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Nikoloski Z, Shkolnikov VM, Mossialos E. Preventable mortality in the Russian Federation: a retrospective, regional level study. THE LANCET REGIONAL HEALTH. EUROPE 2023; 29:100631. [PMID: 37180281 PMCID: PMC10172901 DOI: 10.1016/j.lanepe.2023.100631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 03/17/2023] [Accepted: 03/20/2023] [Indexed: 05/16/2023]
Abstract
Background Avoidable mortality, including both treatable and preventable deaths, is frequently used as an indicator of health system performance. Whilst the term treatable mortality refers to deaths that might be averted by medical interventions, preventable mortality generally reflects the impact of system-wide health policies. The concept of preventable mortality has not been evaluated extensively in the Russian Federation, particularly at the regional or sub-national (oblast) level. Methods We calculated total preventable mortality as well as individual rates for males and females in each oblast using data from the Russian Fertility and Mortality Database (RusFMD) and computed the contributions of specific preventable causes of death to the overall rates. We also evaluated the relationship between preventable mortality and its main correlates during the years 2014-2018 using panel fixed effects modelling with variables that reflected both, behavioural risk factors and access to health care. Findings Overall preventable mortality in the Russian Federation has been on a downward trend. Whilst 548 preventable deaths per 100,000 person-years were reported in the year 2000, only 301 per 100,000 person-years were reported in 2018. Whilst mortality due to cancer, cardiovascular, and alcohol-related diseases has declined (albeit unevenly) amongst both males and females, deaths resulting from complications of diabetes and human immunodeficiency virus infection have increased. Our findings also revealed significant heterogeneity in preventable mortality at the oblast level. For example, in 2018, deaths due to preventable causes were concentrated primarily in Siberia and the Far East. Smoking and the availability of nurses were identified as significant correlates of preventable mortality at the oblast level. Interpretations Efforts designed to strengthen the current health care system, notably those serving the rural and less densely populated oblasts, might reduce the rate of preventable mortality in Russia. These efforts might be coupled with an ongoing focus on programs designed to reduce smoking. Funding None.
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Affiliation(s)
- Zlatko Nikoloski
- Department of Health Policy, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, United Kingdom
- Corresponding author.
| | - Vladimir M. Shkolnikov
- Laboratory of Demographic Data, Max Planck Institute for Demographic Research, Rostock 18057, Germany
| | - Elias Mossialos
- Department of Health Policy, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, United Kingdom
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Arafa A, Kashima R, Kokubo Y, Teramoto M, Sakai Y, Nosaka S, Kawachi H, Shimamoto K, Matsumoto C, Gao Q, Izumi C. Alcohol consumption and the risk of heart failure: the Suita Study and meta-analysis of prospective cohort studies. Environ Health Prev Med 2023; 28:26. [PMID: 37150604 PMCID: PMC10188284 DOI: 10.1265/ehpm.22-00231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 02/26/2023] [Indexed: 05/09/2023] Open
Abstract
BACKGROUND Alcohol consumption is a modifiable lifestyle, but its role in heart failure (HF) development is controversial. Herein, we investigated the prospective association between alcohol consumption and HF risk. METHODS A total of 2,712 participants (1,149 men and 1,563 women) from the Suita Study were followed up every two years. Cox regression was applied to calculate the hazard ratios (HRs) and 95% confidence intervals (95% CIs) of HF risk for heavy drinking (≥46 g/day in men or ≥23 g/day in women) and never drinking compared to light drinking (<23 g/day in men or <11.5 g/day in women). Then, we combined the results of the Suita Study with those from other eligible prospective cohort studies in a meta-analysis using the random-effects model. RESULTS In the Suita Study, within a median follow-up period of 8 years, 319 HF cases (162 in men and 157 in women) were detected. In men, but not women, never and heavy drinking carried a higher risk of HF than light drinking: HRs (95% CIs) = 1.65 (1.00, 2.73) and 2.14 (1.26, 3.66), respectively. Alike, the meta-analysis showed a higher risk of HF among heavy drinkers: HR (95% CI) = 1.37 (1.15, 1.62) and abstainers: HR (95% CI) = 1.18 (1.02, 1.37). CONCLUSION We indicated a J-shaped association between alcohol consumption and HF risk among Japanese men. The results of the meta-analysis came in line with the Suita Study. Heavy-drinking men should be targeted for lifestyle modification interventions.
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Affiliation(s)
- Ahmed Arafa
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan
- Department of Public Health, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Rena Kashima
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan
- Department of Cardiovascular Pathophysiology and Therapeutics, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Yoshihiro Kokubo
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Masayuki Teramoto
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yukie Sakai
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Saya Nosaka
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Haruna Kawachi
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan
- Department of Environmental Medicine and Population Sciences, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Keiko Shimamoto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Chisa Matsumoto
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan
- Department of Cardiology, Center for Health Surveillance and Preventive Medicine, Tokyo Medical University Hospital, Shinjuku, Japan
| | - Qi Gao
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Chisato Izumi
- Department of Heart Failure and Transplantation, National Cerebral and Cardiovascular Center, Suita, Japan
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Iakunchykova O, Schirmer H, Leong D, Malyutina S, Ryabikov A, Averina M, Kudryavtsev A, Kornev M, Voronina E, Paramonov A, Wilsgaard T, Leon D. Heavy alcohol drinking and subclinical echocardiographic abnormalities of structure and function. Open Heart 2021; 8:openhrt-2020-001457. [PMID: 34083387 PMCID: PMC8174503 DOI: 10.1136/openhrt-2020-001457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 05/14/2021] [Indexed: 11/12/2022] Open
Abstract
Objective The aim of the study is to assess changes in heart structure and function associated with heavy alcohol use by comparing echocardiographic indices in a population-based sample to those in patients admitted to an inpatient facility with severe alcohol problems. Methods and results We used data from the Know Your Heart study (2015–2017) which is a cross-sectional study that recruited 2479 participants aged 35–69 years from the general population of the city of Arkhangelsk in Northwest Russia and 278 patients from the Arkhangelsk Regional Psychiatric Hospital with a primary diagnosis related to chronic alcohol use (narcology clinic subsample). The drinking patterns of the population-based sample were characterised in detail. We used regression models controlling for age, sex, smoking, education and waist to hip ratio to evaluate the differences in echocardiographic indices in participants with different drinking patterns. The means of left ventricular end-diastolic diameter and indexed left atrial systolic diameter were increased among heavy drinkers (narcology clinic subsample), while mean left ventricular ejection fraction was decreased in this group compared with the population-based sample. In contrast, the harmful and hazardous drinkers in the population-based sample did not differ from non-problem drinkers with respect to echocardiographic indices of systolic and diastolic function. Conclusions Extremely heavy drinking is associated with a specific set of structural and functional abnormalities of the heart that may be regarded as precursors of alcohol-related dilated cardiomyopathy.
