Trends in premature cerebrovascular disease mortality in the Polish population aged 25-64 years, 2000-2016.

Background: Many scientific reports have shown a decrease in total cerebrovascular disease (CeVD) mortality over the past few decades, but too little attention has been paid to premature mortality. CeVD accounted for 22.5% and 17.8% of premature cardiovascular disease deaths in Poland, in 2000 and 2016, respectively. Objective: The aim of the study was to analyse premature CeVD mortality in the Polish population in the recent years, the dynamics of its changes and the potential factors that may have contributed to the decline in mortality. The main goal of the study was to overview the levels and trends in premature CeVD mortality with an emphasis on haemorrhagic, ischaemic and unspecified (not specified as haemorrhagic or ischaemic) stroke. Material and methods: The analysis was based on a database of the Central Statistical Office of Poland and included data from 2000-2016 on premature cerebrovascular deaths occurring between 25 and 64 years of age (N=104,786). CeVD and haemorrhagic, ischaemic or unspecified stroke were coded with ICD-10 codes I60-I69, I61-I62, I63 and I64, respectively. The analysis included assessment of CeVD deaths distribution and evaluation of age-specific mortality rates in 10-year age groups and age-standardised mortality rates (SMR) in the age group 25-64 years, separately for men and women. Trends in SMRs have been studied in the period 2000-2016. Results: The number of CeVD deaths decreased by 32.8% in men and 48.8% in women. There was a two-fold decline in CeVD mortality: from 59 to 29 male and from 30 to 12 female per 100,000. In addition, a 2-year increase in the median age of CeVD death was observed (Men: 56.4 to 58.4 years, Women: 56.4 to 58.7 years, p<0.001). A statistically significant decline in mortality (per 100,000) was also noticed for haemorrhagic stroke (Men: 18.7 to 10.4; Women: 9.6 to 3.8), ischaemic stroke (Men: 11.8 to 8.4; Women: 4.7 to 3.0) and unspecified stroke (Men: 19.7 to 3.5; Women: 9.1 to 1.3). Conclusions: A substantial decline in premature CeVD mortality was observed in the period 2000-2016. Additionally, the number of deaths that could not be classified as haemorrhagic or ischaemic stroke death decreased significantly. The increasingly widespread use of new post-stroke therapies and their availability make it possible to expect a further decrease in CeVD mortality. However, the necessary actions should be taken to compensate for the disparities in CeVD mortality between men and women.

A note of caution on the diagnosis of Martin-Probst syndrome by the detection of the p.D59G mutation in the RAB40AL gene.

UNLABELLED: Martin-Probst syndrome (MPS) is an X-linked multisystem neurodevelopmental disorder, reported to be caused by the p.D59G mutation in RAB40AL. Whereas evidence against the pathogenic role of p.D59G has been published, the presence of RAB40AL p.D59G continues to be used as a support for MPS diagnosis. Our purpose was to provide further arguments for excluding pathogenicity of RAB40AL p.D59G. We detected p.D59G in two healthy males ascertained as family members of p.D59G carriers who underwent whole exome sequencing for diagnostic reasons. Furthermore, we found that p.D59G was present in 2.86% (4/140) of randomly selected Polish males with higher education. CONCLUSION: Our findings are inconsistent with a causative effect of RAB40AL p.D59G on cognitive impairment combined with severe to profound bilateral hearing loss but indicate that p.D59G is a common genetic variation. Our data emphasize the need for genotyping large sample sizes of diverse populations as a basic tool in determining variant pathogenicity.

Regional and temporal differences in the associations between cardiovascular disease and its classic risk factors: an analysis of 49 cohorts from 11 European countries.

