Circulatory System Disease Mortality Research Articles

Смертность от болезней системы кровообращения среди ликвидаторов последствий аварии на Чернобыльской АЭС из числа работников предприятий атомной промышленности

Summary. The aim of the study was to evaluate the mortality from circulatory system diseases (CSD) and its dynamics in liquidators of the Chernobyl accident consequences, workers of nuclear industry enterprises. Materials and research methods. The information base of the study was the data contained in the Industry Register of persons exposed to radiation as a result of the Chernobyl NPP accident (ORCh) functioning since 1987 in FGBU GSC FMBC named after A.I. Burnazyan FMBA of Russia. The database (DB) of the ORCH contains information about 21356 liquidators of the Chernobyl accident consequences. The study covers the period from 1987 to 2021. 304023 persons/years were accumulated in the register for the observation period. The material was processed using the Excel statistical package, the growth rate was calculated when assessing the dynamics of mortality. The results of the study and their analysis. In the structure of CSD mortality (ICD10: I00-I99,9) in liquidators of Chernobyl accident consequences the first rank place is occupied by chronic ischaemic heart disease unspecified (CIHD) (ICD10: I25,9), the second rank place – cerebrovascular diseases (CVD) (ICD10: I67,9), the third rank place – Unspecified cardiomyopathy (ICD10: I42,9). The growth rate of CSD mortality during the observation period is mainly positive, the highest in liquidators of working age.

Large sex differences in vulnerability to circulatory-system disease under current and future climate in Bucharest and its rural surroundings

Circulatory-system diseases (CSDs) are responsible for 50–60% of all deaths in Romania. Due to its continental climate, with cold winters and very warm summers, there is a strong temperature dependence of the CSD mortality. Additionally, within its capital Bucharest, the urban heat island (UHI) is expected to enhance (reduce) heat (cold)-related mortality. Using distributed lag non-linear models, we establish the relation between temperature and CSD mortality in Bucharest and its surroundings. A striking finding is the strong temperature-related response to high urban temperatures of women in comparison with men from the total CSDs mortality. In the present climate, estimates of the CSDs attributable fraction (AF) of mortality at high temperatures is about 66% higher in Bucharest than in its rural surroundings for men, while it is about 100% times higher for women. Additionally, the AF in urban areas is also significantly higher for elderly people, and for those with hypertensive and cerebrovascular diseases than in the rural surroundings. On the other hand, in rural areas, men but especially women are currently more vulnerable with respect to low temperatures than in the urban environment. In order to project future thermal-related mortality, we have used five bias-corrected climate projections from regional circulation models under two climate-change scenarios, RCP4.5 and RCP8.5. Analysis of the temperature-mortality associations for future climate reveals the strongest signal under the scenario RCP8.5 for women, elderly people as well as for groups with hypertensive and cerebrovascular diseases. The net AF increase is much larger in urban agglomeration for women (8.2 times higher than in rural surroundings) and elderly people (8.5 times higher than in rural surroundings). However, our estimates of thermal attributable mortality are most likely underestimated due to the poor representation of UHI and future demography.

Smoking Bans and Circulatory System Disease Mortality Reduction in Macao (China): Using GRA Models.

This study evaluates the association between smoking rates and mortality from circulatory system diseases (CSD) after implementing a series of smoking bans in Macao (China). (1) Background: Macao phased in strict total smoking bans since 2012. During the past decade, smoking rates among Macao women have dropped by half. CSD mortalities in Macao also show a declining trend. (2) Method: Grey relational analysis (GRA) models were adopted to rank the importance of some key factors, such as income per capita, physician density, and smoking rates. Additionally, regressions were performed with the bootstrapping method. (3) Results: Overall, smoking rate was ranked as the most important factor affecting CSD mortality among the Macao population. It consistently remains the primary factor among Macao's female population. Each year, on average 5 CSD-caused deaths were avoided among every 100,000 women, equivalent to about 11.45% of the mean annual CSD mortality. (4) Conclusions: After the implementation of smoking bans in Macao, the decrease in smoking rate among women plays a primary role in the reduction in CSD mortality. To avoid excess CSD mortality due to smoking, Macao needs to continue to promote smoking cessation among the male population.

