Aim. To study the epidemiological characteristics and changes of hypertension (HTN), as well as factors associated with HTN in the Russian population aged 35-74 years.Material and methods. The Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation-3 (ESSE-RF3) study examined a representative sample of the population aged 35-74 years of 15 Russian regions with a response >70% (n=28611). Modular design questionnaire was used. Blood pressure (BP) was measured twice after a 5-minute rest in a sitting position on the right arm with an Omron blood pressure monitor. There were following criteria for hypertension: systolic blood pressure (SBP) ≥140 mm Hg and/or diastolic blood pressure (DBP) ≥90 mm Hg, and/or antihypertensive therapy. The effectiveness of treatment was considered the proportion (%) of people who achieved target blood pressure values among those being treated, while the control was considered the proportion (%) of patients with a BP <140/90 mm Hg of the total number of hypertensive patients. HTN changes were studied in a single age range of 35-64 years with the inclusion of materials from the ESSE-RF (2012-14) and ESSE-RF2 (2017) studies, carried out using the same methodology as ESSE-RF3. Statistical analysis was carried out using the open-source R 3.6.1 environment. Analysis of the association between factors and a binary variable was performed using logistic regression. The significance level for all tested hypotheses was 0,05.Results. According to ESSE-RF3, the average levels of SBP and DBP in the population were 131,9±18,7 and 84,4±10,9 mm Hg, respectively, while the proportion of those with BP ≥140/90 mm Hg — 38,8% (men: 44,8%, women: 33,9%). Prevalence of hypertension was 53,9% (men: 56,0%, women: 52,1%), awareness — 77,7% (men: 71,5%, women: 82,3%), while the treatment received 63,4%, significantly higher among women than among men: 72,3 vs 53,3%. The effectiveness of treatment was 44,0%, higher among women compared to men (48,2 vs 37,4%). In addition, 27,9% of patients have controlled HTN.Conclusion. The problem of controlled HTN in Russia remains unresolved in the 21st century. The following significant sex differences remain: the prevalence of HTN is higher among men, but awareness of the disease, treatment rate and its effectiveness are lower compared to women.

Russia has one of the highest rates of cardiovascular disease in the world. The International Project on Cardiovascular Disease in Russia (IPCDR) was set up to understand the reasons for this. A substantial component of this study was the Know Your Heart Study devoted to characterising the nature and causes of cardiovascular disease in Russia by conducting large cross-sectional surveys in two Russian cities Novosibirsk and Arkhangelsk. The study population was 4542 men and women aged 35-69 years recruited from the general population. Fieldwork took place between 2015-18. There were two study components: 1) a baseline interview to collect information on socio-demographic characteristics and cardiovascular risk factors, usually conducted at home, and 2) a comprehensive health check at a primary care clinic which included detailed examination of the cardiovascular system. In this paper we describe in detail the rationale for, design and conduct of these studies.

Background: The study aims at identifying long-term trends and patterns of current smoking by age, gender, and education in Russia, including the most recent period from 2008 during which tobacco control policies were implemented, and to estimate the impact on mortality of any reductions in prevalence. We present an in-depth analysis based on an unprecedentedly large array of survey data. Methods: We examined pooled micro-data on smoking from 17 rounds of the Russian Longitudinal Monitoring Study of 1996–2016, 11 other surveys conducted in Russia in 1975–2017, and two comparator surveys from England and the USA. Standardization by age and education, regression and meta-analysis were used to estimate trends in the prevalence of current smoking by gender, age, and educational patterns. Results: From the mid-1970s to the mid-2000s smoking prevalence among men was relatively stable at around 60%, after which time prevalence declined in every age and educational group. Among women, trends in smoking were more heterogeneous. Prevalence more than doubled above the age of 55 years from very low levels (< 5%). At younger ages, there were steep increases until the mid-2000s after which prevalence has declined. Trends differed by educational level, with women in the lowest educational category accounting for most of the long-term increase. We estimate that the decline in male smoking may have contributed 6.2% of the observed reduction in cardiovascular deaths among men in the period 2008–16. Conclusions: The implementation of an effective tobacco control strategy in Russia starting in 2008 coincided with a decline in smoking prevalence among men from what had been stable, high levels over many decades regardless of age and education. Among women, the declines have been more uneven, with young women showing recent downturns, while the smoking prevalence in middle age has increased, particularly among those with minimal education. Among men, these positive changes will have made a small contribution to the reduction in mortality seen in Russia since 2005.

