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Title: Health, cardiovascular disease and their determinants in the Kazakh population
Author: Supiyev, Adil
ISNI:       0000 0004 7659 7042
Awarding Body: UCL (University College London)
Current Institution: University College London (University of London)
Date of Award: 2018
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Background: The high and fluctuating mortality and rising health inequalities in post-Soviet countries have attracted considerable attention, but there are very few individual-level data on distribution of health outcomes in Central Asian countries of the former Soviet Union, including Kazakhstan. The main causes of death driving the low life expectancy (some 12 years shorter than in Western Europe) are chronic non-communicable diseases, particularly cardiovascular diseases (CVD). Aim: The main aim of the thesis was to investigate the levels and distribution of risk factors of CVD and the associations between a range of risk factors and CVD in Kazakhstan. Methods: This thesis describes a population-based cross-sectional survey and a case-control study of acute coronary syndrome (ACS) and stroke in the Astana (Kazakhstan capital city) region. The cross-sectional survey examined 977 men and women aged 50-74 years (493 in Astana city and 484 in a rural area) randomly selected from primary care registers. Subjects in the crosssectional survey served as controls for 348 cases of acute coronary syndrome (ACS) and 235 cases of stroke hospitalised during the study period in two hospitals covering over 80% of acute admissions for these two conditions in the Astana region. The examination of both sets of cases followed identical protocol, including a structured questionnaire, objective examination and collection of blood samples. Results: The cross-sectional survey found high prevalence of cardiometabolic risk factors and differences in the prevalence of risk factors by socioeconomic and demographic characteristics, including less favourable pattern in urban vs. rural residents. The case-control study identified associations between ACS and stroke and cardio-metabolic risk factors, health behaviours and socioeconomic factors. A consistent finding was a less favourable risk profile in the Russian vs. Kazakh ethnicity. Conclusions: The prevalence of cardio-metabolic risk factors in the Kazakh population is high compared to Western Europe. The associations of ACS and stroke with risk factors were as expected, and there were some specific associations with socio-demographic characteristics. The pronounced sociodemographic differences in prevalence of cardio-metabolic risk factors suggest that preventive strategies may target population groups at higher risk of CVD.
Supervisor: Bobak, M. ; Peasey, A. Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available