Cardiovascular diseases as a reservoir for latent deaths from drug addiction (exemplified by Moscow)

Abstract

Abstract The life expectancy gap between Russia and post-industrial countries is mainly due to mortality from diseases of the circulatory system (DCS), primarily in working ages, substantiating the need for a program to reduce cardiovascular mortality, currently implemented in Russia. In general, this program has resulted in a multiple reduction in cardiovascular mortality in Russia, however, in 2015-2017, Moscow turned out to be the absolute outsider among the Russian regions in DCS mortality among males of young and middle working ages and a contrastive outsider among females: in ages 15-29 mortality increased 4.4-fold among males and 3-fold among females; in ages 30-44 - 2.1-fold and 2.0-fold, respectively. The purpose of the study is to identify causes of the abnormal increase in mortality in Moscow in 2015-2017. The study shows that, first, the abnormal dynamics were due to cardiomyopathy, unspecified (CU) (I42. 9): the CU mortality in ages 15-44 increased 20-fold in males and 10-fold in females; in ages 45-59 - 7-fold and 8-fold, respectively, resulting in the highest ever CU mortality in Russia. Second, the CU deaths were usually sudden, not predated by a long-term treatment: admissions one month prior to death were registered in about 1% of cases in both sexes. Third, similar processes with the same reference point (2015) have been reported for drug poisoning, the rates of increase are comparable: about 10-fold in ages 15-29, 13 and 29-fold in ages 30-44 and 7.5 and 4-fold in ages 45-59, respectively. Fourth, numerous studies have shown that drug addiction (DA) leads to cardiovascular disorders, especially cardiomyopathies. Official data show that total DA mortality in Russia in the 2010s ranged from 3,752 to 5,581, which hardly corresponds to the actual scale of the problem because of underestimation of DA deaths due to their transferring to a latent form. In Moscow, DCS and cardiomyopathy, unspecified, in particular are one of the reservoirs for DA latent deaths. Key messages Drug addiction (DA) leads to cardiovascular disorders, especially cardiomyopathies. As to the capital, DCS, CU in particular, are one of the latent reservoirs of DA mortality.