Treatment goal attainment for secondary prevention in coronary patients with or without diabetes mellitus : Polish multicenter study POLASPIRE

Introduction: Cardiovascular disease is still a leading cause of death in Poland and across Europe. The aim of this study was to assess the attainment of the main treatment goals for secondary cardiovascular prevention in coronary patients with or without diabetes mellitus (DM) in Poland. Material and methods: The study group included 1026 patients (65.5 ±9 y.o.; males: 72%) included at least 6 months after the index hospitalisation for myocardial infarction, unstable angina, elective percutaneous coronary intervention or coronary artery bypass surgery. The target and treatment goals were defined according to the 2016 European Society of Cardiology guidelines on cardiovascular prevention. Results: Patients with DM (n = 332; 32%) were slightly older compared to non-diabetic (n = 694) individuals (67.2 ±7 vs. 64.6 ±9 years old; p < 0.0001). The DM goal was achieved in 196 patients (60%). The rate of primary (LDL: 51% vs. 35%; p < 0.0001) and secondary (non-HDL: 56% vs. 48%; p < 0.02) goal attainment was higher in DM(+) compared to DM(–) patients. The rate of target blood pressure was lower in DM(+) than in normoglycemic patients (52% vs. 61% at < 140/90 mm Hg, p < 0.01. As expected, goal achievement of normal weight (9.5% vs. 19%; p < 0.0001) and waist circumference (7% vs. 15%; p < 0.001) was lower in diabetic patients and the rate of regular physical activity was similar (DM+ 12% vs. DM– 14%; p = ns). Finally, there was no difference in active smokers (DM+ 23% vs. DM– 22%; p = ns). Conclusions: Great majority of Polish patients in secondary prevention do not achieve treatment goals. Although lipid goals attainment is better in DM and the rate of smokers is similar, the management of all risk factors needs to be improved

Secondary prevention of coronary artery disease in Poland. Results from the POLASPIRE survey

Background: The highest priority in preventive cardiology is given to patients with established coronary artery disease (CAD). The aim of the study was to assess the current implementation of the guidelines for secondary prevention in everyday clinical practice by evaluating control of the main risk factors and the cardioprotective medication prescription rates in patients following hospitalization for CAD.Methods: Fourteen departments of cardiology participated in the study. Patients (aged ≤ 80 years) hospitalized due an acute coronary syndrome or for a myocardial revascularization procedure were recruited and interviewed 6–18 months after the hospitalization.Results: Overall, 947 patients were examined 6–18 months after hospitalization. The proportion of patientswith high blood pressure (≥ 140/90 mmHg) was 42%, with high low-density lipoprotein cholesterol (LDL-C ≥ 1.8 mmol/L) 62%, and with high fasting glucose (≥ 7.0 mmol/L) 22%, 17% of participants were smokers and 42% were obese. The proportion of patients taking an antiplatelet agent 6–18 months after hospitalization was 93%, beta-blocker 89%, angiotensin converting enzyme inhibitor or sartan 86%, and a lipid-lowering drug 90%. Only 2.3% patients had controlled all the five main risk factors well (non-smoking, blood pressure &lt; 140/90 mmHg, LDL-C &lt; 1.8 mmol/L and glucose &lt; 7.0 mmol/L, body mass index &lt; 25 kg/m2), while 17.9% had 1 out of 5, 40.9% had 2 out of 5, and 29% had 3 out of 5 risk factors uncontrolled.Conclusions: The documented multicenter survey provides evidence that there is considerable potential for further reductions of cardiovascular risk in CAD patients in Poland. A revision of the state funded cardiac prevention programs seems rational

Secondary prevention of coronary artery disease in Poland : results from the POLASPIRE survey

Background: The highest priority in preventive cardiology is given to patients with established coronary artery disease (CAD). The aim of the study was to assess the current implementation of the guidelines for secondary prevention in everyday clinical practice by evaluating control of the main risk factors and the cardioprotective medication prescription rates in patients following hospitalization for CAD. Methods: Fourteen departments of cardiology participated in the study. Patients (aged <= 80 years) hospitalized due an acute coronary syndrome or for a myocardial revascularization procedure were recruited and interviewed 6-18 months after the hospitalization. Results: Overall, 947 patients were examined 6-18 months after lwspitalization. The proportion of patients with high blood pressure (>= 140/90 mmHg) was 42%, with high low-density lipoprotein cholesterol (LDL-C >= 1.8 mmol/L) 62%, and with high fasting glucose (>= 7.0 mmol/L) 22%, 17% of participants were smokers and 42% were obese. The proportion of atients taking an antiplatelet agent 6-18 months after hospitalization was 93%, beta-blacker 89%, angiotensin converting enzyme inhibitor or sartan 86%, and a lipid-lowering drug 90%. Only 2.3% patients had controlled all the five main risk factors well (non-smoking, blood pressure < 140190 mmHg, LDL-C < 1.8 mmoIlL and glucose < 7.0 mmoilL, body mass index < 25 kg/m(2)), while 179% had 1 out of 5, 40.9% had 2 out of 5, and 29% had 3 out of 5 risk factors uncontrolled. Conclusions: The documented multicenter survey provides evidence that there is considerable potential for further reductions of cardiovascular risk in CAD patients in Poland. A revision of the state funded cardiac prevention programs seems rational