Is area-level socioeconomic deprivation associated with mortality due to circulatory system diseases in Poland?

BackgroundSocioeconomic deprivation (SED) is known to influence cardiovascular health. However, studies analyzing the relationship between deprivation and circulatory system diseases (CSD) in Central and Eastern Europe are limited. This study aimed to assess the relationship between SED and mortality due to CSD at a population level in 66 sub-regions of Poland.MethodsThe 2010–2014 data regarding mortality and SED components were obtained from the Central Statistical Office. An area-based SED index was calculated based on the higher education rates, employment structure, wages, unemployment, and poverty. The dynamics of changes in mortality due to CSD was expressed by the number of deaths prevented or postponed (DPP) in terciles of the SED index. The associations between the mortality from CSD and SED index were analyzed using multivariate Poisson regression models and generalized estimating equations.ResultsAmong men, the percentage of DPP in 2014 was 13.1% for CSD, 23.4% for ischemic heart disease (IHD), and 21.4% for cerebrovascular diseases (CeVD). In the case of women, the proportion of DPP was 12.8, 25.6, and 21.6%, respectively. More deprived sub-regions experienced a greater decrease in CSD-related mortality than less deprived sub-regions. The disparity in mortality reduction between more deprived and less deprived sub-regions was even more pronounced for women. After adjusting for smoking prevalence, average BMI, population density, and changes in mortality over time, it was found that the SED index over the 2010–2014 time period was significantly associated with CSD- and IHD-related mortality for men (respectively 5.3 and 19.5% expected mortality increase per 1-unit increase of SED index), and with IHD- and CeVD-related mortality for women (respectively 30.3 and 23.0% expected mortality increase per 1-unit increase of SED index).ConclusionsSignificant differences in mortality changes due to CSD in Poland could be observed in relation to socioeconomic deprivation, resulting in reduced health inequalities. To reduce CSD mortality, more comprehensive preventive measures, including approaches addressing the socioeconomic factors, mainly poverty, education and employment, are needed, particularly in less urbanized areas.

Circulatory system disease mortality and occupational exposure to radon progeny in the cohort of Newfoundland Fluorspar Miners between 1950 and 2016

ObjectivesExposure to ionizing radiation may increase the risk of circulatory diseases, including heart disease. A limited number of cohort studies of underground miners have investigated these associations. We previously reported a positive but non-statistically significant association between radon progeny and heart disease in a cohort of Newfoundland fluorspar miners. In this study, we report updated findings that incorporate 15 additional years of follow-up.MethodsThe cohort included 2050 miners who worked in the fluorspar mines from 1933 to 1978. Statistics Canada linked the personal identifying data of the miners to Canadian mortality data to identify deaths from 1950 to 2016. We used previously derived individual-level estimates of annual radon progeny exposure in working-level months. Cumulative exposure was categorized into quantiles. We estimated relative risks and their 95% confidence intervals using Poisson regression for deaths from circulatory, ischemic heart disease and acute myocardial infarction. Relative risks were adjusted for attained age, calendar year, and the average number of cigarettes smoked daily.ResultsRelative to the Newfoundland male population, the standardized mortality ratio for circulatory disease in this cohort was 0.82 (95% CI 0.74–0.91). Those in the highest quantile of cumulative radon progeny exposure had a relative risk of circulatory disease mortality of 1.03 (95% CI 0.76–1.40) compared to those in the lowest quantile. The corresponding estimates for ischemic disease and acute myocardial infarction were 0.99 (95% CI 0.66–1.48), and 1.39 (95% CI 0.84–2.30), respectively.ConclusionsOur findings do not support the hypothesis that occupational exposure to radon progeny increases the risk of circulatory disease.

