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- Koupil, Ilona, et al.
(författare)
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Blood pressure, hypertension and mortality from circulatory disease in men and women who survived the siege of Leningrad
- 2007
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Ingår i: European Journal of Epidemiology. - : Springer Science and Business Media LLC. - 0393-2990 .- 1573-7284. ; 22:4, s. 223-234
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Tidskriftsartikel (refereegranskat)abstract
- The population of Leningrad suffered from severe starvation, cold and psychological stress during the siege in 1941–1944. We investigated long-term effects of the siege on cardiovascular risk factors and mortality in surviving men and women. 3905 men born 1916–1935 and 1729 women born 1910–1940, resident in St Petersburg (formerly Leningrad) between 1975 and 1982, of whom a third experienced the siege as children, adolescents or young adults,were examined for cardiovascular risk factors in 1975–1977 and 1980–1982 respectively and followed till end 2005. Effects of siege exposure on bloodpressure, lipids, body size, and mortality were studied in multivariate analysis stratified by gender and period of birth, adjusted for age, smoking, alcohol and social characteristics. Women who were 6–8 years old and men who were 9–15 years-old at the peak of starvation had higher systolic blood pressure compared to unexposed subjects born during the same period of birth (fully adjusted difference 8.8, 95% CI:0.1–17.5 mm Hg in women and 2.9, 95% CI: 0.7–5.0 mm Hg in men). Mean height of women who were exposed to siege as children appeared to be greater than that of unexposed women. Higher mortality from ischaemic heart disease and cerebrovascular disease was noted in men exposed at age 6–8 and 9–15, respectively. The experience of severe stress and starvation in childhood and puberty may have long-term effects on systolic blood pressure and circulatory disease in surviving men and women with potential gender differences in the effect of siege experienced at pre-pubertal age.
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| 3. |
- Sparén, Pär, et al.
(författare)
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Long term mortality after severe starvation during the siege of Leningrad : prospective cohort study
- 2004
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Ingår i: The BMJ. - 1756-1833. ; 328:7430, s. 11-14A
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To determine whether starvation during periods of increased growth after birth have long term health consequences.Design Analysis of cardiovascular risk factors and mortality in a longitudinal follow up after the 1941-4 siege of Leningrad. Mortality measured from 1975 up to the end of 1999.Setting St Petersburg, Russia (formerly Leningrad).Participants 5000 men born 1916-35 who lived in Leningrad, randomly selected to take part in health examinations in 1975-7. Of the 3905 men who participated, a third had experienced the siege.Main outcome measures Relative risk of ischaemic heart disease and mortality from stroke by siege exposure. Odds ratios and means for several cardiovascular risk factors.Results Three to six decades after the siege, in men who experienced the siege around the age of puberty blood pressure was raised (mean difference in systolic 3.3 mm Hg, in diastolic 1.3 mm Hg) as was mortality from ischaemic heart disease (relative risk 1.39, 95% confidence interval 1.07 to 1.79) and stroke (1.67, 1.15 to 2.43), including haemorrhagic stroke (1.71, 0.90 to 3.22). The effect on mortality was partly mediated via blood pressure but not by any other measured biological, behavioural, or social factor.Conclusions Starvation, or accompanying chronic stress, particularly at the onset of or during puberty, may increase vulnerability to later cardiovascular disease.
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| 4. |
- Sparén, Pär, et al.
(författare)
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Stagnation, sammanbrott och social nyordning - rötterna till den ryska folkhälsokrisen
- 2000
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Ingår i: Sociologisk forskning. - : Sveriges Sociologförbund. - 0038-0342 .- 2002-066X. ; 37:1, s. 127-149
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Tidskriftsartikel (refereegranskat)abstract
- Stagnation, break-down and a new social order - the roots of the Russian public health crisisLong term trends of deteriorating health status in Soviet Union and Eastern Europe during the last two decades of communism were followed by a new crisis in health, after the collapse of its social system. In contrast, the perestroika period coincided with strongly improved public health. Explanations for the latest Russian health crisis are discussed. It is concluded that explanations based on poor medical care, excessive alcohol consumption or nutrional deprivation are, at best, insufficient. The collapse of the social system itself has lead to a narrowing of individual and collective decision latitudes; we speculate that historical factors, such as vulnerability of specific birth cohorts or segments of the population, may be part of the unexpected and very steep rise of mortality during the first half of the 1990s.
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| 5. |
- Vågerö, Denny, et al.
(författare)
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Long-Term Health Consequences Following the Siege of Leningrad
- 2013
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Ingår i: Early Life Nutrition and Adult Health and Development. - New York : Nova Science Publishers, Inc.. - 9781624171291 - 9781624171369 ; , s. 207-225
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- We are interested in the long-term health consequences associated with severe starvation and war trauma, and whether certain “age windows” exist when exposure to such events are particularly harmful. The siege of Leningrad (now St. Petersburg) during World War II provided an opportunity to study this. For 872 days, German troops prevented supplies from reaching Leningrad. Simultaneously, there was a food blockade and a steady and merciless bombardment by shells from guns and from the air. The first winter, 1941/42, represents the most severe food shortage, amounting to mass starvation or semi-starvation. Our late colleague, Professor Dimitri Shestov, had suffered the consequences of the Leningrad siege as a boy and believed that it had taken a toll on people beyond its immediate short- and medium-range consequences. He was particularly concerned about its long-term consequences for circulatory disease. A 1973 US-Soviet agreement, the so called Lipid Research Clinics Collaboration, gave him an opportunity to study this. From 1975 to 1982 men and women living in Leningrad (now St. Petersburg) were randomly sampled and invited to examine their health and cardiovascular functioning. Dimitri Shestov added a simple question to this examination: “Were you in Leningrad during the blockade?” A third of the participants were. They had experienced peak starvation (in January 1942) at ages 1-31 (women) or 6-26 (men). The mortality follow-up began immediately after the first clinical examinations in 1975 and continued for three decades, until the end of 2005. Our analyses show that the siege of Leningrad, particularly when experienced in puberty, has had long-term effects on blood pressure both in men and women.We also found a raised IHD and stroke risk among those men. This was partly mediated via blood pressure but not by any other measured biological, behavioral, or social factors. Girls experiencing the siege around puberty suffered an elevated risk of dying from breast cancer later in life. The fact that the effect of siege exposure is modified by the age at exposure is highly interesting from a scientific point of view. It may suggest that a reprogramming of physiological systems can occur at specific age windows in response to starvation and/or war trauma. The team that worked from 1975-2005 to collect clinical information and death certificates for participants in the study included Svetlana Plavinskaya, born in Leningrad during the siege. Dimitri Shestov and Svetlana Plavinskaya died in 2010 and 2011, respectively. We dedicate this chapter to their memory.
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