Cardiovascular disease in Eastern EuropeWhy do Eastern Europeans suffer from low life expectancy and high rates of cardiovascular disease? |
The last 30 years have seen marked changes in the health of the former communist and now restructuring countries of central and Eastern Europe and the former Soviet Union. Deaths from infectious diseases have fallen, as have child deaths. But life expectancy has stubbornly refused to increase, in some countries has actually declined, and remains substantially lower than in the West. In 1994, for example, Eastern European life expectancy was six years lower than Western, and more than half of this gap was due to cardiovascular disease.
What lies behind this low life expectancy and high rates of cardiovascular disease? Epidemiologist Dr Martin Bobak (University College London) is investigating three leading candidates – alcohol, bad diet and stress. With funding from a Wellcome Trust programme grant, he and four colleagues are establishing a longitudinal study of 30 000 men and women aged 45–69 in Russia, Poland and the Czech Republic. Cardiovascular mortality in Russia is about twice of that in the other two countries. The study is assessing consumption of fruit and vegetables, how much alcohol is drunk and in what manner, and psychosocial factors such as depression, anxiety, social support and deprivation.
Dr Bobak’s pilot study has already made some intriguing findings. Czechs and Poles but particularly Russians eat far less fruit and vegetables in winter and spring than in autumn, and thus have for a large part of the year low intake of foods that are considered cardio-protective. Russians tend to ‘binge drink’ – they drink less frequently than people in the other countries, but consume larger amounts of alcohol when they do drink. Depression is more common in Russia than in the other two countries, and the rates of depression are strongly influenced by deprivation and stress at the workplace. The main cohort, which is currently being assembled, will provide extensive data about determinants of cardiovascular diseases and population health during societal transition.