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Affiliation(s)
- Olena Iakunchykova
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Henrik Schirmer
- Department of Cardiology, Akershus University Hospital, Lorenskog, Norway.,Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway.,Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Darryl Leong
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Sofia Malyutina
- Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Research Institute of Internal and Preventive Medicine, Novosibirsk, Russian Federation.,Novosibirsk State Medical University, Novosibirsk, Russian Federation
| | - Andrew Ryabikov
- Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Research Institute of Internal and Preventive Medicine, Novosibirsk, Russian Federation.,Novosibirsk State Medical University, Novosibirsk, Russian Federation
| | - Maria Averina
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.,Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway.,Department of Laboratory Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Alexander Kudryavtsev
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.,Department of Innovative Programs, Northern State Medical University, Arkhangelsk, Russia
| | - Mikhail Kornev
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ekaterina Voronina
- Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Research Institute of Internal and Preventive Medicine, Novosibirsk, Russian Federation
| | - Andrey Paramonov
- Central Scientific Research Laboratory, Northern State Medical University, Arkhangelsk, Russian Federation
| | - Tom Wilsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - David Leon
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.,Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.,International Laboratory For Population and Health, National Research University Higher School of Economics, Moscow, Russia
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4
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Britton A, O’Neill D, Kuh D, Bell S. Sustained heavy drinking over 25 years is associated with increased N-terminal-pro-B-type natriuretic peptides in early old age: Population-based cohort study. Drug Alcohol Depend 2020; 212:108048. [PMID: 32450480 PMCID: PMC7301434 DOI: 10.1016/j.drugalcdep.2020.108048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/01/2020] [Accepted: 04/21/2020] [Indexed: 10/29/2022]
Abstract
UNLABELLED Heavy alcohol consumption is associated with an increased risk of heart failure. We sought to investigate whether levels of NT-proBNP differ by alcohol consumption profiles, both current drinking as well as cumulative exposure to drinking over several decades in a general population sample. METHODS Data on 2054 participants (49% male) were taken from the UK Medical Research Council National Survey for Health and Development, a longitudinal cohort study based on a nationally representative sample of births in 1946. Categories of long-term alcohol consumption were created based on consumption over 25 years of observations and compared with levels of NT-proBNP measured at mean age 63. RESULTS We found that those who drank heavily (both currently and long-term) had higher levels of NT-proBNP than moderate drinkers, after adjusting for major confounders (age, sex, socio-economic position and smoking). As NT-proBNP has attracted attention as a biomarker for heart failure, this suggests a critical pathway through which heavy drinking may increase risk of this cardiovascular disease. When we looked at heavy drinkers who varied their intake over the decades, it was only the recently heavy group that had higher levels of NT-proBNP. Further work is needed to demonstrate whether effects are reversible upon cessation of heavy drinking, but this finding highlights the need to have repeated data to unpack dynamics over time. CONCLUSION Our findings suggest heavy drinkers could be screened for NT-proBNP levels in order to identify those at high risk earlier in the clinical stages of heart failure and targeted for risk reduction strategies.
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Affiliation(s)
- Annie Britton
- Department of Epidemiology and Public Health, University College London, London, WC1E 6BT, UK.
| | - Dara O’Neill
- Department of Epidemiology and Public Health, University College London, London, WC1E 6BT, UK,CLOSER, UCL Institute of Education, University College London, London, UK
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing at University College London, London, UK
| | - Steven Bell
- Department of Epidemiology and Public Health, University College London, London, WC1E 6BT, UK,Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Wort’s Causeway, Cambridge, CB1 8RN, UK,Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
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Lakunchykova O, Averina M, Wilsgaard T, Watkins H, Malyutina S, Ragino Y, Keogh RH, Kudryavtsev AV, Govorun V, Cook S, Schirmer H, Eggen AE, Hopstock LA, Leon DA. Why does Russia have such high cardiovascular mortality rates? Comparisons of blood-based biomarkers with Norway implicate non-ischaemic cardiac damage. J Epidemiol Community Health 2020; 74:698-704. [PMID: 32414935 PMCID: PMC7577103 DOI: 10.1136/jech-2020-213885] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 04/13/2020] [Indexed: 02/06/2023]
Abstract
Background Russia has one of the highest rates of mortality from cardiovascular disease (CVD). At age 35–69 years, they are eight times higher than in neighbouring Norway. Comparing profiles of blood-based CVD biomarkers between these two populations can help identify reasons for this substantial difference in risk. Methods We compared age-standardised mean levels of CVD biomarkers for men and women aged 40–69 years measured in two cross-sectional population-based studies: Know Your Heart (KYH) (Russia, 2015–2018; n=4046) and the seventh wave of the Tromsø Study (Tromsø 7) (Norway, 2015–2018; n=17 646). A laboratory calibration study was performed to account for inter-laboratory differences. Results Levels of total, low-density lipoprotein-, high-density lipoprotein-cholesterol and triglycerides were comparable in KYH and Tromsø 7 studies. N-terminal pro-b-type natriuretic peptide (NT-proBNP), high-sensitivity cardiac troponin T (hs-cTnT) and high-sensitivity C-reactive protein (hsCRP) were higher in KYH compared with Tromsø 7 (NT-proBNP was higher by 54.1% (95% CI 41.5% to 67.8%) in men and by 30.8% (95% CI 22.9% to 39.2%) in women; hs-cTnT—by 42.4% (95% CI 36.1% to 49.0%) in men and by 68.1% (95% CI 62.4% to 73.9%) in women; hsCRP—by 33.3% (95% CI 26.1% to 40.8%) in men and by 35.6% (95% CI 29.0% to 42.6%) in women). Exclusion of participants with pre-existing coronary heart disease (279 men and 282 women) had no substantive effect. Conclusions Differences in cholesterol fractions cannot explain the difference in CVD mortality rate between Russia and Norway. A non-ischemic pathway to the cardiac damage reflected by raised NT-proBNP and hs-cTnT is likely to contribute to high CVD mortality in Russia.
