Objective. The aim of the present study was to estimate the premature ischemic heart disease (IHD) mortality attributable to alcohol abuse in Russia on the basis of aggregate-level data of mortality and alcohol consumption. Method. Age-standardized sex-specific male and female IHD mortality data for the period 1980–2005 and data on overall alcohol consumption were analyzed by means of autoregressive integrated moving average (ARIMA) time series analysis. Results. The results of the analysis suggest that 41.1% of all male deaths and 30.7% of female deaths from IHD in Russia could be attributed to alcohol. The estimated alcohol-attributable fraction for men ranged from 24.0% (75+ age group) to 62.0% (15–29 age group) and for women from 20.0% (75+ age group) to 64.0% (30–44 age group). Conclusions. The outcomes of this study provide indirect support for the hypothesis that the high rate of IHD mortality in Russia may be related to alcohol, as indicated by a close aggregate-level association between number of deaths from IHD and overall alcohol consumption per capita. 1. Introduction Ischemic heart disease (IHD) remains the largest contributor to morbidity and mortality in Europe, accounting for 1.92 million deaths each year [1]. Over the past decades there was a trend towards a decrease in IHD mortality in Western Europe (WE) [2]. In contrast to Western Europe, in many countries of Eastern Europe (EE) IHD mortality continues to increase [2, 3]. Moreover, dramatic increase in IHD mortality is a major cause of the health decline in EE [4]. The increase in deaths from IHD has been especially pronounced among middle-aged men [1]. Several studies have shown that high cardiovascular mortality in EE could not be explained by traditional risk factors identified in the Western countries [5, 6]. This apparent paradox has been a matter of much speculation, but is still poorly understood. Some experts have underlined the importance of binge drinking as the main reason for the IHD mortality crisis in Russia [7–11]. The level of alcohol consumption in Russia is among the highest in the world with an annual sales rate about 10 litres of pure alcohol per capita, while independent estimates show a figure as high as 17 litres [12, 13]. The distinctive trait of Russian drinking culture is the preference for binge drinking of vodka, leading to an increase in deaths from alcohol poisoning and cardiovascular diseases [12, 14–17]. Evidence of a major effect of binge drinking on Russian IHD mortality pattern comes from both aggregate level analyses and studies of individuals [10,
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