Association between unrecognized myocardial infarction and self-reported health in the Russian population age 35-69 years

INTRODUCTION Russia has one of the highest rates of mortality from cardiovascular disease (CVD) in the world (non-communicable disease mortality data from the World Health Organization (WHO), despite an ongoing pattern of decline that began in 2005. In 2015 the CVD mortality rate was four times higher in Russia than in England and Wales or Norway (Human Cause-of- Death Database and WHO mortality database). These exceptional CVD mortality rates are considerable reason for the lower life expectancy in Russia compared to other industrialized countries (70.9 years in 2014; (The Demographic Yearbook of Russia 2015). (cook et al.2018) Cardiovascular mortality in Russia has a unique pattern; since the beginning of the 1990’s the Russian population has been experiencing decline in number of population growth, decrease in life expectancy among the Russian population in the past 15 years is also a trend that available studies have found in this population. Cardiovascular disease are the common cause of death when this ratio was compared to the cardiovascular death in Western Europe, it was shown that the majority of incidence of cardiovascular death among the Russian population falls between the ages of 35-44. The premature death of middle-aged men accounted for a large sex gap in life expectancy. In the year 2000 life expectancy in Russia was 59.0 for men and 72.2 years for women. The gap in healthy life expectancy (HALE) between Russia and Western Europe countries was 18–20 years and 10–13 years for men and women respectively. Irrespective of this burden in the public heath, there have been only few epidemiological studies carried out in Russia during the post-Soviet union eras. However, from the few available studies the cardiovascular phenotype for the increase prevalence of cardiovascular disease in Russian still remains fully unknown. For example, some previous studies dating from 1975-2000 have tend to find relatively low risk lipid profile in Russian compared to Western countries, with unexceptional low density lipoprotein (LDL) cholesterol, higher levels of high density lipoprotein (HDL) cholesterol and more favorable ratios of ApoB/A1 or HDL/total cholesterol (Sarah cook et al. 2015). The International Project on Cardiovascular Disease in Russia (IPCDR) who is responsible to research the high rate of cardiovascular disease in the Russian population and the project has four separate but inter-connected themes: 1) investigating the extent to which the differences between Russia and other countries in CVD mortality rates may be biased because of differences in the way in which deaths are certified and coded; 2) generating improved overviews of trends and differences on CVD mortality and established risk factors in Russia by bringing together and synthesizing already collected data; 3) examining the potential role of the health-care system and treatment in contributing to the trends in CVD rates within Russia and to differences with other countries; 4) characterizing the nature and causes of cardiovascular disease in Russia by conducting large cross-sectional surveys in two Russian cities Novosibirsk and Arkhangelsk. Although alcohol consumption remain one of the major risk factor for the increase in cardiovascular mortality among Russian population, but this research paper is set to look at the association between silent myocardial infarction and self-reported health in the Russian population age range of 35-69 using data collected from cross-sectional study that is known as “Know Your Heart”. Self-reported health is subjective to individual thought, about his/her evaluation or judgment in the absence of visible signs and symptoms of illness. On the other hand, Silent myocardial ischemia is an objective evidence of myocardial ischemia in the absence of chest discomfort or another angina equivalent symptom such as dyspnea, nausea, diaphoresis.