Relation between awareness of circulatory disorders and smoking in a general population health examination

BACKGROUND: Little is known about proportions of smokers who maintain smoking after they are aware of a circulatory disorder. The goal was to analyze the extent to which the number of circulatory disorders may be related to being a current smoker. METHODS: Cross-sectional survey study with a probability sample of residents in Germany investigated in health examination centers. Questionnaire data of 3,778 ever smoking participants aged 18 – 79 were used, questions included whether the respondent had ever had hypertension, myocardial infarction, other coronary artery disease, heart failure, stroke, other cerebrovascular disease, peripheral vascular disease, and venous thrombosis. Logistic regression was calculated for circulatory disorders and their number with current smoking as the dependent variable, and odds ratios (OR) are presented adjusted for physician contact, inpatient treatment, smoking cessation counseling, heavy smoking, exercise, overweight and obesity, school education, sex and age. RESULTS: Among ever smokers who had 1 circulatory disorder, 52.1 % were current smokers and among those who reported that they had 3 or more circulatory disorders 28.0 % were current smokers at the time of the interview. The adjusted odds of being a current smoker were lower for individuals who had ever smoked in life and had 2 or more central circulatory disorders, such as myocardial infarction, heart failure or stroke, than for ever smokers without central circulatory disorder (2 or more disorders: adjusted OR 0.6, 95 % confidence interval, CI, 0.4 to 0.8). CONCLUSION: Among those with central circulatory disorders, there is a substantial portion of individuals who smoke despite their disease. The data suggest that only a portion of smokers among the general population seems to be discouraged from smoking by circulatory disorders or its accompanying cognitive or emotional processes

Stroke risk perception among participants of a stroke awareness campaign

BACKGROUND: Subjective risk factor perception is an important component of the motivation to change unhealthy life styles. While prior studies assessed cardiovascular risk factor knowledge, little is known about determinants of the individual perception of stroke risk. METHODS: Survey by mailed questionnaire among 1483 participants of a prior public stroke campaign in Germany. Participants had been informed about their individual stroke risk based on the Framingham stroke risk score. Stroke risk factor knowledge, perception of lifetime stroke risk and risk factor status were included in the questionnaire, and the determinants of good risk factor knowledge and high stroke risk perception were identified using logistic regression models. RESULTS: Overall stroke risk factor knowledge was good with 67–96% of the participants recognizing established risk factors. The two exceptions were diabetes (recognized by 49%) and myocardial infarction (57%). Knowledge of a specific factor was superior among those affected by it. 13% of all participants considered themselves of having a high stroke risk, 55% indicated a moderate risk. All major risk factors contributed significantly to the perception of being at high stroke risk, but the effects of age, sex and education were non-significant. Poor self-rated health was additionally associated with high individual stroke risk perception. CONCLUSION: Stroke risk factor knowledge was high in this study. The self perception of an increased stroke risk was associated with established risk factors as well as low perception of general health

Psychiatric disorders and urbanization in Germany

<p>Abstract</p> <p>Background</p> <p>Epidemiological studies over the last decade have supplied growing evidence of an association between urbanization and the prevalence of psychiatric disorders. Our aim was to examine the link between levels of urbanization and 12-month prevalence rates of psychiatric disorders in a nationwide German population study, controlling for other known risk factors such as gender, social class, marital status and the interaction variables of these factors with urbanization.</p> <p>Methods</p> <p>The Munich Composite International Diagnostic Interview (M-CIDI) was used to assess the prevalence of mental disorders (DSM-IV) in a representative sample of the German population (N = 4181, age: 18–65). The sample contains five levels of urbanization based on residence location.</p> <p>The epidemiological study was commissioned by the German Ministry of Research, Education and Science (BMBF) and approved by the relevant Institutional Review Board and ethics committee. Written informed consent was obtained for both surveys (core survey and Mental Health Supplement). Subjects did not get any financial compensation for their study participation.</p> <p>Results</p> <p>Higher levels of urbanization were linked to higher 12-month prevalence rates for almost all major psychiatric disorders (with the exception of substance abuse and psychotic disorders). The weighted prevalence percentages were highest in the most urbanized category. Alongside urbanization, female gender, lower social class and being unmarried were generally found to be associated with higher levels of psychopathology. The impact of urbanization on mental health was about equal (for almost all major psychiatric disorders) in young people and elderly people, men and women, and in married and single people. Only people from a low social class in the most urbanized settings had more somatoform disorders, and unmarried people in the most urbanized settings had more anxiety disorders.</p> <p>Conclusion</p> <p>Psychiatric disorders are more prevalent among the inhabitants of more urbanized areas. probably because of environmental stressors.</p

