Changes in Cardiovascular Risk Factors in Residents of the Siberian Region (According to Epidemiological Studies)

Aim. To analyze prevalence of cardiovascular risk factors in the Kemerovo region based on the results of epidemiological studies (2013 and 2016).

Material and methods. The study was based on two large epidemiological studies of the Kemerovo region: on 2013, «The epidemiology of cardiovascular diseases and their risk factors in the Russian Federation» and on 2016, «The prospective study of urban and rural epidemiology: study of the influence of social factors on chronic non-infectious diseases in low, middle and high income countries». In the study we analyzed cardiovascular risk factors using identical questionnaires, functional, anthropometric, biochemical means and measured on identical scales. As a result, we analyzed the prevalence of smoking, diabetes mellitus, overweight and obesity, abdominal obesity, hypercholesterolemia and hypertriglyceridemia, high levels of low-density lipoprotein (LDL).

Results. Univariate analysis indicates that in the sample of 2016, compared to the sample of 2013, the prevalence of smoking is statistically significantly lower, as well as the proportion of participants with high cholesterol levels, but not taking lipid-lowering drugs. In contrast, the prevalence of diabetes, hypercholesterolemia and hypertriglyceridemia is higher. In women, the frequency of abdominal obesity on 2016 is lower than on 2013: at 35-44 age group odds ratio (OR) =0.67 with 95% confidence interval (CI) 0.44-1.03, at 45-54 age group OR =0.47 with 95% CI 0.31-0.72, 55-65 age group OR =0.49 with 95% CI 0.30-0.79. A high incidence of diabetes, hypercholesterolemia and hypertriglyceridemia is characteristic mainly of older women (55-65 age group): accordingly, OR =1.96 with 95% CI 1.19-3.22, OR =1.42 with 95% CI 1,02-1.97, OR =1.51 at 95% CI 1.08-2.12. In the 45-54 age group of men, they smoked statistically significantly less often on 2016 compared to 2013, OR =0.59 with 95% CI 0.36-0.96. The prevalence of overweight and obesity in both samples is the same: for women, the OR for overweight in different age groups is within 0.74-0.87, for men - within 0.95-1.78; for obesity OR in women is from 0.70 to 0.79, in men - from 1.03 to 1.34.

Conclusion. A significant advantage of the study is the analysis of changes in prevalence in age and gender groups, which showed significant differences in the dynamics of men and women in different age categories for a number of risk factors. Analysis of the dynamics of the prevalence of cardiovascular risk factors makes it possible to assess the effectiveness of state and regional policies in the field of health protection and, first of all, "risk groups” that require closer attention, development and implementation of targeted health-saving technologies.

1. Hudson SE, Feigenbaum MS, Patil N, et al. Screening and socioeconomic associations of dyslipidemia in young adults. BMC Public Health. 2020;20(1):104. DOI:10.1186/s12889-019-8099-9.

2. Maksimov SA, Indukaeva EV, Skripchenko AE, et al. Prevalence of the main factors of cardiovascular risk in the Kemerovo region: results of a multicenter epidemiological study "ESSE-RF". Medicine in Kuzbass. 2014;3:36-42 (In Russ.)

3. Dedov II, Shestakova MV, Galstyan GR. The prevalence of type 2 diabetes mellitus in the adult population of Russia (NATION study). Diabetes Mellitus. 2016;19(2):104-12 (In Russ.) DOI:10.14341/DM2004116-17.

4. Muromtseva GA, Kontsevaya AV, Konstantinov VV, et al. The prevalence of non-infectious diseases risk factors in Russian population in 201 2-201 3 years. The results of ECVD-RF Cardiovascular Therapy and Prevention. 2014;13(6):4-11 (In Russ.) DOI:10.15829/1728-8800-2014-6-4-11.

5. Kish L. Survey Sampling. New York: John Wiley and Sons; 1 965.

6. Shlyakhto EV, Nedogoda SV, Konradi AO, et al. Diagnostics, treatment, prevention of obesity and associated diseases. National Clinical Guidelines, 2017 [cited 01/10/2021]. Available from: https://scardio.ru/content/Guidelines/project/Ozhirenie_klin_rek_proekt.pdf (In Russ.)

7. NCD Risk Factor Collaboration (NCD-RisC). Effects of diabetes definition on global surveillance of diabetes prevalence and diagnosis: a pooled analysis of 96 population-based studies with 331,288 participants. Lancet Diabetes Endocrinol. 2015;3(8):624-37. DOI:10.1016/S2213-8587(15)00129-1.

8. Shestakova MV, Vikulova OK, Zheleznyakova AV, et al. Epidemiology of diabetes mellitus in the Russian Federation: what has changed over the past decade? Ter Arkhiv. 2019;91(10):4-13 (In Russ.)

9. Dedov II, Shesta kovа MV, Vikulova OK. Epidemiology of diabetes mellitus in Russian Federation: clinical and statistical report according to the federal diabetes registry. Diabetes Mellitus. 2017;20(1):13-41 (In Russ.) [Дедов И.И., Шестакова М.В., Викулова О.К. Эпидемиология сахарного диабета в Российской Федерации: клинико-статистический анализ по данным Федерального регистра сахарного диабета. Сахарный Диабет, 2017;20(1):13-41]. DOI:10.14341/DM8664.

10. Di Cesare M, Bentham J, Stevens GA, et al. Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19, 2 million participants. Lancet. 2016;387(1 0026):1377-96. DOI:10.1016/S0140-6736(16)30054-X.

11. NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1 975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128-9 million children, adolescents, and adults. Lancet. 2017;390(101 13):2 627-42. DOI:10.1016/S0140-6736(17)32129-3.

12. Europe's visible epidemic. Bull. World Health Organ. 2013;91:549-50. DOI: 10.2471/BLT13.020813.

13. Benjamin EJ, Virani SS, Callaway CW, et al.; American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Heart Disease and Stroke Statistics-2018 Update: A Report From the American Heart Association. Circulation. 2018;137(12): e67-e492. DOI:10.1161/CIR.0000000000000558.

14. Vilkov VG, Shalnova SA, Deev AD, et al. Obesity trends in populations of the Russian Federation and the United States of America. Thirty-year long dynamics. Cardiovascular Therapy and Prevention. 2018;17(4):67-72 (In Russ.) DOI:10.15829/1728-8800-2018-4-67-72.

15. Simonova GI, Mustafina SV, Shcherbakova LV. Prevalence of abdominal obesity in the Siberian population. Siberian Scientific Medical Journal. 2015;1:60-4 (In Russ.)

16. Noncommunicable Diseases Country Profiles. WHO global report, 2011 [cited by Jan 1 0, 2021]. Available from: http://apps.who.int/iris/bitstream/handle/10665/44704/9789241502283_eng.pdf;jsessionid=0578D013B02925105903C9A33CACE225?sequence=1.

17. Global status report on noncommunicable diseases 2014. WHO, 2014 [cited by Jan 1 0, 2021]. Available from: http://apps.who.int/iris/bitstream/handle/10665/148114/9789241564854_eng.pdf?sequence=1.

18. Borodulin K, Vartiainen E, Peltonen M. Forty-year trends in cardiovascular risk factors in Finland. Eur J Public Health. 2015;25;539-46. DOI:10.1093/eurpub/cku174.

19. Giampaoli S, Palmieri L, Donfrancesco C, et al. Cardiovascular health in Italy. Ten-year surveillance of cardiovascular diseases and risk factors: Osservatorio EpidemiologicoCardiovascolare/Health Examination Survey 1 998-201 2. Eur J Prev Cardiol. 2015;22(2 Suppl):9-37. DOI:10.1177/2047487315589011.

20. Peters SAE, Muntner P, Woodward M. Sex Differences in the Prevalence of, and Trends in, Cardiovascular Risk Factors, Treatment, and Control in the United States, 2001 to 2016. Circulation. 2019;1 39(8):1 025-35. DOI:10.1161/CIRCULATIONAHA.118.035550.

21. Jeong JS. Prevalence and clinical characteristics of dyslipidemia in Koreans. Endocrinol Metab (Seoul). 2017;32(1):30-5. DOI:10.3803/EnM.2017.32.1.30.

22. QuickStats: Percentage of Adults Aged >20 Years Told Their Cholesterol Was High Who Were Taking Lipid-Lowering Medications, by Sex and Age Group — National Health and Nutrition Examination Survey, 2005-2006 to 201 5-201 6. MMWR Morb Mortal Wkly Rep. 2018;67(27):771. DOI:10.15585/mmwr.mm6727a6.

23. Rabani S, Sardarinia M, Akbarpour S, et al. 12-year trends in cardiovascular risk factors (2002-2005 through 201 1-2014) in patients with cardiovascular diseases: Tehran lipid and glucose study. PLoS One. 2018;16;13(5):e0195543. DOI:10.1371/journal.pone.0195543.

24. Nuotio J. Cardiovascular risk factors in 2011 and secular trends since 2007: the Cardiovascular Risk in Young Finns Study. Scand J Public Health. 2014;42:563-71. DOI:10.1177/1403494814541597.

25. Karpov YuA. Prevalence of hypertriglyceridemia: new all-Russian data. Research PROMETHEUS. Kar-diologiia. 2016;56(7):63-71 (In Russ.) DOI: 10.18565/cardio.2016.56(7).63-71.

26. Ng M, Freeman MK, Fleming TD, et al. Smoking prevalence and cigarette consumption in 187 countries, 1 980-201 2. JAMA. 2014;31 1(2):1 83-92. DOI:10.1001/jama.2013.284692.

27. Reitsma MB, Fullman N, Ng M, et al. Smoking prevalence and attributable disease burden in 195 countries and territories, 1 990-201 5: a systematic analysis from the Global Burden of Disease Study 2015. Lancet. 2017;389(10082):1 885-906. DOI:10.1016/S0140-6736(17)30819-X.

28. Noncommunicable Diseases Country Profiles. WHO global report, 2014 [cited by Jan 1 0, 2021]. Available from: http://apps.who.int/iris/bitstream/handle/10665/128038/9789241507509_eng.pdf?sequence=1.

29. Balanova YuA, Shalnova SA, Deev AD, et al. The prevalence of smoking in Russia. What has changed in 20 years? Preventive Medicine. 2015;6:47-52 (In Russ.) DOI:10.17116/profmed201518647-52.

30. Tamosiunas A, Klumbiene J, Petkeviciene J, et al. Trends in major risk factors and mortality from main non-communicable diseases in Lithuania, 1 985-201 3. BMC Public Health. 2016;16(717):1-10. DOI:10.1186/s12889-016-3387-0.

31. Klumbiene J, Sakyte E, Petkeviciene J, et al. The effect of tobacco control policy on smoking cessation in relation to gender, age and education in Lithuania, 1994-201 0. BMC Public Health. 2015; 15(181):1-10. DOI:10.1186/s12889-015-1525-8.