Cardiovascular diseases prevention in Poland - results of WOBASZ and WOBASZ II

Background: Cardiovascular diseases are the main cause of morbidity and an important cause of disability and premature death in European countries. Current guidelines recommend prevention delivery by physicians during medical consultations. Aim: We sought to evaluate the prevention support offered by Polish physicians in 2013–2014 compared to 2003–2005, and its determinants. Methods: The data from two population surveys were analysed: WOBASZ (6392 men and 7153 women, aged 20–74 years, screened in 2003–2005) and WOBASZ II (2751 men and 3418 women, aged ≥ 20 years, screened in 2013–2014). For comparison analysis, the population of WOBASZ II was restricted to persons aged 20–74 years. Prevention delivery was assessed using a questionnaire. Results: Overall, 64% of men and 75% of women screened in 2003–2005 consulted their physicians at least once in the preceding year; 10 years later these rates were 70% and 82%, respectively. In both studies, 70% of respondents recalled having received one piece of prevention advice during a medical consultation. One-third of participants neither received any prevention advice nor had their blood pressure or cholesterol level measured. In WOBASZ II we observed a significant increase in the frequency of counselling regarding smoking cessation, nutrition, and increased physical activity, as well as in the frequency of cholesterol measurements, compared to WOBASZ. The prevention support was related to the health status. Conclusions: The prevention support in the years 2013–2014 was better than in 2003–2005, but was still insufficient. About one-third of participants did not receive any preventive advice. The prevention support was offered more often to patients with worse health status

Metabolic syndrome and its components in Polish women of childbearing age : a nationwide study

Abstract Background Abnormal body mass and related metabolic disorders may affect female reproductive health. The purpose of the study was to determine the prevalence of underweight, overweight, obesity, lipid and glucose metabolism disorders, hypertension, and metabolic syndrome, among Polish women of childbearing age. Methods One thousand five hundred eighty-eight non-pregnant Polish women of childbearing age (20–49 years) who participated in the Multi-Centre National Population Health Examination Survey (WOBASZ II study) in 2013–2014, were assigned to 3 age groups: 20–29 years (n = 403), 30–39 years (n = 600) and 40–49 years (n = 585). Measurements of weight, height, waist circumference, blood pressure, blood lipids, and blood glucose were taken. For statistical analysis, the Kruskal-Wallis, Chi-Square, and Cohran-Armitage tests were used. Results Of the participants, 4.3% were determined to be underweight, 25.2% were overweight, 15% were obese, and 53.1% had abdominal obesity. With age, the prevalence of both excessive body mass and abdominal obesity tended to increase, and that of underweight to decrease. Frequency of hypercholesterolemia and hypertriglyceridemia found in the whole group were 50% and 12.6% respectively, and also tended to rise with age. Low serum HDL-cholesterol (high density lipoprotein cholesterol) levels were found in 15.1% of the participants. Prevalence of impaired fasting glucose in the whole group was 8.2% and tended to increase with age. Diabetes was found in 1.2% of the participants and its prevalence also tended to rise with age, at the borderline of significance. Frequency of arterial hypertension and metabolic syndrome in the whole group was 15.7% and 14.1% respectively and both tended to increase with age. Conclusions Overweight and obesity, especially of abdominal type, and the related metabolic abnormalities are common in Polish women of childbearing age. Their prevalence tends to increase with age. Underweight is relatively common in the youngest age group

Children’s Education Program on Prevention of Hypertension and Blood Pressure Measurement — SOPKARD Junior Project

