Mortality in 55 Years and Older Population and Its Relation With Ischemic Heart Disease, Traditional Risk Factors and Inflammation Markers: The Results of Prospective Cohort Study

Баланова²,

Капустина³

et al. 2021

Russ J Cardiol

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Aim. Based on Russian and United States population studies, to determine the criterion for distinguishing between normal and low blood pressure (BP), which is the most significant for predicting all-cause mortality.Material and methods. We used data from prospective Russian studies of 14730 men aged 19-82 years (9307 deaths per 342309 person-years of followup) and 6141 women aged 18-72 years (2101 deaths per 158727 person-years of follow-up), and two United States population studies: the First National Health and Nutrition Examination Survey (NHANES I) in conjunction with the NHANES I Epidemiologic Followup Study, and the Second National Health and Nutrition Examination Survey (NHANES II) in conjunction with the NHANES II Mortality Study. The total American cohort included only white subjects: 8618 men aged 25-75 years (3130 deaths per 121794 person-years of follow-up) and 11135 women 25-75 years (2465 deaths per 176676 person-years of follow-up). Primary examinations were carried out in 1971-1982, while the latest information on the subjects’ survival status was obtained in 2017 (Russia) and 1992 (USA). KaplanMeier curves and Cox proportional hazards models were created; all-cause death was taken into account as an outcome.Results. Survival analysis using Cox models, in which, in addition to BP levels, sex, age and risk factors were taken into account, showed that in persons with a pronounced BP decrease, survival is worse in comparison with those with normal BP. Mean dynamic BP, unfavorable for all-cause mortality, was below 70 and 68 mm Hg and 76 and 72 mm Hg in men and women in the Russian and US cohorts, respectively.Conclusion. Not only hypertension, but also severe hypotension is associated with increased all-cause mortality compared to normal BP. Survival decrease is manifested in severe hypotension, subject to sex and adjustment for age and risk factors.

Section: Discussionunclassified

Hypotension and survival: diagnostic criteria in Russian and United States population

Баланова²,

Капустина³

et al. 2021

Russ J Cardiol

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Prevalence of hypotension in populations of the Russian Federation and the United States of America according to 30-year follow-up

Шальнова²,

Баланова³

et al. 2020

Cardiovasc Ther Prev

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Aim. To study the prevalence of hypotension according to several criteria in the Russia and the USA.Material and methods. We used data of Russian population studies performed in 1975-1982 and ESSE-RF study performed in 2012-2014 at the National Medical Research Center for Therapy and Preventive Medicine. A comparison was made with the data of cross-sectional stu - dies of the US population — National Health and Nutrition Examination Survey (NHANES): NHANES II (1976-1980) and Continuous NHANES (2007-2012). We analyzed age, sex, and systolic and diastolic blood pressure. The prevalence of individuals with hypotension was calculated in men and women of five age groups using four different criteria for hypertension.Results. The prevalence of hypotension in studies of different years according to different criteria was as follows: in the Russia — 0,3-9,0% in men and 2-15% in women; in the USA — 5-30% in men and 8-45% in women. In age group >30 years, the prevalence of hypotension in Russia, by most criteria, decreased approximately by 50% in men and did not change in women. In the United States, according to all criteria, the prevalence in men and women has increased 2-3 times.Conclusion. The prevalence of hypotension in the adult population ranges from decimal percentages to 45% and varies many times depending on the selected criterion.

Thirty-year trends in the prevalence of cardiometabolic risk factors in the populations of the Russian Federation and the United States of America

Shalnova²

2022

Cardiovasc Ther Prev

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Aim. To study trends in the prevalence of hypertension (HTN), obesity, elevated non-high-density lipoprotein cholesterol (non-HDL cholesterol) levels in Russia and the USA from 1975 to 2014.Material and methods. According to the data of cross-sectional population studies in Russia and the USA in 1975-1982 and 2007-2014, the prevalence of risk factors (RFs) in men and women aged 25-64 was studied. The data of Lipid Research Clinics studies, Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation (ESSE-RF) study, as well as data from National Health And Nutrition Examination Survey (NHANES) studies (USA) were used. The total number of persons analyzed was 41268. The proportion of individuals with risk factors and 95% confidence interval were calculated.Results. In the 1980s, the prevalence of studied RFs in Russia and the United States did not differ in most sex and age groups. Over the next 30 years, both populations are characterized by a decrease in the prevalence of HTN and elevated non-HDL cholesterol (≥ 3.7 mmol/l) and an increase in the prevalence of obesity. In 2012, HTN in men and women in Russia occurred more frequently than in the United States. Obesity was less common in men and women 25-44 years old in Russia and in women >54 years old in the USA. The prevalence of non-HDL cholesterol ≥3,7 mmol/l in Russia compared with the United States was higher in people >44 years old and lower in women 25-34 years old.Conclusion. In the 1980s, there were no differences in the prevalence of cardiometabolic risk factors in Russia and the United States. In the 2010s, HTn and partly dyslipidemia were more common in Russia, and the prevalence of obesity in young and middle-aged people was higher in the United States.