Compared with Western Europe, the decline in cardiovascular (CV) mortality has been delayed in former communist countries in Europe, including the Czech Republic. We have assessed longitudinal trends ...in major CV risk factors in the Czech Republic from 1985 to 2016/17, covering the transition from the totalitarian regime to democracy.
There were 7 independent cross-sectional surveys for major CV risk factors conducted in the Czech Republic in the same 6 country districts within the WHO MONICA Project (1985, 1988, 1992) and the Czech post-MONICA study (1997/98, 2000/01, 2007/08 and 2016/2017), including a total of 7,606 males and 8,050 females. The population samples were randomly selected (1%, aged 25-64 years).
Over the period of 31/32 years, there was a significant decrease in the prevalence of smoking in males (from 45.0% to 23.9%; p < 0.001) and no change in females. BMI increased only in males. Systolic and diastolic blood pressure decreased significantly in both genders, while the prevalence of hypertension declined only in females. Awareness of hypertension, the proportion of individuals treated by antihypertensive drugs and consequently hypertension control improved in both genders. A substantial decrease in total cholesterol was seen in both sexes (males: from 6.21 ± 1.29 to 5.30 ± 1.05 mmol/L; p < 0.001; females: from 6.18 ± 1.26 to 5.31 ± 1.00 mmol/L; p < 0.001).
The significant improvement in most CV risk factors between 1985 and 2016/17 substantially contributed to the remarkable decrease in CV mortality in the Czech Republic.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Abstract Objective The aim of our study was to assess longitudinal trends in major CV risk factors in a representative population sample of the Czech Republic. Methods Three cross-sectional surveys ...of CV risk factors were conducted within the WHO MONICA project in six Czech districts in 1985 ( n = 2570), 1988 ( n = 2768), and 1992 ( n = 2343). In 1997/98, 2000/01, and 2007/08, another three screenings for CV risk factors (a 1% random sample, aged 25–64, mean age 45 years) were conducted in the six original districts ( n = 1990; 2055; and 2246, respectively). Results Over a period of 22/23 years, there was a significant decrease in the prevalence of smoking in males (from 45.0 to 30.5%; p < 0.001) and no change in smoking habits in females. BMI increased in males and did not change in females. Both systolic and diastolic blood pressure decreased significantly in both genders, while the prevalence of hypertension declined only in females. Awareness of hypertension also rose as did the proportion of individuals treated by antihypertensive drugs in both genders. Hypertension control improved in either gender. A remarkable drop in total cholesterol was seen in both sexes (males: from 6.21 ± 1.29 to 5.29 ± 1.10 mmol/L; p < 0.001; females: from 6.18 ± 1.26 to 5.30 ± 1.06 mmol/L; p < 0.001). Conclusions The striking improvement in CV risk factors documented between 1985 and 2007/8 most likely contributed to the decrease in CV mortality in the Czech Republic.
Background: Severe hypercholesterolemia is associated with an increase in the risk of developing atherosclerotic cardiovascular disease. The aim of this analysis was to assess longitudinal trends in ...severe dyslipidemia (defined as total cholesterol > 8 mmol/L or LDL-cholesterol > 5 mmol/L) in a representative population sample of the Czech Republic and to analyze the longitudinal trends in the basic characteristics of individuals with severe dyslipidemia. Methods: Seven independent cross-sectional surveys were organized in the Czech Republic to screen for major cardiovascular risk factors (from 1985 to 2015–2018). A total of 20,443 randomly selected individuals aged 25–64 years were examined. Results: The overall prevalence of severe dyslipidemia was 6.6%, with a significant downward trend from the fifth survey onwards (2000/2001). Over the study period of 30+ years, the individuals with severe dyslipidemia became older, increased in BMI, and did not change their smoking habits. Total cholesterol and non-HDL-cholesterol decreased significantly in both sexes throughout the duration of the study. Conclusions: Despite a significant improvement in lipids in the Czech Republic from 1985, substantially contributing to the decline in cardiovascular mortality, the number of individuals with severe dyslipidemia remained high, and in most cases, they were newly detected during our screening examinations and were thus untreated.
