Aim. To study the association of blood pressure (BP) and hypertension (HTN) with salt intake estimated by the survey and the urinary Na+ concentration among men and women 25-64 years old, examined within the ESSE-RF and ESSE-RF-2 studies.Material and methods. Representative samples of the Russian population aged 25-64 years were examined. At the first phase in 2012-2014, 21,888 people (men — 38,2%) were included, and at the second phase in 2017 — 6,714 people (men — 44,7%). The response rate was 80%. We used standard questionnaire. Adding more salt and the consumption of salted foods (sausages, deli meats, and pickled foods) in the criteria “daily or almost daily” was considered excess salt intake (ESI). BP measurement was carried out in a sitting position on the right hand. BP was measured twice with an interval of about 2-3 minutes. HTN was diagnosed at a systolic BP (SBP) ≥140 mm Hg and/or diastolic BP ≥90 mm Hg, or in case of antihypertensive therapy. In ESSE-RF-2, an analysis of the morning urine was additionally performed. Na+ was determined using the EX-Ds ion-selective electrolyte analyzer. All participants were stratified by the quintiles of urine sodium level. Data analysis was performed using the software package R 3.6.1. The models of linear and logistic regression were used. The differences were considered at p<0,05.Results. The average level of SBP significantly increases with an increase in Na+ in urine: 1,04 (0,60-1,48) mm Hg for the quintile of sodium distribution (p<0,001), the odds of HTN increases by 1,11 (1,05-1,17) times for the quintile (p<0,001). Questionnaire components of ESI are also significantly related to urinary Na+ levels. The consumption of sausages and deli meats has the greatest effect, causing an increase in the average Na+ level by 11,59 (7,06-16,12) mmol/l (p<0,001). The applied point scale is significantly related to urine sodium level and predicts HTN no worse than Na+ in the urine (p=0,15 for the difference hypothesis). One point on the scale increases the Na+ level by an average of 7,51 (5,01-10,02) mmol/l, SBP by an average of 0,74 (0,41-1,07) mm Hg and the odds of HTN by 1,1 (1,06-1,15) times (p<0,001 for all).Conclusion. In the pattern of ESI components, processed meat and sausage products take first place in terms of association strength with urine sodium. The questionnaire used to assess the proportion of people with ESI can be recommended for assessing this risk factor during screening. ESI detected by the questionnaire is associated with elevated BP and urinary Na+ values.
Aim. Description of current dynamics of registered alcohol-attributable mortality in Krasnodar Krai.Materials and methods. The study was conducted using official statistics reports and published materials of the Federal State Statistics Service. The survey covers 1,398,636 cases in Krasnodar Krai from 2000 to 2018, including 42,612 deaths from alcohol-related causes. Intensive (IM), extensive (EM) and standardised mortality (SM) rates were estimated according to the European Population Standard. Statistical analyses were performed with Microsoft Office software.Results. Krasnodar Krai displays a positive trend of alcohol-attributable mortality (AAM), with a reduction rate 3.5 times above the similar total mortality (TMR) values (74.4 vs. 21.5%). The decline is more pronounced in both men and women compared to the country average. Thus, AAM in men and in women was 2.9 and 3.7 times lower, respectively, in Krasnodar Krai in 2018. At the same time, TMR values were similar, 1,245.2 against 1,200.6 per 100,000 population in the Russian Federation and Krasnodar Krai, respectively (p <0.05). Alcoholic cardiomyopathy, alcoholic liver disease and poisoning prevailed as causes of AAM for almost the entire period analysed, with their total cumulative contribution varying from 55.6 to 91.7%.We demonstrate a steady growth of AAM incidents subject to state registration in Form C-51 (from 4 in 2000 to 17 in 2018), which hampers a retrospective analysis of AAM dynamics in terms of individual nosologies’ contribution.Conclusion. The trends revealed objectively illustrate a positive AAM dynamics in Krasnodar Krai. However, overall contribution of alcohol-attributed causes to the current total mortality profile of the population is underestimated. Recommendations in national healthcare are needed for step-wise improvement and strict supervision of statistical indicator reporting, particularly, of death causes associated with alcohol intake.
Background. The population prevalence of alcohol abuse-associated drug-related diseases bears high social impact. This indicator holds special value both as a potential indirect estimator of the quality of life, availability and efficiency of drug addiction treatment, a well as parameter for qualitative prognostic models of social and economic development. The burden of alcohol-associated drug diseases is typically ambiguous in prevalence estimation, both across Russian Federation and worldwide.Objectives. A study of the alcohol abuse-associated drug-related morbidity prevalence in Krasnodar Krai for period 2000–2020.Methods. A retrospective descriptive study included legal-paper data of the “Information on Drug-Related Disorders” federal statistics survey (Form 11) of Krasnodar Krai, years 2000-2020, describing the re-registration rate of alcohol use-associated drug disorders. The inclusion criterion was an established drug-related disease among all age cohorts. The main study indicators were regional prevalence values of alcoholic psychosis, alcohol dependence syndrome and harmful alcohol use relative to gender, area and age.Results. Prevalence trends in alcohol use-related drug pathology were more favourable in Krasnodar Krai over Southern Federal District and country-wide. The decline rate among males was significantly higher (22.1-fold) vs. the female population (3.0-fold). The prevalence of alcohol use-related drug pathology remained higher in urban vs. rural areas, with higher rural vs. urban decline rates. Over the entire study period, the 40–59 years-age population was leading by the incidence of overall alcohol use-related drug pathology and, separately, of alcoholic psychosis and alcohol dependence syndrome. Highest harmful alcohol use values were registered for 20–39-year population.Conclusion. The revealed dynamics of legal-registered alcoholic drug pathology prevalence has a multifactorial origin. The changes are conditioned by improvement in the narcological aid institutional regulation within the state guarantee programme, federal and regional preventive measures, current progress in drug therapy, regional demography, as well as underreporting of alcohol-associated drug diseases due to a missing strict vertical statistic registration at the level of any-type medical institutions.
The use of the method of expert assessments is an indispensable element of the search for reserves to improve the quality and safety of medical activities for the realization of strategic tasks in the field of population conservation and improvement of health indicators of the Russian population.The purpose of the study was to assess the factors influencing the appeal for drug treatment of alcohol–associated diseases in state medical organizations on the model of a large agro-industrial region.Materials and methods. Anonymous sociological survey was conducted in 2022. 135 doctorsspecialist in the field of “Psychiatry-narcology” working in outpatient or inpatient units of the public health system of the Krasnodar region. The following methods were applied in this study: sociological, statistical, content analysis, expert assessments.Results. The representative group of experts was characterized by a predominance of female doctors (57,0 %), persons aged 40–49 years (25.2 %) with a qualification category (76.3 %), with more than 15 years of work experience in the specialty “Psychiatry-narcology” (58.5 %). The organization of drug treatment in outpatient settings was rated “good” and “excellent” by 54.8 % of respondents, in inpatient – 71.1 %. According to experts, the factors of legal restrictions, public censure, as well as defects in the self-assessment of the nosological status of patients and the lack of general medical literacy of the population had the greatest impact on the decrease in the incidence of drug treatment for alcohol-related pathology.Conclusion. The potential aspects of possible directions for selective influence in order to increase the appeal of the population with addictive alcohol disorders to specialized professionals and the preservation of human resources were identified.
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