Background: Environmental problems can significantly influence population health. Cardiovascular diseases (CVDs) are the most common cause of death in developed countries including in Kazakhstan. The aim of our study was to assess the relationship between exposure to ionizing radiation and mortality risks from major CVDs for the population of Kazakhstan living in areas adjacent to the Semipalatinsk nuclear test site (SNTS). Materials and Methods: The study of the structure and dynamics of cardiovascular mortality was based on the State Scientific Automated Medical Registry (SSAMR) database. Among members of the exposed group, the median equivalent radiation dose was 864.0 mSv, compared to 64.4 mSv in the control group. It should be noted that almost the entire population of the Semipalatinsk region was exposed to some degree of radiation; however, the Kokpekti district received the lowest radiation doses. Results: Mortality rates from CVD were statistically significantly higher in the radiation-exposed population from 1960 to 1994, with RR fluctuating from 1.118 to 8.7. The predominant mortality events were chronic coronary heart disease, chronic cerebrovascular disease, and hemorrhagic stroke throughout the study period, and acute myocardial infarction within 20 years of the start of nuclear testing. In the exposed group, RR = 10.35 for chronic cerebrovascular disease, RR = 3.56 for hemorrhagic stroke, and RR = 5.77 for peripheral arterial atherosclerosis. A dose of 100–500 mSv increased the risk of mortality from CVD by 3.14 times, and a dose of >600 mSv increased it by 7.05 times. Conclusions: A link has been established between long-term exposure to ionizing radiation and increased risks of mortality from CVD in the population of areas contaminated with radiation as a result of nuclear testing.

Background: The purpose of the study is the assessment of mortality from cardiovascular diseases (CVDs) and their dose–response relationships and the calculation of the number of years of life lost (YLL) in Kazakhstani residents living in territories around the Semipalatinsk nuclear test site. Materials and Methods: The study is based on the State Scientific Automated Medical Registry (SSAMR) database. The study included 3482 residents of the Abay and Beskaragai districts exposed to radiation and 1886 residents of the Kokpekty district (control group). The median equivalent radiation dose for the exposed group was 864.0 mSv, compared to 64.4 mSv in the control group. The study period was from 1949 to 2024. Results: Mortality rates in the exposed group exceeded those of the comparison group throughout the study. The relative risk (RR) of mortality was 1.41 for all CVDs, 2.0 for stroke, 7.88 for chronic cerebrovascular disease (CCVD), and 2.39 for congenital heart disease (CHD). Age-standardized mortality rates were higher in the radiation-exposed population, with the highest excess risk recorded in 1960–1964 (RR = 5.31; 95% CI 4.32–6.53). The number of YLL from acute myocardial infarction (AMI) was 6097.0 in the exposed group versus 5893.0 in the comparison group, 3857.5 from hemorrhagic stroke versus 1996.9, and 2696.6 from CHD versus 957.7. An increase in radiation dose by 1 cSv was associated with an 8.5% increase in the odds of death from CVDs (OR = 1.085; 95% CI 1.075–1.094; p < 0.001). Radiation dose demonstrated good predictive ability for mortality from cardiovascular diseases (AUC = 0.700). Conclusions: The results indicate an increased risk of CVD mortality among residents of radiation-contaminated areas of Kazakhstan throughout the study period.

Background: The Semipalatinsk Nuclear Test Site (SNTS) represents a unique example of long-term population exposure to ionizing radiation. This study aimed to assess the health status of individuals from three generations permanently residing in territories affected by radioactive contamination resulting from nuclear weapons testing at the SNTS, based on the findings of a population screening examination. Materials and Methods: A cross-sectional screening study was conducted among 2802 adults aged 18 years and older. The exposed group consisted of residents of the Abay and Beskaragai districts of the Abay Region and their descendants (n = 1358). The control group included residents of Arshaly village in the Akmola Region with no history of radiation exposure (n = 1444). All participants underwent a structured questionnaire survey, clinical examination, biochemical and hematological testing, and assessment of thyroid function. Individual radiation doses were obtained from the State Scientific Automated Medical Registry of Persons Exposed to Radiation (SSAMR). Results: Arterial hypertension (p < 0.001), chronic ischemic heart disease (p < 0.001), thyroid disorders (p < 0.001), malignant neoplasms (p = 0.003), renal diseases, and respiratory diseases were significantly more prevalent in the exposed population than in the control group. Exposed individuals also demonstrated significantly higher levels of total cholesterol, triglycerides, and the triglyceride-glucose (TyG) index, indicating increased insulin resistance. After adjustments, the only outcome that retained a statistically significant association with radiation dose was thyroid disorders (adjusted OR per 10 mSv increase = 1.017; 95% CI: 1.009–1.025; p < 0.001). ROC analysis demonstrated a moderate discriminative ability of radiation dose with respect to arterial hypertension (AUC = 0.715), chronic ischemic heart disease (AUC = 0.735), and ischemic stroke (AUC = 0.711). Conclusions: The findings suggest long-term adverse health effects associated with radiation exposure among populations residing near the SNTS. Continued epidemiological surveillance and medical monitoring of exposed individuals and their descendants are warranted.