Effect of regional living conditions on middle-term cardiovascular outcomes: data from prospective stage of the ESSE-RF study

Abstract

Aim. To assess regional living conditions with cardiovascular outcomes based on prospective stage of the Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation (ESSE-RF) study.Material and methods. We used data from a 3- and 5-year prospective stage of the ESSE-RF study (2012-2013). For initial screening, 16210 people aged 25-64 were included. To characterize the regions of residence, 5 regional indices (RIs) were used. The following endpoints were considered: cardiovascular death, myocardial infarction, stroke, composite endpoint (cardiovascular death + myocardial infarction + stroke). To assess the correlations, generalized estimating equations with nested data structure (individuals in the regions) were used. The studied associations were adjusted for a wide range of potential effect modifiers.Results. There are multiple direct associations of RIs with the likelihood of all endpoints. The exception was the reverse association of Industrial RI with cardiovascular death. The most stable associations regarded Mixed RI, Industrial RI and Socio-geographical RI, with a high RI significance in endpoint development, compared with well-known individual cardiovascular risk factors. Separate associations were noted for Economic RI and Demographic RI.Conclusion. The results indicate a significant contribution of a number of regional living conditions to individual risk of fatal and non-fatal cardiovascular outcomes.