Association of Marital Status With Total and Cause-Specific Mortality in Asia

Marital status has been shown to be associated with mortality, but evidence in Asian populations is limited. To examine the association of marital status with total and cause-specific mortality. This cohort study included individual participant data from 16 prospective studies in the Asia Cohort Consortium conducted between 1963 and 2015. Asian participants with complete information on marital and vital status were included. Study-specific hazard ratios (HRs) and 95% CIs were estimated using Cox proportional hazards model and then pooled using a random-effects meta-analysis. The analysis began in February 2021 and ended in August 2021. Marital status. All-cause and cause-specific mortality. Of 623 140 participants (326 397 women [52.4%] and 296 743 men [47.6%]; mean [SD] age, 53.7 [10.2] years; mean [SD] follow-up time, 15.5 [6.1] years), 123 264 deaths were ascertained. Compared with married individuals, those who were unmarried had pooled HRs of 1.15 (95% CI, 1.07-1.24) for total mortality, 1.12 (95% CI, 1.03-1.22) for cerebrovascular disease mortality, 1.20 (95% CI, 1.09-1.31) for coronary heart disease mortality, 1.17 (95% CI, 1.07-1.28) for circulatory system diseases mortality, 1.06 (95% CI, 1.01-1.11) for cancer mortality, 1.14 (95% CI, 1.05-1.23) for respiratory diseases mortality, and 1.19 (95% CI, 1.05-1.34) for external causes of death. Positive associations with total mortality were also observed for those who were single (HR, 1.62; 95% CI, 1.41-1.86), separated (HR, 1.35; 95% CI, 1.13-1.61), divorced (HR, 1.38; 95% CI, 1.13-1.69), and widowed (HR, 1.09; 95% CI, 1.04-1.13). In subgroup analyses, the positive association persisted across baseline health conditions, and the risk of death was more pronounced among men or people younger than 65 years. This large pooled cohort study of individual participant data provides strong evidence that being unmarried, as well as belonging to the unmarried subcategories, was positively associated with total and cause-specific mortality. Investment of targeted social support services might need to be considered in light of the mortality differences between married and unmarried individuals.

Time series analysis of short-term effects of particulate matter pollution on the circulatory system disease mortality risk in Lishui District, China.

Epidemiological evidence has shown a significant association between short-term exposure to air pollution and mortality risk for circulatory system diseases (CSD). However, informative insights on the significance and magnitude of its relationship in the process of government interventions on abating air pollution are still lacking, particularly in a burgeoning Chinese city. In this study, we conducted a time series study in Lishui District, Nanjing, to examine the effect of ambient particulate matter (PM), e.g., PM2.5 and PM10, on daily death counts of CSD which included cardiovascular disease (CVD), cerebrovascular disease (CEVD), and arteriosclerotic heart disease (ASHD) mortality from January 1, 2015, to December 31, 2019. The results revealed that each 10μg/m3 increase in PM2.5 and PM10 concentration at lag0 day was associated with an increase of 1.33% (95% confidence interval, 0.08%, 2.60%) and 1.12% (0.43%, 1.82%) in CSD mortality; 2.42% (0.44%, 4.43%) and 1.43% (0.32%, 2.55%) in CVD mortality; 1.20% (- 0.31%, 2.73%) and 1.21% (0.38%, 2.05%) in CEVD mortality; and 2.78% (0.00%, 5.62%) and 1.66% (0.14%, 3.21%) in ASHD mortality, respectively. For cumulative risk, the corresponding increase in daily mortality for the same change in PM2.5 concentration at lag03 day was significantly associated with 1.94% (0.23%, 3.68%), 3.17% (0.58%, 5.84%), 2.38% (0.17%, 4.63%), and 4.92% (1.18%, 8.81%) for CSD, CVD, CEVD, and ASHD, respectively. The exposure-response curves were approximately nonlinear over the entire exposure range of the PM concentrations. We also analyzed the effect modifications by season (warm or cold), age group (0-64years, 65-74years, or ≥ 75years), and sex (male or female). Although not statistically significant, stratified analysis showed greater vulnerability to PM exposure for cold season, population over 65years of age, and female group.

Ischaemic heart and cerebrovascular disease mortality in uranium enrichment workers

ObjectiveLinear and non-linear dose–response relationships between radiation absorbed dose to the lung from internally deposited uranium and external sources and circulatory system disease (CSD) mortality were examined in a cohort...

