Prevalence of risk factors and risk of mortality in relation to occupational group.

The aims of this study were to examine the prevalence of risk factors in different occupational groups of Kaunas men and women aged 35-64 years, and to assess the prognostic value of occupation on all-cause and cardiovascular mortality risk. The four random samples of Kaunas men and women (3,293 men and 3,561 women) aged 35-64 years from the Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) study (1983-2002) were examined using the standard epidemiological methods. The participants of the first three surveys were followed-up, in terms the end points reached, from the beginning of each survey until January 1, 2004. A multivariate Cox model was used for the analysis. In 1983-1984, the proportion of manual workers was greater than proportion of non-manual workers among both men and women. Twenty years later, the proportion of female manual workers decreased twice to 26.2%. The prevalence of majority risk factors showed no difference in manual and non-manual workers among both men and women. The risk of death from cardiovascular diseases among manual workers was 1.5 times greater than among non-manual workers. The different prognostic value of various variables has been determined on all-cause mortality risk in groups of manual and non-manual workers.

[Association of metabolic syndrome with ischemic heart disease among middle-aged Kaunas population]. / Metabolinio sindromo rysys su isemine sirdies liga tarp vidutinio amziaus Kauno gyventoju.

UNLABELLED: The aim of the present study was to estimate an association of metabolic syndrome with ischemic heart disease (IHD) in middle-aged Kaunas population. MATERIAL AND METHODS: The epidemiological examination was carried out in Kaunas from 2001 to 2002. Health survey was carried out according to the MONICA study protocol. Analysis was performed in 1336 persons aged 35-64 years (603 men and 733 women). Metabolic syndrome was defined by the presence of three or more out of five components: central obesity (waist circumference >102/88 cm (men/women)); fasting plasma glucose > or =6.1 mmol/l; triglycerides > or =1.7 mmol/l; high density lipoprotein cholesterol <1.04/1.3 mmol/l (men/women); systolic/diastolic blood pressure > or =130 and/or 85 mmHg. IHD was diagnosed by the criteria: previous myocardial infarction, angina pectoris or ischemic changes of electrocardiogram. RESULTS: In the study population cohort prevalence of metabolic syndrome was 19.4% for men and 26.3% for women, prevalence of IHD--14.3% and 19.4%, respectively. Prevalence of metabolic syndrome and IHD among men and women increased with age. Comparing prevalence of metabolic syndrome among persons with IHD and without IHD, in the groups of men and women aged 35-44 years metabolic syndrome was not associated with IHD; in the group of men with IHD aged 45-64 years rate of metabolic syndrome was 1.8 times higher than among persons without IHD (odds ratio: 2.25 (95% CI 1.24-4.06)); in the group of women with IHD aged 45-64 years the rate of metabolic syndrome was marginally higher (1.3 times) than among women without IHD (odds ratio: 1.55 (95% CI 0.99-2.43)). The highest rate of metabolic syndrome was determined for men diagnosed with angina pectoris (odds ratio: 3.39 (95% CI 1.36-8.41)). In conclusion, study data showed that metabolic syndrome was associated with IHD in men aged 45-64 years.

[Trends in morbidity from acute myocardial infarction, risk factors and risk of ischemia]. / Sergamumas uminiu miokardo infarktu, rizikos veiksniai ir isemijos rizika.

THE AIM: To assess the linkages of trends between the mean values of main risk factors of ischemic heart disease, the overall high risk of coronary within 10 years and morbidity from acute myocardial infarction in Kaunas population aged 35-64 years during the period from 1983 to 2002. MATERIAL AND METHODS: Data sources were four cross-sectional surveys (1983-1984, 1986-1987, 1992-1993, 2001-2002) and population-based ischemic heart disease register (1983-2001) of Kaunas population aged 35-64 years. Data collection was conducted according to the method using in the Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) project. The overall high risk developing a fatal or non-fatal myocardial infarction or sudden death within 10 years was calculated by PROCAM Risk Score. RESULTS: During 1983-2002 the mean value of systolic blood pressure decreased among men and women (respectively, from 138.8 to 136.4 mmHg, p<0.05 and from 139.7 to 133.2 mmHg, p<0.05). Body mass index decreased among men (from 27.5 to 27.4 kg/m2, p<0.05), and diastolic blood pressure decreased among women (from 86.5 to 82.7 mmHg, p<0.05). In 1983-2002 the overall high 10-year risk also decreased in men and women (respectively, from 20.4 % to 16.3% and from 7.9% to 5.4%). During 1992-2001 the trend of morbidity from acute myocardial infarction was declining among men (by - 4.6 %/year, p<0.01) and among women (by--1.3 %/year, p>0.05). CONCLUSION: Trends of the overall high 10-year coronary risk and morbidity from acute myocardial infarction were analogous in both genders.

