Factors governing individual response to ionizing radiation and risk of diseases of the circulatory system: human epidemiological studies

Treatment-Related Circulatory Diseases and Mortality in Hodgkin Lymphoma Patients Using Multi-State Modelling and Relative Survival

Significance: This article is about assessing changes in selected indicators of public health against the background of the pandemic of a new coronavirus infection COVID-19 in adult population of the Siberian Federal District - a territory of the Russian Federation with a special climatic, geographical and ecological "portrait", characterized by a high prevalence of risk factors for chronic non-communicable diseases. The study of this issue creates prerequisites for a detailed analysis of the leading causes of death and peculiar features of their statistical coding in the Siberian Federal District for a given time interval, which helps to identify true mortality from diseases of the circulatory system (in particular, coronary artery disease and myocardial infarction. The purpose of the study was to assess dynamics in the indicators of total mortality and mortality from diseases of the circulatory system in adult population of the Siberian Federal District during the pandemic caused by a new coronavirus infection COVID-19. Material and methods. The study used data of the Federal State Statistics Service «Virtual statistical data mart» official website. The study analyzed non-standardized total mortality rates in adult population of the Siberian Federal District (per 100,000 population), and mortality from diseases of the circulatory system, coronary artery disease and myocardial infarction for the period from 2016 to 2021 and compared these indicators with the all-Russia data. The COVID-19 impact was assessed starting from January 2020, while the period preceding this date was conventionally designated as pre-COVID period. Ranks and econometric analysis of time series were used. Results. In the pre-COVID period, the total mortality rate in adult population was decreasing over time in the Russian Federation and most regions of the Siberian Federal District, with the exception of the Altai Republic. With the onset of the new coronavirus infection, total mortality increased in most regions of the Siberian Federal District, except for the Republic of Tyva. In the Siberian Federal District in the pre-COVID period, mortality from diseases of the circulatory system increased due to a rise in mortality from diseases of the circulatory system in the Altai Republic and Krasnoyarsk region, Irkutsk, Tomsk and Kemerovo regions; mortality from coronary artery disease increased due to a rise in mortality from diseases of the circulatory system in the Krasnoyarsk region, Altai Republic, Kemerovo, Novosibirsk and Tomsk regions; while increased mortality from myocardial infarction is associated with the increased mortality from diseases of the circulatory system in the Republic of Khakassia, Kemerovo, Novosibirsk and Irkutsk regions. With the beginning of the COVID-19 pandemic in 2020, there was an increase in mortality from diseases of the circulatory system and coronary artery disease in the Russian Federation and regions of the Siberian Federal District, including a rise in mortality from myocardial infarction, with the exception of the Altai Republic, and the Irkutsk region. In the Siberian Federal District in 2021, there was no increase in mortality from diseases of the circulatory system and coronary artery disease in the republics of Tyva and Khakassia, the Novosibirsk region and Krasnoyarsk Territory (only from coronary artery disease); mortality from myocardial infarction - in all regions of the Siberian Federal District, except the Tomsk region. Conclusion. The tendency towards lower total mortality in adult population in the pre-COVID period in the Russian Federation and the Siberian Federal District has changes towards increasing starting from official registration of COVID-19 cases. A similar trend is typical of diseases of the circulatory system (including coronary artery disease and myocardial infarction) in the Russian Federation and some regions of the Siberian Federal District. The COVID-19 pandemic is obviously associated with changes in public health indicators in the Russian Federation