Wstęp Nadciśnienie tętnicze (NT) jest główną przyczynąchorób serca i naczyń w Polsce i na świecie.Dlatego edukację o zachowaniach prozdrowotnychi profilaktyce NT należy rozpoczynać jak najwcześniej.Podstawa programowa Ministerstwa EdukacjiNarodowej (MEN) zakłada takie działania jużu dzieci w szkole podstawowej.Celem projektu była ocena wiedzy dzieci klas V i VIszkoły podstawowej w zakresie prewencji choróbukładu krążenia oraz opracowanie i sprawdzenieprzydatności dla edukacji prozdrowotnej multimedialnychinteraktywnych warsztatów dla dzieci.Materiał i metody Projektem objęto 74 dzieci w wieku11–12 lat. Sprawdzono ich wiedzę w relacji dopodstawy programowej MEN. Następnie dzieciwzięły udział w warsztatach edukacyjnych złożonychz 6 jednostek lekcyjnych w podgrupach 5–6osobowych. Na koniec przeprowadzono monitorowanieefektów edukacji. Odpowiednio wyszkolonedzieci mierzyły ciśnienie swoim rodzicom podczaswywiadówek.Wyniki W teście przed warsztatami średni wynikwynosił 65% prawidłowych odpowiedzi, aż 30%dzieci odpowiedziało poprawnie na mniej niż połowępytań. Test sprawdzający po zakończeniu kursuwykazał 90% dobrych odpowiedzi, a najniższy wynikwynosił 82%. U rodziców i pracowników szkoływ pomiarach wykonanych przez dzieci 22% badanychmiało nowo wykryte podwyższone wartości ciśnienia.Wnioski 1. Wiedza prozdrowotna dzieci ze szkołypodstawowej w stosunku do podstawy programowejw zakresie edukacji zdrowotnej MEN jest niedostateczna.2. Dzieci bardzo chętnie i aktywnie uczestnicząw multimedialnych, interaktywnych warsztatach edukacyjnychw zakresie prozdrowotnego stylu życiai profilaktyki NT. Monitorowanie efektów takichwarsztatów wykazało bardzo duże zmiany poziomuwiedzy i świadomości dzieci, włącznie z umiejętnościąsamodzielnych pomiarów ciśnienia tętniczego.Background Arterial hypertension (AH) is the main causeof cardiovascular diseases in Poland and all over the world.That is why education on health supporting and prophylacticactivities concerning AH should be implemented assoon as possible. According to the program of Ministry ofNational Education (MEN) these activities should bestarted in primary schools.The aim of the project was to evaluate knowledge of childrenin class V and VI and to elaborate health supportingmultimedia and interactive workshops for primary schoolchildren.Material and methods Seventy four (74) children aged11–12 years have been included in the study. Their knowledgehas been tested in relation to the program of MEN.The studied children took part in the educational workshops composed of six lesson modules in subgroups of 5–6persons. Finally monitoring of the educational effects hasbeen performed. Well trained children also did measurearterial blood pressure of their parents during school–parentsmeetings.Results In the test performed before the workshops a meanresult was equal to 65% of good answers, about 30% ofchildren answered correctly in less than 50% of questions.The test performed after the workshops showed 90% ofcorrect answers; the worst result was 82%. Among the examinedparents and school employees 22% of them hadnewly detected increased blood pressure.Conclusions1. Health supporting knowledge among primary school childrenis unsatisfactory in relation to the program of MEN.2. Children readily and actively participate in the multimediainteractive educational workshops on health supportingand prophylactic activities concerning AH. Monitoringof the effects of such workshops showed increasedknowledge and answers concerning issues of AH includingability of arterial blood pressure measurement

Tobacco smoking in Poland in the years from 2003 to 2014 : multi-centre National Population Health Examination Survey (WOBASZ)

The reduction of tobacco smoking remains a challenge for public health. The main purpose of this study was to evaluate changes in the prevalence and patterns of tobacco use in the adult population of Poles in the years from 2003 to 2014. Furthermore, changes in the smoking addiction, the declared reasons for smoking, as well as readiness and motivation to stop smoking were assessed. Based on data from the Polish studies WOBASZ and WOBASZ II, the analysis included 14 576 participants from the first study (6906 men and 7670 women) and 5696 participants from the second study (2578 men and 3118 women), aged between 20 and 74 years. According to the WOBASZ II study, 30% of men and 21% of women in Poland smoked, the rates being 9% and 4% lower for men and women, respectively, in comparison with the WOBASZ study (P <0.001). The average number of cigarettes smoked daily per smoker significantly decreased during the follow‑up period among men (from 17.9 to 15.8 cigarettes per day) and women (from 13.7 to 12.1 cigarettes per day). The percentage of men who never smoked increased from 29.8% to 36.1% (P <0.0001), while the proportion of women who never smoked did not change. However, the percentage of those expressing unwillingness to quit smoking nearly doubled in WOBASZ II in comparison with WOBASZ. Although the smoking rates in Poland have declined over the past decade, smoking remains prevalent among men and women. Therefore, it is necessary to optimize tobacco control in Poland, including fiscal policy, counseling and tobacco addiction treatment, as well as promotional and educational activities, with a special emphasis on the female population

