Cardiovascular risk assessment, cardiovascular disease risk factors, and lung function parameters

Background: Decreased lung function is related to higher cardiovascular disease (CVD) incidence and mortality. However, little is known about the relationship between the risk factors of CVD and pulmonary function. Aim: The aim of the study was to assess the relationship between the prevalence of cardiovascular risk factors, the total CVD risk, and pulmonary function. Methods: The analysis included 4104 men and women aged 45 to 69 years, participants of the Polish part of the Health, Alcohol, and Psychosocial factors In Eastern Europe (HAPIEE) Project, who provided valid measurements of forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) using a Micro-Medical Microplus spirometer. The prevalence of CVD risk factors was defined as follows: hypertension (systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg or taking hypertension medication), diabetes (glucose ≥ 7.1 mmol/L or self-reported diabetes), and hypercholesterolaemia (total cholesterol ≥ 5 mmol/L or low-density lipoprotein-cholesterol ≥ 3 mmol/L or taking lipid lowering medication). Categories of total CVD risk were defined according to the 2016 European Guidelines on CVD prevention in clinical practice. The analysis of covariance was used to compare the lung function in the CVD risk factors and the total CVD risk categories. Results: Mean values of FEV1 and FVC, adjusted for age and height, were significantly higher in men than in women (3.02 L; 95% confidence interval [CI] 2.96–3.08 L vs. 2.52 L; 95% CI 2.45–2.63 L for FEV1 and 3.62 L; 95% CI 3.56–3.69 L vs. 3.05 L; 95% CI 2.98–3.12 L for FVC). Obesity was significantly associated with FVC in men and women; it was associated with FEV1 only in men. Compared with participants with normal body mass index, obese men and women had 280 mL and 112 mL lower mean FVC, respectively. Men without hypertension had almost 100 mL higher mean FVC than those with hypertension. The difference in FVC in women was approximately 80 mL. Diabetes was associated with lower values of FVC in both sexes and with FEV1 in women. A significant negative trend was observed in the mean FVC and FEV1 by the considered CVD risk categories. Conclusions: Impaired lung function was associated with higher CVD risk, which could be explained partly by an adverse association between lung function and prevalence of obesity, hypertension, and diabetes.Wstęp: Upośledzenie funkcji oddechowych  jest związane z wyższym ryzykiem zachorowania i zgonu  z powodu chorób  sercowo-naczyniowych (ChSN). Jednak  wiedza dotycząca związku pomiędzy czynnikami ryzyka ChSN oraz ogólną oceną ryzyka sercowo-naczyniowego, a funkcjami oddechowymi nie jest pełna. Cel: Oszacowanie związku pomiędzy występowaniem czynników ryzyka ChSN oraz  całkowitym ryzykiem sercowo-naczyniowym a funkcjami oddechowymi. Metody: Do analizy zakwalifikowano 4104 mężczyzn i kobiet w wieku pomiędzy 45 a 69 lat, uczestników polskiej części badania HAPIEE (Health, Alcohol and Psychosocial factors In Eastern Europe), dla których uzyskano wiarygodne pomiary natężonej pojemności życiowej płuc (FVC) oraz  natężonej objętości wydechowej pierwszo-sekundowej (FEV1) przy użyciu aparatu Micro-Medical Microplus. Przyjęto następujące definicje czynników ryzyka: nadciśnienie tętnicze (SBP≥140 [mmHg] lub DBP≥90 [mmHg] lub przyjmowanie leków hipotensyjnych), cukrzyca (glukoza≥7,1[mmol/l] lub cukrzyca rozpoznana przez lekarza), hipercholesterolemia (cholesterol całkowity≥5 [mmol/l]  lub LDL-cholesterol≥3 [mmol/l] lub przyjmowanie leków hipolipemizujących). Kategorie całkowitego ryzyka sercowo-naczyniowego  zostały określone w oparciu o wytyczne ESC dotyczące prewencji chorób układu sercowo-naczyniowego w praktyce klinicznej w 2016 roku.. Do porównania funkcji oddechowych w kategoriach narażenia na czynniki ryzyka ChSN zastosowana została analiza kowariancji. Wyniki: Średnie wartości FEV1 oraz FVC standaryzowane do wieku oraz wzrostu były istotnie wyższe u mężczyzn w porównaniu do kobiet i wynosiły odpowiednio FEV1:3.02 L; 95% CI = 2,96–3,08 L vs. 2,52 L; 95% CI = 2,45–2,63 L;  FVC: 3,62 L: 95% CI= 3,56-3,69 L  vs.  3,05L; 95% CI= 2,98-3,12 L). Otyłość była istotnie związana z FVC u kobiet i mężczyzn, natomiast z FEV1 tylko u kobiet. W porównaniu do badanych o pożądanej masie ciała (BMI=20-25), otyli mężczyźni i kobiety (BMI>30) mieli niższe wartości FVC odpowiednio o 280 ml i 122 ml. Nadciśnienie tętnicze było istotnie związane z FEV1 i FVC. Mężczyźni z nadciśnieniem mieli o 100 ml niższe FVC w porównaniu do mężczyzn bez nadciśnienia. U kobiet różnica ta była mniejsza i wynosiła 80 ml. Występowanie cukrzycy było istotnie związane z niższymi wartościami  FVC u mężczyzn i u kobiet, natomiast z FEV1 tylko u kobiet. Nie zaobserwowano istotnego związku pomiędzy hipercholesterolemią a FEV1 i FVC. Zaobserwowano istotny ujemny trend w średnich wartościach FEV1 i FVC pomiędzy kategoriami całkowitego ryzyka sercowo-naczyniowego. Wniosek: Upośledzenie funkcji oddechowych  było związane z wyższym ryzykiem sercowo-naczyniowym, co częściowo może być wyjaśnione odwrotnym związkiem pomiędzy obniżonymi funkcjami  oddechowymi a występowaniem otyłości, nadciśnienia tętniczego  i cukrzycy.

