Background. Recent studies showed that depression was an independent predictor of mortality from cardiovascular disease in healthy women. Objective. To explore the effect of depression (D) on relative risk (RR) of myocardial infarction (MI) and stroke for 16 years (1995-2010) in the female population aged 25-64 years from Novosibirsk, Russia. Materials and methods. Under the third screening of the WHO ‘‘MONICA-psychosocial’’ (MOPSY) programme, a cohort of women aged 25-64 years (N=560) was surveyed. Women were followed for 16 years for the incidence of MI and stroke (1995-2010). D was measured at the baseline examination by means of test ‘‘MOPSY’’. Participants having stroke, MI, arterial hypertension, coronary artery diseases and diabetes in their medical history at the baseline were excluded from this analysis. Results. The prevalence of D in women aged 25-64 years was 55.2%. With the growth of D levels, positive self-rated health reduced and almost 100% of those women have complaints about their health, but considered the care of their health insufficient. Women with major D significantly extended negative behavioural habits: smoking and unsuccessful attempts to give up, low physical activity, and less likely to follow a diet (healthy food). Major D associated with high job strain and family stress. Relative risk (RR) of MI development in women with D during 16 years of study was higher in 2.53 cases (p<0.05) and risk of stroke was higher in 4.63 cases (p<0.05). Conclusions. The prevalence of D in women aged 25-64 years was >50%. Women with D had a 2.53-fold risk of MI and 4.63-fold risk of stroke during the 16 years of follow-up. Keywords: depression; awareness; attitude to the health; relative risk; myocardial infarction; stroke (Published: 5 August 2013) This paper is part of Supplement 1, 2013, ICCH15 Proceedings. More papers from this Supplement can be found here. Citation: Int J Circumpolar Health 2013, 72: 21223 - http://dx.doi.org/10.3402/ijch.v72i0.21223

The influence of social support on risk of acute cardiovascular diseases in female population aged 25-64 in Russia

To establish gender differences in health attitudes and awareness of risk factors for cardiovascular diseases in an open 25-64-year-old population of Russia/Siberia. A representative sample from the population of a Novosibirsk district was examined using the 1988 WHO MONICA-MOPSY (847 women and 739 men aged 25-64 years) and the 2003 HAPIEE (1074 women and 576 men aged 45-64 years) programs. The health awareness and attitudes questionnaire was used. The number of persons who considered perfectly healthy was minimal (2%) in the open Siberian population aged 25-64 years. The view of health in the women proved to be more pessimistic than that in the men. The fact that two thirds of the population could fall ill with a serious disease in the coming 5-10 years was accepted. Mainly the men took the view that modern medicine might prevent heart disease. The men were regularly examined 2 to 3 times more often than the women. The latter versus the men were less frequently inclined to stop work if they felt not quite well on-site, with the difference being more marked in old age groups. The majority of the study participants considered preventive examination to be useful for health. At the same time only a small portion of the population itself undergoes examination. The changed socioeconomic situation in the country leads to the need to alter the established stereotypes of conscience and behavior of the population in health and to realize the need for personal responsibility for health.

The aim of the study was to determine the impact of stress on work on the risk of cardiovascular disease over a 16-year period in an open population of 25–64 years in Russia/Siberia. Materials and methods. A random representative sample of the population of both sexes of 25–64 years old in Novosibirsk in 1994 (men: n=657, 44.3±0.4 years, response – 82.1%, women: n=689, 45.4±0.4 years, response – 72.5%). The screening survey program included: registration of socio-demographic data, determination of stress at work (Karazek scale). The period of prospective follow-up of participants was 16 years. The study identified the following "end points": the first cases of myocardial infarction (MI), stroke. Results. A high level of stress at work was in 29.5% of men and 31.6% of women, the average level in 48.9% of men and 50.7% of women (χ2=2.574, υ=2, p=0.276). The risk of developing MI for a 16-year period, among people experiencing stressful situations at work, was: in men, HR=3.592, and women HR=3.218 (95% CI 1.146–9.042); stroke risk – among men, HR=2.603 (95% CI 1.06–4.153) in women HR=1.956 (95% CI 1.008–3.795). In multivariate analysis, in men with stress at work, the risk of MI among men was HR=1.15 (95% CI 0.6–2.2), among women – HR=2.543 (95% CI 1.88–7.351); risk of stroke, was in men, HR=3.8 (95% CI 1.6–8.8), in women – HR=1.95 (95% CI 0.984–3.887). The risk of stroke was higher among single, divorced and widowed men, HR=4.2 (95% CI 1.5–13.2), and in women with secondary or primary education, HR=3 (95% CI 0.852–11.039). Conclusion. It was established that a high level of stress at work is not gender-specific; the risk of developing MI over a 16-year period is higher in women than in men, stroke in men; the risk of myocardial infarction and stroke in both sexes is affected by the social gradient. Keywords: gender, men, women, myocardial infarction, stroke, stress at work relative risk

