Aim To study the effect of arterial hypertension (AH) in combination with frequent alcohol consumption on the formation of risk for cardiovascular death and all-cause death according to results of a 27-year prospective cohort study. Material and methods This 27‑year prospective cohort study of an unorganized population of the Tomsk city (1546 people aged 20–59 years, including 630 men and 916 women) investigated AH prevalence and alcohol consumption (1988–1991) and analyzed the predictive significance of the effect of AH in combination with frequent alcohol consumption on the formation of risk for all-cause and cardiovascular death. AH was diagnosed at blood pressure ≥140 / 90 mm Hg. Frequent alcohol users were defined as those who consumed alcohol more than once a week. Results The combination of AH and frequent alcohol consumption increased the risk of all-cause death 4.1 times compared to that for persons without these risk factors (p<0.001). This was true for all age groups of the total cohort (higher relative risk, RR, was observed for persons aged 20–39 years) and for men (except for the group aged 40–59 years). RR of cardiovascular death was 5.3 (p<0.001) for frequent alcohol users with AH. It was established that frequent alcohol consumption additionally increased RR of all-cause death for persons with AH (RR 1.89; p<0.05) primarily at the expense of persons aged 20-39 years. Prediction of 27‑year survival for frequent alcohol users with AH was 35.3 %. Conclusion A combination of AH with frequent alcohol consumption considerably increases the risk of all-cause and cardiovascular death. Frequent alcohol consumption significantly impairs the prediction of 27-year survival for persons with AH by additionally (1.9 times) increasing the risk of all-cause death. Binary AH combinations with frequent alcohol consumption exert a more pronounced adverse effect on young men and women.
The purpose of the seventeenyear prospective cohort study was to explore the dynamics of smoking among men and women depending on the changes in the attitudes of a spouse to smoking. Doortodoor survey was performed randomly based on the list of apartments of Leninsky district residents in Tomsk (1546 residents including 427 married couples). The first stage of the study (from 1988 to 1991) aimed at elucidation of frequency of smoking among spouses. The observation period was 17 years. During the second stage of examination (from 2002 to 2005), 278 couples (456 individuals) from the previously observed family cohort were examined. An individual was considered to be a smoker if he/she had been smoking at least one cigarette daily for at least one year by the time of the study and if his/her experience of smoking cessation had been less than one year. The highest risk of smoking (RR=2.48; 95% CI 2.08-2.96) was found among men living with their wives who began to smoke during the study period; men whose wives were smoking during the first and the second examination had RR of 1.73 (95% CI 1.11-2.70) in comparison with men whose wives did not smoke. Women whose husbands were smoking during all stages of the survey had higher risk of smoking than women whose husbands never smoked (RR=5.12; 95% CI 1.22-21.39) or quitted smoking (RR=4.59; 95% CI 1.39-15.14). The frequency of smoking among individuals living with their spouses who stopped smoking and did not relapsed (13.1%) was significantly lower than among the spouses who relapsed after quitting smoking (31.6%; 2=4.02; p=0.045) and those whose spouses started smoking during the observation period (66.7%; 2=11.95; p=0.006).
The aim: to explore natural dynamics of overweight (development of new cases, regression), mortality from cardiovascular diseases and all causes among people with overweight in seventeenyear prospective cohort study. Primary screening study on the basis of random doortodoor samples was conducted in the years 1988-1991, repeated in 2002-2005. There are 1546 people (630 men and 916 women) in a cohort at the age from 20 to 59 years. The observation was being carried out during 1 to 17 years, on the average during 15.47 years. Overweight was registered when body mass index was 25 kg/m2 or higher. In seventeenyear supervision high frequency of new cases of overweight 12.36 cases on 1000 personyears of observation (PYO) is revealed. Among women the indicator of incidence of overweight was higher (13.71 on 1000 PYO), than among men (10,88 on 1000 PYO). In a man"s part of a cohort the highest level of incident of overweight is revealed in younger age group 20-29 years (15.71 cases on 1000 PYO). Among women the highest point of this indicator is revealed in more advanced age of 30-39 years (18.55 cases on 1000 PYO) and 40-49 years (21.1 on 1000 PYO). Less often overweight developed among people of the senior age group 50-59 years (5.18 on 1000 PYO). According to the results of study high stability of course of overweight was found out, and also it was found out that regression level (4.7 on 1000 PYO) does not depend neither on sex, nor on age. It is revealed that mortality from cardiovascular diseases (3.16 on 1000 PYO) and all causes (6.52 on 1000 PYO) is higher among women with overweight, than among women with initially normal weight of body (0.61 and 2.82 on 1000 PYO accordingly). For men overweight was not a significant risk factor concerning mortality from cardiovascular diseases and all causes.