Alcohol use disorder increases the risk of nonfatal and fatal cardiovascular disease : an 11-year follow-up of a Polish population-based cohort. The HAPIEE study

INTRODUCTION Self‑reported alcohol intake is an inaccurate measure, especially in heavy drinkers. The simple 4‑item CAGE questionnaire assessing alcohol use disorder was found to be positively associated with alcohol consumption and mortality. OBJECTIVES This study aimed to investigate the relationship between alcohol use disorder assessed with the CAGE questionnaire and the incidence of cardiovascular disease (CVD) in a population‑based Polish sample. PATIENTS AND METHODS A cohort study with an 11‑year follow‑up was conducted. A random sample of 10 728 residents of Kraków aged 45 to 69 years completed baseline examination, including the CAGE questionnaire. Information on new cases of CVD was obtained from further questionnaires and confirmed by clinical diagnosis. Data on mortality and causes of death were obtained from the local registry, the Central Statistical Office, and the participants’ families. The effect of the CAGE score on the risk of CVD was assessed using Cox proportional hazard models. RESULTS The analysis included 7112 individuals who completed the CAGE questionnaire and were free of CVD at baseline. No alcohol use disorder was reported in 94% of the participants. There was a positive association between the CAGE score and the risk of CVD. In the fully adjusted model, compared with participants scoring 0, the hazard ratios among those scoring 3 and 4 points were 2.19 (95% CI, 1.43–3.37) and 2.79 (95% CI, 1.65–4.73), respectively. The association was somewhat stronger for fatal CVD. CONCLUSIONS We found a strong, graded association between the CAGE score and the risk of CVD incidence, which was independent of other risk factors for CVD. The CAGE questionnaire might be considered as an additional tool to identify individuals at high risk of CVD