AIMS: The regional and temporal differences in the associations between cardiovascular disease (CVD) and its classic risk factors are unknown. The current study examined these associations in different European regions over a 30-year period. METHODS AND RESULTS: The study sample comprised 553 818 individuals from 49 cohorts in 11 European countries (baseline: 1982-2012) who were followed up for a maximum of 10 years. Risk factors [sex, smoking, diabetes, non-HDL cholesterol, systolic blood pressure (BP), and body mass index (BMI)] and CVD events (coronary heart disease or stroke) were harmonized across cohorts. Risk factor-outcome associations were analysed using multivariable-adjusted Cox regression models, and differences in associations were assessed using meta-regression. The differences in the risk factor-CVD associations between central Europe, northern Europe, southern Europe, and the UK were generally small. Men had a slightly higher hazard ratio (HR) in southern Europe (P = 0.043 for overall difference), and those with diabetes had a slightly lower HR in central Europe (P = 0.022 for overall difference) compared with the other regions. Of the six CVD risk factors, minor HR decreases per decade were observed for non-HDL cholesterol [7% per mmol/L; 95% confidence interval (CI), 3-10%] and systolic BP (4% per 20 mmHg; 95% CI, 1-8%), while a minor HR increase per decade was observed for BMI (7% per 10 kg/m2; 95% CI, 1-13%). CONCLUSION: The results demonstrate that all classic CVD risk factors are still relevant in Europe, irrespective of regional area. Preventive strategies should focus on risk factors with the greatest population attributable risk.

All classic cardiovascular disease (CVD) risk factors are still relevant in Europe, irrespective of regional area. The differences in the associations of CVD risk factors with overt CVD between regions of Europe are generally small. Minor temporal hazard decreases were observed for non-HDL cholesterol and systolic blood pressure, while a minor hazard increase was observed for body mass index.

Disparities in knowledge of cardiovascular risk factors and prevention methods related to cardiovascular status and functional health literacy in Poland, 2020-2021.

BACKGROUND: Numerous studies have reported a significant role of health literacy (HL) in the prevention or treatment of various diseases. However, in Poland, there was no scientific research involving simultaneously the status of cardiovascular disease (CVD) and HL in assessment of health knowledge; therefore, it became the objective of our study. AIMS: We aimed to evaluate the level of CVD knowledge depending on CVD status and functional HL in the Polish population. METHODS: The study population consisted of 2827 participants from the WOBASZ II Survey aged 20-89 years: 2266 were CVD-free (non-CVD), 361 were hospitalized for CVD (CVDH[+]), and 200 were diagnosed with CVD but not hospitalized (CVDH[-]). The Newest Vital Sign test (NVS) was applied to determine functional HL. Self-reported knowledge of CVD risk factors (RFs) and prevention methods (PMs) in participants with different CVD status depending on HL was estimated. Multivariable ordinal and binary logistic regression analyses were performed to find predictors of RFs and PMs knowledge. RESULTS: The knowledge of CVD RFs and/or PMs was strictly related to HL and CVD status. Inadequate HL decreased the satisfactory (≥5 RFs/PMs) knowledge of RFs (odds ratio [OR], 0.50; 95% confidence interval [CI], 0.40-0.62) and PMs (OR, 0.56; 95% CI, 0.45-0.71). CVDH(-) participants were more likely to have satisfactory PMs knowledge (OR, 1.49; 95% CI, 1.02-2.16), while CVDH(+) participants satisfactory RFs knowledge (OR, 1.85; 95% CI, 1.35-2.53). CONCLUSIONS: HL and CVD status are the key determinants of CDV RFs/PMs knowledge. Functional HL significantly affects health knowledge; therefore, HL screening should be recommended in primary care to increase the effectiveness of primary CVD prevention.

Identifying associations between the social network index, its components, and the prevalence of cardiovascular diseases in Polish adults. Results of the cross-sectional WOBASZ II study.

BACKGROUND: Psychosocial risk factors are important determinants of cardiovascular diseases (CVDs): people involved in positive relationships live longer than those with low social support (SS). AIMS: Our study aimed to evaluate the association between SS, components of the social network, and CVDs. METHODS: A cross-sectional population-based survey WOBASZ II conducted in the years 2013-2014 included a sample of 6043 individuals, aged 20 and over, who completed the Berkman-Syme questionnaire to assess SS using the social network index (SNI). RESULTS: Higher percentage of low SS was observed in women (52.15%) compared to men (45.4%) (P <0.001). People with a low SNI had a worse CVD risk factor profile. None of the analyzed social contacts (with children, relatives, or friends), regardless of how satisfactory they were, was associated with CVDs in men. In women, satisfying contact with children or relatives appeared to be associated with better cardiovascular health. Furthermore, active participation in organized social activity increased the chance of arrhythmia in both sexes: 1.50 (1.04-2.15); P = 0.029 in men; 1.47 (1.11-1.95); P = 0.007 in women. Although a low SNI was associated with analyzed CVDs in the univariate analysis, it was not confirmed in the fully adjusted model. CONCLUSIONS: More women had low SS compared to men. People with low SS had a worse CVD risk factor profile. There was a significant independent relationship between different components of the SNI, such as social contacts and CVDs in women and active participation in organized social activity and arrhythmia in both sexes.