Subclinical inflammation is a risk factor for cardiovascular disease. The mechanisms underlying increased levels of inflammatory markers and their changes in response to weight loss are not fully ...understood yet. It has been proposed that elevated concentrations of C-reactive protein (CRP) are mediated by cytokines produced in adipose tissue. We investigated the changes in circulating CRP after weight reduction, in relation to parameters relevant to the metabolic syndrome. Forty 25- to 35-year-old obese female volunteers participated in an intervention program of dietary education and supervised physical activity for a period of 9 weeks. Anthropological parameters and biochemical measurements (high-sensitivity CRP hsCRP, plasma lipoproteins, interleukin 6 IL-6, adiponectin) were analyzed before and after the intervention. Body mass index decreased by more than 7% from 31.5 ± 4.1 to 29.1 ± 3.9. Plasma free fatty acid (FFA) concentrations decreased by 30%, high-density lipoprotein cholesterol increased by 8%, and fasting insulin concentrations decreased by 15%. There were no significant changes in either low-density lipoprotein cholesterol or triacylglycerol concentrations. Subcutaneous and visceral adipose tissue mass decreased by 12% and 18%. High-sensitivity CRP concentrations decreased by 30%; however, mean plasma IL-6 and adiponectin concentrations remained unchanged. In linear regression analysis, the changes in plasma hsCRP concentrations were associated with baseline hsCRP concentration, change in triacylglycerols and FFA concentrations, and in waist circumference. The decrease in hsCRP concentration after weight reduction does not appear to be mediated by decreases in circulating IL-6 or adiponectin concentrations; however, change in hsCRP concentration is related to changes in waist circumference and lipid metabolism, reflected by plasma triacylglycerol and FFA levels.
Abstract Introduction Atherosclerosis is the main cause of mortality in the Czech Republic. In our previous cross-sectional studies, we detected a high prevalence of metabolic cardiovascular risk ...factors in women before and after menopause and found menopausal transition to be critical period for atherosclerosis acceleration. In the present longitudinal study, we studied changes of main cardiovascular risk factors in women after transition to menopause. Methods We analyzed data of 195 women who became menopausal and 292 women who stayed in menopause during 6-year period. The cardiovascular risk factors under study were as follows: smoking, body mass index, waist circumference, blood pressure, plasma lipids including apolipoprotein B and A1 and fasting glycemia. Results The most striking differences between newly and steadily menopausal women were found in changes of plasma lipids. With the exception of HDL cholesterol all changes were less favorable in newly menopausal women and were not associated with treatment with statins. No significant differences between both groups were found for changes in body mass index, waist circumference, blood pressure and fasting glycemia. Conclusions In longitudinal study we confirmed that time around menopausal transition is one of the most dynamic periods regarding changes of cardiovascular risk factors, mainly plasma lipids.
It has been shown that high-sensitivity C-reactive protein (hsCRP) concentrations are associated with elevated risk of myocardial infarction, but the mechanisms regulating hsCRP concentration are not ...completely elucidated yet. In our study, association of interleukin-10 (
) and
polymorphisms and environmental factors with the risk of myocardial infarction was studied.
: The study group consisted of 284 male patients aged below 65 years, admitted to hospital for myocardial infarction. The controls were age-matched individuals selected from a 1% representative population sample of adult men.
: While there was no difference in body mass index (BMI), the patients more frequently had abdominal-type obesity. hsCRP concentration was higher in patients (2.12±2.31 mg/L) than in controls (1.40±1.56 mg/L; p=0.001), in spite of statin treatment in most of the patients. No significant difference in lipoprotein concentrations was found. There was no difference in
and
genotype distributions between the patients and controls. In smoking patients carrying the
C allele, hsCRP concentration was significantly higher (p=0.0012) than in a non-smoking patients with the same allele. According to linear regression analysis, statin treatment was the only variable with an influence that reached statistical significance in the patient group, while in the control group, age, smoking, education and BMI significantly influenced hsCRP concentration.
: There was no association between
and
polymorphisms and myocardial infarction occurrence. Gene-environment interaction may play an important role in influencing hsCRP concentration.
Clin Chem Lab Med 2007;45:855–61.
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