Correlates of mortality in Russian and US women. The Lipid Research Clinics Program

Abstract

Associations between selected risk factors and 7-year all-cause mortality were studied in 2,187 Russian women and 2,146 US women who were screened as part of a US-Russian collaborative program. The US women were screened during the period 1972-1976, while the Russian women were screened from 1978 to 1982. Cigarette smoking and elevated systolic blood pressure were associated with increased mortality in both samples. High density lipoprotein (HDL) cholesterol was inversely related to mortality in US women, but there was no association of HDL cholesterol with mortality in Russian women. Prevalent angina and electrocardiographic abnormalities were associated with mortality in both samples, but the relations achieved statistical significance only in the Russian sample. The problems of cigarette smoking and elevated blood pressure should be addressed with public health measures in both countries. The absence of an association between HDL cholesterol and mortality in the Russian sample should be investigated further.

PIP: Associations between selected risk factors and 7-year all-cause mortality were studied in 2187 Russian women and 2146 US women who were screened as part of the US-Russian collaborative program conducted at 9 sites during the period 1972-1976. Cholesterol and triglycerides were measured in males and females aged birth to 99 years. US women between 40 and 69 years of age were examined during the period 1972-1976. In Russia, women aged 20-69 years were screened on a single occasion during the years 1978-1982. Russian women aged 40-69 years were included in this report. The proportional hazards model was used to assess the associations between mortality and the risk factors. 4% of the Russian women and 22% of the US women reported taking hormones. In the US sample, the only statistically significant interaction was that between hormone use and high density lipoprotein (HDL) cholesterol. Cigarette smoking and elevated systolic blood pressure were associated with increased mortality in both samples. Although the associations of prevalent angina and electrocardiographic abnormalities were similar in magnitude, they were significant only in the Russian sample, while cigarette smoking was significant only in the US sample. The major difference in the 2 samples related to HDL cholesterol, where there was a strong negative association in the US women and no association in the Russian women. Although it was relatively weak, there was also a statistically significant association between triglycerides and mortality in the US sample. HDL cholesterol was inversely related to mortality in US women, but there was no association of HDL cholesterol with mortality in Russian women. The noticeable differences between the samples were the higher systolic blood pressure, body mass index, and prevalence of angina and electrocardiographic abnormalities in the Russian women, and the much higher prevalence of current cigarette smoking in the US women. The respective public health services should address smoking and elevated blood pressure.