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CVD deaths often
occur at a younger age than in western countries and are much more likely to
be sudden. While much of the cardiovascular disease in Russia is likely to
be attributable to the traditional risk factors, such as a poor diet and
smoking, there is now considerable evidence that many of the excess deaths
especially among younger men are attributable to heavy alcohol consumption,
with this factor explaining the large fluctuations in cardiovascular deaths
since the mid 1980s. (18).
The second most important cause of death involves external causes of
injury and poisoning (which includes homicide, suicide, alcohol poisonings,
etc.). As with cardiovascular diseases, these deaths peaked in 1994. The
importance of this category of causes of death is unusual by the standards
of most industrialized countries, where external causes tend to be
superseded by cancer. A reduction in deaths from external causes after 1994
was reversed in 1998 and the Russian rate continues to be the highest in the
European Region (2). The male mortality rate in this category is 4.4
times greater than that of women, accounting for about half the deaths of
working-age men, and there is considerable evidence to link it to alcohol
abuse. |