Increase in the prevalence of metabolic syndrome in Poland: comparison of the results of the WOBASZ (2003-2005) and WOBASZ II (2013-2014) studies.

INTRODUCTION Metabolic syndrome (MS) significantly increases cardiovascular risk. Knowledge about the current prevalence of MS in the Polish population is limited. OBJECTIVES The aim of this study was to assess the prevalence of MS in the Polish population based on the results of the WOBASZ II study (2013-2014) and to compare the obtained data with the results of the WOBASZ study (2003-2005). PATIENTS AND METHODS A representative sample of 19 751 Polish adults from the WOBASZ and WOBASZ II studies was analyzed. Diagnostic criteria for MS included abdominal obesity, elevated blood pressure, elevated fasting glucose values, and lipid disorders; MS was diagnosed if at least 3 individual components were present. RESULTS Based on the WOBASZ II study (2013-2014), the prevalence of MS in Poland was 32.8% in women and 39% in men. In women, the most frequent component of MS was abdominal obesity (64.7%), while in men it was increased blood pressure (62%). In the decade between the WOBASZ and WOBASZ II studies, there was a significant increase in the prevalence of MS in Polish adults aged 20 to 74 years: by 3.3 percentage points in women (26.6% vs 29.9%; P <0.001) and by 8.8 percentage points in men (30.7% vs 39.4%; P <0.001). The increase in the frequency of carbohydrate metabolism disorders was the greatest contributor to this phenomenon; however, abdominal obesity and lipid disorders were also significantly more frequent. CONCLUSIONS It is alarming that in the decade between the WOBASZ and WOBASZ II studies there was such a significant increase in the prevalence of MS and its individual components in Poland.

Association between cardiovascular diseases and depressive symptoms in adults. A pooled analysis of population-based surveys: WOBASZ, NATPOL 2011, and WOBASZ II.

INTRODUCTION Psychosocial risk factors play an important role in the origins of cardiovascular risk. OBJECTIVES The aim of the study was to evaluate the prevalence of depressive symptoms (DSs) in relation to some sociodemographic characteristics and selected cardiovascular diseases (CVDs) and to assess the relationship between self­reported CVDs and the severity of DSs. PATIENTS AND METHODS Three cross­sectional population­based surveys: WOBASZ (2003-2005), NATPOL 2011 (2011), and WOBASZ II (2013-2014) covered a total sample of 20 514 participants (9614 men and 10 900 women), aged 20 to 74 years, who all completed the Beck Depression Inventory. RESULTS One­fifth of men and one­third of women had DSs. The prevalence of DSs increased with age, was higher in unmarried persons and in individuals with a medical history of CVDs, and decreased with increasing education level. Individuals with DSs, both men and women, even those with borderline depression, had from 1.5- to more than 2­fold higher odds of either coronary artery disease or arrhythmia, and 2- to almost 4­fold higher chance of previous stroke in their medical history. CONCLUSIONS This study showed that DSs were a frequently observed condition in the general Polish population including patients with CVDs. We also demonstrated that there is a relationship between self­reported CVDs and severity of DSs regardless of age, marital status, education, and concomitant disorders.

Ten-year risk of fatal cardiovascular disease in the Polish population and medical care. Results of the WOBASZ study.