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Affiliation(s)
- Olena Lakunchykova
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Maria Averina
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway.,Department of Laboratory Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Hugh Watkins
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.,Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Sofia Malyutina
- Novosibirsk State Medical University, Russian Ministry of Health, Novosibirsk, Russian Federation.,Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russian Federation
| | - Yulia Ragino
- Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russian Federation
| | - Ruth H Keogh
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK
| | - Alexander V Kudryavtsev
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway.,Department of Innovative Programs, Northern State Medical University, Arkhangelsk, Russian Federation
| | - Vadim Govorun
- Federal Research and Clinical Center of Physical-Chemical Medicine of the Federal Medical Biological Agency of Russia, Moskva, Russian Federation
| | - Sarah Cook
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Henrik Schirmer
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway.,Department of Cardiology, Akershus University Hospital, Lorenskog, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Anne Elise Eggen
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | | | - David A Leon
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway.,Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
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Imahori Y, Frost C, Mathiesen EB, Ryabikov A, Kudryavtsev AV, Malyutina S, Kornev M, Hughes AD, Hopstock LA, Leon DA. Effect of adiposity on differences in carotid plaque burden in studies conducted in Norway and Russia: a cross-sectional analysis of two populations at very different risk of cardiovascular mortality. BMJ Open 2020; 10:e036583. [PMID: 32381537 PMCID: PMC7223302 DOI: 10.1136/bmjopen-2019-036583] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES Large differences exist in the burden of cardiovascular disease (CVD) between Russia and Western European countries including Norway. Obesity prevalence may contribute to the differences. We investigated whether difference in the level of adiposity, assessed using body mass index and waist-to-hip ratio(WHR), could explain intercountry differences in the burden of carotid plaque, a measure of atherosclerosis, in the populations. DESIGN Cross-sectional analysis. Logistic and linear regression models were used. SETTING We used population-based cross-sectional Know Your Heart (KYH) study in Russia and the Tromsø 7 study (Tromsø 7) in Norway. PARTICIPANTS 3262 and 1800 men and women aged 40-69 years in KYH and Tromsø 7, respectively. PRIMARY AND SECONDARY OUTCOME The presence of carotid plaques and plaque score assessed using ultrasound. RESULTS The presence of carotid plaques and plaque score were higher in KYH than Tromsø 7 regardless of age group and sex. A positive association between carotid plaque burden and adiposity was found (OR of having at least one plaque per SD in WHR 1.18 (95% CI 1.06 to 1.31) for men; 1.15 (1.06 to 1.25) for women)) adjusted for age, smoking and education in a pooled analysis of the two studies. There was little evidence of the interaction between study and adiposity. These effects did not differ between the two studies. However, neither adiposity nor CVD risk factors (smoking, systolic blood pressure, cholesterol, glycosylated haemoglobin) explained the higher carotid plaque burden in KYH compared with Tromsø 7. CONCLUSION Adiposity, especially abdominal adiposity, is a risk factor for carotid plaque in Russia and Norway, although neither adiposity nor established CVD risk factors explained the higher plaque burden in Russia. To reduce the CVD burden in Russia, beyond prevention and treatment of adiposity, further research is required to understand why Russia has a high burden of atherosclerosis.
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Affiliation(s)
- Yume Imahori
- London School of Hygiene and Tropical Medicine, London, UK
| | - Chris Frost
- London School of Hygiene and Tropical Medicine, London, UK
| | | | - Andrey Ryabikov
- Reserach Institute of Internal and Preventive Medicine, Novosibirsk, Russian Federation
- Novosibirsk State Medical University, Novosibirsk, Russian Federation
| | | | - Sofia Malyutina
- Reserach Institute of Internal and Preventive Medicine, Novosibirsk, Russian Federation
- Novosibirsk State Medical University, Novosibirsk, Russian Federation
| | - Michael Kornev
- Northern State Medical University, Arkhangelsk, Russian Federation
| | | | | | - David A Leon
- London School of Hygiene and Tropical Medicine, London, UK
- UiT The Arctic University of Norway, Tromsø, Norway
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Iakunchykova O, Averina M, Kudryavtsev AV, Wilsgaard T, Soloviev A, Schirmer H, Cook S, Leon DA. Evidence for a Direct Harmful Effect of Alcohol on Myocardial Health: A Large Cross-Sectional Study of Consumption Patterns and Cardiovascular Disease Risk Biomarkers From Northwest Russia, 2015 to 2017. J Am Heart Assoc 2019; 9:e014491. [PMID: 31847661 PMCID: PMC6988140 DOI: 10.1161/jaha.119.014491] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Background Alcohol drinking is an increasingly recognized risk factor for cardiovascular disease. However, there are few studies of the impact of harmful and hazardous drinking on biomarkers of myocardial health. We conducted a study in Russia to investigate the impact of heavy drinking on biomarkers of cardiac damage and inflammation. Methods and Results The Know Your Heart study recruited a random sample of 2479 participants from the population of northwest Russia (general population) plus 278 patients (narcology clinic subsample) with alcohol problems. The general population sample was categorized into harmful drinkers, hazardous drinkers, nonproblem drinkers, and nondrinkers, according to self-reported level of alcohol consumption, whereas the narcology clinic sample was treated as the separate group in the analysis. Measurements were made of the following: (1) high-sensitivity cardiac troponin T, (2) NT-proBNP (N-terminal pro-B-type natriuretic peptide), and (3) hsCRP (high-sensitivity C-reactive protein). The narcology clinic subsample had the most extreme drinking pattern and the highest levels of all 3 biomarkers relative to nonproblem drinkers in the general population: high-sensitivity cardiac troponin T was elevated by 10.3% (95% CI, 3.7%-17.4%), NT-proBNP by 46.7% (95% CI, 26.8%-69.8%), and hsCRP by 69.2% (95% CI, 43%-100%). In the general population sample, NT-proBNP was 31.5% (95% CI, 3.4%-67.2%) higher among harmful drinkers compared with nonproblem drinkers. Overall, NT-proBNP and hsCRP increased with increasing intensity of alcohol exposure (test of trend P<0.001). Conclusions These results support the hypothesis that heavy alcohol drinking has an adverse effect on cardiac structure and function that may not be driven by atherosclerosis.
