L. Chenet et al., ALCOHOL AND CARDIOVASCULAR MORTALITY IN MOSCOW - NEW EVIDENCE OF A CAUSAL ASSOCIATION, Journal of epidemiology and community health, 52(12), 1998, pp. 772-774
Background-In explaining recent trends in Russian mortality, alcohol d
rinking has often been put forward as a major factor. However, cardiov
ascular disease remains the major cause of death in Russia and alcohol
is currently viewed as having a protective effect on heart disease. T
his study explores this apparent paradox by examining daily trends in
deaths from cardiovascular disease in Moscow. Subjects-Those dying in
Moscow in the years 1993-1995. Methods-Analysis of daily variation in
deaths based on data from Moscow City death certificates. Results-Ther
e is a significant increase in deaths from alcohol poisoning, accident
s, and violence and cardiovascular diseases on Saturdays, Sundays, and
Mondays. This is especially marked for sudden deaths. This pattern is
consistent with the known pattern of drinking in Russia, which is mor
e likely to take place in binges than is the case in other countries.
Conclusion-A possible causative role for alcohol in sudden cardiovascu
lar death is suggested as there are no other obvious explanations for
this pattern, which cannot be accounted for by daily variations in tra
ditional risk factors such as smoking or lipids. Although this is inco
nsistent with the prevailing view in the West that alcohol is seen as
cardioprotective, there is considerable supporting evidence from a nec
ropsy study and from studies in other places with a similar pattern of
drinking. In countries such as Russia, where patterns of drinking dif
fer considerably from that in the West, binge drinking can be an impor
tant cause of sudden cardiac death. This has important implications fo
r estimates of the amount of mortality worldwide attributable to speci
fic risk factors and thus for national and international policy.