Fracción de la mortalidad por accidente cerebrovascular atribuible al consumo de alcohol en Rusia Fraction of stroke mortality attributable to alcohol consumption in Russia

Autores/as

  • Y. E. Razvodovsky Grodno State Medical University, Belarus

DOI:

https://doi.org/10.20882/adicciones.14

Palabras clave:

accidente cerebrovascular, mortalidad, consumo de alcohol, series de análisis temporales ARIMA, Rusia, 1980-2005. stroke, mortality, alcohol consumption, ARIMA time series analysis, Russia, 1980-2005.

Resumen

El accidente cerebrovascular es un problema internacional de salud asociado a altos costes humanos y económicos. La tasa de mortalidad por accidente cerebrovascular en Rusia es una de las más altas del mundo. Por lo tanto, la identificación de los factores de riesgo constituye una prioridad desde el punto de vista de la salud pública. La evidencia epidemiológica sugiere que el consumo de atracón (binge drinking) supone en Rusia un importante factor determinante de dicha alta tasa de mortalidad por accidente cerebrovascular. El objetivo del presente estudio fue estimar la mortalidad prematura por accidente cerebrovascular atribuible al consumo de alcohol sobre una base de datos agregados de mortalidad por accidente cerebrovascular y de consumo de alcohol. Datos estandarizados, por grupo de edad y sexo, de mortalidad por accidente cerebrovascular para el periodo 1980-2005 y datos del consumo total de alcohol se analizaron mediante análisis de series temporales ARIMA. Los resultados del análisis indican que el 26,8% de todas las muertes por accidente cerebrovascular, entre los varones, y el 18,4%, entre las mujeres, serian atribuibles al alcohol. La fracción atribuible al alcohol para los hombres oscila entre un 16,2% (grupo de +75 años) y un 57,5% (grupo de 30-44 años); y para las mujeres entre el 21,7% (grupo de 60-74 años) y 43,5% (grupo de 30-44 años). Los resultados de este estudio apoyan la hipótesis de que el alcohol es un importante factor que contribuye a las altas tasas de mortalidad por accidente cerebrovascular en la Federación Rusa. Por tanto, la prevención del daño atribuible al alcohol debe tener una mayor prioridad de la salud pública en Rusia. Dada la distribución de las muertes por accidente cerebrovascular relacionado con el alcohol, las intervenciones deben centrarse en los hombres y mujeres de mediana edad.
Stroke is an international health problem with high associated human and economic costs. The mortality rate from stroke in Russia is one of the highest in the world. Risk factors identification is therefore a high priority from the public health perspective. Epidemiological evidence suggests that binge drinking is an important determinant of high stroke mortality rate in Russia. The aim of the present study was to estimate the premature stroke mortality attributable to alcohol abuse in Russia on the basis of aggregate-level data of stroke mortality and alcohol consumption. Age-standardized sex-specific male and female stroke mortality data for the period 1980-2005 and data on overall alcohol consumption were analyzed by means ARIMA time series analysis. The results of the analysis suggest that 26.8% of all male stroke deaths and 18.4% female stroke deaths in Russia could be attributed to alcohol. The estimated alcohol-attributable fraction for men ranged from 16.2% (75+ age group) to 57,5% (30-44 age group) and for women from 21.7% (60-74 age group) and 43.5% (30-44 age group). The outcomes of this study provide support for the hypothesis that alcohol is an important contributor to the high stroke mortality rate in Russian Federation. Therefore prevention of alcohol-attributable harm should be a major public health priority in Russia. Given the distribution of alcohol-related stroke deaths, interventions should be focused on the young and middle-aged men and women.

Citas

Andreev, E. M., Nolte, E., Shkolnikov, V. M., Varavicova, E., & McKee. M. (2003). The evolving pattern of avoidable mortality in Russia. International Journal of Epidemiology, 32, 437-446. doi: 10.1093/ije/dyg085

Bobak, M., Gilmore, A., Mckee, M., & Marmot, M. (2006). Changes in smoking prevalence in Russia, 1996-2004. Tobacco Control, 15, 131-135.

Box, G. E. P., & Jenkins, G. M. (1976). Time Series Analysis: forecasting and control. London: Holden-Day Inc.

