The prevalence of risk factors for atherosclerosis among middle school students in Sopot, Poland: results of the SOPKARD 15 programme.

BACKGROUND: SOPKARD 15 is a comprehensive programme to assess the health status of a population of teenagers. The aspects assessed in the study are: physical development, nutritional status, arterial blood pressure, lipid and carbohydrate metabolism, oral hygiene, and psychological parameters. AIM: To assess the prevalence of cardiovascular risk factors in the study population. METHODS: We examined 372 children (185 girls) at the age of 14. The cut-off values for normal lipid blood levels were based on the NCEP-Peds guidelines. Body mass index was assessed on the basis of the Polish centile charts. Blood pressure values assessed against the centile charts were the mean values calculated on the basis of the second and third measurements. RESULTS: Systolic and diastolic blood pressure values were elevated in 15.81% and 10.90% of the subjects, respectively. Abnormal blood glucose was detected in fewer than 6% of the children. Total cholesterol was elevated in 8% and borderline in 24% of the subjects; 8.5% of children were overweight and 7.4% were obese; 5.0% of the subjects took very little physical exercise; 16.4% of boys and 23.4% of girls admitted smoking. Dental examination revealed inflamed gums in 77.6% of the subjects. The diagnosis of a depressive episode was confirmed in 4.2% of the teenagers. CONCLUSIONS: 1. Due to the high prevalence of the risk factors there is a need to launch a comprehensive cardiovascular prevention programme among the teenagers. 2. A considerable proportion of children with lipid abnormalities indicate the need for more frequent lipid profile testing in children.

[Program of early diagnosis of chronic renal disease in children--SopKard 15 nephrological project]. / Zalozenia programu wczesnego wykrywania przewleklej choroby nerek u mlodziezy--SopKard 15 modul nefrologiczny.

The Sopot Program of Cardiac Infarct and Stroke Prevention--SopKard 1999-2009 was established for health promotion to decrease cardio-vascular diseases mortality. To serve these purposes a new project SopKard 15 for adolescents was created. The main aim of SopKard 15 is evaluation of health status with particular attention to risk factors of civilization diseases, with chronic kidney disease (CKD) among them. In population of 14-year-old students a complex nephrological examination including medical history, blood pressure measurements, ultrasound examination, and laboratory tests with e.g. albuminuria, urinalysis, and serum creatinine and cystatin C levels was performed. Nephrology part of Program SopKard 15 aspired to early detection of CKD and verifies normal value for this age group.

Social support level in relation to metabolic syndrome--results of the SOPKARD study.

BACKGROUND: Low level of social support is one of the psychosocial cardiovascular risk factors. Moreover, social support level (SSL) has been reported to be associated with components of metabolic syndrome (MS). AIM: To evaluate the association of SSL with MS in 50- and 60-year-old citizens of Sopot. METHODS: The study covered 476 citizens of Sopot (218 males - M; 258 females - F), aged 50-60 years, invited to take part in the screening project SOPKARD aimed at increasing detectability of hypertension, dyslipidaemia and diabetes mellitus in 2002-2003. Patients with MS were diagnosed according to the AHA/NHLBI criteria (2007). The Berkman and Syme's questionnaire was used for assessment of SSL which was categorised into 3 groups: low, medium and high. RESULTS: Metabolic syndrome was diagnosed in 34% (W 29%, M 39%, p <0.05) of examined subjects. The prevalence of MS criteria was as follows: elevated blood pressure 68% (F 67%, M 69%, NS), elevated fasting glucose 48% (W 45%, M 53%, p=0.08), elevated waist circumference 30% (W 33%, M 25%, p=0.06), hypertriglyceridaemia 42% (F 41%, M 42%, NS) and low level of HDL cholesterol (HDL-C) 23% (W 23%, M 23%, NS). Low SSL was observed in 50% of studied subjects (W 58%, M 39%), middle SSL in 31% (F 29%, M 35%) and high in 19% (F 13%, M 26%). In men with low SSL, MS and low level of HDL-C were found twice as frequent as in men with high SSL (45 vs. 22%, p <0.05; 24 vs. 12%, p <0.05). High level of triglycerides was observed significantly more frequently in women with low SSL than in those with high SSL (51 vs. 21%, p <0.05). Results of regression analysis showed that in men (all and 60-year olds) SSL was significantly associated with MS prevalence (p <0.05). In women, SSL was related to elevated fasting glucose prevalence (p <0.001). Moreover, in 50-year-old women SSL was significantly associated with MS (p=0.05) and elevated waist circumference (p <0.0001). All these relationships were independent of education. CONCLUSIONS: The examined group of middle-aged persons, especially women, was characterised by high frequency of low SSL. Metabolic syndrome and its components were found more frequently in persons with low SSL, compared to those with high SSL. Low SSL was significantly associated with occurrence of MS and dyslipidaemia in men and women, and elevated fasting glucose and elevated waist circumference in 50-year old women.