[Self-rated health and probability of death among middle-aged Kaunas population (20-year follow-up)]. / Kauno vidutinio amziaus gyventoju subjektyvus sveikatos vertinimas ir mirties tikimybe (20-ties metu stebejimo duomenys).

The aim of this study was to examine the self-rated health differences in relation with risk factors among middle-aged men and women and to assess the probability of death from all causes, from cardiovascular diseases and from ischemic heart disease in the self-rated health groups during the 20-year follow-up. In the framework of the World Health Organization MONICA-1 survey (1983-1984) random samples of Kaunas men and women aged 35-64 and stratified by age and gender (response rate 70.2%) were examined using standard epidemiological methods. Self-rated health was divided into five levels based on information from questionnaire: excellent, very good, good, fair, or ill. The participants of the survey were followed-up in terms of the end points reached, from the beginning of each study until December 31, 2001. The study population was followed-up through the death register: among women there were 197 deaths (94 deaths from cardiovascular diseases and 44 deaths from ischemic heart disease) and among men there were 303 deaths (154 deaths from cardiovascular diseases and 98 from ischemic heart disease). Among dead men and women the prevalence of fair and ill self-rated health was higher as compared to alive ones (respectively, 71.0% and 54.9%, p<0.001; 84.3% and 76.7%, p<0.05). Among dead women with hypercholesterolemia (> or =5.0 mmol/l), overweight (body mass index > or =25.0 kg/m2), nonsmoking and sufficient physical activity the prevalence of "fair and ill" self-rated health was higher as compared to alive; the prevalence of "fair and ill" self-rated health in men with hypercholesterolemia (> or =5.0 mmol/l) and sufficient physical activity was higher among dead as compared to alive. During the 20 year follow-up the probability of death from all causes, cardiovascular and ischemic heart disease among men with self-rated health as "ill and fair" as compared to "excellent and very good", showed statistically significant difference (log rank=18.5, p<0.001, log rank=10.8 p<0.01, log rank=8.9, p<0.01, respectively); among women there were no significant differences. The results of this study suggest that special attention and care should be directed to persons with reporting self-rated health as "fair and ill".

[Prevalence and risk factors of age-related maculopathy among middle aged people]. / Vidutinio amziaus zmoniu sergamumas makulopatija, susijusia su amziumi, ir jos rizikos veiksniai.

OBJECTIVE: To investigate the prevalence of age-related maculopathy and the relationships of age-related maculopathy to age, sex, ocular factors, education, work exposures. A population-based cohort study included 1357 subjects (35-64 years of age) living in Kaunas (Lithuania), who were examined during the interval from 2001 to 2002. The diagnosis of age-related maculopathy was based on ophthalmoscopic findings or on fundus photographs. The prevalence of early age-related maculopathy was 7.3% in persons 40-64 years of age. No late age-related maculopathy (AMD) was found. Prevalence of early age-related maculopathy was strongly related to age (P<0.001). No significant prevalence differences were between the sexes. The frequency of age-related maculopathy was higher in eyes with light iris color but association was not significant. No associations were found between cataract or cataract type and ARM. There was no association between education and age-related maculopathy. Exposure to harmful work was found to be related to the presence of early age-related maculopathy in all. The prevalence of age-related maculopathy was significantly higher between men working in high temperature.

[The prevalence and trends of the smoking habits among middle-aged Kaunas population during 20 years and their relation with sociodemographic status]. / Vidutinio amziaus Kauno gyventoju rukymo iprociu paplitimas, pokyciai per 20 metu ir sasajos su sociodemografiniais rodikliais.

THE AIM: To evaluate the prevalence and time trends of smoking habits among middle-aged Kaunas population during 20 years and its relation with sociodemographic status. MATERIAL AND METHODS: Four cross-sectional surveys were carried out according to the WHO MONICA protocol in 1983-1985, 1986-1987, 1992-1993, and 2001-2002. During these surveys, 2,450, 1,762, 1,238, and 1,404 persons aged 35-64 years, respectively, were screened. Data of the last survey were used to evaluate the relationship between smoking habits and sociodemografic status (educational level, occupation). Data of all four surveys were used to assess the prevalence of smoking habits among the Kaunas population aged 35-64 years and its trends during 20 years. Regular smoker was subject who smoked at least one cigarette per day. Prevalence rates for age group of 35-64 years were age-standardized using the European population as the standard. RESULTS: According to the results of the last survey, 41.4% of men and 11.3% of women were regular smokers. During the last twenty years the prevalence of regular smokers increased by 2.7-fold among women and didn't change among men. Age, educational level, occupation and age when starting smoking showed a strong relationship with the smoking habits among men. Education level didn't show any association with smoking habits among women. The lowest prevalence of the regular smoking was among men with a higher education (24.9%) and among professional workers (27.1%) as compared to those with a lowest education (44.6%, p<0.01) and workers (47.3%, p<0.001), respectively. Among all regular smokers, 65.2% of men started to smoke at age 16-21 years, and 52.3% of women - at age 22 years or more. During 20-year period the prevalence of never smokers decreased (beta=-0.95, p<0.05) and that of ex-smokers increased (beta=0.96, p<0.05) among women. No statistically significant trends in smoking habits were detected among men during the study period. CONCLUSION: The prevalence of never smokers decreased and that of ex-smokers increased among women 2.7-fold while no significant changes in smoking habits were found among men during 20-year study period. The lowest prevalence of regular smokers was among men with higher education and among professional workers.

