Skip to main content
SpringerLink
Log in

High cardiovascular mortality in Russia cannot be explained by the classical risk factors. The Arkhangelsk study 2000

  • Published:
European Journal of Epidemiology Aims and scope Submit manuscript

Abstract

Since the beginning of the 1990s the public health situation in Russia has been characterized by an extremely high mortality and a significant reduction in life expectancy. Cardiovascular diseases remained the major cause of death. Only a few large population studies were conducted in Russia during this period. A total of 1968 men and 1737 women aged 18–75 years participated in a health survey in Arkhangelsk, Russia, over the period 1999–2000. Investigation included assessment of classic cardiovascular risk factors (family history, smoking, blood pressure, and blood lipids) along with general health variables. The paper presents sex specific data on risk factors for coronary heart disease. Though the cardiovascular mortality is high in Russia, the calculated risk for coronary heart disease (the Framingham risk score and the Norwegian risk score) was lower in all age groups of men and women in Arkhangelsk compared with studies from the Western Europe and USA. Our data suggest that high cardiovascular mortality in Russia may be driven not only by the classic risk factors for coronary heart disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Leon DA, Chenet L, Shkolnikov VM, et al. Huge variation in Russian mortality rates 1984-94: Artifact, alcohol, or what? Lancet 1997; 350: 383–388.

    Google Scholar 

  2. Shkolnikov VM, McKee M, Leon DA. Changes in life expectancy in Russia in the mid-1990s. Lancet 2001; 357: 917–921.

    Google Scholar 

  3. Cockerham WC. The social determinants of the decline of life expectancy in Russia and Eastern Europe: A lifestyle explanation. J Health Social Behavior 1997; 38: 117–130.

    Google Scholar 

  4. Health in Russia is broke, but who is to fix it? (editorial) Lancet 1999; 353: 337.

    Google Scholar 

  5. Walberg P, McKee M, Shkolnikov VM, Chenet L, Leon DA. Economic change, crime, and mortality crisis in Russia: Regional analysis. Br Med J 1998; 317: 312–318.

    Google Scholar 

  6. Vassin SA, Costello CA. Spatial, age, and cause-of-death patterns of mortality in Russia, 1988-89. In: Bobadilla JL, Costello CA, Mitchel F. Premature Death in the New Independent States. Washington DC: National Academy Press, 1997, pp. 66–119.

    Google Scholar 

  7. Leon DA, Shkolnikov VM. Social stress and the Russian Mortality Crisis (editorial). JAMA 1998; 279: 790–791.

    Google Scholar 

  8. Ciment J. Life expectancy of Russian men falls to 58. Br Med J 1999; 319: 468.

    Google Scholar 

  9. Shkolnikov VM, Mesle F, Vallin J. Recent trends in life expectancy and causes of death in Russia, 1970-1993. In: Bobadilla JL, Costello CA, Mitchel F (eds), Premature Death in the New Independent States. Washington DC: National Academy Press, 1997, p. 34–65.

    Google Scholar 

  10. Notzon FC, Komarov YM, Ermakov SP, Sempos CT, Marks JS, Sempos EV. Causes of declining life expectancy in Russia. JAMA 1998; 279: 793–800.

    Google Scholar 

  11. Goskomstat of Russia. The Demographic Yearbook of Russia. Moscow, Russia: Goskomstat, 2001.

    Google Scholar 

  12. McKee M, Shkolnikov VM. Understanding the toll of premature death among men in Eastern Europe. Br Med J 2001; 323: 1051–1054.

    Google Scholar 

  13. WHO Statistical Information System (WHOSIS). Statistical annex of the WHO Health Report 2001. Annex table 4: Healthy life expectancy in all Member states, estimates for 2000. http://www.who.int/whr/2001/ main/en/annex/index.htm.

  14. Bobak M, Pikhart H, Hertzman C, Rose R, Marmot M. Socioeconomic factors, perceived control and selfreported health in Russia. A cross-sectional survey. Soc Sci Med 1998; 47: 269–279.

    Google Scholar 

  15. Ginter E. Cardiovascular risk factors in the former communist countries. Analysis of 40 European MONICA populations. Eur J Epidemiol 1995; 11: 199–205.

    Google Scholar 

  16. Kuulasmaa K, Tunstall-Pedoe H, Dobson A, et al. Estimation of contribution of changes in classic risk factors to trends in coronary-event rates across the WHO MONICA project populations. Lancet 2000; 355: 675–687.

    Google Scholar 

  17. Shalnova S, Shestov D, Ekelund L-G, et al. Blood pressure and heart rate response during exercise in men and women in the USA and Russia lipid research clinics prevalence study. Atherosclerosis 1996; 122: 47–57.

    Google Scholar 

  18. Puska P, Matilainen T, Jousilahti P, et al. Cardiovascular risk factors in the Republic of Karelia, Russia, and in the North Karelia, Finland. Int J Epidemiol 1993; 22: 1048–1055.

