Objective The objective of this study was to compare ischaemic heart disease (IHD) mortality and risk factor burden across former Soviet Union (fSU) and satellite countries and regions in 1990 and 2015.
Methods The fSU and satellite countries were grouped into Central Asian, Central European and Eastern European regions. IHD mortality data for men and women of any age were gathered from national vital registration, and age, sex, country, year-specific IHD mortality rates were estimated in an ensemble model. IHD morbidity and mortality burden attributable to risk factors was estimated by comparative risk assessment using population attributable fractions.
Results In 2015, age-standardised IHD death rates in Eastern European and Central Asian fSU countries were almost two times that of satellite states of Central Europe. Between 1990 and 2015, rates decreased substantially in Central Europe (men −43.5% (95% uncertainty interval −45.0%, −42.0%); women −42.9% (−44.0%, −41.0%)) but less in Eastern Europe (men −5.6% (−9.0, –3.0); women −12.2% (−15.5%, −9.0%)). Age-standardised IHD death rates also varied within regions: within Eastern Europe, rates decreased −51.7% in Estonian men (−54.0, −47.0) but increased +19.4% in Belarusian men (+12.0, +27.0). High blood pressure and cholesterol were leading risk factors for IHD burden, with smoking, body mass index, dietary factors and ambient air pollution also ranking high.
Conclusions Some fSU countries continue to experience a high IHD burden, while others have achieved remarkable reductions in IHD mortality. Control of blood pressure, cholesterol and smoking are IHD prevention priorities.
- Heart Disease
- Global Disease Patterns
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Contributors AM and AEM led the writing and revision of the manuscript. All authors contributed to the conception of the study, analysis and interpretation of the data, revision of the manuscript and decision to submit.
Funding This research was supported by the Bill and Melinda Gates Foundation, a Wellcome Trust Research Fellowship 104349/Z/14/Z to AM, an American Heart Association Postdoctoral Fellowship to GAR, and a US National Heart, Lung, and Blood Institute award K08 HL089675-01A1 and Columbia University Irving Scholarship to AEM. The funding sources for this study did not play any role in study design; in the collection, analysis and interpretation of data; in the writing of the report; nor in the decision to submit the paper for publication.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.