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Health Report: Heart Disease Risk, Prevention In Eastern Europe

  • Kevin Foley

This edition of the RFE/RL Health Report updates a U.S.-Russian project to help Russian public health authorities prevent, and treat, heart disease. The Health Report also looks at heart disease in the U.S., focusing on the case of U.S. Vice President Dick Cheney. There are also stories this week on developments in the struggle against HIV/AIDS.

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U.S., Russia Continue Work On Heart Disease Prevention

Washington, 9 March 20001 (RFE/RL) -- U.S. and Russian public health authorities are continuing work on a project to establish a national system in Russia for monitoring the risk factors for heart disease among Russians.

Helena Zabina, a cardiologist with the U.S. Centers for Disease Control, told RFE/RL that the surveillance system is part of a major joint effort to develop a policy for heart disease prevention in Russia.

Heart disease is the leading cause of death in Russia. It is also the leading cause of death in the United States. In health, a "risk factor," is something that increases the chance that a person will develop a medical condition.

There are risk factors that cannot be controlled, such as age, gender, and heredity. There are also risk factors that can be modified, such as smoking, eating habits, or physical activity. Knowing how widespread risk factors are in a population helps health experts develop strategies to reduce them.

Zabina said there has been a lack of this sort of health information in Russia. The goal of the bilateral project was to install a system to periodically collect information for comparison to "see how the picture is changing."

At an American Heart Association Conference in Texas last week, Zabina reported on the U.S.-Russian risk factor monitoring system. She said the U.S. and the Russians set up a pilot data collection program in Moscow. It was based on the "Behavioral Risk Factor Surveillance System," which is in use in all 50 U.S. states.

In Moscow, researchers selected a random sample of 6,065 people from the 2.5 million private telephone listings in the Russian capital. The sample group members were contacted by telephone and asked questions about their diet and physical activity, their blood pressure, and whether they smoked or drank.

Zabina told RFE/RL that the Russian Center for Preventive Medicine hopes to make the survey system a nationwide tool.

"If it becomes [a] real nationwide survey, then they'll be able to monitor prevalence of risk factors in different regions, compare different regions, different cities, compare year-by-year. Then they can use this information for health education."

The information gathered, she said, might be used in a variety of ways.

"They can target their health education programs, for instance. And they also can plan preventive measures, preventive programs according to this information, and then they can evaluate the preventive and education efforts, depending on how the situation with the risk factor prevalence changes."

Zabina said that next year, 11 sites in Russia will conduct the risk factor survey.

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Study Suggests Heart Disease Risks Widespread In Bulgaria

A study in the March issue of the American Journal of Public Health suggests that risk factors for cardiovascular disease are widespread in Bulgaria, as they are throughout most of Central and Eastern Europe and the former Soviet Union.

The researchers (Aryeh Stein, Valentina Mincheva, and Vassil Stoyanovsky) noted that Bulgaria has the third highest death rate from heart disease, and the highest death rate from stroke, in all of Europe. They said controllable risk factors such as smoking and diet are known to be high in a variety of Bulgarian population groups, but they wanted to compare the prevalence of risk factors now with those present before the collapse of communism in 1989.

The authors compared results of health surveys of male transport workers in Sofia that were conducted in 1986 and again in 1996-97. The transport workers were chosen because they are a stable work force and because the data was readily available since it was taken from annual physical examinations the men had to undergo.

The study authors said they found that three major risk factors -- smoking, being overweight, and having high blood pressure -- were widespread among the transport workers in 1986. They said the prevalence of these risk factors had increased over the ten-year period, suggesting an increase in heart disease.

The researchers said public health authorities should establish nationwide risk factor surveillance systems to make accurate assessments of the prevalence of heart disease risks in the general population. They said results of their studies and other investigations indicate the need for campaigns to help people stop smoking, improve their diets, and lower high blood pressure.

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Cheney Among Millions Of Americans Living With Heart Disease

U.S. Vice President Dick Cheney may be the most famous American heart patient, but he is just one of 12.4 million Americans living with heart disease.

The statistic comes from the American Heart Association, which notes that heart disease is still the main cause of death among adults in the United States, killing more than 459,000 people annually.

The Heart Association calls the death toll staggering. It says the numbers may be explained by the high prevalence of heart disease risk factors reported in the 1990s. The Association also blames the lack of improvement in changing behaviors that are known to reduce the risk of heart disease. These include smoking, being overweight, and not getting enough physical activity.

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Researchers See No Male-Female Difference In HIV Progression

The U.S. National Institutes of Health says new research shows that men and women infected with the virus that causes AIDS develop that deadly condition at the same rate.

Researchers looked at 200 men and women in a study group to chart the progression of the disease from infection with the Human Immune Deficiency Virus (HIV) to the onset of full-scale Acquired Immune Deficiency Syndrome (AIDS). The experts wanted to examine differences specific to gender in HIV infection. The study participants were all American drug users who all became infected through sharing of contaminated needles for drug injections.

Drug use has rapidly emerged as one of the main pathways for the spread of HIV. This is now especially true in Russia and Ukraine.

The U.S. researchers learned that even though female patients who developed AIDS had significantly lower levels of the virus in their blood when they first became infected, they progressed to AIDS just as quickly as men. This measurement of the blood level of the virus is known as the "viral load."

The researchers noted that previous studies have shown that the initial viral load in men can be used to estimate the likelihood of the progression to AIDS. Data from the new study shows that the viral load is at first much lower in women, which means this measure is not as useful in predicting the progression to AIDS in women.

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Congress Repeals Workplace Health Regulations

The U.S. Congress has approved a repeal of federal health regulations meant to prevent a class of workplace injuries caused by the constant repetition of the same task. The condition is known as "repetitive stress," or "repetitive motion," injury.

The U.S. Occupational Safety and Health Administration (OSHA) says millions of workers suffer debilitating injuries directly related to the tasks they perform on their jobs. Repetition of the same motion over time, says OSHA, leads to severe strains on muscles, tendons, and joints.

At the end of last year, former President Bill Clinton approved a rule sought by OSHA that would have held most U.S. enterprises more accountable for this type of injury. Among other things, businesses would have been required to provide information on the injuries and make changes at the work site to reduce the likelihood of injury. Employees would also have been made eligible for full pay while undergoing treatment and rehabilitation.

Businesses strongly opposed the rules, saying they would cost $100 billion to implement. OSHA estimated implementation costs at $4.5 billion. Business groups began an intensive campaign to convince the new Congress to rescind the regulations. Both the Senate and the House passed repeal measures this week and President George W. Bush has indicated he will sign the legislation.

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