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Quantifying the contribution of established risk factors to cardiovascular mortality differences between Russia and Norway.

Published version
Peer-reviewed

Type

Article

Change log

Authors

Trias-Llimós, Sergi 
Tverdal, Aage 
Kudryavtsev, Alexander V 
Malyutina, Sofia 

Abstract

Surprisingly few attempts have been made to quantify the simultaneous contribution of well-established risk factors to CVD mortality differences between countries. We aimed to develop and critically appraise an approach to doing so, applying it to the substantial CVD mortality gap between Russia and Norway using survey data in three cities and mortality risks from the Emerging Risk Factor Collaboration. We estimated the absolute and relative differences in CVD mortality at ages 40-69 years between countries attributable to the risk factors, under the counterfactual that the age- and sex-specific risk factor profile in Russia was as in Norway, and vice-versa. Under the counterfactual that Russia had the Norwegian risk factor profile, the absolute age-standardized CVD mortality gap would decline by 33.3% (95% CI 25.1-40.1) among men and 22.1% (10.4-31.3) among women. In relative terms, the mortality rate ratio (Russia/Norway) would decline from 9-10 to 7-8. Under the counterfactual that Norway had the Russian risk factor profile, the mortality gap reduced less. Well-established CVD risk factors account for a third of the male and around a quarter of the female CVD mortality gap between Russia and Norway. However, these estimates are based on widely held epidemiological assumptions that deserve further scrutiny.

Description

Keywords

Adult, Aged, Blood Pressure, Cardiovascular Diseases, Cholesterol, Diabetes Complications, Female, Humans, Hypercholesterolemia, Hypertension, Male, Middle Aged, Norway, Prevalence, Risk Factors, Russia, Smoking

Journal Title

Sci Rep

Conference Name

Journal ISSN

2045-2322
2045-2322

Volume Title

10

Publisher

Springer Science and Business Media LLC
Sponsorship
Medical Research Council (MR/L003120/1)
British Heart Foundation (None)
British Heart Foundation (CH/12/2/29428)