BACKGROUND: An individual assessment of global risk of death from cardiovascular diseases (CVD) should guide management, both life style changes and medical therapy, in order to decrease risk factors and improve prognosis. AIM: We assessed global risk in the Polish population and its relation to medical care, including blood pressure and cholesterol measurements, smoking cessation and dietary advice, and recommendations regarding increased physical activity. METHODS: A sample of the Polish population including 6392 men and 7153 women aged 20-74 years was screened in 2003-2005. We calculated global risk for subjects aged 40-70 years using the SCORE function for high-risk regions of Europe. RESULTS: We found high global risk (> or = 5%) in 46% of men and 21% of women. Compared to low risk subjects, high risk subjects more often had hypercholesterolaemia, hypertension or were obese, and they more often visited their primary care physicians. Dietary advice was given to 36% of high global risk men compared to only 20% of low global risk men with hypercholesterolaemia (47% vs 23% among women, respectively p < 0.0001), and cholesterol measurement was made in 31% of high global risk men and 19% of low global risk men with hypercholesterolaemia (38% vs 27% among women, respectively p < 0.0001). Smokers with high global risk received smoking cessation advice significantly more often than low global risk smokers (men: 72% vs 55%; women: 63% vs 52%). Subjects with hypertension and high global risk had their blood pressure measured significantly more often than those with hypertension and low global risk (men: 83% vs 68%; women: 87% vs 79%). High-risk obese persons significantly more often received both dietary advice (men: 55% vs 36%; women: 60% vs 34%) and recommendations regarding higher physical activity (men: 43% vs 32%; women: 40% vs 27%). In the logistic regression analysis, the quality of medical care was significantly associated with the global risk. CONCLUSIONS: The Polish population is characterised by a high proportion of subjects with high global risk especially among men. The quality of medical care was found to be associated with the global risk level: the higher was the global risk, the better was the medical care, although it is still insufficient compared to current standards.

Do depressive symptoms adversely affect the lifestyle? Results of the WOBASZ study.

BACKGROUND: The negative psychosocial risk factors for cardiovascular (CV) disease, such as low social support or depression, may adversely affect the lifestyle. AIM: To evaluate the lifestyle in terms of anti-health behaviours in patients with depressive symptoms (DS) compared to individuals without DS. METHODS: A total of 6392 men and 7153 women aged 20-74 years were evaluated in the WOBASZ study [a multicentre nationwide study of the Polish population's health]). The presence of DS was assessed with Beck's Depression Inventory (BDI). Depressive symptoms were considered to be present if the patient scored at least 10 points on the BDI scale. RESULTS: The DS were present in 24% of men and 34% of women. In both groups, the mean age of subjects with DS was significantly higher compared to healthy individuals. Compared to healthy individuals, subjects with DS had a more unfavourable CV risk profile (hypertension, diabetes mellitus, obesity and hyperlipidaemia were significantly more prevalent among the subjects with DS), were characterised by a lower socioeconomic status and inhabited small administrative districts. Subjects with DS were also characterised by more anti-health lifestyles than healthy individuals. Of the 6 elements of anti-healthy lifestyle, 3 or more were observed in 18.8% of men with DS and 14.6% of men without DS (p < 0.0001) and in 17.5% of women with DS and 11.3% of women without DS (p < 0.0001). Significantly more men and women with DS than men and women without DS were regular smokers (men [M]: 42.3% vs 37.4%, p < 0.0007; women [W]: 25.6% vs 23.3%, p < 0.0346), were not physically active (M: 37.4% vs 30.2%, p < 0.0001; W: 43.4% vs 34.9%, p < 0.0001), consumed alcohol at least three times a week (M: 3.8% vs 1.7%, p < 0.0097; W: 0.3% vs 0.1%, p = 0.0349), were incompliant with their doctor's recommendations (M: 17.9% vs 12.3%, p < 0.0001; W: 22.2% vs 13.9%, p < 0.0001) and failed to have their blood pressure measured within the past year (M: 19.4% vs 15.0%, p < 0.0003; W: 15.1% vs 11.4%, p < 0.0001). The lack of physical activity and smoking, and - in women - regular consumption of alcohol, were demonstrated to be the lifestyle factors which were significantly and independently related to DS. CONCLUSIONS: A high prevalence of DS, especially among women, has been observed in the Polish population. The DS were found in every fourth man and every third woman. In both groups, subjects with DS were characterised by more anti-health lifestyle compared to healthy individuals. Of all the analysed factors of anti-health lifestyle the following were significantly and independently associated with DS - lack of physical activity and smoking in both sexes and, additionally, regular alcohol consumption in women.