    Google Scholar 

  19. Goskomstat of Russia. Cities of the Arkhangelsk Region: Statistical Handbook. Arkhangelsk, Russia: Arkhangelsk Region Committee of State Statistics, 1998.

    Google Scholar 

  20. Goskomstat of the Russia. Women and Men of the Arkhangelsk Region: Statistic Compendium. Arkhangelsk, Russia: Arkhangelsk Region Committee of State Statistics, 2000.

    Google Scholar 

  21. Nilssen O, Lipton R, Høyer G, Bojko J, Tkatchev A, Brenn T. Blood serum analyses in population studies: Parallel analyses and degree of agreement in a Norwegian-Russian co-project. The Svalbard Study. Arct Med Res 1996; 55: 75–82.

    Google Scholar 

  22. Njølstad I, Arnesen E, Lund-Larsen PG. Smoking, serum lipids, blood pressure, and sex differences in myocardial infarction. A 12-year follow-up of the Finnmark study. Circulation 1996; 93: 450–456.

    Google Scholar 

  23. Westlund K, Søgaard AJ. [in norwegian] Helse, livsstil og levekår i Finnmark. Resultater fra Hjerte-karundersøkelsen i 1987-1988. Finnmark III. (Health, life style and living conditions in Finnmark. Results from Cardiovascular study in 1987-1988. Finnmark III). Universitetet i Tromsø, Institutt for Samfunnsmedisin, 1993.

  24. Jorde R, Sundsfjord J, Fitzgerald P, Bønaa KH. Serum calcium and cardiovascular risk factors and diseases. Hypertension 1999; 34: 484–490.

    Google Scholar 

  25. Stensland-Bugge E, Bonaa KH, Joakimsen O, Njolstad I. Sex differences in the relationship of risk factors to subclinical carotid atherosclerosis measured 15 years later: The Tromso study. Stroke 2000; 31: 574–581.

    Google Scholar 

  26. Wilson PWF, D'Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation 1998; 97: 1837–1847.

    Google Scholar 

  27. Grundy SM, Pasternak R, Greenland P, Smith S, Fuster V. Assessment of cardiovascular risk by use of multiple-risk-factor assessment equations. A statement for health care professionals from the American Heart Association and the American College of Cardiology. Circulation 1999; 100: 1481–1492.

    Google Scholar 

  28. Bjartveit K, Foss OP, Gjervig T, Lund-Larsen PG. The cardiovascular disease study in Norwegian countries. Background and organization. Acta Med Scand 1979 (suppl 634).

  29. DiIorio F, Hardy KA. Quick Start to Data Analysis with SAS. Wadsworth Publishing Company, 1996.

  30. Van Popele NM, Bos WJW, de Beer NAM, et al. Arterial stiffness as underlying mechanism of disagreement between an oscillometric blood pressure monitor and a sphygmomanometer. Hypertension 2000; 36: 484–488.

    Google Scholar 

  31. Barker ME, Shiell AW, Law CM. Evaluation of the Dinamap 8100 and Omron M1 blood pressure monitors for use in children. Peadiatr Perinat Epidemiol 2000; 14: 179–186.

    Google Scholar 

  32. McKee M, Bobak M, Rose R, Shkolnikov VM, Chenet L, Leon D. Patterns of smoking in Russia. Tobacco Control 1998; 7: 22–26.

    Google Scholar 

  33. Handbook of the main health care parameters in Arkhangelsk region in 1997-1998 [Russian]. http:// www.msa.ru/statistics/1997-1998/.

  34. The 6th analytical report about demographic situation in Russia. Center of Demography and Human Ecology, 1999 [in Russian]. http://www.demoscope.ru/dem-98/sod-r.html.

  35. Norgehelsa, Folkehelseinstitutt [Norwegian]. www.fhi. no.

  36. Zatonski W. Alcohol and health: What is good for the French may not be for the Russians (editorial). J Epidemiol Community Health 1998; 52: 766–767.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Institute of Community Medicine, Medical Faculty, University of Tromsø, Norway

    Maria Averina, Odd Nilssen & Tormod Brenn

  2. Department of Clinical Chemistry, University Hospital of Tromsø, Tromsø, Norway

    Jan Brox

  3. Northern State Medical University, Arkhangelsk, Russia

    Alexei G. Kalinin

  4. Semashko Clinic, Arkhangelsk, Russia

    Vadim L. Arkhipovsky

Authors
  1. Maria Averina
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Odd Nilssen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tormod Brenn
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jan Brox
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Alexei G. Kalinin
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Vadim L. Arkhipovsky
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Averina, M., Nilssen, O., Brenn, T. et al. High cardiovascular mortality in Russia cannot be explained by the classical risk factors. The Arkhangelsk study 2000. Eur J Epidemiol 18, 871–878 (2003). https://doi.org/10.1023/A:1025626202235

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1025626202235

Search

Navigation