ABSTRACT
OBJECTIVE: To determine the association between social factors and the increase in mortality in Russia in the 1990s. DESIGN: Prospective population cohort study. SETTING: Saint Petersburg, Russia. PARTICIPANTS: Two cohorts of men aged 40-59 years randomly selected from district voting list: 3907 screened in 1975-7 and 1467 in 1986-8. MAIN OUTCOME MEASURES: Education, various health related measures, alcohol intake. Mortality in subsequent 10 years. RESULTS: There was no recorded increase in mortality in men with university degrees. The relative risk in the second cohort compared with the first was 0.92 (95% confidence interval 0.67 to 1.24). For participants with only high school education it was significantly higher in the second cohort (1.32, 1.02 to 1.71). The most pronounced differences were found among participants with the lowest level of education, in which the relative risk was 1.75 (1.44 to 2.12). The same pattern held for coronary vascular disease and cancer mortality. CONCLUSION: In Russia men in the lower socioeconomic groups were most affected by the sharp increases in mortality in the 1990s.
Subject(s)
Mortality/trends , Risk Assessment , Social Class , Adult , Age Distribution , Alcohol Drinking/mortality , Cardiovascular Diseases/mortality , Cause of Death , Cohort Studies , Educational Status , Follow-Up Studies , Humans , Male , Middle Aged , Neoplasms/mortality , Poisson Distribution , Prospective Studies , Risk Factors , Russia/epidemiology , Socioeconomic Factors , Survival AnalysisABSTRACT
BACKGROUND AND AIM: In the early 90s an increase in coronary heart disease (CHD) mortality in post-communist countries was observed. Based on the lipid theory of the pathogenesis of atherosclerosis, we looked to see whether these changes were accompanied by changes in blood lipid profiles and how lipid levels are related in a post-communist country with a relatively high standard of living (East Germany) and a country still facing economic troubles (Russia). METHODS AND RESULTS: This investigation was conducted in 1995-1997 by a cooperative program between the Department of Clinical Chemistry and Pathobiochemistry, University of Leipzig, Leipzig, Germany and the Department of Biochemistry, Institute for Experimental Medicine, St. Petersburg, Russia. The Russian part of the study included 1646 subjects and the German part 3189 subjects. The blood lipids were measured using a dry-chemistry analyzer (Reflotron). Russian and German males had almost the same level of total cholesterol with a significantly lower level of HDL-C in Russians. A significantly lower level of HDL-C was also observed in Russian females. Differences were in range 2-3 mg/dl for males and 8-13 mg/dl for females. In St. Petersburg, almost 40% of all screened young males (age < 30 yr) had hypoalphacholesterolemia. In the St. Petersburg study carried out in 1986-1988, in age group 40-49 years around 6% of those screened had HDL-C lower than 35 mg/dl. In 1995-1997 this number increased to 36%. The number of subjects with HDL-C less than 30 mg/dl in 1986-1988 was only 2.4% and in 1995-1997, 12.3%. CONCLUSION: There is a dramatic decrease in HDL-C in the Russian population, probably due to the socioeconomic factors which began to develop after the fall of communist.
