DIFFERENCES IN MORTALITY AND CORONARY HEART-DISEASE BETWEEN LITHUANIAAND THE NETHERLANDS - RESULTS FROM THE WHO KAUNAS-ROTTERDAM INTERVENTION STUDY (KRIS)

Background A 9.5-year follow-up of the Kaunas-Rotterdam Intervention S tudy (KRIS) provided an opportunity to compare mortality patterns and rates in a population from Lithuania, one of the former republics of t he Soviet Union, with a population from the Netherlands. These populat ions consisted of 2452 and 3365 males, respectively, aged 45-60 years. In 1972-1974, these males were extensively screened for cardiovascula r risk factors, using uniform methods. Methods and results During the follow-up, 303 males in Kaunas (Lithuania) and 350 males in Rotterdam (the Netherlands) died. Using Cox proportional hazards and logistic re gression analysis, it was found that all-cause mortality rates during follow-up were 30% higher in Kaunas; this was mainly due to higher mor tality rates from external causes (relative risk = 6.69), stomach canc er (RR = 2.78), stroke (RR = 2.30) and infectious diseases (RR = 12.43 ). The risk of fatal and non-fatal coronary heart disease (CHD) was, h owever, smaller in Kaunas (RR = 0.72). This lower risk closely corresp onded with the Lithuanian risk profile which could be described by les s smoking, lower cholesterol levels, and higher physical activity. As Lithuanians had a more advantageous cardiovascular risk profile, the h igher Lithuanian all-cause mortality rates could not be explained by t his risk profile. Conclusions The results provide evidence for geograp hical differences in mortality and morbidity between Lithuania and the Netherlands. Population-specific health behaviours were shown to be i nvolved in differences in the risk of CHD. The lower CHD rates in East ern European communities in the 1970s, in this study confirmed for Lit huania, suggests that the apex of the CHD epidemic had not yet reached the Lithuanian population.