Validation of SCORE2 on a sample from the Russian population and adaptation for the very high cardiovascular disease risk region.

SCORE2 (Systematic COronary Risk Evaluation 2) is a risk assessment scale for cardiovascular events, presented in 2021 by the European Society of Cardiology. Both for training and validation of the SCORE2 model, representative samples from the Russian population were not used. Therefore, we aimed to validate SCORE2 on a such sample. For this purpose, we used a sample from the ESSE-RF epidemiological study consisting of 7251 participants aged 40-69 years without history of CVDs. We performed the validation by comparing SCORE2 risk estimates for ESSE-RF participants with the observed incidence of cardiovascular events in the study, adjusted for event information losses. The validation demonstrated that SCORE2 risk estimates were accurate for Russian men and inaccurate for Russian women. Together with the quantitative assessment of risk, SCORE2 offers its interpretation in terms of 10-year CVD risk group: low-moderate, high, and very high. For Russian men we considered the original interpretation of the SCORE2 estimates to be questionable because almost none of the men would be categorized as having "low-to-moderate" 10-year CVD risk. This problem would be typical for all countries of the very high CVD risk region. Therefore, we proposed a new interpretation of the SCORE2 risk estimates for men from the very high risk region. According to the proposed interpretation, the fraction of men in ESSE-RF in "low-to-moderate" 10-year CVD risk increased from 2% to 18% and the fraction of men in "very high" CVD risk decreased from 63% to 20% as compared to the original interpretation. The proposed interpretation would allow a more personalized approach to CVD treatment and optimize the burden on primary healthcare in the very high risk region countries.

Mental Health of the Russian Federation Population versus Regional Living Conditions and Individual Income.

The objective of our study was to assess the impact of regional living conditions on the Russian population's mental health. For the analysis, we used data from the cross-sectional stage of a 2013-2014 study, "Epidemiology of Cardiovascular Diseases in the Regions of the Russian Federation (ESSE-RF)". The final sample included 18,021 men and women 25-64 years of age from 11 regions of Russia. Using principal component analysis, we performed an integral simultaneous assessment of stress, anxiety, and depression. To describe the regional living conditions, we utilized five regional indices, which were computed from publicly available data of the Federal State Statistics Service of Russia. Overall, mental health indicators were improved, on the one hand, with the deterioration of social conditions and an aggravation of the demographic depression in the region, but on the other hand, they were improved with an increase in economic and industrial development, along with economic inequality among the population. In addition, the impact of regional living conditions on mental health increased with a higher individual wealth. The obtained results provided new fundamental knowledge on the impact of the living environment on health, using the case study of the Russian population, which has been little studied in this regard.

Children's exposure to television advertising of unhealthy foods and beverages across four countries of WHO European Region.

OBJECTIVE: To compare the frequency and healthfulness of foods being advertised to children and adolescents in four countries of WHO European region. DESIGN: Cross-sectional quantitative study, guided by an adapted version of the WHO protocol. All recorded food advertisements were categorised by categories and as either 'permitted' or 'not permitted' for advertising to children in accordance with WHO Regional Office for Europe Nutrient Profile Model. SETTINGS: Four countries: Russia, Turkey, Kazakhstan and Kyrgyzstan. PARTICIPANTS: TV channels most popular among children and adolescents. RESULTS: Analysis included 70 d of TV broadcasting for all channels, during which time there were 28 399 advertisements. The mean number of advertisements per hour varied from eleven in Turkey and Kazakhstan to eight and two in Russia and Kyrgyzstan. In all countries, the majority of the food and beverages advertised should not be permitted for advertising to children according to the WHO Nutrient Profile Model. The mean number of non-permitted food and beverage advertisements per hour was high in Turkey and Kazakhstan (8·8 and 8·5 ads) compared with Russia (5·1) and Kyrgyzstan (1·9). Turkey was the only country where nutritional information was fully available, and no values were missing that prevented coding for some product categories. CONCLUSIONS: Results revealed that children and adolescents in four countries are exposed to a considerable volume of food and beverage advertisements, including sugary products on broadcast television. As such, policymakers should consider protecting youth by developing regulations to restrict these marketing activities within media popular with children.

Regional living conditions and the prevalence, awareness, treatment, control of hypertension at the individual level in Russia.

BACKGROUND: The objective of our study was to investigate the associations of characteristics inherent in large Russian Federation (RF) regions with prevalence, awareness, treatment and control of hypertension at the individual level. METHODS: Regional characteristics were obtained from the official website of the Federal State Statistics Service of the RF. We employed principal component analysis to reduce the dimensionality of data, which allowed defining five integral regional indices. Prevalence, awareness, treatment and control of hypertension were assessed from the data of the cross-sectional stage of ESSE-RF study conducted in 2013-2014. The final sample included 19,791 patients from 12 RF regions. Generalized estimating equations were used to identify the associations of regional indices with prevalence, awareness, treatment and control of hypertension at the individual level, taking into consideration nested data structures (study subjects in the regions). RESULTS: The index characterizing deterioration of social living conditions and societal marginalization exhibited positive associations with the prevalence of hypertension among men (OR = 1.18; 95% CI: 1.05-1.32) and elderly people (OR = 1.16; 95% CI: 1.02-1.32). Moreover, deterioration in the social environment was associated with a reduction in treatment (OR = 0.76; 95% CI: 0.64-0.90) and control of hypertension (OR = 0.79; 95% CI: 0.69-0.90). Hypertension awareness was directly connected with demographic crisis (OR = 1.13; 95% CI: 1.02-1.25) and augmented industrial development (OR = 1.15; 95% CI: 1.01-1.33) in the regions. The association of regional living conditions with the prevalence of hypertension is relatively weak, compared to predictors at the individual level, but this influence is important for awareness, treatment and control of hypertension. CONCLUSION: The study contributed to evaluating the associations of the vital characteristics inherent in population of large RF regions with arterial hypertension prevalence, as well as with awareness, treatment and control of this disease. Our results provided original insights from the standpoint of cardiovascular disease epidemiology in the RF, as well as in the context of investigating the impact of living conditions on population health.

What Regional Living Conditions Affect Individual Smoking of Adults in Russia.

Objectives: Our study evaluated the impact of a wide range of characteristics of large administrative regions on the individual level of cigarette smoking in the Russian adult population. Methods: The pool of participants included 20,303 individuals aged 25-64 years. We applied 64 characteristics of the 12 Russian regions under study for 2010-2014. Using principal component analysis, we deduced five evidence-based composite indices of the regions. We applied the generalized estimating equation to determine associations between the regional indices and the individual level of smoking. Results: The increased Industrial index in the region is associated with the probability of smoking (odds ratio = 1.15; 95% confidence interval = 1.06-1.24). The other indices show associations with smoking only in separate gender and educational groups. Surprisingly, it was found that the Economic index has no associations with the probability of smoking. Conclusion: We evaluated the key associations of the territorial indices with the individual probability of smoking, as well as the mutual influence between the territorial indices and individual factors.