The contribution of a residential area infrastructure to the cardiovascular pathology combined endpoint development in the population

In recent years, infrastructural characteristics of urban and rural environments are considered as possible determinants of cardiovascular diseases and their complications development in addition to traditional risk factors. Objective. To evaluate the contribution of residential area infrastructure to the development of combined endpoint of cardiovascular pathology in the population of one of the constituent entities of the Russian Federation. Materials and methods. A two-stage prospective clinical and epidemiological study was carried out at the Research Institute for Complex Issues of Cardiovascular Diseases (Kemerovo) in 2017—2021. During the first stage (2017—2019), 1600 persons living in Kemerovo and surrounding rural areas underwent medical check-up, examination and survey using the NEWS scale. At the second stage (2020—2021), 1034 subjects, or 64.6% of all participants in the first stage, underwent a repeated examination. Fatal and non-fatal cardiovascular events were considered as combined endpoint (CEP). Logistic regression analysis and classification trees were used. Results. It has been found that the perceived characteristics of the population residence area on scale B, reflecting the availability of basic infrastructure [OR=1.53; p=0.046], and scale D, characterizing pedestrian infrastructure [OR=2.21; p=0.001], increase the odds ratio of CEP. The relationships were statistically significant for persons aged 45—70 and female s ubjects. Of the infrastructure parameters, the following criteria made the greatest contribution to the development of CEP: large number of intersections in the neighborhood (100 conditional scores); walking inaccessibility of working places (90); safety of pedestrian areas related to road traffic (73); state of streets in the residential area (57); lack of interesting places in the vicinity that can be seen on walks (51); heavy traffic making walking difficult (47). Conclusion. The study results proved the contribution of infrastructural characteristics of the residence area to the development of fatal events and non-fatal cardiovascular events of the population through the example of one constituent entity of the Russian Federation.