[Cardiovascular screening programme in the Central Hungarian region. The Budakalász Study]. / Cardiovascularis szuroprogram a közép-magyarországi régióban. Budakalász Vizsgálat.

INTRODUCTION: The reduction in mortality due to prevention programmes observed in some European countries is not currently reached in Hungary. Effective prevention is based on the screening of risk factors and health state of the population. AIM: The goal of this study was to develop a longitudinal, population-based screening programme in the Central Hungarian region in order to collect information on the health state and cardiovascular risk profile of the citizens and discover new potential cardiovascular risk factors. METHOD: The Budakalász Study is a self-voluntary programme involving the adult population (>20 yrs, approx. 8000 persons), and it consists of questionnaires, non-invasive tests (anthropometry, cardiac echo, carotid duplex scan, blood pressure measurement, ankle-brachial index), venous blood sample collection and laboratory tests. RESULTS: Until January, 2014, 2420 persons (30% of the population, male: 41.2%, average age 54.8 years) participated in the programme. Cardiovascular morbidity was higher in contrast to a former national survey. The number of risk factors and, therefore, 10-year cardiovascular risk were also elevated in this population. CONCLUSIONS: These findings underline the importance of screening programmes and effective therapies.

[Change of the political system and epidemiologic transition in Hungary]. / Rendszerváltozás és epidemiológiai korszakváltás Magyarországon.

A new epidemiological stage has begun in Hungary as a result of the implosion of state-socialism. It has made the transition to market economy and open society possible. The emerging economic and social system has created the basis for terminating the chronic qualitative epidemiological crisis and for the renewal of the epidemiological development. The new political and socio-economic system has had a decisive impact on the decrease in mortality and consequently to the increase in life expectancy in the countries east of the River Elbe. Besides the spread of health conscious behaviour, the efficacy of new medications and invasive medical interventions just as much as the network of emergency centres have contributed to the favourable changes. The most characteristic feature of the new epidemiological stage is that it delays the progression of chronic diseases and postpones the time of death. In a large extent the successful prevention, treatment and care of diseases of the circulatory system are mainly responsible for increasing the life expectancy at birth. Paradoxically, whereas life expectancy has increased in the country on the whole, social inequality has also increased.

Continued improvement of cardiovascular mortality in Hungary--impact of increased cardio-metabolic prescriptions.

BACKGROUND: During the last 35 years the poor ranking of Hungary on the list of life expectancy at birth among European countries, has not changed. In 1970 our lag behind the leading European countries was the smallest. The gap was growing between 1970 and 1993 but from 1994 onwards the life expectancy at birth in Hungary has increased continuously and somewhat faster than in other European countries. The aim of this study was to analyze the association between decreasing cardiovascular mortality rates, as a main cause of death and the increase in cardio-metabolic prescriptions and possible changes in lifestyle behavior. METHODS: Analyses were conducted on national data concerning cardiovascular mortality and the number of cardio-metabolic drug prescription per capita. The association between yearly rates of cardiovascular events and changes in antihypertensive, antilipidemic and antidiabetic prescription rates was analyzed. The changes in other cardiovascular risk factors, like lifestyle were also considered. RESULTS: We observed a remarkable decline of mortality due to stroke and acute myocardial infarction (AMI). The fall was significantly associated with all prescription rates. The proportion of each treatment type responsible for suppression of specific mortality rates is different. All treatment types comparably improved stroke mortality, while antilipidemic therapy improved AMI outcome. CONCLUSIONS: These results emphasize the importance of a comprehensive strategy that maximizes the population coverage of effective treatments. Hungary appears to be at the beginning of the fourth stage of epidemiologic transition, i.e. it has entered the stage of delayed chronic noninfectious diseases.

[New trends in mortality and life expectancy: epidemiologic transition in Hungary?]. / Fordulat a halandóságban és az életkilátásokban, epidemiológiai korszakváltás Magyarországon?

In 2001 there were 18,000 fewer deaths than in 1993. In eight years, the annual number of deaths decreased by 12 per cent, the death rate by 10 per cent, and life expectancy at birth increased by 3.3 years. The chronic epidemiologic crisis came to an end, and the long process of closing the gap in life expectancy at birth between Hungary and the European Union started in the mid 1990s. There is still a long way to go, however, before the country reaches EU levels in terms of life expectancy at birth. The most important phenomenon of the favourable turn in mortality and life expectancies has been the decline in the death rate due to cardiovascular diseases. Health promotion and preventive and curative medicine have contributed to the improving epidemiological situation, but the decisive factor in the lower death rates and consequently longer life expectancies at different ages, including old age, has been the change in the socio-economic and political system. Hungary appears to be at the beginning of the fourth stage of epidemiologic transition, i.e. having left the stage of chronic noninfectious diseases, it has entered the stage of delayed chronic noninfectious diseases.