Obesity prevalence from a European perspective: a systematic review

<p>Abstract</p> <p>Background</p> <p>Obesity has been recognised as an important contributing factor in the development of various diseases, but comparative data on this condition are limited. We therefore aimed to identify and discuss current epidemiological data on the prevalence of obesity in European countries.</p> <p>Methods</p> <p>We identified relevant published studies by means of a MEDLINE search (1990–2008) supplemented by information obtained from regulatory agencies. We only included surveys that used direct measures of weight and height and were representative of each country's overall population.</p> <p>Results</p> <p>In Europe, the prevalence of obesity (body mass index ≥ 30 kg/m²) in men ranged from 4.0% to 28.3% and in women from 6.2% to 36.5%. We observed considerable geographic variation, with prevalence rates in Central, Eastern, and Southern Europe being higher than those in Western and Northern Europe.</p> <p>Conclusion</p> <p>In Europe, obesity has reached epidemic proportions. The data presented in our review emphasise the need for effective therapeutic and preventive strategies.</p

Verbreitung der Herz-Kreislauf-Risikofaktoren Hypercholesterinämie, Übergewicht, Hypertonie und Rauchen in der Bevölkerung

Die Daten des Bundes-Gesundheitssurveys 1998 erlauben Aussagen über die Prävalenz der Herz-Kreislauf-Risikofaktoren in der in Deutschland lebenden Bevölkerung. Der Survey ist eine gesundheitsbezogene Befragung und Untersuchung von 7124 Personen einer repräsentativen Stichprobe der 18- bis 79-Jährigen. Auch wenn nicht zu strenge Bewertungskriterien zur Einstufung von Befunden als Risiko zugrunde gelegt werden, um Überschätzungen bezüglich der Risikopopulation zu vermeiden, lässt sich eine alarmierend hohe Verbreitung der Risikofaktoren in der Bevölkerung nachweisen. So haben etwa ein Drittel der 18- bis 79-jährigen Männer und Frauen einen Cholesterinwert ≥ 250 mg/100 ml. Eine Adipositas, d. h. einen Body-Mass-Index ≥ 30 kg/m2, weist rund jede bzw. jeder Fünfte auf. Bei deutlich über der Hälfte der adipösen über 50-jährigen Frauen liegt ein abdominales Fettverteilungsmuster vor, was als zusätzlich belastend gewertet werden muss. 18% der Männer und Frauen haben eine (nach WHO-Kriterien) “mittelschwere” bis “schwere” Hypertonie. Mehr als 20% der 20- bis 49-jährigen Männer sind starke Raucher mit einem Zigarettenkonsum von ≥ 20 Zigaretten pro Tag. Nur etwa ein Drittel aller 18- bis 79-Jährigen haben keinen der Risikofaktoren tägliches Rauchen, Hypercholesterinämie, Adipositas und Hypertonie (letztere wie vorstehend definiert). Um 40% weisen einen Faktor auf, ca. 20% zwei Faktoren. Die Verbreitung der Risikofaktoren zeigt eine starke Abhängigkeit von der sozialen Schicht. Bei den Frauen zeichnet sich eine Zunahme der Risikobelastung für die letzten Jahre ab.The data of the National Health Interview and Examination Survey provides information about the prevalence of cardiovascular risk factors in the population living in Germany. The survey consists of a health oriented questionnaire and an examination of 7124 persons from a representative sample of the 18 to 79 year-old population. Even using strict criteria for each risk factor in order to avoid overestimating the number of subjects at risk, the results show an alarmingly high dissemination of risk factors among the population. Thus one third of the 18 to 79 year-old men and women got cholesterol levels ≥ 250 mg/100 ml. Obesity, i. e. a body mass index ≥ 30 kg/m2 is prevalent in one of five persons. More than half of the overweight, over 50-year-old women, show an abdominal fat distribution, which is an additional factor to the risks in question. 18% of the men and women show a “moderate” to “severe” hypertension (as defined by the WHO criterias). More than 20% of the 20 to 49 year-old men are heavy smokers with a daily consumption of ≥ 20 cigarettes a day. Only one third of all 18 to 79 years old do not have any of the risk factors, as there are daily smoking, hypercholesterolemia, obesity and hypertension (the last terms defined as mentioned above). About 40% show one factor, ca. 20% two factors. There is a strong dependence between the distribution of the risk factors and the socio-economic level. For women, an increase of the total risk has been shown over the last years