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Affiliation(s)
- Olena Iakunchykova
- Department of Community Medicine UIT The Arctic University of Norway Tromsø Norway
| | - Maria Averina
- Department of Community Medicine UIT The Arctic University of Norway Tromsø Norway.,Department of Laboratory Medicine University Hospital of North Norway Tromsø Norway
| | - Alexander V Kudryavtsev
- Department of Community Medicine UIT The Arctic University of Norway Tromsø Norway.,Department of Innovative Programs Northern State Medical University Arkhangelsk Russia
| | - Tom Wilsgaard
- Department of Community Medicine UIT The Arctic University of Norway Tromsø Norway
| | - Andrey Soloviev
- Department of Psychiatry and Clinical Psychology Northern State Medical University Arkhangelsk Russia
| | - Henrik Schirmer
- Department of Cardiology Akershus University Hospital Lørenskog Norway.,Institute of Clinical Medicine Campus Ahus University of Oslo Norway.,Department of Clinical Medicine UIT The University of Norway Tromsø Norway
| | - Sarah Cook
- Department of Noncommunicable Disease Epidemiology London School of Hygiene and Tropical Medicine London United Kingdom
| | - David A Leon
- Department of Community Medicine UIT The Arctic University of Norway Tromsø Norway.,Department of Noncommunicable Disease Epidemiology London School of Hygiene and Tropical Medicine London United Kingdom
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8
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Barmano N, Charitakis E, Kronstrand R, Walfridsson U, Karlsson JE, Walfridsson H, Nystrom FH. The association between alcohol consumption, cardiac biomarkers, left atrial size and re-ablation in patients with atrial fibrillation referred for catheter ablation. PLoS One 2019; 14:e0215121. [PMID: 30970005 PMCID: PMC6457637 DOI: 10.1371/journal.pone.0215121] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 03/28/2019] [Indexed: 12/14/2022] Open
Abstract
Background Information on alcohol consumption in patients undergoing radiofrequency ablation (RFA) of atrial fibrillation (AF) is often limited by the reliance on self-reports. The aim of this study was to describe the long-term alcohol consumption, measured as ethyl glucuronide in hair (hEtG), in patients undergoing RFA due to AF, and to examine potential associations with cardiac biomarkers, left atrial size and re-ablation within one year after the initial RFA. Methods The amount of hEtG was measured in patients referred for RFA, and a cut-off of 7 pg/mg was used. N-terminal pro B-type natriuretic peptide (NT-proBNP) and the mid-regional fragment of pro atrial natriuretic peptide (MR-proANP) were examined and maximum left atrium volume index (LAVI) was measured. The number of re-ablations was examined up to one year after the initial RFA. Analyses were stratified by gender, and adjusted for age, systolic blood pressure, body mass index, presence of heart failure and heart rhythm for analyses regarding NT-proBNP, MR-proANP and LAVI and heart rhythm being replaced by type of AF for analyses regarding re-ablation. Results In total, 192 patients were included in the study. Median (25th– 75th percentile) NT-proBNP in men with hEtG ≥ 7 vs. < 7 pg/mg was 250 (96–695) vs. 130 (49–346) pg/ml (p = 0.010), and in women it was 230 (125–480) vs. 230 (125–910) pg/ml (p = 0.810). Median MR-proANP in men with hEtG ≥ 7 vs. < 7 pg/mg was 142 (100–224) vs. 117 (83–179) pmol/l (p = 0.120) and in women it was 139 (112–206) vs. 153 (93–249) pmol/l (p = 0.965). The median of maximum LAVI was 30.1 (26.7–33.9) vs. 25.8 (21.4–32.0) ml/m2 (p = 0.017) in men, and 25.0 (18.9–29.6) vs. 25.7 (21.7–34.6) ml/m2 (p = 0.438) in women, with hEtG ≥ 7 vs. < 7 pg/ml, respectively. Adjusted analyses showed similar results, except for MR-proANP turning out significant in men with hEtG ≥ 7 vs. < 7 pg/mg (p = 0.047). The odds ratio of having a re-ablation was 3.5 (95% CI 1.3–9.6, p = 0.017) in men with hEtG ≥ 7 vs. < 7 pg/mg, while there was no significant difference in women. Conclusions In male patients with AF and hEtG ≥ 7 pg/mg, NT-proBNP and MR-proANP were higher, LA volumes larger, and there was a higher rate of re-ablations, as compared to men with hEtG < 7 pg/mg. This implies that men with an alcohol consumption corresponding to an hEtG-value ≥ 7, have a higher risk for LA remodelling that could potentially lead to a deterioration of the AF situation.
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Affiliation(s)
- Neshro Barmano
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
- Department of Internal Medicine, County Hospital Ryhov, Jönköping, Sweden
- * E-mail:
| | - Emmanouil Charitakis
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
- Department of Cardiology, Linköping University Hospital, Linköping, Sweden
| | - Robert Kronstrand
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
- National Board of Forensic Medicine, Linköping, Sweden
| | - Ulla Walfridsson
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
- Department of Cardiology, Linköping University Hospital, Linköping, Sweden
| | - Jan-Erik Karlsson
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
- Department of Internal Medicine, County Hospital Ryhov, Jönköping, Sweden
| | - Håkan Walfridsson
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
- Department of Cardiology, Linköping University Hospital, Linköping, Sweden
| | - Fredrik H. Nystrom
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
- Primary Health Care Centre Centrum, Norrköping, Sweden
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9
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Cook S, Malyutina S, Kudryavtsev AV, Averina M, Bobrova N, Boytsov S, Brage S, Clark TG, Diez Benavente E, Eggen AE, Hopstock LA, Hughes A, Johansen H, Kholmatova K, Kichigina A, Kontsevaya A, Kornev M, Leong D, Magnus P, Mathiesen E, McKee M, Morgan K, Nilssen O, Plakhov I, Quint JK, Rapala A, Ryabikov A, Saburova L, Schirmer H, Shapkina M, Shiekh S, Shkolnikov VM, Stylidis M, Voevoda M, Westgate K, Leon DA. Know Your Heart: Rationale, design and conduct of a cross-sectional study of cardiovascular structure, function and risk factors in 4500 men and women aged 35-69 years from two Russian cities, 2015-18. Wellcome Open Res 2018; 3:67. [PMID: 30123849 PMCID: PMC6073094 DOI: 10.12688/wellcomeopenres.14619.3] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2018] [Indexed: 12/03/2022] Open
Abstract
Russia has one of the highest rates of cardiovascular disease in the world. The International Project on Cardiovascular Disease in Russia (IPCDR) was set up to understand the reasons for this. A substantial component of this study was the Know Your Heart Study devoted to characterising the nature and causes of cardiovascular disease in Russia by conducting large cross-sectional surveys in two Russian cities Novosibirsk and Arkhangelsk. The study population was 4542 men and women aged 35-69 years recruited from the general population. Fieldwork took place between 2015-18. There were two study components: 1) a baseline interview to collect information on socio-demographic characteristics and cardiovascular risk factors, usually conducted at home, and 2) a comprehensive health check at a primary care clinic which included detailed examination of the cardiovascular system. In this paper we describe in detail the rationale for, design and conduct of these studies.
