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To provide effective primary and secondary stroke prevention, the epidemiological stroke rates were investigated in the open population of a large Transbaykal town by the register method. During one year, 989 cases have been examined in the population aged above 25 years. The age-standardized stroke incidence rate (per 100 000 persons) was 300 in women and 329 in men. The age-standardized stroke morbidity (per 100 000 persons) was 390 in women and 409 in men. Stroke mortality was 77 in women and 81 in men per 100 000 (p = 0.01). The stroke mortality in men was higher than in women. Stroke case fatality was 20% in men and 16% in women. The prevalence and significance of the main cardiovascular risk factors were revealed among patients by case-control study. Hypertension, psychological and social risk factors were the most significant in Chita's population of stroke patients.

Based on WHO MONICA methods and diagnostic criteria, it is shown that first-ever stroke incidence and mortality in Siberia (a total number of residents included in the analysis varied from 450,000 to about 800,000) that are among the highest in the world. In Novosibirsk, for the period from 1982 through 1991 there was a trend towards decreasing stroke incidence and mortality rates, but for the period from 1992 through 1997 there was a trend towards increasing there rates in both men and women. Age-standardized (US white population was used as a standard) stroke incidence rates increased from west to east and from south to north across Siberia, with a corresponding increase in the proportion of hemorrhagic strokes. In 1987-1988, age-adjusted stroke incidence rate in Novosibirsk was 212 per 100,000 residents per year, in Krasnoyarsk--325, in Tynda--329, in Anadyr--348. Stroke-case fatality rates ranged from 28% in Tynda to 41% in Anadyr. A multivariate regression analysis revealed that hypertension, left ventricular hypertrophy, ischemic heart disease. mitral valve disease, current cigarette smoking, excessing body mass index, winter season, and low ambient temperature are all significant and independent risk factors for the occurrence of ischemic stroke in Novosibirsk. A significant association between stroke occurrence and air pressure/geomagnetic activity change was found. Possible reasons for such unfavorable trends in stroke incidence in Siberia are discussed, and an optimal approach for improving organization of cerebrovascular disease care is suggested.

Previous studies have established a seasonal variation in stroke occurrence, but none have assessed the influence of inclement weather conditions on stroke incidence in a general population of Russia. We performed a stroke population-based study in the Oktiabrsky District of Novosibirsk, Siberia, Russia. Included in the analysis were 1929 patients with their first occurrence of ischemic stroke (IS), 215 patients with their first occurrence of intracerebral hemorrhage (ICH) and 64 patients with their first occurrence of subarachnoid hemorrhage (SAH): all patients were aged between 25 and 74 years. The cumulative daily occurrence of total strokes and stroke subtypes was evaluated in relation to aggregated daily mean values of ambient temperature, relative humidity and air pressure by means of Poisson regression analysis to estimate the rate ratio (RR) with corresponding confidence interval (CI) and to identify the weather parameters of most importance. In a multivariate analysis, with adjustment for the effects of season, solar and geomagnetic activity, and age of the patients, low ambient temperature (RR 1.32; 95% CI 1.05-1.66) and mean value of air pressure (RR 0.986; 95% CI 0.972-0.999) were important predictors of IS occurrence, while mild ambient temperature (RR 1.52; 95% CI 1. 04-2.22) was an important predictor of ICH occurrence. No relationship between SAH occurrence and any one of the weather parameters studied was revealed. There was no interaction between any meteorological variables that was statistically significant. Inclement weather conditions are associated with the occurrence of IS and ICH in Siberia, Russia. Among the meteorological parameters studied, low ambient temperature and mean air pressure are the most important predictors of IS occurrence, whereas the occurrence of ICH is associated with mild ambient temperature. There is no association between any one of the weather parameters studied and the occurrence of SAH.

The worsening of the health status of northern populations is a matter of concern to scientists in many countries. International collaboration aimed at using international experience in the field of circumpolar health may speed up the research, making it more effective for solving problems of medical science and public health in the North.

The data on the studies using WHO programs "Register of Acute Myocardial Infarction", "Register of Brain Apoplexy", "MONICA" in one of the districts of Novosibirsk have been pooled and analyzed. The studies have established objective trends in the incidence, mortality, lethality of myocardial infarction and brain apoplexy in the population aged 25-64 for 10 years.

To study the incidence of coronary heart disease (CHD), cerebrovascular diseases (CVD), combined pathology (CHD and CVD), and their risk factors such as arterial hypertension (AH), overweight (OW), hypercholesterolemia (HC), and tobacco smoking in the same population, a random representative sample of male and female populations were examined in three districts of Novosibirsk. AH and tobacco smoking were found predominant among men, whereas OW and HC among women. It turned out that almost every fourth person out of the men and almost every second woman suffered from cardiovascular diseases. In the men, the CHD/CVD ratio was 1:1, that in the women, was 1:7. In the men and women, suffering from combined pathology, AH occurred more frequently as compared to those with CHD or CVD alone. OW promoted the development of CVD and combined pathology in women to a greater degree, whereas HC favoured the development of CHD and CVD in men.