OBJECTIVE
Analyze the variability of standardized mortality rates (SMR) from causes associated with arterial hypertension (AH), indicated as the oroginal cause of death (OCD) in the regions of the Russian Federation based on Rosstat data, and discuss the problems of assessing mortality from these causes.
MATERIAL AND METHODS
It was analyzed the Rosstat data provided upon request based on the «Brief Nomenclature of Death Causes of Rosstat» for the following 3—digit ICD-10 codes: I11, I12, I13, I10, I67.4. The calculations were performed using the European Standard Population and the program developed at the National Medical Research Center for Therapy and Preventive Medicine. For each cause of death, the SMR that means standard deviation and coefficient of variation (Cv) of the SMR were determined. The grouping of regions by SMR levels from 5 studied forms was performed using hierarchical cluster analysis.
RESULTS
SMR from the sum of 5 considered reasons in the Russian Federation in 2019 amounted to 8.7 per 100 thousand population (or 1% of all deaths); the coefficient of variation of the SMR by region was 122.7 (μs. 276 for the I13 code, min. 135 for the I11 code). The ratio of the maximum SMR value to the minimum value is 622. The average value of the 5 codes’ share in the regional structure of mortality from all causes was 1.3±1.7%. Only under the I11 code, deaths were registered in all subjects of the Russian Federation. In terms of the SMR value and the structure of mortality from the 5 indicated codes the significant difference from other regions was noted: the Karachay—Cherkess Republic, the Republic of North Ossetia—Alania, the Chukotka Autonomous Region. The rest of the regions are combined into 2 clusters (66 regions in the first cluster and 13 in the second one with pronounced and statistically significant differences in SMR according to the I11 code).
CONCLUSION
In the regions of the Russian Federation, there is a pronounced variability in SMR values from hypertension. Given the lack of uniform criteria for determining OCD from hypertension (ICD-10 uses the term hypertension) in the presence of competing pathology the variability is probably due not so much to differences in mortality rates as to different approaches to determining OCD.