Otępienie i depresja po udarze mózgu

Wstęp: U pacjentów po udarze mózgu usprawnianych w Oddziałach Rehabilitacji oprócz niepełnosprawności fizycznej występują zaburzenia emocjonalne i poznawcze. Mogą one być wynikiem udaru, ale mogą również występować bez związku z udarem. Bez względu na etiologię i mechanizm powstawania wymagają uwzględnienia w pracy z pacjentem, gdyż wpływają na proces usprawniania, ryzyko kolejnego udaru oraz na umieralność. Cel: Ocena częstości występowania depresji i otępienia w grupie pacjentów po udarze mózgu, a także związku ich występowania z cechami socjo-demograficznymi i klinicznymi. Materiał i metody: Dokonano przeglądu dokumentacji pacjentów. Przeanalizowano dokumentację 124 pacjentów w wieku od 37 do 91 lat wypisanych z Oddziału Rehabilitacji Neurologicznej w okresie od 01.01.2012 do 31.07.2013. Obecność otępienia i depresji stwierdzano na podstawie klinicznej diagnozy postawionej przez psychologów posiłkujących się testami: Mini-Mental State Examination (MMSE) i Krótkim Testem Stanu Psychicznego (KTSP) oraz skalą Hamiltona i skalą Becka. Wyniki: Otępienie stwierdzano u 46% pacjentów po udarze mózgu usprawnianych w Oddziale Rehabilitacji Neurologicznej Ośrodka Rehabilitacji Narządu Ruchu „Krzeszowice”, a depresję u blisko 39%. U osób w wieku powyżej 65 lat stwierdzono większą szansę wystąpienia otępienia w porównaniu do osób młodszych (OR=5,91; 95%CI: 2,52-13,89). Występowanie afazji było związane z pięciokrotnie większą szansą wystąpienia otępienia (OR=5,74; 95%CI: 1,93-17,11). Płeć, wykształcenie oraz pozostałe czynniki kliniczne i socjo-demograficzne nie były związane z występowaniem otępienia. Nie stwierdzono związku pomiędzy występowaniem depresji a otępieniem, wiekiem, płcią, wykształceniem, liczbą współmieszkańców, typem udaru, lokalizacją udaru, liczbą udarów, czasem od udaru, nadciśnieniem tętniczym, cukrzycą oraz afazją. Wnioski: Depresja i otępienie towarzyszą niepełnosprawności po udarze mózgu. Otępienie częściej występuje u osób powyżej 65 roku życia oraz u pacjentów z afazją. Ponieważ depresja i otępienie zwiększają ryzyko kolejnego udaru mózgu oraz u osób na nie cierpiących stwierdza się wyższą śmiertelność w porównaniu do pacjentów bez tych schorzeń, powinno się je wcześnie wykrywać i leczyć aby zapobiegać ich skutkom.Introduction: In addition to physical impairment, post-stroke patients also display emotional and cognitive disorders, e.g., depression and dementia, which may result from a stroke or occur independently of it. Because these disorders affect treatment outcome, the risk of a subsequent stroke, and mortality, they should be taken into account during rehabilitation. Aim: The aim of this study was to assess the prevalence of depression and dementia among post-stroke patients and to assess the correlation between these disorders and sociodemographic and clinical characteristics. Material and methods: Retrospective analysis of medical documentation of 124 post‑stroke patients hospitalised in a neurological rehabilitation ward from 1 January 2012 to 31 July 2013 was conducted. Depression and dementia were diagnosed by psychologists using the Mini-Mental State Examination, Short Test of Mental State, Hamilton Rating Scale for Depression, and Beck Depression Inventory. Results: a total of 46% of post-stroke patients rehabilitated in the Krzeszowice Rehabilitation Centre were diagnosed with dementia, and 39% were diagnosed with depression. Persons aged over 65 years had a higher chance of dementia compared to younger persons (OR=5.91, 95%CI: 2.52–13.89). Aphasia correlated with a five times higher chance of dementia (OR=5.74, 95%CI: 1.93–17.11). Sex, education, and other analysed clinical and sociodemographic characteristics did not correlate with dementia. No correlation was found between depression and dementia, age, sex, education, number of inhabitants, the type, location and number of strokes, time since stroke, hypertension, diabetes, or aphasia. Conclusions: Dementia and depression were diagnosed in a group of post-stroke patients. Dementia was more prevalent among persons aged over 65 years and persons with aphasia. Because depression and dementia increase the risk of a subsequent stroke and mortality in post-stroke patients, both disorders should be diagnosed and treated early to prevent their effects