Risk analysis of the mortality from the diseases of the circulatory system in the Ural cohort of emergency-irradiated population for the years 1950–2015

The paper describes for the first time the results of the radiation effect study using the example of the analysis of circulatory system disease mortality in newly established cohort combining the population exposed in 1950–1960 due to 2 radiation incidents in the Southern Urals (the Techa River and East-Urals radioactive Trace). The cohort consists of 60,205 people. Over a 65-year follow up period 14,830 deaths from all diseases of the circulatory system were registered. Out of this number 6,163 deaths were from ischemic heart disease, and 4,388 deaths were from cerebrovascular diseases. Analysis was performed on the basis of individualized estimates of dose accumulated in muscle tissue (both internal and external components of the dose), calculated with new Techa River Dosimetry System 2016. As per the latest calculations, mean dose to muscle tissue in members of the combined cohort was 34 mGy, maximum dose was 995 mGy. Simple parametric model of excess relative risk (ERR) was used in the analysis. The number of person-years at risk was 1836,203. The findings of the analysis show linear increase of mortality risk per unit dose from all the disease of circulatory system (ERR/100 mGy was 3%; 95% CI: 0,8%; 5,2%) and from ischemic heart disease (ERR/100 mGy was 9,2%; 95% CI: 5,4%; 13,5%). with 15-year latent period. No statistically significant increase in mortality from the cerebrovascular diseases in the combined cohort of the population exposed in the Southern Urals over a 65-year period received evidence. The obtained results are in good agreement with those received in the analysis of the effect in the Techa River Cohort in 2013. The latter covered a 53-year period (with minimum latent period of 15 years) and revealed statistically significant linear dose response for all diseases of the circulatory system (ERR/100 mGy – 0.036) and ischemic heart disease (ERR/100 mGy – 0.056).

Trends in overall mortality and from diseases of the circulatory system in elderly individuals in Rio Branco, Acre, 1980-2012

Abstract Objective: To analyze trends in general mortality and circulatory system disease mortality among elderly persons living in the city of Rio Branco, Acre, Brazil, from 1980 to 2012. Method: A study of the cause of death of elderly people was carried out from the data available in the Brazilian Mortality Information System. Crude and age-based overall and circulatory system mortality rates were calculated. The trend analyses of these rates were performed using the JoinPoint Regression program. Results: Despite the reductions in mortality rates, diseases of the circulatory system remained the main cause of death of the elderly in Rio Branco. The decrease in overall mortality rates was higher among elderly women and those aged 70 years or older. There was a tendency for death rates due to diseases of the circulatory system to decline among elderly men and grow among elderly women. Conclusion: The mortality rate among the elderly in Rio Branco revealed a declining trend. Deaths from diseases of the circulatory system were the leading cause of death, suggesting that research should be carried out to assess the need for investment to ensure that increased longevity is accompanied by good quality of life.

Evolution of Mortality from Diseases of the Circulatory System and of Gross Domestic Product per Capita in the Rio de Janeiro State Municipalities

Abstract Background: Diseases of the circulatory system are the leading cause of death in Brazil and the world, falling progressively during the twentieth century, preceded by an increase in Gross Domestic Product. Objective: To correlate balanced and adjusted mortality rates from circulatory system diseases in the municipalities of Rio de Janeiro state between 1979 and 2010 with the gross domestic product per capita (GDPpc) beginning in 1950. Methods: Population and death data were obtained from the Department of Information and Computer Services at the National Health System/Brazilian Ministry of Health (Departamento de Informatica do Sistema Unico de Saude - Ministerio da Saude - DATASUS-MS). Mortality rates were calculated for Ischemic Heart Disease (IHD), Cerebrovascular Disease (CBVD), and Circulatory System Disease (CSD); adjusted by the direct method; and balanced for ill-defined causes. The GDPpc data were obtained from the Institute of Applied Economic Research (Instituto de Pesquisas Economicas Aplicadas - IPEA). Mortality rates were correlated with socioeconomic indicators using Pearson's linear correlation coefficient to determine the annual optimized lag time. Regression slope coefficients between the dependent disease and independent socioeconomic indicator were estimated. Results: In recent decades, there has been a reduction in mortality from CSD in all Rio de Janeiro state municipalities, mainly due to a decline in mortality from CBVD. The decline in mortality from CSD was preceded by an increase in the GDPpc, and a strong correlation was observed between this index and mortality rates. Conclusion: The evolution of the variation in GDPpc demonstrated a strong correlation with the reduction in CSD mortality. This relationship demonstrates the importance of improving the living conditions of the population to reduce cardiovascular mortality.