Aim. To study the prevalence of dyslipidemias and their association with various risk factors in the Russian population of men and women aged 35-74 years in 2020-2022.Material and methods. This work was carried out as part of the Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation-3 (ESSE-RF3) study. The sample included 28731 men and women aged 35-74 years living in 15 Russian regions. Hypercholesterolemia (HC) was diagnosed with total cholesterol (TC) ≥5,0 mmol/l, while elevated low-density lipoprotein cholesterol (LDL-C) was considered ≥3,0 mmol/l, hypertriglyceridemia — with triglyceride levels ≥1,7 mmol/l, reduced high-density lipoprotein cholesterol (HDL-C) <1,0 mmol/l in men and <1,2 mmol/l in women. Associations were assessed using logistic regression after adjustment for socio-demographic characteristics, drinking status, presence of hypertension (HTN) and stroke.Results. The prevalence of hypertriglyceridemia in the Russian Federation in 2020-2022 was 58,8%, hypertriglyceridemia — 32,2%. The incidence of lipid-lowering therapy increased with age from 1% in the group of 35-44 years to 16% in the group of 65-74 years. On average, only 7,6% of study participants received lipid-lowering therapy. Significant associations of HC with HTN, obesity and alcohol abuse were identified. Similar results were obtained for elevated LDL-C levels, with the exception of alcohol abuse. In turn, a reduced HDL-C level was significantly associated with the lack of higher education, marriage, physical activity, smoking and the presence of diseases.Conclusion. The prevalence of lipid disorders in the Russian Federation in 2020-2022 remained at a high level. These disorders occurred more often in women, and they were better informed about their cholesterol levels and more often received lipid-lowering therapy. HTN, obesity, and some behavioral and social risk factors were associated with dyslipidemia.

Aim. To study the problem of obesity at the national level.Material and methods. The ESSE-RF3 study examined a representative sample of the population of 15 Russian regions aged 35-74 years with a response >70% (n=28731). Modular design questionnaire was used. The study received approval from the Independent Ethics Committee of the National Medical Research Center for Therapy and Preventive Medicine. Signed informed consent was obtained from each participant. Body mass (BM) was measured once with an accuracy of 100 g. The height was measured with an accuracy of 0,5 cm once in a standing position without shoes. Waist circumference was measured with a standard measuring tape with an accuracy of 0,5 cm. There were following BM categories: insufficient (BM index (BMI) 40). Abdominal obesity (AO) was assessed using the following criteria: waist circumference ≥102 cm and ≥88 cm for men and women, respectively. The changes of obesity were studied with the inclusion of materials from the ESSE-RF (2012-14) and ESSE-RF2 (2017) studies, carried out using the same methodology with ESSE-RF3 in the same age range of 35-64 years. Statistical analysis was carried out using the open-source R 3.6.1 environment. Analysis of associations between factors and a binary variable was carried out using the logistic regression method. The significance level for all tested hypotheses was 0,05.Results. Mean BMI values is 28,2±4,6 kg/m² among men and 28,9±5,9 kg/m² among women. The prevalence of overweight is 44,0 and 33,7%, obesity — 30,0 and 39,5%, AO — 30,9 and 55,1% among men and women, respectively. In addition, 30,3% have a combination of obesity and AO; obesity and/or AO — 49,1%. Obesity statistics did not significantly change, but in each section the rates are higher among women. The closest associations were found between obesity and hypertension (men: odds ratio (OR) (95% confidence interval) 2,88 (2,66-3,12), women: OR 3,03 (2,81-3,27) (p<0,001) and hyperuricemia for women (OR 4,21 (3,74-4,75) (p<0,001).Conclusion. A third of the Russian population is obese, and half has obesity and/or AO. This severity of the problem requires the development and adoption of a strategy to monitor obesity at the national level.

Background. To describe suicide rates in the indigenous and non-indigenous populations of the Nenets Autonomous Okrug (NAO) in 2002–2012, as well as associated socio-demographic characteristics. Study design. Retrospective population-based mortality study. Methods. Data from autopsy reports were used to identify 252 cases of suicide in the NAO in 2002–2012. Data on socio-demographic characteristics of these cases were obtained from passports and medical records at local primary health care units, and were then linked to total population data from the Censuses in 2002 and 2010. Suicide rates for the indigenous Nenets population and the non-indigenous population were standardized to the European standard population. The rates were also estimated according to different socio-demographic characteristics and compared by calculating relative risks. Results. The crude suicide rates were 79.8 per 100,000 person-years (PYs) in the Nenets population and 49.2 per 100,000 PYs in the non-indigenous population. The corresponding standardized estimates were 72.7 per 100,000 PYs and 50.7 per 100,000 PYs. The highest suicide rates in the Nenets population were observed in the age group 20–29 years (391 per 100,000 PYs), and in females aged 30–39 years (191 per 100,000 PYs). Socio-demographic characteristics associated with high suicide rates in the Nenets population were age 20–39 years, male, urban residence, having secondary school or higher education, being an employee or employer, and being single or divorced. Males aged 20–29 years, and females aged 30–39 and aged 70 years and above had the highest suicide rates in the non-indigenous population (137.5, 21.6 and 29.9 per 100,000 PYs, respectively). The elevated suicide rates observed in the non-indigenous population were associated with male sex, rural residence, secondary school education, being an employee or employer, and being single or divorced. Conclusions. Suicide rates in the NAO were substantially higher among the indigenous Nenets population than the non-indigenous population, and were associated with different socio-demographic characteristics. Keywords: suicide rates; relative risks; person-years; indigenous Nenets (Published: 6 May 2014) Citation: Int J Circumpolar Health 2014, 73: 24308 - http://dx.doi.org/10.3402/ijch.v73.24308