discusses clinical aspects of bilateral connection manifested by an increase in frequency, severity and worsening prognosis of comorbid diseases. Common risk factors and pathophysiological mechanisms of diseases can serve as a basis for the development of optimal treatment of patients with comorbidity.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>мyльтиморбидность</kwd><kwd>коморбидность</kwd><kwd>персонализированная медицина</kwd><kwd>двунаправленные связи</kwd></kwd-group><kwd-group xml:lang="en"><kwd>multimorbidity</kwd><kwd>comorbidity</kwd><kwd>personalized medicine</kwd><kwd>bidirectional associations</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Co nrad N., Judge A., Tran J. et al. Temporal trends and patterns in heart failure incidence: a population-based study of 4 million individuals. Lancet. 2018;391(10120):572–580. DOI: 10.1016/S0140-6736(17)32520-5</mixed-citation><mixed-citation xml:lang="en">Co nrad N., Judge A., Tran J. et al. 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