Prevalence of cardiometabolic risk factors and selected cardiovascular diseases in hypertensive and normotensive participants in the adult Polish population: The WOBASZ II study.

Hypertension is one of the most important causes of cardiovascular disease (CVD) incidence and mortality. The aim of the study was to assess the prevalence of metabolic syndrome and its individual components i.e., diabetes, obesity, elevated triglycerides (TG), low HDL (high-density lipoprotein) cholesterol, as well as selected manifestations of CVD i.e., atrial fibrillation (AF), peripheral artery disease (PAD), coronary artery disease (CAD), myocardial infarction (MI), and stroke in persons with and without hypertension in the Polish population.The analysis included participants of Polish multicentre WOBASZ II Study i.e., 6163 persons aged 19 and above. The Mantel Haenszel anlysis and multidimensional logistic regression model were used to assess the relations between the prevalence of metabolic syndrome and its individual components as well as selected manifestations of CVD with hypertension.Compared to normotensives, metabolic syndrome was over 5 times more prevalent in participants with hypertension (OR = 5.35, 95% CI:4.71-6.09). Components of the metabolic syndrome and selected manifestations of CVD were more prevalent in participants with hypertension compared to normotensives. The Mantel-Haenszel odds ratios (95% confidence intervals) were as follows: obesity counted as BMI > 30 kg/m OR = 2.58 (2.26-2.96), raised triglycerides OR = 2.34 (2.07-2.64), reduced HDL-C OR = 1.81 (1.59-2.06), metabolic syndrome OR = 5.35 (4.71-6.09), diabetes OR = 2.54 (1.98-3.26), AF OR = 1.47 (1.09-2.00), PAD OR = 1.51 (1.14-1.99), CAD OR = 1.94 (1.52-2.49), MI OR = 1.89 (1.32-2.70), hospitalization due to HF OR = 2.02 (1.43-2.87), hospitalization due to exacerbation of CAD OR = 2.13 (1.58-2.86), hospitalization due to revascularization OR = 2.38 (1.49-3.80), hospitalization due to stroke OR = 1.72 (1.1-2.68).Compared to normotensive participants, persons with hypertension had higher prevalence of diabetes, obesity, MS, PAD, CAD, stroke, MI and AF, and more frequent need for hospitalization due to HF, exacerbation of CAD and for coronary revascularization.

Population prevalence of electrocardiographic abnormalities: results of the Polish WAW­KARD study.

BACKGROUND: Electrocardiogram (ECG) is a very important instrument in the diagnostic workup of the heart disease, both in clinical and epidemiological studies. AIMS: The aim of the study was to evaluate ECG abnormalities in adult residents of Warsaw and to determine the time trends of ECG abnormalities in the years 1984 to 2012. METHODS: A total of 1081 individuals aged 20 years of older were examined in the years 2011 to 2012. All of them had resting ECG obtained, later coded using the Minnesota Code. To determine time trends, we additionally used the ECG data from Pol­MONICA studies. RESULTS: More than one­third of individuals had normal ECG, and that number increased to half of them when heart rate was ignored as the only abnormality (in young persons 44% and 69.8%, respectively, and in asymptomatic individuals 45.9% and 68.1%, respectively). The most prevalent abnormality in men was intraventricular conduction disturbances, and in women ST­segment depression and negative T­wave changes (repolarization changes). QRS­axis deviation and R wave of high amplitude were observed significantly more often in men compared with women. The frequency of ECG abnormalities and simultaneous occurrence of several ECG changes increased with the age of the study participants. CONCLUSIONS: Normal ECG was observed only in one­third of adult residents of Warsaw, and in half of those who were young or asymptomatic. The most frequent ECG abnormalities in men were intraventricular conduction disturbances and repolarization changes in women. Atrial fibrillation was the most prevalent arrhythmia. We did not find significant time trends for repolarization changes, conduction disturbances, and arrhythmia.

Blood pressure and cholesterol control in patients with hypertension and hypercholesterolemia: the results from the Polish multicenter national health survey WOBASZ II.