Aim. To identify gender differences in the prevalence of depression in an open population of individuals aged 25—64 years and to evaluate its impact on the risk of cardiovascular diseases (CVD) in the population of Siberia. Subjects and methods. A random representative sample of a 25—64-year-old Novosibirsk population (657 men and 689 women) was surveyed within the framework of the third screening of the WHO MONICA-psychosocial program in 1994. The screening program included sociodemographic data registration and depression detection. Over a 16-year study period, women had myocardial infarction (MI) in 15 cases and stroke in 35 cases and men had these conditions in 30 and 22 cases, respectively. Results. In the open 25—64-year-old population, depression was detected in 54.5% of the women and in 29% of the men; major depression was present in 11.8% of the women and 3.1% of the men (χ2=66.724; υ=2; p=0.0001). The risk of MI in the depressed patients was higher in the women (hazard ratio (HR)=2.5) than in the men (HR=2); when social parameters and age are included in the model, only a trend towards the impact of depression on the risk of MI persisted in the women (HR=3.4; p>0.05) and the men were observed to have a 1.6-fold higher risk for MI. The greatest risk of MI was seen in the men (HR=6.8) and women (HR=6.3) at the age of 55—64 years, as well as in the men who had incomplete secondary or primary education (HR=3.2); in blue-collar workers (HR=6.7), in the men who were single (HR=3.6), divorced (HR=4.5), or widowed (HR=6). The risk of stroke in the depressed patients during a 16-year study period was greater in the men (HR=5.8) than in the women (HR=4.6); after adjusting for age and social gradient, the risk of stroke in the women was higher in both the population and those who were aged 55—64 years (HR=8.5 and 6.9, respectively) than that in the men (HR=4.2 and 3.1, respectively). Among the men, the risk of stroke was higher in those who had primary education (HR=8.8), were widowed (HR=8.4) or divorced (HR=2.7). Conclusion. The women are much more susceptible to depression than are the men. The risk of MI with depression is higher in the women than in the men; at the same time, the risk of stroke is higher in the men than in the women. The picture is opposite in the older age group. The risk of CVD in the depressed men is exacerbated by a social gradient; these relationships have not been revealed in the women.

Aim. To determine the dynamics and impact of sleep duration in 2003-2018 on the risk of myocardial infarction (MI) in an open population aged 45-64 years in Novosibirsk.Material and methods. The study included representative samples of the population aged 45-64 years, obtained as part of the screening IV in 2003-2005 (men, 576; mean age, 54,23±0,2 years; response rate, 61%; women, 1074; mean age, 54,27+0,2 years; response rate, 72%) and screening VI in 2015-2018 (men, n=275; mean age, 49±0,4 years; response, 72%; women, n=390; mean age, 45±0,4 years; response rate, 75%). Screenings were carried out according to the standard protocol of the WHO MONICA-psychosocial Program (MOPSY). The Jenkins Questionnaire was used to assess sleep duration and disturbances.Results. For the period from 2003-2005 to 2015-2018, we revealed decrease in the number of following people: with 7 hours of sleep at night from 44,9% to 31,9%; with 8 hours of sleep from 28,5% to 24,4%. In addition, the number of participants with ≤5 hours of sleep increased from 4,9% to 9,9%, while those with ≤6 hours — from 16,2% to 27,2%, as well as the number of people sleeping 9 hours a day (from 3,7% to 5,4%). In 2003-2005, among the population in the age group of 55- 64 years, 7-hour sleep was observed more often (45б1%); 6-hour sleep prevailed in the group of people aged 45-54 (18,9%). There were no significant differences between the duration of sleep and the age group according to screening VI in 2015- 2018. Among men, 6-hour sleep were observed more often (38.4%), and among women — 7 hours (37,3%). Those who sleep 7 hours a night were more likely to consider their sleep “good” (35,3%) in 2015-2018. In a population of 45-64 years old, over a 14-year period, the risk of MI was higher as follows: 1. in men with 5-6 hours of sleep than with 7-8 hours of sleep at night by 1,689 times (95% confidence interval (CI), 1,124-2,537 p<0,012); in men aged 45-54 years by 2,416 times (95% CI, 1,311-4,452; p<0,005), respectively; 2. in women with 5-6 hours of sleep by 1,591 times (95% CI, 1,058-2,392; p<0,026) compared with 7-8-hour duration of sleep. In the 45-54 year group, the risk of MI was higher among women with 9-10 hours of sleep a night by 4,44 times (95% CI, 2,726-20,309; p<0,0001) compared with women who had 7-8 hours of sleep at night.Conclusion. We revealed that over the period of 2003-2018, the duration of night sleep of 7-8 hours among the population aged 45-64 years (without cardiovascular diseases) decreased both among men and women. At the same time, the “good” quality of sleep was more often found in people with 7-hour sleep. It was determined that short sleep duration was associated with MI among men and women, and long sleep duration turned out to be a risk factor for MI for women in the group of 45-54 years.