Significance. Diseases of the circulatory system are the leading causes of high morbidity and mortality in many countries of the world, including the Russian Federation, and largely determine the state of public health and public health. The purpose of this work was to study the structure and annual dynamics of mortality rates from diseases of the circulatory system in the Magadan region for the period from 2016 to 2019 in comparison with the climatic characteristics of the region. Material and methods. Daily mortality rates from diseases of the circulatory system for 2016-2019 were analyzed, the average values of which were compared with the climatic characteristics of the Magadan region. Results. During the analyzed period of time in the Magadan region (2016-2019), 2,142 deaths from diseases of the circulatory system were recorded (2016 – 538,2017 – 520,2018 – 534, 2019 – 550) of which 4% were from diseases characterized by high blood pressure, 57% from coronary heart disease (including from myocardial infarction – 22% of the total mortality of diseases of the circulatory system) and from cerebrovascular diseases, the contribution of deaths was (39%). It is shown that the share of mortality from diseases of the circulatory system in the total mortality in the Magadan region was 33%, which is significantly lower than the same value typical for the Russian Federation – 55-56%. The incidence of diseases of the circulatory system deaths from coronary heart disease and cerebrovascular diseases in the Magadan region was 96%, which is significantly higher than the similar average in the Russian Federation. – 74%. An analysis of the seasonal dynamics of the mortality rate from diseases of the circulatory system allowed us to conclude that the highest average value of diseases of the circulatory system was noted in March. Conclusion. In summary, the obtained data indicate that both the annual dynamics of overall mortality and the analysis of mortality from cardiovascular diseases exhibit a peak during the spring season, with the maximum incidence occurring in March. This pattern is likely attributable to the initial transition of the temperature curve crossing the zero mark, combined with the delayed effects of exposure to the coldest period (February) Keywords: mortality from diseases of the circulatory system, climatic characteristics, residents of the Magadan region

Significance. Diseases of the circulatory system remain one of the leading causes of death and morbidity of the adult population. Over the years, the efforts of the State aimed at controlling diseases of the circulatory system have made the contribution of this disease class to the total mortality in Russia gradually reduce. Nevertheless, diseases of the circulatory system remain the leading ones among diseases, characterized by a steady growth and rapidly increasing prevalence among the population. The purpose of the study is to analyze dynamics in incidence and prevalence of the diseases of the circulatory system among the Russian adult population in 2007-2019. Material and methods. The study used data of the statistical collections of the Ministry of Health of the Russian Federation and the Federal Research Institute for Health Organization and Informatics of the Ministry of Health of Russia: "Morbidity of the adult population of the Russian Federation" for 2007-2019. The study, which is a continuous statistical observation, used the method of direct ranking, calculation of indicators of time series. Results. Diseases of the circulatory system in 2019 ranked fourth in the incidence structure of the adult population (8%), while its prevalence ranked second to none (21%). Over 13 years, the incidence of diseases of the circulatory system in adults increased by 42% (2007-2019) while its prevalence increased by 24%. The highest levels of incidence of diseases of the circulatory system in 2019 are registered in the Krasnodar Territory (9,024.3 per 100 000 population, + 324%), the Kurgan Region (7,404.2, + 103%) and the Karachayevo-Circassian Republic (7 286.2, + 268%), and prevalence - in the Altai Territory (52 557.6, + 2%), the Chuvash Republic (51 814.6, + 38%) and the Voronezh Region (45 339.4, + 59%). The maximum rates of increase in morbidity with diseases of the circulatory system from 2007 to 2019 are registered in the South Federal district (incidence - by 119%, prevalence - by 56%), among the constituent entities of the Russian Federation: incidence - in the Krasnodar Territory (by 324%), prevalence – the Karachayevo-Circassian Republic (by 136%). According to the state statistical reporting, on average, every 7th acute myocardial infarction is complicated by recurrent heart attack in Russia. Conclusions. Throughout the study period of 13 years, the leading nosological forms include: Hypertensive diseases (35%; 45%, respectively), Ischemic heart diseases (22%; 21,6%) and Cerebrovascular diseases (23%; 20%). Over half of the diseases of the circulatory system are registered in the older working ages (55-60 and over). Scope of application. The study results can be useful to regional authorities in public health in planning and implementing regional programs aimed at controlling diseases of the circulatory system.