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Affiliation(s)
- Sarah Cook
- London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Sofia Malyutina
- Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, 630090, Russian Federation.,Novosibirsk State Medical University, Russian Ministry of Health, Novosibirsk, 630091, Russian Federation
| | | | - Maria Averina
- UiT the Arctic University of Norway, Tromsø, 9037, Norway
| | - Natalia Bobrova
- London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Sergey Boytsov
- Federal State budget organization, National medical research center of cardiology, Russian Ministry of Health, Moscow, 121552, Russian Federation
| | - Soren Brage
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Taane G Clark
- London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | | | | | | | - Alun Hughes
- UCL Institute of Cardiovascular Science, University College London, London, WC1E 6BT, UK
| | - Heidi Johansen
- UiT the Arctic University of Norway, Tromsø, 9037, Norway
| | - Kamila Kholmatova
- Northern State Medical University, Arkhangelsk, 163000, Russian Federation
| | | | - Anna Kontsevaya
- National research center for preventive medicine, Moscow, 101990, Russian Federation
| | - Michael Kornev
- Northern State Medical University, Arkhangelsk, 163000, Russian Federation
| | | | - Per Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, 0851, Norway
| | | | - Martin McKee
- London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Katy Morgan
- London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Odd Nilssen
- UiT the Arctic University of Norway, Tromsø, 9037, Norway
| | - Ilya Plakhov
- Lytech Laboratory LLC, Moscow, 107023, Russian Federation
| | - Jennifer K Quint
- Royal Brompton Campus, Imperial College London, London, SW3 6LY, UK
| | - Alicja Rapala
- UCL Institute of Cardiovascular Science, University College London, London, WC1E 6BT, UK
| | - Andrey Ryabikov
- Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, 630090, Russian Federation.,Novosibirsk State Medical University, Russian Ministry of Health, Novosibirsk, 630091, Russian Federation
| | - Lyudmila Saburova
- Institute of Philosophy and Law, Ural Branch of the Russian Academy of Sciences, Ekaterinburg, 620990, Russian Federation
| | | | - Marina Shapkina
- Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, 630090, Russian Federation.,Novosibirsk State Medical University, Russian Ministry of Health, Novosibirsk, 630091, Russian Federation
| | - Suhail Shiekh
- London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Vladimir M Shkolnikov
- Max Planck Institute for Demographic Research, Rostock, 18057, Germany.,Higher School for Economics, National Research University , Moscow, 101000, Russian Federation
| | | | - Michael Voevoda
- Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, 630090, Russian Federation
| | - Kate Westgate
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - David A Leon
- London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK.,UiT the Arctic University of Norway, Tromsø, 9037, Norway
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10
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Cook S, Malyutina S, Kudryavtsev AV, Averina M, Bobrova N, Boytsov S, Brage S, Clark TG, Diez Benavente E, Eggen AE, Hopstock LA, Hughes A, Johansen H, Kholmatova K, Kichigina A, Kontsevaya A, Kornev M, Leong D, Magnus P, Mathiesen E, McKee M, Morgan K, Nilssen O, Plakhov I, Quint JK, Rapala A, Ryabikov A, Saburova L, Schirmer H, Shapkina M, Shiekh S, Shkolnikov VM, Stylidis M, Voevoda M, Westgate K, Leon DA. Know Your Heart: Rationale, design and conduct of a cross-sectional study of cardiovascular structure, function and risk factors in 4500 men and women aged 35-69 years from two Russian cities, 2015-18. Wellcome Open Res 2018. [PMID: 30123849 DOI: 10.12688/wellcomeopenres.14619.1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Russia has one of the highest rates of cardiovascular disease in the world. The International Project on Cardiovascular Disease in Russia (IPCDR) was set up to understand the reasons for this. A substantial component of this study was the Know Your Heart Study devoted to characterising the nature and causes of cardiovascular disease in Russia by conducting large cross-sectional surveys in two Russian cities Novosibirsk and Arkhangelsk. The study population was 4542 men and women aged 35-69 years recruited from the general population. Fieldwork took place between 2015-18. There were two study components: 1) a baseline interview to collect information on socio-demographic characteristics and cardiovascular risk factors, usually conducted at home, and 2) a comprehensive health check at a primary care clinic which included detailed examination of the cardiovascular system. In this paper we describe in detail the rationale for, design and conduct of these studies.