Smoking cessation in patients with established coronary artery disease: data from the POLASPIRE survey

Background: Smoking cessation in patients with coronary artery disease (CAD) is related to decreased risk of cardiovascular events. Aims: To evaluate factors related to persistent smoking in patients with established coronary artery disease. Methods: Patients aged 80 years or younger and hospitalized for acute coronary syndrome or a myocardial revascularization procedure were interviewed 6 to 18 months after the recruiting event. Medical history, smoking behavior, and exposure to environmental smoke were assessed during the interview. Self­­reported smoking status was validated by carbon monoxide in exhaled air measurement. Persistent smoking was defined as smoking at the time of interview among those who smoked during the month prior to the recruiting event. Results: We analyzed the data of 1034 patients, including 764 (73.9%) who reported smoking at any time in the past and 296 (28.6%) who smoked within 1 month before the recruiting hospitalization. At the time of the interview, the overall smoking rate was 17.2%, whereas 54.7% of patients were persistent smokers. Secondhand smoke exposure and duration of smoking were associated with lower likelihood whereas older age, high socioeconomic status, cardiac rehabilitation following a cardiovascular event, and consultation with a cardiologist were associated with higher likelihood of smoking cessation. Conclusions: Over half of all smokers hospitalized for CAD are still smoking 6 to 18 months after discharge. Older age, secondhand smoking, low socioeconomic status, lack of consultation with a cardiologist, and cardiac rehabilitation following hospitalization were related to persistent smoking. Our findings may help develop strategies aimed at assisting smoking cessation in patients with CAD

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30–79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings The number of people aged 30–79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306–359) million women and 317 (292–344) million men in 1990 to 626 (584–668) million women and 652 (604–698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55–62) of women and 49% (46–52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43–51) of women and 38% (35–41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20–27) for women and 18% (16–21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings

Colour, moisture adsorption, and antioxidant properties of oven-dried chokeberry powder obtained after ultrasound-assisted osmotic dehydration

Osmotic dehydration (OD) of chokeberry samples in erythritol (ERT) and xylitol (XYL) solutions enhanced by ultrasonication (US) has been examined in terms of moisture adsorption, colour and antioxidant properties. After air-forced drying, the powder subjected to OD in ERT solution exhibited higher equilibrium moisture contents (EMC) in 0.20–0.45 aw than those in XYL solution. On the other hand, EMC values increased with the prolongation of US time from 5 to 30 min in the case of XYL solution. CIEL*a*b colour system was used for the determination of colour changes. While L* (the colour coordinate represents lightness (L* ~ 100) or darkness (L* ~ 0) of the sample) values decreased with the prolongation of US time from 5 to 30 min for both osmotic agents, only XYL solution caused the increase of a* (the colour coordinate represents green (−a*) or red (+a*) colour of the sample) and b* (the colour coordinate represents blue (−b*) or yellow (+b*) colour of the sample) to their maximum values at 30 min of sonication. A sample of powder subjected to OD in ERT solution has shown a higher total phenolic, total anthocyanin and antioxidant capacity. We may conclude that OD of chokeberries coupled with 30 min of sonication has resulted in chokeberry powder with the highest content of bioactive substances

Focal lesions of the liver in the course of retroperitoneal firosis – case report and brief review of the literature

Włóknienie zaotrzewnowe (ang. retroperitoneal firosis, RF) jest rzadkim schorzeniem, którego istotę stanowi proliferacja patologicznej tkanki łącznej w przestrzeni zaotrzewnowej. Zmiany lokalizują się najczęściej wokół aorty brzusznej, żyły głównej dolnej i moczowodów. Włóknienie może przyjmować także nietypową lokalizację i zajmować inne narządy jamy brzusznej. Etiologia choroby nie jest w pełni poznana, jakkolwiek uważa się, iż może mieć związek z procesami autoimmunizacyjnymi. W diagnostyce schorzenia główną rolę odgrywają badania obrazowe i obraz histopatologiczny. Leczenie opiera się na glikokortykoterapii, lekach immunosupresyjnych oraz leczeniu chirurgicznym. Rokowanie uzależnione jest od wczesnego rozpoznania i wdrożenia odpowiedniego rodzaju terapii. W pracy przedstawiamy przypadek 53-letniej chorej ze zmianami ogniskowymi w wątrobie w przebiegu RF, które uległy znamiennej regresji w wyniku leczenia glikokorykosteroidem wraz z syntetycznym przeglądem piśmiennictwa.Retroperitoneal firosis, (RF) is a rare disease characterized by proliferation of pathological fibrous tissue in the retroperitoneum. Changes are mostly located around abdominal aorta, inferior vena cava and ureters. The firosis can also appear in untypical locations and reach other organs of abdominal cavity. Etiology of the disease is unknown, although it is supposed to be related to autoimmune processes. The major role in RF diagnostics play radiology and histopathology. The treatment is based on corticosteroids, immunosuppressive drugs and surgery. Prognosis depends on early diagnosis and implementation of a proper therapy. We present a case of 53 years old female patient with focal lesions within the liver in the course of the RF which have undergone significant regression in the course of glycocorticotherapy and brief review of the literature