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Blood pressure, hypertension and mortality from circulatory disease in men and women who survived the siege of Leningrad

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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 blood pressure, 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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Acknowledgements

This study was supported by grants from the Foundation for Baltic and East European Studies and the Swedish Council for Social Research. Denny Vågerö is a member of the Macarthur Foundation network on social upheaval and health, which also gave support to the re-organisation of the data base. We would like to thank Maria Branting and Reidar österman for help with preparation of the dataset, David Leon, Hans Lithell and anonymous reviewers for comments on an earlier draft, and Sviatoslav Plavinski and Diana Kuh for alerting us to some crucial references on war time starvation.

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Authors and Affiliations

  1. Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institute, Stockholm, 10691, Sweden

    Ilona Koupil & Denny Vågerö

  2. Institute of Experimental Medicine, Russian Academy of Medical Sciences, St Petersburg, Russian Federation

    Dmitri B. Shestov, Svetlana Plavinskaja & Nina Parfenova

  3. Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden

    Pär Sparén

  4. University College of South Stockholm (Södertörn), Huddinge, Sweden

    Denny Vågerö

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  1. Ilona Koupil
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  2. Dmitri B. Shestov
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  3. Pär Sparén
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  4. Svetlana Plavinskaja
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  5. Nina Parfenova
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  6. Denny Vågerö
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Correspondence to Ilona Koupil.

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Koupil, I., Shestov, D.B., Sparén, P. et al. Blood pressure, hypertension and mortality from circulatory disease in men and women who survived the siege of Leningrad. Eur J Epidemiol 22, 223–234 (2007). https://doi.org/10.1007/s10654-007-9113-6

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  • DOI: https://doi.org/10.1007/s10654-007-9113-6

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