INTRODUCTION: The course and outcomes of the disease, including diseases of the circulatory system, are greatly influenced not only by the quality of medical care, but also by the attitude of patients to their health, as well as their medical activity. AIM: To study the age characteristics of the medical activity of patients with diseases of the circulatory system, taking into account gender and marital status. MATERIALS AND METHODS: On the basis of the Vinogradov City Clinical Hospital, Moscow, using a specially designed questionnaire, 582 patients hospitalized in the cardiological and neurological departments of the hospital for diseases of the circulatory system were interviewed. In the mathematical processing of the obtained data, the methods of variation statistics were used. RESULTS: Only 28.9% of the respondents answered that they regularly see a doctor for diseases of the circulatory system. Women were more active than men in terms of compliance with the dispensary observation schedule and the frequency of consultations with doctors of other specialties. According to the data obtained, 62.4% of the respondents considered it necessary to establish schools for the chronically ill and their family members, but only 17.4% of the respondents attended a school for a patient with diseases of the circulatory system. It was found that 86.1% of the surveyed patients with diseases of the circulatory system kept self-monitoring diaries: 68.7 per 100 respondents monitored blood pressure, 46 — blood sugar level and 33.6 — body weight. At the same time, married men are more likely to keep self-monitoring diaries for blood pressure, blood sugar levels and body weight. The timeliness of seeking medical care is the most important criterion that characterizes the medical activity of patients and largely determines the outcome of treatment and the cost of it. The conducted sociological study revealed a rather high medical activity of patients with diseases of the circulatory system, as well as its significant differences in a number of positions in age, gender, and marriage and family aspects. CONCLUSION: The identified features of the self-preserving behavior of patients with diseases of the circulatory system should be taken into account when providing them with therapeutic and preventive care.

Significance. Diseases of the circulatory system are among the leading ones in the structure of morbidity and top the structure of adult mortality in Russia. Analyzing dynamics in morbidity and coverage with regular health examination is necessary to develop comprehensive programs to control cardiovascular diseases. In order to preserve and prolong the life of the patients suffering from diseases of the circulatory system, the federal project “Fighting Cardiovascular Diseases” has been implemented in the Russian Federation since 2019. Due to high significance of diseases of the circulatory system in the structure of morbidity and mortality, it is of great scientific and practical interest to study trends in incidence and prevalence, as well as coverage with regular health examination of the Russian adult population. The purpose of the study is to analyze dynamics in incidence and prevalence of diseases of the circulatory system as well as coverage with regular health examination of the adult population of the Russian Federation in 2019-2023. Material and methods. The study used statistical reference books of the Ministry of Health of the Russian Federation “Disease prevalence among the Russian adult population” for 2019-2023. The following methods were used: statistical, analytical, and descriptive statistics. The coverage of patients with diseases of the circulatory system with regular health examination was calculated as a share of those taken under regular examination out of the total number of the registered patients with diseases of the circulatory system diseases, expressed in percent. Results. The prevalence of diseases of the circulatory system among the Russian adult population increased from 31975.4 in 2019 to 34757.5 in 2023 per 100000 adult population, with the growth rate adding up to 8.7%. In the period from 2019 to 2023, there was an increase in prevalence of diseases of the circulatory system across all federal districts, with the growth rate ranging from 2.8 to 20.0%, with an average of 9.8%. The highest growth rate was registered in the North Caucasian Federal District (20.0%), the lowest one- in the Southern Federal District (2.8%). There were registered both growth and fall in prevalence of diseases of the circulatory system among adults in the constituent entities of all federal districts of the Russian Federation. Incidence of diseases of the circulatory system in the Russian adult population increased from 4208.5 in 2019 to 4296.7 in 2023 per 100000 adult population, with the growth rate adding up to 2.1%. In the period from 2019 to 2023, there was an increase in incidence in four federal districts (Central, North Caucasian, Ural and Siberian Federal Districts), with the growth ranging from 1.9% to 19.5%, with an average of 9.95%. In other federal districts (Northwestern, Southern, Volga and Far Eastern Federal Districts) there was a decrease in incidence of diseases of the circulatory system by 0.7-7.4%, 3.7% on average. In the constituent entities of all federal districts of the Russian Federation there were registered both growth and fall in incidence of diseases of the circulatory system among adult population. The coverage of adult patients suffering from cardiovascular diseases with regular medical examination in the Russian Federation increased from 67.1% in 2019 to 79.6% in 2023 (by 12.5%). In all federal districts, the coverage differed and averaged to 67.6% in 2019 and 79.6% in 2023. Conclusion. In 2020, in the first year of the COVID-19 pandemic, there was a decrease in both incidence and prevalence of diseases of the circulatory system among the Russian adults. In 2021, there was an increase in both incidence and prevalence. In 2023, compared to 2022, the growth rate of incidence and prevalence of diseases of the circulatory system amounted to 7.6% and 5.7%, respectively. The overall growth rate in 2019-2023 added up to 8.7% for prevalence and 2.1% for incidence. In the regions of the Russian Federation, there were registered both growth and fall in prevalence and incidence. When comparing prevalence of diseases of the circulatory system and coverage with regular health examination with all registered cases of diseases of the circulatory system among adult population, no correlation has been identified. Scope of application. The study results can be used to develop activities of preventive programs. Keywords: prevalence; incidence; dynamics in morbidity indicators; adult population; regular health examination; diseases of the circulatory system; COVID-19

