Cardiovascular risk factors in the former communist countries. Analysis of 40 European MONICA populations.

MONICA Project findings provide a unique opportunity to compare cardiovascular disease (CVD) risk factor levels in a large number of populations living in different political systems. 15 European communist populations had significantly higher age-standardized mortality for age groups 35-64 years from all causes, from CVD and stroke than 25 democratic MONICA populations. The prevalence of systolic and diastolic hypertension in males and females, prevalence of smoking in males and prevalence of overweight in females were significantly higher in communist MONICA populations. In these populations there was tendency to lower prevalence of hypercholesterolemia. In simple and multiple regression analysis hypertension and smoking prevalence had the highest relation with CVD mortality in men; hypertension and overweight prevalence had the highest relation with CVD mortality in women. The combination of 'classical' CVD risk factors could explain only part of differences observed. In communist Europe there was high consumption of spirits, low consumption of fruits and extremely low intake of citrus fruits. Instead of exaggerated anti-cholesterol propaganda emphasis should be given to the prevention of antioxidant deficiencies by the increase of fruit and vegetable consumption and to the decrease in salt, spirit and cigarette consumption in former communist countries.