Lifestyle characteristics influencing hypertension in middle-age to old people: comparison of two populations

Background: Hypertension is a significant global public health problem and the data suggest a wide health disparity in hypertension prevalence worldwide. Our objective was to assess some epidemiological determinants in individuals ≥ 50 years influencing blood pressure/hypertension in United States and Croatia and derive some meaningful conclusions and recommendations. Material and methods: We used the American National Health and Nutrition Examination Survey (NHANES) (n = 1,556; 48.9% women) and the Croatian Adult Health Cohort Study (CroHort) (n = 2,182; 66% women), both taken in 2008. The health indicators compared were anthropometries, blood pressure, socioeconomic and marital status, education and lifestyle, including physical activity, alcohol and coffee consumption, smoking and presence of dyslipidemia and diabetes. Results: Prevalence of hypertension based either on medication use or blood pressure values was significantly higher in Croatian men and women compared to American (all p < 0.001). Waist circumference was the main positive predictor and education a negative predictor for blood pressure in CroHort; significance was not reached in NHANES, although the trends were similar. Taking medications for diabetes decreased the odds for hypertension in NHANES, while taking medications for both diabetes and dyslipidemia decreased the odds in CroHort. Conclusions: Croatian people older than 50 years have higher prevalence of hypertension compared to their counterparts in the U.S. The difference in the prevalence of hypertension in two populations cannot be explained by different prevalence of risk factors examined, except education level. Higher prevalence of hypertension diagnosed by medication use indicates a relatively good control of the disease in both populations

Smoking behaviors in Kosova: Results of steps survey

Tobacco use continues to be the leading global cause of preventable death. Most of these deaths occur in low and middle-income countries, and this trend is expected to widen further over the next several decades. The overall objective of the study is to describe and analyse the smoking behaviours of adults in Kosova

Health-risk behaviour in Croatia

OBJECTIVE: To identify the health-risk behaviour of various homogeneous clusters of individuals. ----- STUDY DESIGN: The study was conducted in 13 of the 20 Croatian counties and in Zagreb, the Croatian capital. In the first stage, general practices were selected in each county. The second-stage sample was created by drawing a random subsample of 10% of the patients registered at each selected general practice. ----- METHODS: The sample was divided into seven homogenous clusters using statistical methodology, combining multiple factor analysis with a hybrid clustering method. ----- RESULTS: Seven homogeneous clusters were identified, three composed of males and four composed of females, based on statistically significant differences between selected characteristics (P<0.001). Although, in general, self-assessed health declined with age, significant variations were observed within specific age intervals. Higher levels of self-assessed health were associated with higher levels of education and/or socio-economic status. Many individuals, especially females, who self-reported poor health were heavy consumers of sleeping pills. Males and females reported different health-risk behaviours related to lifestyle, diet and use of the healthcare system. Heavy alcohol and tobacco use, unhealthy diet, risky physical activity and non-use of the healthcare system influenced self-assessed health in males. Females were slightly less satisfied with their health than males of the same age and educational level. Even highly educated females who took preventive healthcare tests and ate a healthy diet reported a less satisfactory self-assessed level of health than expected. ----- CONCLUSION: Sociodemographic characteristics, life style, self-assessed health and use of the healthcare system were used in the identification of seven homogeneous population clusters. A comprehensive analysis of these clusters suggests health-related prevention and intervention efforts geared towards specific populations

Evaluation of Croatian model of polycentric health planning and decision making

Objective To determine the progress in the development and implementation of health policies on a county level resulting from the learning-by-doing training provided through the County Public Health Capacity Building Program started in 2001 in Croatia.Methods Modular training using management tools, public health theory and practice, and SMDP's Healthy Plan-it(TM) tool, followed by the self-evaluation of the progress made by county teams in health needs assessment and health policy development, implementation, and assurance. Fifteen county teams consisting of politicians, executive officers, public health professionals, and community members.Results Twelve of 15 county teams completed the program. The teams made progress in the evaluated areas, although to a different extent, which did not depend on the amount of time they had or the governance experience. The differences in improvement depended on the differences in the strength of political, executive, and professional components of the teams. Teams with a strong political and/or executive component, but weak public health professional and community components made major improvements in policy development and/or assurance function, but performed less well in the health needs assessment and constituency building. The reversed was also true.Conclusion Learning-by-doing training program improved public health practices on a county level in Croatia.Decentralization Health policy Community health planning Health needs Health priorities Croatia