Introduction: This study aimed to determine if a relationship between average length of stay of patients diagnosed with diseases of the nervous system (ICD-10 code G) and of the circulatory system (ICD-10 code I) and their functional gains private sub-acute hospital in Gauteng exists.. Method: A retrospective chart review study of patients with diseases of the nervous system (ICD-10 code G) and patients with diseases of the circulatory system (ICD-10 code I) admitted in Gauteng, South Africa, from 2017-2021. Descriptive statistics of percentages, median and range were used to summarise the data while inferential statistics of Mann-Whitney U, Kruskal-Wallis and Spearman rank correlation were used to determine median differences and relationship between the variables during data analysis. Results: A total of 380 patient records were included in the study (n=380). The records with code “G” and “I” consisted of 24.7% and 75.3% respectively. The median length of stay (LOS) for code G and I were 29 (IQR 17-59.25) and 27 (IQR 14-42) days, respectively and the median differences were statistically significant (p=0.028). The median total functional outcomes achieved by patients with code G and I was 19 (IQR 3-30.25) and 22 (IQR of 9.75-35.25) respectively. The median differences were statistically significant (p=0.034). Conclusion: Patients with diseases of the circulatory system (ICD 10 code I) have shorter length of stay and better functional outcomes in comparison to diseases of the nervous system (ICD 10 code G) patients. There is a direct relationship between LOS and functional outcomes of patients with diseases of the circulatory system (ICD-10 code I) but this was not seen with patients with diseases of the nervous system (ICD-10 code G). Implications for practice Early identification of rehabilitation potential and referral to a sub-acute hospital is of utmost importance considering that patients with diseases of the nervous system (ICD 10 code G) require a longer length of stay and generally achieve less functional outcomes. Therapists and sub-acute hospitals should consider prioritising their resources with the aim of discharge preparation of patients with diseases of the nervous system (ICD 10 code G) earlier in the rehabilitation process. Sub-acute hospital case managers could potentially consider admission of patients with diseases of the circulatory system (ICD 10 code I) in a certain wing of the hospital considering that they displayed better functional outcomes with a shorter length of stay. Hence more patients with the same ICD-10 code could potentially be admitted more frequently to assist more patients in goal achievement. This does not imply that patients with diseases of the nervous system (ICD-10 code G) should receive less rehabilitation than patients with diseases of the circulatory system (ICD 10-code I), instead it is suggested that therapists and clinicians readjust their focus and plan their therapy programs to the expected functional outcomes.

The relevance is determined by the high proportion of diseases of the circulatory system in the structure of the total mortality of the population, as well as the potential modifiability of external factors of pathology. The aim of the research is to study the regional epidemiology of mortality from diseases of the circulatory system in the context of a regional program to reduce it. Materials and methods - аn analysis of the structure and dynamics of mortality rates from diseases of the circulatory system and the peculiarities of the organization of medical care for the population of the Astrakhan Region with cardiovascular diseases for the 7-year period from 2014 to 2020, based on the data of the Medical Information and Analytical Center and the Office of the Federal State Statistics Service for the Astrakhan Region, was carried out. Results and discussion - diseases of the circulatory system rank first in the structure of total mortality in the Astrakhan region, which accounted for about half (48%) of all deaths in 2020. During the study period, an increase in mortality from diseases of the circulatory system was established by 2.8% with a sharp increase of 17.6% in 2020 compared to 2019, which is associated with the spread of coronavirus infection. At the same time, the proportion of deaths outside the hospital was 65% in 2020. It’s indicates both the late seeking of medical care and the shortcomings of dispensary observation of the category of citizens with the maximum risk of developing cardiovascular complications. In the structure of mortality from diseases of the circulatory system, ischemic heart disease is steadily leading, with an increase of 5.8% over the reporting period. The second place is occupied by cerebrovascular diseases, which showed a slight decrease by 3.3%. In addition to the infectious threats associated with the spread of the coronavirus COVID-19, it is necessary to take into account such a stable phenomenon as the progressive aging of the population when predicting the mortality rate for the coming years. Conclusion. Research findings can be used to adjust activities to health care organizations for patients with cardiovascular diseases at the regional level.