Age-related maculopathy and consumption of fresh vegetables and fruits in urban elderly.

The purpose of this study was to investigate the rate of age-related maculopathy among elderly males and females in relation to frequency of consumption of fresh vegetables and fruit. During ophthalmological investigation of Kaunas city inhabitants aged 65-74 years (240 males and 206 females) age-related maculopathy (early and late) was determined for 22.1% of males and 20.4% of females. Frequency of usage of fresh (uncooked) vegetables and fruits in winter-spring and in summer-autumn seasons by investigated persons was determined, using food frequency questionnaire. In this work an association between age-related maculopathy and usage of vegetables and fruits has been investigated in 170 males and 181 females aged 65-74 years without diabetes who never smoked; age-related maculopathy was found for 18.8% of males and 17.7% of females. Obtained data have demonstrated an inverse association between consumption of vegetables during winter-spring season and age-related maculopathy: usage of vegetables two times a week or more versus usage less than two times a week decreases prevalence of age-related maculopathy 2.0 times among males (OR=0.42; 95% CI 0.18-1.0; p=0.05) and 2.2 times among females (OR=0.37; 95% CI 0.15-0.9; p=0.02). Data have demonstrated a tendency that increasing consumption of fresh vegetables and fruits during both seasons can reduce risk of age-related maculopathy among females. In conclusion, characteristic for Lithuanian urban elderly rare usage of fresh vegetables during winter-spring season can increase risk of age-related maculopathy independently from other risk factors.

[Time trends in mortality from malignant tumors and lung cancer during the period 1971-2000 and the risk of death in the middle-aged Kaunas men]. / Vidutinio amziaus Kauno vyru mirtingumo nuo piktybiniu naviku pokyciai ir prognostiniai veiksniai (1971-2000 m.).

The aims of this study were: 1. To examine the prevalence of risk factors and the risk of mortality from malignant tumors and lung cancer in 45-59-year-old Kaunas men; 2. To assess time trends during the period 1971-2000 in mortality from malignant tumors and lung cancer in Kaunas men aged 25-64 years. The random samples of Kaunas men aged 45-59 years from the Kaunas Rotterdam Intervention Study (1972-1974) and Study of Multifactorial Prevention of IHD (1977-1980) surveys (n=6446) were examined using the standard epidemiological methods. The participants of the two surveys were followed-up, in terms of the end points reached, from the beginning of each study until January 1, 2001. A multivariate Cox model was used for the analysis. The risk of death from malignant tumors and lung cancer among screened men was directly related to age and smoking habits and inversely related to education, total cholesterol, and body mass index levels. The mortality from malignant tumors and lung cancer among Kaunas men aged 25-64 years has not changed over the period 1971-2000. The mortality from all malignant tumors statistically significantly decreased from 1991 to 2000.

Trends in main cardiovascular risk factors among middle-aged Kaunas population between 1983 and 2002.

OBJECTIVE OF THE STUDY: To evaluate dynamics in prevalence of main risk factors of cardiovascular diseases among middle-aged Kaunas population between 1993 and 2002. MATERIAL AND METHODS: Four independent surveys in 1983-1984, 1986-1987, 1992-1993, and 2001-2002 were carried out in random samples of men and women aged 35-64 involving 2413, 1762, 1231 and 1403 persons respectively. The risk factors were defined within the framework of the WHO MONICA study (Multinational Monitoring of Trends and Determinants in Cardiovascular Disease). RESULTS: During the 19 years the mean values of systolic blood pressure decreased among men. Among women decreased both mean values of systolic and diastolic blood pressure, however the prevalence of hypertension has decreased only among women by 11.9%, with no significant changes among men. The prevalence of overweight decreased among men, and the prevalence of obesity declined among women. Among women the body mass index decreased as well. No changes in the prevalence of hypercholesterolemia among men (80.7%) as well as among women (82.7%) have been detected, meanwhile the mean of total cholesterol among men increased from 5.9 mmol/l to 6.1 mmol/l and among women - from 6.09 mmol/l to 6.31 mmol/l (p<0.001). The prevalence of smoking has increased by 7.2% among women and didn't change among men. IN CONCLUSION: The decreasing trends in the prevalence of some risk factors have been estimated in Kaunas middle-aged population during 1983-2002 years. However the profile of cardiovascular disease risk factors is still rather high. Programs or strategies targeted to control levels of main cardiovascular disease risk factors are urgently needed.