Cockerham, W. C., Hinote, B. P., & Abbott, P. (2006). Psychological distress, gender, and health lifestyles in Belarus, Kazakhstan, Russia, and Ukraine. Social Science & Medicine, 63, 2381-2394.

Djousse, L., Ellison, R. C., Beiser, A., Scaramucci, A., D’Agostino, R. B., & Wolf P. A. (2002). Alcohol consumption and risk of ischemic stroke. The Framingham study. Stroke, 33, 907-912.

Donna, G. A., Fisher, M., Macleod M., & Davis S. M. (2007). Stroke. Lancet, 370, 1-12. doi: 10.1016/S0140-6736(08)60694-7.

Feigin, V. L., Wiebers, D. O., Nikitin, Y. P., O’Fallon, W. M., & Whisnant J. P. (1998). Risk factors for ischemic stroke in a Russian community. A population-based case-control study. Stroke, 29, 33-39.

Field, M. G. (2005). A comment on the Russian health crisis. Eurasian Geography and Economics, 46, 5. doi:10.2747/1538-7216.46.7.552

Ginter, E. (1995). Cardiovascular risk factors in the former communist countries. Analysis of 40 European MONICA populations. European Journal of Epidemiology, 11, 199-205.

Gorelic P. B. (1987). Alcohol and stroke. Stroke, 18, 268-270.

Hillbom, M., Numminen, H., & Juvela S. (1999). Recent heavy drinking of alcohol and embolic stroke. Stroke, 30, 2307-2312.

Kesteloot, H., Sans, S., & Kromhout, D. (2006). Dynamics of cardiovascular and all-cause mortality in Western and Eastern Europe between 1970 and 2000. European Heart Journal, 27, 107-113. doi: 10.1093/eurheartj/ehi511

Kim, A. S., & Johnston S. C. (2011). Global variation in the relative burden of stroke and ischemic heart disease. Circulation, 124, 314-323. doi: 10.1161/CIRCULATIONAHA.111.018820

Leon, D. A., & Shkolnikov, V. M. (2005). Social stress and the Russian mortality crisis. Journal of American Medical Association, 279, 790-91. doi:10.1001/jama.279.10.790.

Leon, D., Saburova, L., Tomkins, S., Andreev E., Kiryanov N., McKee M. & Shkolnikov V. (2007). Hazardous alcohol drinking and premature mortality in Russia: a population based case-control study. Lancet, 369, 2001-2009.

McKee, M., & Britton, A. (1998). The positive relationship between alcohol and heart disease in Eastern Europe: potential physiological mechanisms. Journal of the Royal Society of Medicine, 91, 402-407.

Mostofsky, E., Burger, M. R., Schlaug, G., Mukamal, K. J., Rosamond, W. D., & Mittleman M. A. (2010). Alcohol and acute ischemic stroke onset. The stroke onset study. Stroke, 42, 1-4. doi: 10.1161/STROKEAHA.110.580092.

Muller-Nordhorn, J., Binting, S., Roll, S., & Willich, N. (2008). An update on regional variation in cardiovascular mortality within Europe. European Heart Journal, 29,1316-1326. doi: 10.1093/eurheartj/ehm604

Nemtsov, A. V. (2002). Alcohol-related human losses in Russia in the 1980s and 1990s. Addiction, 97, 1413-1425.

Nemtsov, A.V., & Razvodovsky, Y. E. (2008). Alcohol situation in Russia, 1980-2005. Social and Clinical Psychiatry, 2, 52-60.

Norström, T. (1989). The use of aggregate data in alcohol epidemiology. British Journal of Addiction, 84, 969-977.

Norström, T., & Skog, O. J. (2001). Alcohol and mortality: methodological and analytical issue in aggregate analysis. Addiction, 96, 5-17.

Pajak, A., & Kozela, M. (2012). Cardiovascular disease in Central and Eastern Europe. Public Health Review, 33, 416-435.