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Affiliation(s)
- Sarah Cook
- London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Sofia Malyutina
- Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, 630090, Russian Federation.,Novosibirsk State Medical University, Russian Ministry of Health, Novosibirsk, 630091, Russian Federation
| | | | - Maria Averina
- UiT the Arctic University of Norway, Tromsø, 9037, Norway
| | - Natalia Bobrova
- London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Sergey Boytsov
- Federal State budget organization, National medical research center of cardiology, Russian Ministry of Health, Moscow, 121552, Russian Federation
| | - Soren Brage
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Taane G Clark
- London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | | | | | | | - Alun Hughes
- UCL Institute of Cardiovascular Science, University College London, London, WC1E 6BT, UK
| | - Heidi Johansen
- UiT the Arctic University of Norway, Tromsø, 9037, Norway
| | - Kamila Kholmatova
- Northern State Medical University, Arkhangelsk, 163000, Russian Federation
| | | | - Anna Kontsevaya
- National research center for preventive medicine, Moscow, 101990, Russian Federation
| | - Michael Kornev
- Northern State Medical University, Arkhangelsk, 163000, Russian Federation
| | | | - Per Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, 0851, Norway
| | | | - Martin McKee
- London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Katy Morgan
- London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Odd Nilssen
- UiT the Arctic University of Norway, Tromsø, 9037, Norway
| | - Ilya Plakhov
- Lytech Laboratory LLC, Moscow, 107023, Russian Federation
| | - Jennifer K Quint
- Royal Brompton Campus, Imperial College London, London, SW3 6LY, UK
| | - Alicja Rapala
- UCL Institute of Cardiovascular Science, University College London, London, WC1E 6BT, UK
| | - Andrey Ryabikov
- Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, 630090, Russian Federation.,Novosibirsk State Medical University, Russian Ministry of Health, Novosibirsk, 630091, Russian Federation
| | - Lyudmila Saburova
- Institute of Philosophy and Law, Ural Branch of the Russian Academy of Sciences, Ekaterinburg, 620990, Russian Federation
| | | | - Marina Shapkina
- Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, 630090, Russian Federation.,Novosibirsk State Medical University, Russian Ministry of Health, Novosibirsk, 630091, Russian Federation
| | - Suhail Shiekh
- London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Vladimir M Shkolnikov
- Max Planck Institute for Demographic Research, Rostock, 18057, Germany.,Higher School for Economics, National Research University , Moscow, 101000, Russian Federation
| | | | - Michael Voevoda
- Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, 630090, Russian Federation
| | - Kate Westgate
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - David A Leon
- London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK.,UiT the Arctic University of Norway, Tromsø, 9037, Norway
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11
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Cook S, Malyutina S, Kudryavtsev AV, Averina M, Bobrova N, Boytsov S, Brage S, Clark TG, Diez Benavente E, Eggen AE, Hopstock LA, Hughes A, Johansen H, Kholmatova K, Kichigina A, Kontsevaya A, Kornev M, Leong D, Magnus P, Mathiesen E, McKee M, Morgan K, Nilssen O, Plakhov I, Quint JK, Rapala A, Ryabikov A, Saburova L, Schirmer H, Shapkina M, Shiekh S, Shkolnikov VM, Stylidis M, Voevoda M, Westgate K, Leon DA. Know Your Heart: Rationale, design and conduct of a cross-sectional study of cardiovascular structure, function and risk factors in 4500 men and women aged 35-69 years from two Russian cities, 2015-18. Wellcome Open Res 2018; 3:67. [DOI: 10.12688/wellcomeopenres.14619.2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2018] [Indexed: 01/03/2023] Open
Abstract
Russia has one of the highest rates of cardiovascular disease in the world. The International Project on Cardiovascular Disease in Russia (IPCDR) was set up to understand the reasons for this. A substantial component of this study was the Know Your Heart Study devoted to characterising the nature and causes of cardiovascular disease in Russia by conducting large cross-sectional surveys in two Russian cities Novosibirsk and Arkhangelsk. The study population was 4542 men and women aged 35-69 years recruited from the general population. Fieldwork took place between 2015-18. There were two study components: 1) a baseline interview to collect information on socio-demographic characteristics and cardiovascular risk factors, usually conducted at home, and 2) a comprehensive health check at a primary care clinic which included detailed examination of the cardiovascular system. In this paper we describe in detail the rationale for, design and conduct of these studies.
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12
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Impact of Modifiable Risk Factors on B-type Natriuretic Peptide and Cardiac Troponin T Concentrations. Am J Cardiol 2016; 117:376-81. [PMID: 26739393 DOI: 10.1016/j.amjcard.2015.10.054] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 10/30/2015] [Accepted: 10/30/2015] [Indexed: 01/25/2023]
Abstract
Alcohol use, physical activity, diet, and cigarette smoking are modifiable cardiovascular risk factors that have a substantial impact on the risk of myocardial infarction, stroke, and cardiovascular death. We hypothesized that these behaviors may alter concentrations of cardiac troponin, a marker of myocyte injury, and B-type natriuretic peptide, a marker of myocyte stress. Both markers have shown strong association with adverse cardiovascular outcomes. In 519 women with no evidence of cardiovascular disease, we measured circulating concentrations of cardiac troponin T, using a high-sensitivity assay (hsTnT), and the N-terminal fragment of B-type natriuretic peptide (NT-proBNP). We used logistic regression to determine if these behaviors were associated with hsTnT ≥ 3 ng/l or with NT-proBNP in the highest quartile (≥ 127.3 ng/l). The median (Q1 to Q3) NT-proBNP of the cohort was 68.8 ng/l (40.3 to 127.3 ng/l), and 30.8% (160 of 519) of the cohort had circulating hsTnT ≥ 3 ng/l. In adjusted models, women who drank 1 to 6 drinks/week had lower odds of having a hsTnT ≥ 3 ng/l (odds ratio 0.58, 95% confidence interval 0.34 to 0.96) and lower odds of having an elevated NT-proBNP (odds ratio 0.55, 95% confidence interval 0.32 to 0.96). We were subsequently able to validate the results for B-type natriuretic peptide in a large independent cohort. In conclusion, our results suggest that regular alcohol consumption is associated with lower concentrations of hsTnT and NT-proBNP, 2 cardiovascular biomarkers associated with cardiovascular risk, and raise the hypothesis that the beneficial effects of alcohol consumption may be mediated by direct effects on the myocardium.
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13
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Cook S, Quint JK, Vasiljev M, Leon DA. Self-reported symptoms of chronic cough and breathlessness in working-age men in the city of Izhevsk, Russia: associations with cardiovascular disease risk factors and comorbidities. BMJ Open Respir Res 2015; 2:e000104. [PMID: 26793315 PMCID: PMC4709862 DOI: 10.1136/bmjresp-2015-000104] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 10/19/2015] [Accepted: 10/20/2015] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION Very little is known about the prevalence of respiratory symptoms or their associations with other health conditions in Russia. METHODS Between 2008 and 2010, a sample of 983 men resident in Izhevsk, Russia, took part in a cross-sectional survey. Presence of respiratory symptoms was determined from self-report of chronic productive cough and breathlessness assessed using the British Medical Research Council (MRC) breathlessness scale. Self-reported physical and mental health were measured using the 12-Item Short-Form Health Survey (SF-12). Hypertension was assessed from mean blood pressure measured at the health check and/or self-reported use of antihypertensive medication. Other comorbidities were assessed from self-report. Logistic regression models were fitted assessing the association between respiratory symptoms and comorbidities. Linear regression models were fitted to investigate the association between respiratory symptoms and self-reported health scores. All models were adjusted for age, education and smoking status. RESULTS The age-standardised prevalence of cough and breathlessness was 20.9% (prevalence with breathlessness MRC grade 3 or above 3.7%). The majority of men with respiratory symptoms (87.3%) were current smokers. Cough and breathlessness were associated with substantially worse self-reported physical and mental health (test for trend with severity of breathlessness p<0.001). Those with chronic cough and grade 3 or above breathlessness had higher odds of having hypertension (OR 3.03; 95% CI 1.36 to 6.74), diabetes (OR 10.55; 95% CI 2.69 to 41.37), angina pectoris (OR 7.54; 95% CI 3.61 to 15.73), previous myocardial infarction (OR 7.61; 95% CI 2.10 to 27.4) and previous stroke (OR 6.61; 95% CI 1.75 to 23.34) compared with those without respiratory symptoms. CONCLUSIONS The prevalence of respiratory symptoms was high. Strong associations were found between respiratory symptoms and cardiovascular comorbidities. These are of particular importance given the extremely high level of cardiovascular disease mortality in Russia.