Socioeconomic and sex differences in health care utilisation, counselling on cardiovascular disease (CVD) risk factors, and CVD risk factors control in the Polish population : the WOBASZ II Study

Background: Socioeconomic status (SES) is one of the causes of inequality in health care utilisation. There is no information whether differences in SES influence the frequency of counselling on cardiovascular disease (CVD) risk factors or risk factors control. Aim: We sought to assess the relationship between SES and the frequency of medical consultations, hospitalisations, counselling on CVD risk factors, and successful CVD risk factors control. Methods: WOBASZ II was a cross-sectional study targeting a representative sample of the Polish population. Trained nurses interviewed participants using a standard questionnaire, collecting information on education, income, self-rated health, and health care utilisation. Blood samples were collected according to standardised methods. Results: A total of 2303 men and 2848 women were included in the analysis. Compared to those with low SES, men with medium or high SES were 68% and 46% more likely to use medical consultations, respectively. Women with medium and high SES used medical consultations 60% more often than those with low SES. Men with medium and high SES had blood pressure measured more often (by 31% and 43%, respectively), and more frequently received nutritional (by 45% and 59%, respectively) and physical activity counselling (by 92% and 122%, respectively). No differences in CVD risk factors control were found. Conclusions: High SES was associated with more frequent medical visits in both sexes. The associations of SES with counselling on CVD risk factors substantially differed between the sexes in favour of men with high SES. However, more complex consultations in high SES men were not followed by better CVD risk factors control

Perceived control as a predictor of cardiovascular disease mortality in Poland. The HAPIEE study

Background: Neither the development in methods of treatment of coronary heart disease nor the changes in exposure to main cardiovascular disease (CVD) risk factors do not fully explain the trends in CVD mortality in Poland. An influence of psychosocial factors is considered. The aims of the study were: (1) to assess the relationship between perceived control and the prevalence of classic CVD risk factors; (2) to assess the relationship between perceived control and the risk of death from all causes and from CVD. Methods: A cohort study with 5-year follow-up was conducted. Random sample of 10,728 permanent residents of Krakow aged 45–69 was examined. Perceived control was measured using a standard 11-item scale. The studied group was divided into four subgroups of people with very high, high, moderate, and low perceived control according to quartile values. Data on deaths and causes were obtained from the local register, death certificates and participants’ families. An independent effect of perceived control on CVD mortality was assessed using Cox proportional hazards models. Results: Low perceived control was strongly associated with a higher CVD mortality, independently of age, education, marital status, history of CVD, hypertension, hypercholesterolemia, smoking, body mass index, physical activity or diabetes in both men and women (HR 2.68, 95% CI 1.36–5.31 and HR 5.18, 95% CI 1.17–22.96, respectively). After adjustment for age, both in men and women, the highest risk of death from all causes was observed in persons with low perceived control. Further adjustment for covariates attenuated the relationship. Conclusions: Perceived control is a strong independent predictor of CVD mortality and may be considered a CVD risk factor in the Polish urban population.

Impact of perceived control on all-cause and cardiovascular disease mortality in three urban populations of Central and Eastern Europe : the HAPIEE study

Background Inverse associations between perceived control and cardiovascular disease (CVD) have been reported in studies from Western Europe and the USA. To assess this relationship across different populations, we investigated the association between perceived control and all-cause and CVD mortality in three population-based cohorts of Eastern European countries. Methods We analysed data from a prospective cohort study in random population samples in Krakow (Poland), Novosibirsk (Russia) and six Czech towns. Baseline survey included structured questionnaire and objective examination in a clinic. Perceived control was assessed using an 11-item scale developed by the MacArthur Foundation Programme on Successful Midlife. Information on vital status was obtained from death registers. Effect of perceived control on mortality was assessed using Cox proportional hazards models. Results A total of 2377 deaths (1003 from CVD) occurred among 27 249 participants over a median 7-year follow-up. In the Czech and Polish cohorts, perceived control was inversely associated with mortality; the adjusted HRs for the lowest versus highest control quintiles were 1.71 (1.34 to 2.19) in men and 1.6 (1.14 to 2.35) in women for all-cause mortality and 2.31 (1.48 to 3.59) and 5.50 (2.14 to 14.13) for CVD deaths. There was no association between perceived control and mortality in Russia; the adjusted HRs for all-cause mortality were 1.03 (0.79 to 1.34) in men and 1.29 (0.82 to 2.02) in women. Conclusions Low perceived control was associated with increased risk of all-cause and CVD mortality in Czech and Polish cohorts but not in Russia. It is possible that this inconsistency may partly reflect a different sociocultural understanding of the concept of control in Russia