Trends in hypertension prevalence, awareness, treatment, and control among Polish adults 75 years and older during 2007–2014

Background: The aim of this study was to assess changes in the prevalence, awareness, and treatment of hypertension and its effectiveness between 2007 (WOBASZ Senior study) and 2013–2014 (WOBASZ II) in a sample of the Polish population over the age of 75 years. Methods: Sampling had three stages, stratified according to voivodeships, type of community, and gen­der. Finally, the WOBASZ II study included 467 persons (290 women and 177 men). For a comparison of the data, 1096 persons (538 women and 554 men) examined in the WOBASZ Senior study were used. Results: Systolic and diastolic blood pressures significantly decreased from 153.0 ± 23.9 mmHg to 142.9 ± 22.3 mmHg and from 85.2 ± 11.9 mmHg to 78.4 ± 11.3 mmHg, respectively, from 2007 to 2014 (p &lt; 0.0001). Prevalence of hypertension among people included in WOBASZ studies slightly decreased from 83.8% to 77.9% (rate ratio [RR]: 0.95; 95% confidence interval [CI]: 0.78–1.16) in men, and from 75.4% to 71.8% (RR: 0.93; 95% CI: 0.8–1.09) in women. Hypertension awareness was improved from 59.2% to 72.9% (RR: 1.23; 95% CI: 0.97–1.56) in men, and from 74,8% to 93% (RR: 1.26; 95% CI: 1.01–1.58) in women. The proportion of men and women, with implemented hypertension treatment, increased from 48.4% to 61.1% (RR: 1.26; 95% CI: 1.01–1.58), and from 63.2% to 82.0% (RR: 1.3; 95% CI: 1.1–1.53), respectively. The effectiveness of the treatment was improved over two-fold, there was an increase from 10.3% to 26.8% (RR: 2.65; 95% CI: 1.81–3.89) in men, and from 13.8% to 33.5% in women (RR: 2.44; 95% CI: 1.81–3.3). Conclusions: The prevalence of hypertension in Polish seniors remains high, but has decreased slightly in the perspective of the last 7 years. Although treatment and control has improved over the last decade, it remains below expectations. Efforts to improve the diagnosis and effective treatment of hypertension in Polish seniors should be intensified

New mtDNA Association Model, MutPred Variant Load, Suggests Individuals With Multiple Mildly Deleterious mtDNA Variants Are More Likely to Suffer From Atherosclerosis

The etiology of common complex diseases is multifactorial, involving both genetic, and environmental factors. A role for mitochondrial dysfunction and mitochondrial DNA (mtDNA) variation has been suggested in the pathogenesis of common complex traits. The aim of this study was to investigate a potential role of mtDNA variants in the development of obesity, diabetes, and atherosclerosis in the Polish population. Whole mtDNA sequences from 415 Polish individuals representing three disease cohorts and a control group were obtained using high-throughput sequencing. Two approaches for the assessment of mtDNA variation were applied, traditional mitochondrial haplogroup association analysis and the mutational or variant load model using the MutPred pathogenicity prediction algorithm for amino acid substitutions in humans. We present a possible association between mildly deleterious mtDNA variant load and atherosclerosis that might be due to having more than one likely mildly deleterious non-synonymous substitution. Moreover, it seems largely dependent upon a few common haplogroup associated variants with MutPred score above 0.5

Prevalence, awareness, treatment and control of hypertension in the adult Polish population : multi-center National Population Health Examination Surveys : WOBASZ studies