Patra, J., Taylor, B., Irving, H., Roerecke, M., Baliunas, D., Mohapatra, S., & Rehm J. (2010). Alcohol consumption and the risk of morbidity and mortality for different stroke types-a systematic review and meta-analysis. BMC Public Health, 10, 258. doi:10.1186/1471-2458-10-258

Perlman, F. J. A. (2010). Drinking in transition: trends in alcohol consumption in Russia 1994–2004. BMC Public Health, 10, 2-13. doi:10.1186/1471-2458-10-691

Petruchin, I. S., & Lunina E. Y. (2012). Cardiovascular disease risk factors and mortality in Russia: challenges and barriers. Public Health Review, 33, 436-449.

Ramstedt, M. (2009). Fluctuations in male ischemic heart disease mortality in Russia 1959–1998: Assessing the importance of alcohol. Drug and Alcohol Review, 28, 390-395. doi: 10.1111/j.1465-3362.2009.00059.x

Razvodovsky, Y. E. (2005). Aggregate level time series association between alcohol consumption and cardiovascular mortality, Adicciones, 17, 43-60.

Razvodovsky, Y. E. (2006). Aggregate level association between alcohol and diabetes mellitus mortality rate. Adicciones, 18, 275-282.

Razvodovsky, Y. E. (2009). Aggregate level beverage specific effect of alcohol sale on myocardial infarction mortality. Adicciones, 21, 229-238.

Razvodovsky, Y. E. (2010a). Unrecorded alcohol consumption: quantitative methods of estimation. Alcoholism, 46, 15-24.

Razvodovsky, Y. E. (2010b). Beverage specific alcohol sales and violent mortality in Russia. Adicciones, 22, 311-316.

Razvodovsky, Y. E. (2012a). Estimation of alcohol attributable fraction of mortality in Russia. Adicciones, 24, 1-7.

Razvodovsky, Y. E. (2012b). Alcohol consumption and ischemic mortality in Russia. Adicciones, 24, 23-30.

Razvodovsky, Y. E. (2014). The effects of beverage type on hypertension mortality in Russia. International Journal of Cardiovascular and Cerebrovascular Disease, 2, 6-10. doi: 10.13189/ijccd.2014.020102

Reynolds, K., Lewis, L. B., Nolen, J. D. L., Kinney, G. L., Sathya, B., & He J. (2003). Alcohol consumption and risk of stroke. A Meta-analysis. Journal of the American Medical Association, 289, 579-588. doi:10.1001/jama.289.5.579.

Roberts B., Stickley A., Balabanova P., Haerpfer C., & McKee M. (2012). The persistence of irregular treatment of hypertension in the former Soviet Union. Journal of Epidemiology Community Health, 66, 1079-1082. doi:10.1136/jech-2011-200645

Romelsjo, A., & Leifman A. (1999). Associated between alcohol consumption and mortality, myocardial infarction, and stroke in 25 year follow up of 49618 young Swedish men. British Medical Journal, 319, 821-822.

Sacco, R., Elkind, M., Boden-Albala, B., Lin, I. F., Kargman, D. E., Hauser, W. A.,… Paik M. C. (1999). The protective effects of moderate alcohol consumption on ischemic stroke. Journal of the American Medical Association, 281 (1), 53-60.

Shkolnikov, V. M., McKee, M., Chervyakov, V. V., & Kyrianov, N. A. (2002). Is the link between alcohol and cardiovascular death among young Russian men attributable to misclassification of acute alcohol intoxication? Evidence from the city of Izhevsk. Journal of Epidemiology & Community Health, 56, 171-175.

Stickley, A., Leinsalu, M., Andreew, E., Razvodovsky, Y. E., Vagero, D. & McKee, M. (2007). Alcohol poisoning in Russia and the countries in the European part of the former Soviet Union, 1970-2002. European Journal of Public Health, 1, 444–449.

Sundell, L., Salomaa, V., Vartiainen, E., Poikolainen, K., & Laatikainen T. (2008). Increased stroke risk is related to a binge drinking habit. Stroke, 39, 3179-3184. doi: 10.1161/STROKEAHA.108.520817

Telishevska, M., Chenet, L., & McKee, M. (2001). Toward an understanding of the high death rate among young people with diabetes in Ukraine. Diabetic Medicine, 18, 3-9.

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Publicado

2014-06-01

Número

Vol. 26 Núm. 2 (2014)

Sección

Originales