Risk factors for work-related eczema and urticaria among vocational students of agriculture

Introduction and objective. Farmers are at high risk of occupational skin diseases which may start already during vocational training. This study was aimed at identification of risk factors for work-related skin diseases among vocational students of agriculture. Materials and method. The study involved 440 students (245 males, 195 females aged 17–21 years) in 11 vocational schools which were at least 100 km from each other. The protocol included a physician-managed questionnaire and medical examination, skin prick tests, patch tests, total IgE and Phadiatop. Logistic regression model was used for the identification of relevant risk factors. Results. Work-related dermatoses were diagnosed in 29 study participants (6.6%, 95%CI: 4.3–8.9%): eczema in 22, urticaria in 14, and co-existence of both in 7 students. Significant risk factors for work-related eczema were: history of respiratory allergy (OR=10.10; p<0.001), history of eczema (itchy rash) provoked by wet work and detergents before entering the school (OR=5.85; p<0.001), as well as history of contact dermatitis to metals, rubber or cosmetics prior to inscription (OR=2.84; p=0.016), and family history of any skin disease (OR=2.99; p=0.013). Significant risk factors for work-related urticaria were: history of allergic rhinitis and asthma prior to inscription (OR=7.29; p=0.006), positive skin prick tests to work place allergens (OR=4.65; p=0.002) and to environmental allergens (OR=3.79; p=0.009), and positive Phadiatop test (OR=3.61; p=0.013). Conclusions. Work-related skin diseases are common among vocational students of agriculture. Atopy, past history of asthma, allergic rhinitis, and eczema (either atopic, allergic or irritant) are relevant risk factors for work-related eczema and urticaria in young farmers, along with family history of any skin disease. Positive skin prick tests seem relevant, especially in the case of urticaria. Asking simple, aimed questions during health checks while enrolling students into agricultural schools would suffice to identify students at risk for work-related eczema and urticaria, giving them the chance for selecting a safer profession, and hopefully avoiding an occupational disease in the future