Recently, the American Heart Association developed a set of 7 ideal health metrics that will be used to measure progress toward their 2020 goals for cardiovascular health. The objective of the present study was to examine how well these metrics predicted mortality from all causes and diseases of the circulatory system in a national sample of adults in the United States. We used data from 7622 adults ≥20 years of age who participated in the National Health and Nutrition Examination Survey from 1999 to 2002 and whose mortality through 2006 was determined via linkage to the National Death Index. For the dietary and glycemic metrics, we used alternative measures. During a median follow-up of 5.8 years, 532 deaths (186 deaths resulting from diseases of the circulatory system) occurred. About 1.5% of participants met none of the 7 ideal cardiovascular health metrics, and 1.1% of participants met all 7 metrics. The number of ideal metrics was significantly and inversely related to mortality from all causes and diseases of the circulatory system. Compared with participants who met none of the ideal metrics, those meeting ≥5 metrics had a reduction of 78% (adjusted hazard ratio, 0.22; 95% confidence interval, 0.10-0.50) in the risk for all-cause mortality and 88% (adjusted hazard ratio, 0.12; 95% confidence interval, 0.03-0.57) in the risk for mortality from diseases of the circulatory system. The number of ideal cardiovascular health metrics is a strong predictor of mortality from all causes and diseases of the circulatory system.

Cause-specific information on socioeconomic differences in health is necessary for a rational public health policy. At the local level, the Municipal Health Service studies these differences in order to support the authorities in policy making. Mortality data of the under 65 age group in The Hague were analysed (1982-1991) at residential area level. Causes of death with a high socioeconomic gradient among males were: homicide, chronic liver disease, 'other' external causes of injury, diabetes, bronchitis, emphysema and asthma, and motor vehicle accidents; and among females: diabetes, ischaemic heart disease, 'other' diseases of the circulatory system, signs, symptoms and ill-defined conditions, malignant neoplasm of cervix, and 'other' diseases. Main contributors to the mortality differences between the highest and lowest socioeconomic quartiles among males were: ischaemic heart disease (17.3%), 'other' diseases of the circulatory system (10.2%), signs, symptoms and ill-defined conditions (9.0%), 'other' external causes of injury (8.6%), and chronic liver disease (7.2%); and among females: ischaemic heart disease (25.5%), 'other' diseases (20.1%), signs, symptoms and ill-defined conditions (18.6%), 'other' diseases of the circulatory system (11.0%), and diabetes (9.1%). Among females the contributions of malignant neoplasms of breast (-16.3%) and colon (-5.5%) and suicide (-4.3%) were negative. The diseases that are the main contributors to urban socioeconomic mortality differences can be influenced by public health policy.

Public funding for medical research in Germany is primarily provided by the German Research Foundation (DFG) and the Federal Ministry of Education and Research (BMBF). The aim of this study was to analyze the amount of national public funding for medical research on predominant causes of death in Germany, cardiovascular diseases and neoplasms, in relation to the burden of these diseases in Germany. Three evaluators categorized medical research projects funded by the DFG or BMBF between 2010 and 2012 into the categories "Diseases of the circulatory system" (with subgroups "Ischemic heart diseases", "Heart failure" and "Cerebrovascular diseases") and "Neoplasms". The total amount of public funding by the national agencies was analyzed in relation to the burden of disease for the respective disease condition. Information on national public funding for medical research of 2091million euros was available; of those, 246.8million euros (11.8%) were categorized being spent for research on "Neoplasms", 118.4million euros (5.7%) for research on "Diseases of the circulatory system". This results in 362.08 euros per case of death, 16.58 euros per year of life lost (YLL) and 16.04 euros per disability-adjusted life year (DALY) for "Neoplasms" and in 113.44 euros per case of death, 8.05 euros per YLL and 7.17 euros per DALY for "Diseases of the circulatory system". In Germany, research on cardiovascular diseases receives a lower share of national public funding for medical research compared to oncological research. These results are comparable to other European countries.

