Cerebrovascular disease mortality rates in the population over 50 years of age in Russia and the USA over a 15-year period

Objective: to compare standardized mortality ratios (SMRs) from cerebrovascular diseases (CVD) among populations aged 50 years or older in Russia and the USA; to discuss the reasons for the differences.

Patients and methods. The investigators calculated SMRs from CVD for men and women aged 50 years or older in Russia (2000–2014) and the USA (1999 to 2013), which corresponded to the 3- and 4-digit codes of the International Statistical Classification of Diseases and Health-Related Problems, 10t h edition (ICD-10). The European standard (European Standard Population, ESP-2013) was used to standardize SMRs.

Results and discussion. The SMRs per 100,000 population from all CVD forms for men aged 50 years or older are 1353 in Russia and 185 in the USA; these for women are 1080 and 175, respectively. The CVD SMRs in percentage of SMRs of all circulatory diseases in Russia were 33.5 for men and 39.6 for women and those in the United States are 14.6 and 19.6, respectively. In Russia, the highest death rates due to CVD fall in the category «Other Cerebrovascular Diseases» (I67) are 35.5% for men and 41.3% for women (about 6% for men and women in the USA); those followed by the rubrics «Cerebral Infarction» (I63) (20.1% for men and 19.2% for women (about 6% for both men and women in the USA)); «Stroke, Not Specified as Hemorrhage or Infarction» (I64) (26% for men and women (about 55% for men and women in the USA)). The death rates from non-traumatic intracranial hemorrhage (I61–I62) in the USA are 18.9% for men and 16.3% for women; those in Russia are 9.5 and 8.6%, respectively. As for all 3-digit codes, SMRs are higher in Russia than those in the USA, with the exception of «Other Nontraumatic Intracranial Hemorrhage» (I62).

The reasons for the revealed differences are discussed. The differences in CVD mortality rates in the United States and Russia are linked to a number of reasons, most of which are due to the peculiarities of selecting the underlying cause of death and using the ICD-10 codes. 

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