Socioeconomic status and cardiovascular risk SCORE

  Background: Cardiovascular diseases (CVD) are one of the most frequent causes of morbidity and death both in men and women. The influence of the following factors on the occurrence and progression of atherosclerosis is well known: hyperten­sion, hypercholesterolaemia, tobacco smoking, obesity, diabetes, age, and sex. As well as the typical risk factors of CVD, there is also a significant association between the incidence of those diseases and socioeconomic status (SES). Aim: The aim of this study was to establish the correlation between SES status and CVD risk assessed according to the SCORE algorithm. Methods: The study encompassed 516 participants (207 men and 309 women) aged 40–74 years, who had never been diagnosed with any CVD. The SES was calculated by multiplying the patient’s education and net monthly income. The cor­relation between the SES and SCORE was established using linear and logistic regression analysis. Results: After considering the influence of age, an inverse correlation between the SCORE risk value and the SES index was established, both in the entire group (p = 0.006) and in the men’s group (p = 0.007). In the analysis of individual age subgroups, this correlation was demonstrated in the following groups: 55–59-year-olds (p = 0.011), 60–64-year-olds (p = 0.014), and 65–69-year olds (p = 0.034). A similar relationship was established in men aged 65–69 years (p = 0.038) and women aged 40–44 years (p = 0.003). The logistic regression analysis demonstrated that, after considering the influence of age, the odds of the SCORE risk value being ≥ 10% were becoming smaller along with the increase in the SES index value in the entire group (p = 0.048) and in the men’s group (p = 0.011). The odds ratio (OR) for the SCORE risk value being ≥ 10% depending on the SES index value was OR = 0.978 (95% confidence interval [CI] 0.956–0.999) in the entire group and OR = 0.964 (95% CI 0.938–0.992) in men. Furthermore, we also established that the risk of SCORE ≥ 5% decreased with the increase in the SES index value in the women’s group (OR = 0.970; 95% CI 0.941–0.999; p = 0.042). Conclusions: 1. We demonstrated a statistically significant correlation between the SES and the CVD risk assessed according to the SCORE algorithm. 2. The value of the CVD risk according to SCORE was inversely correlated with SES status.Wstęp: Schorzenia układu sercowo-naczyniowego są jedną z najczęstszych przyczyn zachorowań i umieralności zarówno wśród mężczyzn, jak i kobiet. Dotychczas określono wiele czynników ryzyka związanych z rozwojem schorzeń układu sercowo-naczyniowego. Dobrze znany jest wpływ czynników, takich jak: nadciśnienie tętnicze, hipercholesterolemia, palenie tytoniu, otyłość, cukrzyca, wiek oraz płeć na wystąpienie i progresję miażdżycy. Oprócz klasycznych czynników ryzyka schorzeń układu sercowo-naczyniowego istotny związek z występowaniem schorzeń z tej grupy ma pozycja socjoekonomiczna (SES). Cel: Celem pracy było określenie zależności między SES a ryzykiem sercowo-naczyniowym ocenionym wg algorytmu SCORE. Metody: Badanie jest częścią projektu WOBASZ II, które przeprowadzono w Polsce w latach 2013–2014 w ramach profilaktyki pierwotnej schorzeń układu sercowo-naczyniowego. Analizie poddano dane zebrane w losowej grupie mieszkańców województw: śląskiego, dolnośląskiego i opolskiego. W każdym z województw wylosowano do badania 6 gmin: 2 małe (do 8 tys. mieszkańców), 2 średnie (od 8 do 40 tys.) i 2 duże (od 40 tys.). Następnie w każdej gminie wylosowano 70 mężczyzn i 70 kobiet w wieku 20 i więcej lat. U wszystkich badanych określono pozycję socjoekonomiczną, którą zdefiniowano wg metody zastosowanej w badaniu ATTICA, jako iloczyn wykształcenia i dochodu miesięcznego (netto). Poszczególnym kategoriom zmiennych nadawano odpowiednie wartości liczbowe — wykształcenie: niepełne podstawowe = 1, podstawowe = 2, zasadnicze zawodowe po szkole podstawowej = 3, gimnazjum = 4, zasadnicze zawodowe po gimnazjum = 5, liceum/technikum (średnie) = 6, policealne = 7, licencjat (niepełne wyższe) = 8, wyższe = 9, dochód: ≤ 500 zł = 1, 501–1000 zł = 2, 1001–1500 zł = 3, 1501–2000 zł = 4, 2001–2500 zł = 5, 2501–3000 zł = 6 i > 3001 zł = 7. Iloczyn wykształcenia i dochodu stanowił wynik SES. Grupy SES zostały wyznaczone następująco: niski SES — wskaźnik 18. Wybrana losowo grupa liczyła 884 osoby. Z powyższej grupy wyodrębniono 516 osób (207 mężczyzn i 309 kobiet) w wieku 40–74 lat, u których nie stwierdzono schorzeń układu sercowo-naczyniowego. Określono u nich ryzyko sercowo-naczyniowe na podstawie algorytmu SCORE dla populacji Polski. SES oceniono jako iloczyn wykształcenia i dochodu miesięcznego (netto). Następnie określono związek między SES a SCORE przy użyciu analizy regresji liniowej i logistycznej. Wyniki: Wyniki analizy regresji liniowej wykazały, że po uwzględnieniu wpływu wieku zależność pomiędzy wartością ryzyka SCORE a wskaźnikiem SES została zaobserwowana zarówno w całej badanej grupie (p = 0,006), jak i w grupie mężczyzn (p = 0.007). Analizując poszczególne podgrupy wiekowe całej badanej grupy, zależność ta potwierdziła się w grupach wiekowych: 55–59 lat (p = 0,011), 60–64 lata (p = 0,014) i 65–69 lat (p = 0.034). Podobną zależność stwierdzono w grupie mężczyzn w wieku 65–69 lat (p = 0,038) i kobiet w wieku 40–44 lata (p = 0,003). Wyniki analizy regresji logistycznej wykazały, że po uwzględnieniu wpływu wieku zwiększone ryzyko wystąpienia wartości ryzyka SCORE ≥ 10% w zależności od wartości wskaźnika SES zaobserwowano w całej badanej grupie (p = 0,048) i w grupie mężczyzn (p = 0,011). Szansa wystąpienia wartości ryzyka SCORE ≥ 10% w zależności od wartości wskaźnika SES wyniosła OR = 0,978 (95% CI 0,956–0,999) w całej grupie oraz OR = 0,964 (95% CI 0,938–0,992) wśród mężczyzn. Ponadto stwierdzono zwiększone ryzyko wystąpienia SCORE ≥ 5% w zależności od wartości wskaźnika SES w grupie kobiet bez uwzględnienia wpływu wieku (p = 0,042; OR = 0,970; 95% CI 0,941–0,999). Wnioski: 1. Wykazano istotną statystycznie zależność między pozycją socjoekonomiczną a ryzykiem sercowo-naczyniowym ocenionym wg algorytmu SCORE. 2. Wartość ryzyka sercowo-naczyniowego wg SCORE była odwrotnie związana z pozycją społeczno-ekonomiczną