Introduction: Along with the mortality rate, the indicator of Potential Years of Life Lost (PYLL) is used to assess health losses in the population. Objective: To assess the structure and rates of mortality from diseases of the circulatory system and to estimate the number of potential years of life lost due to this category of disorders in the population of the Orenburg Region. Methods: We conducted a retrospective analysis of deaths registered among the population of the Orenburg Region in 2010– 2020 using a depersonalized database of medical death certificates within the mortality monitoring system of the Medical Information and Analytical Center of the Orenburg Region. The results were evaluated using parametric and nonparametric methods. Potential years of life lost due to the diseases of the circulatory system were estimated by 5-year age groups for the population aged 18–75 in the years 2019 and 2020. Results: We established that the greatest demographic and socio-economic damage was caused by the diseases of the circulatory system, external causes of death, and neoplasms. We also estimated that in 2019, the mortality rate from diseases of the circulatory system was 633.7 per 100,000 population, i.e. 0.7 % lower than that in 2018 (638.2 per 100,000). In 2010–2020, the circulatory disease mortality rate was the highest in 2010 (842.0 per 100,000 population) and the lowest in 2016 (608.2 per 100,000). The average age of the deceased was 72.9 ± 13.8 years, and we observed its increase from 72.0 ± 10.9 years in 2019 to 73.6 ± 9.4 years in the year 2020 (p = 0.014). In 2019, the indicator of premature mortality was 30,895 and 10,515 years for men and women, including 24,323 and 5,404 potential years of life lost in working-age men and women (< 59 and < 54 years of age), respectively. In 2020, the number of PYLL rose to 39,425 and 16,868 years in men and women, respectively. We found significant age and sex differences in the level of losses from premature mortality. Conclusion: Our findings show that the regional mortality rates from diseases of the circulatory system in 2010–2020 exceeded the national averages. The structure of causes of death from diseases of the circulatory system did not change. In 2020, the number of potential years of life lost increased compared to 2019 and was more than twice as high for men than for women.

Background: Diseases of the circulatory system are the main cause of death in Slovakia and all over the world and claim 17.9 lives every year, which is an estimated 32% of all causes of death. Up to 85% of deaths from the disease are caused by heart attack and stroke, and one-third of these deaths occur in people under 70 years of age. Aim: Analysis of data on the development of cardiovascular diseases based on health status indicators such as mortality and hospitalization. Methods: The materials were obtained from the databases of selected institutions and, in summary, from the Report on the Health Status of the Population of the Slovak Republic for the years 2011-2020. Institutions such as the Statistical Office of the Slovak Republic, the National Center for Health Information, Social Insurance and the Office of Public Health of the Slovak Republic participated in the creation of this report. Results: During the observed period of 2011-2020 in the entire population in the Slovak Republic, diseases of the circulatory system dominated the causes of death. Since 2011, diseases of the circulatory system have had a downward trend, from 45.1% (2011) to 42.6% (2020). The most frequent causes of hospitalization during the observed period, regardless of gender, were diseases of the circulatory system (15.5% of the total number of hospitalizations; in the number of 151,593). Conclusion: During the monitored period 2011-2020, the causes of death in the entire population of the Slovak Republic were dominated by diseases of the circulatory system and tumors. The most frequent causes of hospitalization during the monitored period, regardless of gender, were diseases of the circulatory system.