Circulatory disease in French nuclear fuel cycle workers chronically exposed to uranium: a nested case–control study

ObjectivesThere is growing evidence of an association between low-dose external γ-radiation and circulatory system diseases (CSDs), yet sparse data exist about an association with chronic internal uranium exposure and the...

Current characteristics of all-cause and circulatory disease mortality in the Azerbaijan Republic

To prove the value of summary data from the State Statistics Commission to characterize of risk of death from circulatory system diseases (CSD). The official data of the State Statistics Commission of the Azerbaijan Republic, which are available at its website (www.stat.gov.az), were analyzed using descriptive statistical procedures to identify qualitative signs. The population-level CSD death rates in 2011-2013 ranged from 362.7 to 379.60/0000, amounting to 61.1-63.8% of the all-cause mortality in the population. There were definite differences in male and female deaths due to CSD (377.2-392.0 and 348.4-367.40/0000) and in its proportion among all-cause mortality rates (58.4-60.5 and 64.1-66.4%). The death rates from CSD in the urban (361.1-380.80/0000) and rural (364.5-378.30/0000) populations and its proportion among all-cause mortality rates in these populations (60.6-62.7 and 61.6-62.8%) were similar. The male and female working-age population showed essentially dissimilar CSD mortality rates (169.2-179.8 and 51.8-57.10/0000), the men being at greater risk of death (3.14-3.27). The ratio of all-cause mortality rates in the male and female working-age populations (2.62-2.67) differed from that of CSD-specific ones in these populations (3.14-3.27). There was a slight difference in CSD-specific mortality rates in the urban and rural working-age populations (116.1-125.0 and 104.9-114.70/0000). There was also evidence for their similarity in the proportion of CSD among the all-cause mortality rates (43.2-46.2 and 45.0-49.6%). The existing characteristics of mortality in the population (a growth tendency due to CSD) suggest the priority of preventing these diseases.

Thirty-year trends in mortality from cardiovascular diseases in Korea.

Background and ObjectivesAn understanding of cardiovascular diseases (CVD) mortality is important for the development of strategies aimed at reducing the burden of CVD. Thus, we examined the changing pattern of CVD mortality in Korea over 30 years (1983-2012) by analyzing the Cause of Death Statistics.Materials and MethodsDeaths from diseases of the circulatory system and those of five CVD categories were analyzed: total heart diseases, acute rheumatic fever/chronic rheumatic heart disease, hypertensive heart disease, ischemic heart disease (IHD) and atherosclerosis. To assess the effects of population ageing on CVD mortality, crude and age-adjusted mortality rates were calculated. Age-adjusted mortality rates were calculated by using the direct standardization method.ResultsOver the 30-year period analyzed in this study, circulatory system disease mortality markedly declined. The age-adjusted mortality rate decreased by 78.5% in men and by 76.3% in women. Consistent decreasing trends were observed for mortalities from rheumatic heart disease, hypertensive heart disease, and atherosclerosis. However, IHD mortality rapidly increased during the 30 years. Crude IHD mortality showed a steady increase until 2007, after which there were fluctuations. But the penalized regression splines showed that crude IHD mortality continued to increase. Age-adjusted IHD mortality peaked in the early 2000s, and started to decrease during the last few years.ConclusionIn summary, total CVD mortality rate has significantly decreased over the 30-year period analyzed in this study but the IHD mortality rate has continuously increased until recently. The prevention and management of cardiovascular diseases amongst the Korean population, especially IHD, still represents a great challenge.

