title: Self-reported symptoms of chronic cough and breathlessness in working-age men in the city of Izhevsk, Russia: associations with cardiovascular disease risk factors and comorbidities.
abstract: BACKGROUND
  Very little is known about the prevalence of respiratory symptoms or their associations with other health conditions in Russia.
  
  
  METHODS
  Between 2008 and 2010, a sample of 983 men resident in Izhevsk, Russia, took part in a cross-sectional survey. Presence of respiratory symptoms was determined from self-report of chronic productive cough and breathlessness assessed using the British Medical Research Council (MRC) breathlessness scale. Self-reported physical and mental health were measured using the 12-Item Short-Form Health Survey (SF-12). Hypertension was assessed from mean blood pressure measured at the health check and/or self-reported use of antihypertensive medication. Other comorbidities were assessed from self-report. Logistic regression models were fitted assessing the association between respiratory symptoms and comorbidities. Linear regression models were fitted to investigate the association between respiratory symptoms and self-reported health scores. All models were adjusted for age, education and smoking status.
  
  
  RESULTS
  The age-standardised prevalence of cough and breathlessness was 20.9% (prevalence with breathlessness MRC grade 3 or above 3.7%). The majority of men with respiratory symptoms (87.3%) were current smokers. Cough and breathlessness were associated with substantially worse self-reported physical and mental health (test for trend with severity of breathlessness p<0.001). Those with chronic cough and grade 3 or above breathlessness had higher odds of having hypertension (OR 3.03; 95% CI 1.36 to 6.74), diabetes (OR 10.55; 95% CI 2.69 to 41.37), angina pectoris (OR 7.54; 95% CI 3.61 to 15.73), previous myocardial infarction (OR 7.61; 95% CI 2.10 to 27.4) and previous stroke (OR 6.61; 95% CI 1.75 to 23.34) compared with those without respiratory symptoms.
  
  
  CONCLUSIONS
  The prevalence of respiratory symptoms was high. Strong associations were found between respiratory symptoms and cardiovascular comorbidities. These are of particular importance given the extremely high level of cardiovascular disease mortality in Russia.
authors.affiliation: Department of Non Communicable Disease Epidemiology , London School of Hygiene & Tropical Medicine , London , UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Cook
authors.affiliation: Department of Non Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Department of Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London, London, UK.
authors.forename: Jennifer K
authors.initials: JK
authors.lastname: Quint
authors.affiliation: Izhevsk State Medical Academy , Izhevsk , Russia.
authors.forename: Maxim
authors.initials: M
authors.lastname: Vasiljev
authors.affiliation: Department of Non Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Arctic University of Norway, UiT, Tromsø, Norway.
authors.forename: David A
authors.initials: DA
authors.lastname: Leon
keywords: COPD epidemiology; Clinical Epidemiology