Relationship between the prevalence of depressive symptoms and metabolic syndrome. Results of the SOPKARD Project.

INTRODUCTION: Depression is a newly recognised risk factor for ischaemic heart disease (IHD). The results of many studies show that depression may contribute to the development of components of metabolic syndrome, such as arterial hypertension, obesity and glycaemic abnormalities. Thus it may have a significant impact on IHD development and worsen the course of an already established disorder. AIM: Evaluation of the prevalence of metabolic syndrome and depression among Sopot inhabitants aged 50 or 60 years. METHODS: This study involved 795 consecutive inhabitants of Sopot (477 female and 318 male) who were invited in 2003 and 2004 to participate in screening examinations in the programme of primary prevention of arterial hypertension, diabetes and lipid abnormalities -- SOPKARD. Metabolic syndrome was diagnosed according to the NCEP ATP III guidelines. Beck's Depression Inventory was used for the assessment of depressive symptoms. RESULTS: Metabolic syndrome was recognised in 32% of participants (in 31% of women and in 33% of men). The distribution of particular elements of metabolic syndrome was as follows: elevated blood pressure was found in 63% of subjects (female -- 58%, male -- 70%), abnormal fasting glucose in 24% (female -- 21%, male -- 28%), visceral (abdominal) obesity in 33% (female -- 38%, male -- 26%), elevated triglyceride level in 34% (female - 28%, male - 42%) and decreased HDL level in 26% (female -- 28%, male -- 23%). Symptoms of depression were found in 37% of studied subjects (42% of females, 28% of males). Metabolic syndrome was observed more frequently in subjects with depressive symptoms compared to those without depressive symptoms in the whole group (35% vs 28%, p <0.05) and in males (44% vs 28%, p <.05). This difference was not statistically significant in females (31% vs 28%, ns). Visceral obesity was observed more frequently in males with depressive symptoms than in those without depressive symptoms (37% vs 21%, p <0.001). It was not observed in the whole group and in females. The studied females group with depression more often had a higher fasting serum glucose concentration when compared to those without depression (25% vs 18%, p<0.05). Such a relationship was not observed in the male group and whole group. CONCLUSIONS: In the studied group of middle-aged subjects, especially among women, a high prevalence of depression symptoms was noted. Statistically significant correlations between the prevalence of depressive symptoms and visceral obesity in men and an elevated glucose level in women were shown.

[The role of medical university in modern prevention of cardiovascular diseases. Examples from Medical University of Gdansk]. / Rola uczelni w nowoczesnej prewencji chorób ukladu krazenia na przykladzie programów Akademii Medycznej w Gdansku.

Constant worsening of epidemiological situation in cardiovascular diseases in Poland in the 70's and 80's called for intensive measures in the field of preventive cardiology. Thus in 90's, in order to change this situation, among others, team from Department of Hypertension and Diabetology from Medical University of Gdansk started, in cooperation with other medical universities, important regional and national research programs and preventive interventions. The aim of the educational program carried out in years 1999-2001 for Members of the Polish Parliament, opinion leaders and decision makers was to increase knowledge of the Polish elites about epidemic of cardiovascular diseases in our country. These actions made possible receiving greater support from the government for new epidemiological and preventive programs in this field. Thanks to NATPOL PLUS project, carried out on the representative sample of adults in 2002, we determined for the first time the prevalence and control of main cardiovascular risk factors in Poland. Results of this program helped planning preventive tasks in the National Cardiovascular Diseases Prevention and Treatment Program POLKARD 2003-2005. The aim of the preventive programmes: SOPKARD and Polish Four-Cities Project was to work out standards of modern, comprehensive interventions. They permitted planning and introduction of the largest preventive program: the Polish 400 Cities Project (PP400M). The PP400M is addressed to citizens of all small towns (to 8000 citizens) and surrounding villages in the whole country. All these accomplishments in the field of quickly expanded clinical epidemiology and cardiovascular prevention are directed mainly to Pomeranian and Polish citizens, especially those who are not aware of high risk of myocardial infarction or stroke. The main principle of our strategy is the role of university as an expert in preparation and supervision of the programs, which were carried out by the specialized organizations and firms such as PBS in Sopot. The second important component of our strategy was an intensive cooperation with other leading research centres in Poland that allowed taking advantage of the joint achievements.