Effect of regional living conditions on middle-term cardiovascular outcomes: data from prospective stage of the ESSE-RF study

Abstract

Aim. To assess regional living conditions with cardiovascular outcomes based on prospective stage of the Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation (ESSE-RF) study.Material and methods. We used data from a 3- and 5-year prospective stage of the ESSE-RF study (2012-2013). For initial screening, 16210 people aged 25-64 were included. To characterize the regions of residence, 5 regional indices (RIs) were used. The following endpoints were considered: cardiovascular death, myocardial infarction, stroke, composite endpoint (cardiovascular death + myocardial infarction + stroke). To assess the correlations, generalized estimating equations with nested data structure (individuals in the regions) were used. The studied associations were adjusted for a wide range of potential effect modifiers.Results. There are multiple direct associations of RIs with the likelihood of all endpoints. The exception was the reverse association of Industrial RI with cardiovascular death. The most stable associations regarded Mixed RI, Industrial RI and Socio-geographical RI, with a high RI significance in endpoint development, compared with well-known individual cardiovascular risk factors. Separate associations were noted for Economic RI and Demographic RI.Conclusion. The results indicate a significant contribution of a number of regional living conditions to individual risk of fatal and non-fatal cardiovascular outcomes.

Major and minor ECG abnormalities depending on regional living conditions in Russia

“…An increase in the odd of major ECG abnormalities revealed in men in demographically depressed regions was consistent with previously obtained data on the increase in cardiovascular risk over a 3-year follow-up period 41 . As in the prospective study, an impact of the Demographic Index was less pronounced (compared with the Industrial Index and Mixed Index), which could be due to indirect mediation by other spatial characteristics.…”

“…Numerous published data confirmed the effect of ambient air pollution on cardiovascular morbidity and mortality 37,38 ; the latter is also characteristic of industrial pollution 39,40 . Previously, on the same sample as in this study, we revealed that the growth of the regional industrial development was associated with an increase in the odd of developing myocardial infarction and overall cardiovascular risk in a 5-year prospective follow-up 41 . Therefore, the obtained results exhibited negative impact of anthropogenic pollution on the myocardium, which manifested itself to a greater extent in severe (major) ECG abnormalities.…”

Major and minor ECG abnormalities depending on regional living conditions in Russia

“…An increase in the likelihood of major ECG abnormalities revealed in men in demographically depressed regions was consistent with previously obtained data on the increase in cardiovascular risk over a 3-year follow-up period [42]. As in the prospective study, an impact of the Demographic Index was less pronounced (compared with the Industrial Index and Mixed Index), which could be due to indirect mediation by other spatial characteristics.…”

“…Numerous published data con rmed the effect of ambient air pollution on cardiovascular morbidity and mortality [38,39]; the latter is also characteristic of industrial pollution [40,41]. Previously, on the same sample as in this study, we revealed that the growth of the regional industrial development was associated with an increase in the likelihood of developing myocardial infarction and overall cardiovascular risk in a 5-year prospective follow-up [42]. Therefore, the obtained results exhibited negative impact of anthropogenic pollution on the myocardium, which manifested itself to a greater extent in severe (major) ECG abnormalities.…”