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Affiliation(s)
- Sarah Cook
- Department of Non Communicable Disease Epidemiology , London School of Hygiene & Tropical Medicine , London , UK
| | - Jennifer K Quint
- Department of Non Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Department of Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London, London, UK
| | | | - David A Leon
- Department of Non Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Arctic University of Norway, UiT, Tromsø, Norway
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14
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Leon DA, Ezzati M. High cardiovascular mortality in Russia: role of alcohol versus smoking, blood pressure, and treatment. Nat Rev Cardiol 2015; 12:740. [PMID: 26503408 DOI: 10.1038/nrcardio.2015.167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- David A Leon
- Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Sciences, London School of Hygiene &Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Majid Ezzati
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK
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15
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Abstract
The Rotterdam Study is a prospective cohort study ongoing since 1990 in the city of Rotterdam in The Netherlands. The study targets cardiovascular, endocrine, hepatic, neurological, ophthalmic, psychiatric, dermatological, otolaryngological, locomotor, and respiratory diseases. As of 2008, 14,926 subjects aged 45 years or over comprise the Rotterdam Study cohort. The findings of the Rotterdam Study have been presented in over 1200 research articles and reports (see www.erasmus-epidemiology.nl/rotterdamstudy ). This article gives the rationale of the study and its design. It also presents a summary of the major findings and an update of the objectives and methods.
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16
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Maternal obesity during pregnancy and cardiovascular development and disease in the offspring. Eur J Epidemiol 2015; 30:1141-52. [PMID: 26377700 PMCID: PMC4684830 DOI: 10.1007/s10654-015-0085-7] [Citation(s) in RCA: 183] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 09/08/2015] [Indexed: 01/15/2023]
Abstract
Maternal obesity during pregnancy is an important public health problem in Western countries. Currently, obesity prevalence rates in pregnant women are estimated to be as high as 30 %. In addition, approximately 40 % of women gain an excessive amount of weight during pregnancy in Western countries. An accumulating body of evidence suggests a long-term impact of maternal obesity and excessive weight gain during pregnancy on adiposity, cardiovascular and metabolic related health outcomes in the offspring in fetal life, childhood and adulthood. In this review, we discuss results from recent studies, potential underlying mechanisms and challenges for future epidemiological studies.
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17
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Wannamethee SG, Whincup PH, Lennon L, Papacosta O, Shaper AG. Alcohol consumption and risk of incident heart failure in older men: a prospective cohort study. Open Heart 2015; 2:e000266. [PMID: 26290689 PMCID: PMC4536361 DOI: 10.1136/openhrt-2015-000266] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 07/01/2015] [Accepted: 07/07/2015] [Indexed: 12/03/2022] Open
Abstract
Aims Light-to-moderate drinking has been associated with reduced risk of heart failure (HF). We have examined the association between alcohol consumption and incident HF in older British men. Methods and results Prospective study of 3530 men aged 60–79 years with no diagnosed HF or myocardial infarction (MI) at baseline and followed up for a mean period of 11 years, in whom there were 198 incident HF cases. Men were divided into 6 categories of alcohol consumption: none, <1, 1–6, 7–13, 14–34 and ≥35 drinks/week. There was no evidence that light-to-moderate drinking is beneficial for risk of HF. Heavy drinking (≥35 drinks/week) was associated with significantly increased risk of HF. Using the large group of men drinking 1–6 drinks/week as the reference group, the relative HRs (95% confidence interval) for HF adjusted for age, lifestyle characteristics, blood pressure, atrial fibrillation and renal dysfunction were 0.97 (0.59 to 1.63), 1.39 (0.86 to 2.25), 1.00, 0.94 (0.64 to 1.43), 1.16 (0.78 to 1.71) and 1.91 (1.02 to 3.56) for the 6 alcohol groups, respectively. The increased risk associated with heavy drinking was attenuated after adjustment for N-terminal pro-brain natriuretic peptide (NT-proBNP) (HR=1.43 (0.76 to 1.69)). Stratified analysis showed heavy drinking was associated with increased HF risk only in those with ECG evidence of myocardial ischaemia. Conclusions There was no evidence that light-to-moderate drinking is beneficial for the prevention of HF in older men without a history of an MI. Heavier drinking (≥5 drinks/day), however, was associated with increased risk of HF in vulnerable men with underlying myocardial ischaemia.
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Affiliation(s)
- S Goya Wannamethee
- Department of Primary Care and Population Health , University College London , London , UK
| | - Peter H Whincup
- Department of Population Health Sciences and Education , St George's, University of London , London , UK
| | - Lucy Lennon
- Department of Primary Care and Population Health , University College London , London , UK
| | - Olia Papacosta
- Department of Primary Care and Population Health , University College London , London , UK
| | - A Gerald Shaper
- Department of Primary Care and Population Health , University College London , London , UK
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18
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Oksuzyan A, Shkolnikova M, Vaupel JW, Christensen K, Shkolnikov VM. Sex Differences in Biological Markers of Health in the Study of Stress, Aging and Health in Russia. PLoS One 2015; 10:e0131691. [PMID: 26121035 PMCID: PMC4484801 DOI: 10.1371/journal.pone.0131691] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 06/05/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The apparent contradiction that women live longer but have worse health than men, the so called male-female health-survival paradox, is very pronounced in Russia. The present study investigates whether men in Moscow are healthier than women at the level of biomarkers, and whether the associations between biomarkers and subjective health have sex-specific patterns. MATERIALS Previously collected data in the study of Stress, Aging, and Health in Russia (SAHR, n = 1800) were used to examine sex differences in biomarkers and their associations with physical functioning and self-rated health. RESULTS The present study found mixed directions and magnitudes for sex differences in biomarkers. Women were significantly disadvantaged with regard to obesity and waist circumference, whereas men had a tendency toward higher prevalence of electrocardiographic abnormalities. No sex differences were indicated in the prevalence of immunological biomarkers, and mixed patterns were found for lipid profiles. Many biomarkers were associated with physical functioning and general health. Obesity and waist circumference were related to lower physical functioning among females only, while major Q-wave abnormalities with high probabilities of myocardial infarction and atrial fibrillation or atrial flutter were associated with physical functioning and self-rated health among males only. CONCLUSION No clear patterns of sex differences in prevalence of high-risk levels of biomarkers suggest that the male-female health-survival paradox is weaker at the level of health biomarkers. We found some evidence that certain biomarkers reflecting pathophysiological changes in the organism that do not possess acute health risks, but over many years may lead to physical disability, are associated with physical functioning and self-rated health in women, whereas others reflecting more serious life-threatening pathophysiological changes are associated with physical functioning and self-rated health in men.
