One of the key aims of the project is to understand the nature and causes of cardiovascular disease in Russia. In order to facilitate this understanding, we recruited members of the general public from two Russian cities to take part in a study. This study involved collecting data on the current state and appearance of the participants’ cardiovascular system, or in other words, their heart and blood vessels. The study also involved collecting data on the participants’ risk factors for cardiovascular disease.
We selected at random 4500 men and women aged between 35 and 69 years who were residents of the Russian cities of Arkhangelsk and Novosibirsk. We then invited these men and women to take part in the study. People aged 35-69 years were the focus because it at this age that cardiovascular mortality in Russia is particularly high relative to other industrialized countries. Our aim was to recruit a representative cross-section of people living in these two cities.
Data collection for the study had two primary components. Firstly, a baseline interview was carried out in people’s homes, using a structured questionnaire. This interview included questions about various characteristics of each person such as their education and employment status. It also included questions about their behaviours that were related to risk factors for cardiovascular disease, such as smoking, alcohol intake, diet and their level of physical activity. In addition, the interview included questions as to their general health, including mental health (particularly depression and anxiety) and their use of health services. At each stage of the process participants were provided with full information about the study and any risks and benefits that might be involved. All participants provided signed consent.
For the second component, participants attended a medical examination at a clinic. During this examination, very detailed measurements were collected on the participants’ cardiovascular health. These included blood pressure, ultrasound examination of the heart (ECHO) and blood vessels of the neck (vascular ultrasound). In addition, there were measurements of the heart’s rhythm and electrical activity (ECG) and of the speed of blood flow around the body (pulse wave velocity). Measurements were also made of body size and overall physical function, and people were asked about existing health problems, medications and their history of cardiovascular and other diseases.
Blood samples were taken from the participants during the examination, which were analysed in Moscow at the end of the field work to assess levels of cardiovascular risk factors such as cholesterol, indicators of inflammation and damage to the heart. Participants were also asked to provide urine and stool samples. A further subset of participants had their lung function measured and were also asked to wear a small device called an Actiheart for 5 days, which recorded their energy expenditure during this period.
To understand how their characteristics varied over time 400 participants were selected at random and reinterviewed and reexamined 12 months after their initial participation. In addition we also interviewed and examined an additional 250 men and women who were heavy drinkers. These participants were recruited through the narcology department of a psychiatric hospital in Arkhanglesk.
1) Investigate the relationship between known cardiovascular risk factors (such as smoking, cholesterol, blood pressure, physical activity) and cardiovascular profile in Russia.
2) Investigate how factors such as education, employment, medications and health service use are related to cardiovascular profile in Russia.
3) Compare the cardiovascular profile of people living in Russia with people living in other countries such as Norway (where risk of cardiovascular events such as a heart attack is much lower).
4) Investigate the relationship between novel risk factors such as gut bacteria (as measured from stool samples) and cardiovascular profile. This part of the study is exploratory.
Data collection for the study started in November 2015 and was completed at the end of 2017. Within the main study a total of 4500 people were interviewed at home and subsequently took part in the health check examination.