Perceived control as a predictor of cardiovascular disease mortality in Poland : the HAPIEE study

Background: Neither the development in methods of treatment of coronary heart disease nor the changes in exposure to main cardiovascular disease (CVD) risk factors do not fully explain the trends in CVD mortality in Poland. An influence of psychosocial factors is considered. The aims of the study were: (1) to assess the relationship between perceived control and the preva-lence of classic CVD risk factors; (2) to assess the relationship between perceived control and the risk of death from all causes and from CVD. Methods: A cohort study with 5-year follow-up was conducted. Random sample of 10,728 permanent residents of Krakow aged 45–69 was examined. Perceived control was measured using a standard 11-item scale. The studied group was divided into four subgroups of people with very high, high, moderate, and low perceived control according to quartile values. Data on deaths and causes were obtained from the local register, death certificates and participants’ families. An independent effect of perceived control on CVD mortality was assessed using Cox proportional hazards models. Results: Low perceived control was strongly associated with a higher CVD mortality, indepen

Alcohol consumption and longitudinal trajectories of physical functioning in Central and Eastern Europe : a 10-year follow-up of HAPIEE study

BACKGROUND: Physical functioning (PF) is an essential domain of older persons' health and quality of life. Health behaviors are the main modifiable determinants of PF. Cross-sectionally, alcohol consumption appears to be linked to better PF, but longitudinal evidence is mixed and very little is known about alcohol consumption and longitudinal PF trajectories. METHODS: We conducted longitudinal analyses of 28,783 men and women aged 45-69 years from Novosibirsk (Russia), Krakow (Poland), and seven towns of the Czech Republic. At baseline, alcohol consumption was measured by a graduated frequency questionnaire and problem drinking was evaluated using the CAGE questionnaire. PF was assessed using the Physical Functioning Subscale of the SF-36 instrument at baseline and three subsequent occasions. Growth curve modeling was used to estimate the associations between alcohol consumption and PF trajectories over 10-year follow-up. RESULTS: PF scores declined during follow-up in all three cohorts. Faster decline in PF over time was found in Russian female frequent drinkers, Polish female moderate drinkers, and Polish male regular heavy drinkers, in comparison with regular and/or light-to-moderate drinkers. Nondrinking was associated with a faster decline compared with light drinking only in Russian men. Problem drinking and past drinking were not related to the decline rate of PF. CONCLUSIONS: This large longitudinal study in Central and Eastern European populations with relatively high alcohol intake does not strongly support the existence of a protective effect of alcohol on PF trajectories; if anything, it suggests that alcohol consumption is associated with greater deterioration in PF over time