0194 Circulatory system disease mortality among French uranium miners

ObjectivesThere is currently no consensus for an association between risk of Circulatory System Diseases (CSD) and low exposure to ionising radiation. The aim is to study the relationship between CSD...

Does uranium induce circulatory diseases? First results from a French cohort of uranium workers

ObjectivesIncreased risk of circulatory system diseases (CSDs) was observed in nuclear workers handling uranium and plutonium in Russia and the UK. This work examines the CSD mortality after chronic intake...

Mortality from circulatory system diseases and low-level radon exposure in the French cohort study of uranium miners, 1946–1999

The few studies examining the risk of circulatory system diseases (CSD) associated with ionizing radiation have reported inconsistent results. Radon, a known pulmonary carcinogen, emits ionizing radiation. The aim of this study was to examine CSD mortality in a French cohort of uranium miners and evaluate the plausibility of an association with radon exposure. The cohort included men employed as uranium miners for >/=1 year between 1946-1990. We obtained vital status and cause of death from national registers and reconstructed radon exposure for each year. Exposure--risk relations were estimated with a linear excess relative risk (ERR) model using a 5-year lag time. The cohort comprised 5086 miners, followed up for a mean duration of 30.1 years. The average cumulative exposure of the radon-exposed miners was 36.6 working level months (WLM). A total of 1411 deaths were observed, including 319 deaths due to CSD. No excess risk was found for this overall cause of death. A significant positive trend was observed between deaths from cerebrovascular diseases (CeVD) and cumulative radon exposure, together with a significant ERR per 100 WLM [ERR per 100 WLM 0.49, 95% confidence interval (95% CI) 0.07-1.23)]. Hard physical activity was identified as a potential modifying factor of the exposure-risk relation. For the first time in a cohort of uranium miners, our results suggest an association between CeVD mortality and cumulative radon exposure. Due to a lack of data, which limited our ability to assess possible confounding by cardiovascular risk factors, these findings should be interpreted with caution.

A case–control study relating railroad worker mortality to diesel exhaust exposure using a threshold regression model

A case–control study of lung cancer mortality in U.S. railroad workers in jobs with and without diesel exhaust exposure is reanalyzed using a new threshold regression methodology. The study included 1256 workers who died of lung cancer and 2385 controls who died primarily of circulatory system diseases. Diesel exhaust exposure was assessed using railroad job history from the US Railroad Retirement Board and an industrial hygiene survey. Smoking habits were available from next-of-kin and potential asbestos exposure was assessed by job history review. The new analysis reassesses lung cancer mortality and examines circulatory system disease mortality. Jobs with regular exposure to diesel exhaust had a survival pattern characterized by an initial delay in mortality, followed by a rapid deterioration of health prior to death. The pattern is seen in subjects dying of lung cancer, circulatory system diseases, and other causes. The unique pattern is illustrated using a new type of Kaplan–Meier survival plot in which the time scale represents a measure of disease progression rather than calendar time. The disease progression scale accounts for a healthy-worker effect when describing the effects of cumulative exposures on mortality.

Oral contraceptives and mortality from circulatory system diseases: An epidemiologic study in Taiwan

An epidemiological study on the association between oral contraceptive (OC) use and circulatory system disease (CSD) mortality undertaken in Taiwan by proxy interview of closest family members of 306 deceased cases, 305 deceased controls, and 611 healthy neighborhood controls indicated that the relative risk between the cases and health controls was 0.98 (0.62-1.54) and that between cases and health controls was 0.82 (0.56-1.21). Use of OC by Taiwanese women has not produced any overwhelming adverse effects on CSD mortality.

Oral contraceptives and mortality from circulatory system diseases: An epidemiologic study in Taiwan

An epidemiological study on the association between oral contraceptive (OC) use and circulatory system disease (CSD) mortality undertaken in Taiwan by proxy interview of closest family members of 306 deceased cases, 305 deceased controls, and 611 healty neighborhood controls indicated that the relative risk between the cases and health controls was 0.98 (0.62–1.54) and that between cases and health controls was 0.82 (0.56–1.21). Use of OC by Taiwanese women has not produced any overwhelming adverse effects on CSD mortality.