Fluctuations in male ischaemic heart disease mortality in Russia 1959-1998: assessing the importance of alcohol.
OBJECTIVE
The decline in cardiovascular mortality in Russia following the Soviet anti-alcohol campaign of 1985-1988 and the subsequent increase when these extreme alcohol controls were repealed suggested that alcohol consumption is responsible for a substantial number of ischaemic heart disease (IHD) deaths in Russia. To examine whether a similar conclusion can be drawn on the basis of a time-series analysis covering a longer time period, namely 1959-1998.


METHODS
Using ARIMA time-series analysis, the male IHD mortality rates from 1959 to 1998 were analysed in relation to three indicators of alcohol consumption: estimated per capita consumption, mortality from liver cirrhosis and alcohol poisonings. Cigarette sales and lung cancer mortality were used as indicators of smoking.


RESULTS
Each indicator of alcohol consumption had positive and statistically significant relationships with male IHD mortality in bivariate autoregressive integrated moving average models. The association was stronger in models predicting changes in premature male IHD mortality (30-54 years). At least one alcohol indicator was significantly related to IHD mortality in multivariate models, and in the case of premature IHD mortality, both mortality indicators were significant.


CONCLUSIONS
The results provide additional empirical evidence supporting alcohol's conceivable negative effects on IHD in Russia and the idea that binge drinking could be the mechanism through which this effect is mediated. There were no signs of any protective effects from alcohol among Russian men.
Ramstedt
Mats
M
Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden. mats.ramstedt@sorad.su.se
D000328:Adult; D000367:Age Factors; D000428:Alcohol Drinking / Q000009:adverse effects / Q000639:trends*; D000437:Alcoholism / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D008103:Liver Cirrhosis / Q000209:etiology / Q000401:mortality; D008175:Lung Neoplasms / Q000209:etiology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000209:etiology / Q000401:mortality*; D012044:Regression Analysis; D012426:Russia / Q000453:epidemiology; D012907:Smoking / Q000453:epidemiology; D013997:Time Factors