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Purpose: The purpose of this paper is to assess the relationships of alcohol consumption to total and cardiovascular disease mortality in U.S. and Russian men and women after adjustment for several covariates. A secondary objective is to determine how this relationship varies by country and gender., Methods: Men aged 40-59 and women aged 40-69 screened in Russia and the U.S. between 1972 and 1982 were followed for mortality for 13 years as part of the Lipid Research Clinics Prevalence and Follow-up Studies. Alcohol consumption was based on a 7-day recall of drinks of beer, wine, mixed drinks, and liquors. Drinkers of alcohol were classified into four levels based on amount consumed during the recall period., Results: Age-adjusted mortality rates were higher for non-drinkers than lower level drinkers in both genders and countries, and there was an indication that mortality rates for high level drinkers, especially in men, approached those of non-drinkers. When mortality rates were adjusted for other risk factors they remained higher for non-drinkers in U.S. men and women, but in Russia, with one exception, there was no difference in mortality rates between drinkers and non-drinkers. Relative risks for cardiovascular disease mortality rates were similar to those of total mortality., Conclusions: Beneficial association of alcohol consumption and mortality may be limited depending upon the prevalence of other risk factors in the studied population.

Examination of blood pressure (BP) and heart rate (HR) measurements at rest and during exercise in samples of USA and Russian middle-aged men and women show significant differences between countries for both genders. Russian men had higher resting systolic blood pressure (SBP) than USA men but lower SBP at both stages of exercise. Russian women had significantly higher resting SBP than USA women at rest and also during exercise. Russian men and women had significantly lower HR at rest and during exercise than USA men and women. Differences between countries were also noted for mean body weight, height, lipid levels, percentages of smokers and several other variables, and it was postulated that differences in these factors might be responsible in part for differences in SBP and HR during exercise. After adjustment for these variables, differences in SBP during exercise between USA and Russian men remained, but differences between USA and Russian women disappeared. For both genders, differences in HR during exercise remained after adjustment. Mortality analyses in USA and Russian men indicated that stage 2 SBP response during exercise was generally not a significant mortality risk factor after adjustment for age, BMI, TC, smoking and resting SBP. In a similar model, stage 2 HR response during exercise was also a non-significant risk factor in mortality.

Previous reports from the Russian Lipid Research Clinics (LRC) study showed no association between the level of high-density-lipoprotein (HDL) cholesterol and mortality from coronary heart disease (CHD), while US LRC data indicated a strong negative association between HDL cholesterol and CHD mortality. This report investigated the association of HDL cholesterol and mortality in these same population samples with follow-up extended to 12 years. The association between HDL cholesterol and mortality remained inverse and significant in the US sample. In the Russian sample, high levels of HDL cholesterol were associated with higher risk of all-cause and cancer mortality, although adjustment for known risk factors reduced the strength of the association. The association between HDL cholesterol and CHD mortality was negative in the Russian sample, although the strength of the association was less than that for the US sample. Extended follow-up reduced the difference in the association between HDL cholesterol and mortality between the two countries; however, important differences remained. Further research will be required to clearly determine the cause for their differences.