Prevalence of Early Ischemic Heart Disease and Its Associations with Risk Factors and Socioeconomic Variables in the 25–44-year Age Group in Western Siberia
Authors: Ragino Yuliya I. , Kuzminykh Natalya A. , Shcherbakova Liliia V. , Shramko Viktoriya , Denisova Diana V. 
Published: July 2020

Abstract
The aim of this study was to investigate the prevalence of early ischemic heart disease (IHD) in accordance with standardized epidemiological criteria in the 25–44-year age group in Novosibirsk (Russia) and to identify associations with some risk factors and socioeconomic factors.Materials and methods. A cross-sectional populational medical examination was conducted on a random sample of the 25–44-year age group in Novosibirsk. A total of 1457 people were analyzed (653 males and 804 females). Epidemiological IHD diagnosis was made according to validated epidemiological (cardiological Rose questionnaire) and functional criteria (recording of an ECG interpreted via the Minnesota Code). The “definite IHD” diagnosis was made in the presence of the following criteria: a history of large-focal myocardial infarction (ECG), tension angina pectoris (Rose questionnaire), ischemic changes on ECG without left ventricular hypertrophy (ECG). Further, the diagnosis of "definite IHD" was confirmed by conducting an ECG test with physical activity. The evaluated IHD modifiable risk factors were cigarette smoking, elevated body mass index, elevated waist circumference, the presence of arterial hypertension, low physical activity, and elevated blood levels of low-density lipoprotein cholesterol, non–high-density lipoprotein cholesterol, and triglycerides. Socioeconomic factors were assessed too: marital status, occupation type, education, health self-rating, and economic status.Results. The prevalence of definite IHD in the study population was found to be 3.36% (49 subjects): 2.8% (18 subjects) among males and 3.9% (31 subjects) among females. All quantitative data on IHD risk factors were higher in males than in females. The prevalence of IHD risk factors (except for elevated waist circumference) was higher among males than females. The prevalence of IHD risk factors (except for cigarette smoking) was not different between IHD and no-IHD groups in the study population. Smoker prevalence was 1.66-fold higher (p = 0.031) in the no-IHD group than in the IHD group. Multivariate logistic regression analysis uncovered an inverse association of cigarette smoking (independently of age, sex, and other risk factors) with the relative risk of early IHD in the study population. Furthermore, in males, the relative risk of definite IHD (regardless of age) directly correlated with heavy manual labor (odds ratio [OR] = 3.495, confidence interval [CI] 1.306–9.353, р = 0.013) and unfavorable marital status (divorced or widowed; OR = 4.976, CI 0.944–26.228, р = 0.058). Meanwhile, these two factors inversely correlated with cigarette smoking (OR = 0.202, CI 0.060–0.672, р = 0.009).Conclusion. In males aged 25–44 years in Novosibirsk, the relative risk of early IHD is directly associated with heavy manual labor or unfavorable marital status, and these factors are inversely associated with smoking. This correlation needs further research.The medical-examination–based screening was performed within the framework of a government-funded research topic in State Assignment No. АААА-А17-117112850280-2. The biochemical and functional analyses were financially supported by a Russian Federation President grant for leading scientific schools, No. НШ-2595.2020.7.