Introduction: Hypertension is one of the main risk factors of cardiovascular diseases. The first aim of the study was to evaluate the prevalence, awareness and treatment of hypertension as well as treatment effectiveness (blood pressure < 140/90 mm Hg) in a representative sample of the Polish population over the age of 19, examined in the WOBASZ II program. The second aim was to assess the changes in these parameters between 2003-2005 (WOBASZ study) and 2013-2014 in adults aged 20-74. Material and methods: Sampling was performed in three stages, stratified according to voivodeship (province), type of commune, and gender. Finally, the study included 6163 persons (3406 women and 2757 men) examined in the years 2013-2014 (aged ≥ 19 years). For comparison the data from 14 755 persons (7783 women and 6452 men aged 20-74 years) examined in the years 2003-2005 were used. Results: In the years 2013-2014, the age-standardized prevalence of hypertension, awareness, treatment and control was 42.7%, 59.3%, 46.1%, and 23% respectively. In the last decade an increase in the prevalence of hypertension (relative ratio (RR) 1.12; 95% confidence interval (CI): 1.07- 1.18), treatment (RR = 1.26; 95% CI: 1.17-1.36) and control (RR = 2.16; 95% CI: 1.91-2.45) was found. In contrast, the awareness decreased nonsignificantly (RR = 0.98; 95% CI: 0.92-1.05). Conclusions: The prevalence of hypertension in Poland is high, and increased by about 12% in 10 years. Although the number of treated patients and blood pressure control improved nearly twofold over the last decade, this is still below expectations. Efforts to improve the diagnosis and effective treatment of hypertension in Poland should still be intensifie

Is there any variability in the level of cortisol, corticosterone and cortisone of healthy volunteers versus women and men with elevated cholesterol?

Background: Cardiovascular diseases with the accompanied elevated level of total cholesterol have been a major problem in society for the last several decades. They belong to the diseases of civilization which affect people at an increasingly young age. For this reason, our aim was to investigate whether the concentrations of selected steroids are related to elevated total cholesterol in people without diagnosed cardiovascular diseases. Material and methods: The study involved 71 plasma samples. 19 of them were obtained from women and men with elevated cholesterol levels, whereas 52 samples were from healthy volunteers (control group). Liquid chromatography coupled with mass spectrometry (LC-MS) validated method followed by solid-phase extraction procedure were applied to measure the plasma concentrations of the three endogenous glucocorticosteroids (cortisol, corticosterone and cortisone). Results: Statistically significant differences between the concentration of cortisol were noted among healthy women and women with elevated cholesterol. The measured concentrations of cortisol in healthy women and men are comparable, 111.19 ng/mL and 112.22 ng/mL. respectively. However, the concentrations of cortisol in the elevated cholesterol group was significantly lower among women with elevated cholesterol than in healthy women (74.13 ng/mL and 111.19 ng/mL respectively). The concentration of cortisol for men with elevated cholesterol was 38.60 ng/mL. Hence, it is much higher than in women with elevated cholesterol and higher than in the case of healthy men. Distinctive changes can be observed also for corticosterone measured for both women and men. Conclusions: The observed differences on the level of steroids between healthy control group and patients with elevated cholesterol can be considered as worthy of further investigation from both biochemical as well as clinical points of view

The prevalence of dyspnea in the adult Polish population

Objectives Dyspnea is one of the most predominant symptom in clinical practice. There is a lack of data about incidents of dyspnea among Polish adults therefore it would be important to establish prevalence of this symptom before COVID-19 pandemic to assess the impact of this infection on the functioning of the adult Polish population in the future. The aim of the study was to establish prevalence of dyspnea in adult Polish population. Material and Methods It was an observational-cross-sectional study, with representative sample of adult Poles aged 18–79 years. The 2413 participants were surveyed. Responders were asked if and when dyspnea occurs and what is its severity in relation to one of four categories (A, B, C, and D) describing the impact of dyspnea on reduced exercise tolerance and daily activities. Results The 67.1% of the respondents answered negatively to all question about experiencing dyspnea (females (F) 61% vs. males (M) 74%, p < 0.05). Dyspnea only during intense physical exertion (A), was reported by 22.8% (F 26.2% vs. M 19.2%, p = 0.07). Dyspnea limiting daily activities (B, C and D) was reported by 10.1% (F 13.1% vs. M 7%, p < 0.05). Significant differences in the severity of dyspnea were found between the age groups. People diagnosed with chronic heart failure or lung diseases significantly more often reported dyspnea than people without these conditions. Conclusions Every tenth Pole reported dyspnea limiting performing activities of daily living. Additionally, about 20% of Poles experienced dyspnea considered as "gray area," only during intense physical exertion, that requires deepening and clarifying the medical history