Significance. Cardiovascular diseases currently remain one of the significant medical and social problems in the Russian Federation and the world, determining high mortality rates and economic cost incurred by the state. In 2021, 35,574,831 adult patients with cardiovascular diseases were registered in Russia. Over a ten-year period (2012-2021) in Russia, cardiovascular diseases claimed the lives of 8,209,196 people, accounting for 42.1% of deaths from all causes. The purpose of the study is to analyze dynamics in morbidity and mortality from diseases of the circulatory system in the Tambov region in 2012-2021. Material and methods. The source of information on morbidity and mortality included statistical collections of the Federal Research Institute for Health Organization and Informatics of the Ministry of Health of the Russian Federation, data presented in the unified interdepartmental information and statistical system, and data of the Tambov Statistics Service. Results. During 2012-2021, there was an increase in adult cardiovascular morbidity in the Russian Federation, prevalence - from 27318.1 to 30724.2 cases per 100 thousand adult population (by 11.1%), incidence - from 3040.8 to 3673.9 cases (by 17.2%); prevalence in the Tambov region increased from 31380.2 to 33336.8 cases (by 5.9%), incidence - from 2911.3 to 2942.6 cases (by 1.1 %). The increased adult cardiovascular morbidity in the Tambov region is due to arterial hypertension, its prevalence and incidence increased by 19.6% and 25.8%, respectively. Cerebrovascular diseases are characterized by a 3.9% decrease in prevalence and a 4.4% decrease in incidence, while coronary heart disease is characterized by multidirectional dynamics with a decrease in prevalence (by 3.9%) and an increase in incidence (by 10.0%). In 2021, in the structure of prevalence and incidence in adults with diseases of the circulatory system, the share of arterial hypertension equaled to 53.4% and 42.1%, respectively, the share of coronary heart disease was 20.5% and 25.2%, cerebrovascular diseases - 14.4% and 24.4%, respectively. In 2012-2021, a decrease in mortality from diseases of the circulatory system was registered both in Russia and in the Tambov region, from 737.1 to 640.3 per 100 thousand population (by 13.1%) and from 757.2 to 709.7 (by 6.3%) per 100 thousand population, respectively. However, throughout the analyzed period, mortality in the Tambov region is higher compared to the Russian Federation. Over a ten-year period, there is a decrease in the share of deaths from diseases of the circulatory system among those who died from all causes in Russia and the Tambov region, reaching 38.3% and 34.0% in 2021, respectively. Coronary heart disease and cerebrovascular diseases, reaching a share of 83.4% in the structure, make the main contribution to mortality from diseases of the circulatory system. At the same time, a decrease in mortality from coronary heart disease by 3.2% and from cerebrovascular diseases by 17.7% in the Tambov region was established. Conclusion. Improving organization of medical care has made it possible to reduce mortality, however, it is necessary to continue systematic activities to control risk factors, as well as develop and implement effective technologies for follow-up of patients with cardiovascular diseases to prevent severe complications and further reduce mortality.

The relevance of the study lies in the growth of mortality rates in Ukraine, in particular in the Black Sea economic region. Thus, according to the main classes of causes of death, both in Ukraine and in the Black Sea economic region, the population dies from diseases of the circulatory system, tumors and external causes, which requires an assessment of relevant economic potential losses due to premature mortality. The aim of the study is to assess the potential economic losses due to the main causes of premature mortality of the Black Sea economic region. The problem of increasing mortality rates per 100,000 populations in Ukraine, in particular in the Black Sea economic region, has been identified. It was found that in Kherson and Odessa regions there are the most exceedances of mortality rates for the main reasons compared to the average values in Ukraine. Absolute and relative indicators characterizing the state of mortality in Ukraine and in the Black Sea economic region by the following main causes of death are analyzed: diseases of the circulatory system, neoplasms, external causes. Potential losses in man-years for the economy of the Black Sea economic region from premature mortality in the age group of 16‒59 years due to tumors, diseases of the circulatory system, external causes of death are calculated. Potential economic losses in value terms for the economy of the Black Sea economic region from premature mortality in the age group of 16‒59 years due to tumors, diseases of the circulatory system, external causes of death are calculated. Potential economic losses of the Black Sea economic region from the main causes (diseases of the circulatory system, neoplasms, external causes of death) due to premature mortality in the age group 16‒59 years in the structure of the Gross Regional Product of Ukraine are generalized. Conceptual recommendations for reducing the rate of premature death from the main causes of death in Ukraine, in particular in the Black Sea economic region, are proposed. It is proposed to restore the system of medical examination of the population, to introduce medical social insurance.