Abstract
BACKGROUND: In explaining recent trends in Russian mortality, alcohol drinking has often been put forward as a major factor. However, cardiovascular disease remains the major cause of death in Russia and alcohol is currently viewed as having a protective effect on heart disease. This study explores this apparent paradox by examining daily trends in deaths from cardiovascular disease in Moscow. SUBJECTS: Those dying in Moscow in the years 1993-1995. METHODS: Analysis of daily variation in deaths based on data from Moscow City death certificates. RESULTS: There is a significant increase in deaths from alcohol poisoning, accidents, and violence and cardiovascular diseases on Saturdays, Sundays, and Mondays. This is especially marked for sudden deaths. This pattern is consistent with the known pattern of drinking in Russia, which is more likely to take place in binges than is the case in other countries. CONCLUSION: A possible causative role for alcohol in sudden cardiovascular death is suggested as there are no other obvious explanations for this pattern, which cannot be accounted for by daily variations in traditional risk factors such as smoking or lipids. Although this is inconsistent with the prevailing view in the West that alcohol is seen as cardioprotective, there is considerable supporting evidence from a necropsy study and from studies in other places with a similar pattern of drinking. In countries such as Russia, where patterns of drinking differ considerably from that in the West, binge drinking can be an important cause of sudden cardiac death. This has important implications for estimates of the amount of mortality worldwide attributable to specific risk factors and thus for national and international policy.
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Selected References
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- Gordon T., Kannel W. B. Drinking habits and cardiovascular disease: the Framingham Study. Am Heart J. 1983 Apr;105(4):667–673. doi: 10.1016/0002-8703(83)90492-1. [DOI] [PubMed] [Google Scholar]
- Kauhanen J., Kaplan G. A., Goldberg D. D., Cohen R. D., Lakka T. A., Salonen J. T. Frequent hangovers and cardiovascular mortality in middle-aged men. Epidemiology. 1997 May;8(3):310–314. doi: 10.1097/00001648-199705000-00014. [DOI] [PubMed] [Google Scholar]
- Kauhanen J., Kaplan G. A., Goldberg D. E., Salonen J. T. Beer binging and mortality: results from the Kuopio ischaemic heart disease risk factor study, a prospective population based study. BMJ. 1997 Oct 4;315(7112):846–851. doi: 10.1136/bmj.315.7112.846. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Leon D. A., Chenet L., Shkolnikov V. M., Zakharov S., Shapiro J., Rakhmanova G., Vassin S., McKee M. Huge variation in Russian mortality rates 1984-94: artefact, alcohol, or what? Lancet. 1997 Aug 9;350(9075):383–388. doi: 10.1016/S0140-6736(97)03360-6. [DOI] [PubMed] [Google Scholar]
- Myers A., Dewar H. A. Circumstances attending 100 sudden deaths from coronary artery disease with coroner's necropsies. Br Heart J. 1975 Nov;37(11):1133–1143. doi: 10.1136/hrt.37.11.1133. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ryan M. Alcoholism and rising mortality in the Russian Federation. BMJ. 1995 Mar 11;310(6980):646–648. doi: 10.1136/bmj.310.6980.648. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Suhonen O., Aromaa A., Reunanen A., Knekt P. Alcohol consumption and sudden coronary death in middle-aged Finnish men. Acta Med Scand. 1987;221(4):335–341. doi: 10.1111/j.0954-6820.1987.tb03353.x. [DOI] [PubMed] [Google Scholar]
- Wannamethee G., Shaper A. G. Alcohol and sudden cardiac death. Br Heart J. 1992 Nov;68(5):443–448. doi: 10.1136/hrt.68.11.443. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wannamethee S. G., Shaper A. G. Patterns of alcohol intake and risk of stroke in middle-aged British men. Stroke. 1996 Jun;27(6):1033–1039. doi: 10.1161/01.str.27.6.1033. [DOI] [PubMed] [Google Scholar]