Abstract
The purpose of the study is to identify the relationship between total mortality and due to diseases of the circulatory system (CSD) with indicators of sales and consumption of alcoholic beverages in the Republic of Mari El.
 Material and methods. The analysis includes data from official federal and regional statistics on alcohol sales, total and CSD mortality. Alcohol consumption was calculated according to the methodological recommendations of the Russian Ministry of Health. To evaluate the time series, we calculated the coefficient of determination, the median with a 95% confidence interval, the Mann–Whitney test, and the Spearman correlation coefficient with a time lag.
 Results. Over 2000–2018 mortality due to CSD in the Republic of Mari El decreased, not differing from the average Russian indicator in terms of level and trend. In the region, per capita sales of alcoholic beverages (from 4.4 to 8.1 liters) were significantly lower than estimated alcohol consumption (from 10.9 to 21.3 liters). A strong relationship between CSD associated mortality was established with per capita estimated consumption of strong alcohol (r = 0.97–0.5 with a lag of 0 to 6 years) and sales of vodka per capita (r = 0.77–0.48 with a lag of 0 up to 3 years), with a high correlation among the working-age population in men (r = 0.82–0.64 with a lag of 0 to 4 years) and a long-term one in women (r = 0.72–0.48 with a lag of 0 up to 5 years).
 Research limitations. The study has regional (Republic of Mari El) restrictions.
 Conclusion. CSD associated mortality rates are statistically significantly correlated with the sale and consumption of alcoholic beverages with a delayed effect. Therefore, one of the ways to reduce mortality may be measures to reduce alcohol consumption.
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