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Affiliation(s)
- Anna Oksuzyan
- Max Planck Institute for Demographic Research, Rostock, Germany
- Department of Epidemiology, Biostatistics, and Biodemography, University of Southern Denmark, Odense, Denmark
- * E-mail:
| | - Maria Shkolnikova
- Scientific and Clinical Institute of Pediatry at the Pirogov Moscow Medical University, Moscow, Russian Federation
| | - James W. Vaupel
- Max Planck Institute for Demographic Research, Rostock, Germany
- Max-Planck Odense Center on the Biodemography of Aging, Odense, Denmark
| | - Kaare Christensen
- Department of Epidemiology, Biostatistics, and Biodemography, University of Southern Denmark, Odense, Denmark
- Max-Planck Odense Center on the Biodemography of Aging, Odense, Denmark
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
| | - Vladimir M. Shkolnikov
- Max Planck Institute for Demographic Research, Rostock, Germany
- New Economic School, Moscow, Russian Federation
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19
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Leong DP, Smyth A, Teo KK, McKee M, Rangarajan S, Pais P, Liu L, Anand SS, Yusuf S. Patterns of Alcohol Consumption and Myocardial Infarction Risk. Circulation 2014; 130:390-8. [DOI: 10.1161/circulationaha.113.007627] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Background—
Although moderate alcohol use is associated with protection against myocardial infarction (MI), it is not known whether this effect is generalizable to populations worldwide. It is also uncertain whether differences in the pattern of alcohol use (and in particular heavy episodic consumption) between different regions negate any beneficial effect.
Methods and Results—
We included 12 195 cases of first MI and 15 583 age- and sex-matched controls from 52 countries. Current alcohol use was associated with a reduced risk of MI (compared with nonusers: adjusted odds ratio, 0.87; 95% confidence interval, 0.80–0.94;
P
=0.001); however, the strength of this association was not uniform across different regions (region-alcohol interaction
P
<0.001). Heavy episodic drinking (≥6 drinks) within the preceding 24 hours was associated with an increased risk of MI (odds ratio, 1.4; 95% confidence interval, 1.1–1.9;
P
=0.01). This risk was particularly elevated in older individuals (for age >65 years: odds ratio, 5.3; 95% confidence interval, 1.6–18;
P
=0.008).
Conclusions—
In most participants, low levels of alcohol use are associated with a moderate reduction in the risk of MI; however, the strength of this association may not be uniform across different countries. An episode of heavy drinking is associated with an increased risk of acute MI in the subsequent 24 hours, particularly in older individuals.
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Affiliation(s)
- Darryl P. Leong
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada (D.P.L., A.S., K.K.T., S.R., S.S.A., S.Y.); London School of Hygiene and Tropical Medicine, London, UK (M.M.); St. John’s Medical College, Bangalore, India (P.P.); and Fu Wai Hospital, Beijing, China (L.L.)
| | - Andrew Smyth
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada (D.P.L., A.S., K.K.T., S.R., S.S.A., S.Y.); London School of Hygiene and Tropical Medicine, London, UK (M.M.); St. John’s Medical College, Bangalore, India (P.P.); and Fu Wai Hospital, Beijing, China (L.L.)
| | - Koon K. Teo
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada (D.P.L., A.S., K.K.T., S.R., S.S.A., S.Y.); London School of Hygiene and Tropical Medicine, London, UK (M.M.); St. John’s Medical College, Bangalore, India (P.P.); and Fu Wai Hospital, Beijing, China (L.L.)
| | - Martin McKee
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada (D.P.L., A.S., K.K.T., S.R., S.S.A., S.Y.); London School of Hygiene and Tropical Medicine, London, UK (M.M.); St. John’s Medical College, Bangalore, India (P.P.); and Fu Wai Hospital, Beijing, China (L.L.)
| | - Sumathy Rangarajan
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada (D.P.L., A.S., K.K.T., S.R., S.S.A., S.Y.); London School of Hygiene and Tropical Medicine, London, UK (M.M.); St. John’s Medical College, Bangalore, India (P.P.); and Fu Wai Hospital, Beijing, China (L.L.)
| | - Prem Pais
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada (D.P.L., A.S., K.K.T., S.R., S.S.A., S.Y.); London School of Hygiene and Tropical Medicine, London, UK (M.M.); St. John’s Medical College, Bangalore, India (P.P.); and Fu Wai Hospital, Beijing, China (L.L.)
| | - Lisheng Liu
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada (D.P.L., A.S., K.K.T., S.R., S.S.A., S.Y.); London School of Hygiene and Tropical Medicine, London, UK (M.M.); St. John’s Medical College, Bangalore, India (P.P.); and Fu Wai Hospital, Beijing, China (L.L.)
| | - Sonia S. Anand
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada (D.P.L., A.S., K.K.T., S.R., S.S.A., S.Y.); London School of Hygiene and Tropical Medicine, London, UK (M.M.); St. John’s Medical College, Bangalore, India (P.P.); and Fu Wai Hospital, Beijing, China (L.L.)
| | - Salim Yusuf
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada (D.P.L., A.S., K.K.T., S.R., S.S.A., S.Y.); London School of Hygiene and Tropical Medicine, London, UK (M.M.); St. John’s Medical College, Bangalore, India (P.P.); and Fu Wai Hospital, Beijing, China (L.L.)
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