INTRODUCTION: Persons with multiple risk factors of cardiovascular disease (CVD) are at a greater risk than persons exposed to a single risk factor. Control of specific risk factors of CVD in Poland is rather poor. Effective control of comorbid hypertension and hypercholesterolemia seems especially challenging. OBJECTIVES: The aim of the study was to assess the control of hypertension and hypercholesterolemia in patients with both hypertension and hypercholesterolemia; data from the Polish multicenter national health survey, WOBASZ II, were analyzed. PATIENTS AND METHODS: The WOBASZ II study was a cross­sectional survey conducted from 2013 to 2014 in 6170 people (3410 women and 2760 men) from all 16 Polish voivodships. RESULTS: Age­standardized prevalence of coexisting hypertension and hypercholesterolemia in WOBASZ II sample was 34.6%. The prevalence of hypercholesterolemia in participants with hypertension was 69.7%. Age­standardized rates of control of hypertension, hypercholesterolemia, and both hypertension and hypercholesterolemia in the entire analyzed age range of 19 to 99 years was 24.3%, 11.2%, and 5.4%, respectively. In multivariable logistic regression models, control of both hypertension and hypercholesterolemia was associated with smoking (odds ratio [OR], 0.5; 95% CI, 0.34-0.76), cardiovascular disease (OR, 2.25; 95% CI, 1.70-2.97), frequent medical visits (OR, 1.76; 95% CI, 1.33-2.32), and high education level (OR, 1.37; 95% CI, 1.03-1.80). CONCLUSIONS: Comorbid hypertension and hypercholesterolemia were observed in one­third of the Polish population (included in WOBASZ II study). Only 5.4% have both risk factors controlled. After adjustment for covariates, female sex, nonsmoking, comorbid CVD or diabetes, the frequency of medical visits, and high level of education appeared to increase the proportion of controlled hypertension or hypercholesterolemia.

Depressive symptoms and cardiovascular diseases in the adult Polish population. Results of the NATPOL2011 study.

BACKGROUND: Poland is a country of high cardiovascular risk. Because depression was found to be a predictor of coronary artery disease and the prevalence of depressive symptoms (DSs) has risen worldwide, their monitoring in the population is desirable. AIM: We sought to evaluate the prevalence of DSs in relation to the socio-demographic status and selected types of cardio-vascular diseases in the adult Polish population. METHODS: A country-representative random sample of 2413 subjects, aged 18 to 79 years, was examined in 2011. Rates of self-reported cardiovascular conditions including hypertension (HT), coronary artery disease (CAD), previous myocardial infarction (MI), heart failure, atrial fibrillation (AF), and stroke were assessed by a questionnaire, and the prevalence of DSs was assessed by Beck Depression Inventory (BDI), separately in men and women. DSs were defined as BDI score ≥ 10 points. RESULTS: Depressive symptoms were found in 23.4% of men and 33.4% of women (p < 0.0001). The prevalence of DSs increased with age, from 16.5% in the youngest group of men to 48.3% in the oldest group of women. We found that DSs were significantly more prevalent in subjects suffering from HT, CAD, stroke, AF, and diabetes, and also in women after MI. The rates of DSs in women with a history of MI or stroke were extremely high (76.3% and 83.3%, respectively). Age and primary education level were associated with DSs, as was history of stroke in women. DSs were more often found in older persons and in those with primary level of education. CONCLUSIONS: Depressive symptoms were more prevalent in women compared to men, and they were significantly and inde-pendently associated with age and primary education level in both sexes, and with a history of stroke in women.

The relationship between resting heart rate and atherosclerosis risk factors.

BACKGROUND AND AIM: The imbalance between sympathetic and parasympathetic activity is one of the important factors in pathogenesis of cardiovascular diseases (CVD). There is a relationship between sympathetic activity and some CVD risk factors. Also heart rate (HR) is related to the autonomic nervous system. We analysed the relation of mean resting HR to hypertension, diabetes, obesity and to some risk factors [body mass index (BMI), hsCRP, systolic blood pressure (SBP), diastolic blood pressure (DBP), LDL cholesterol (LDL), triglycerides (TG) and glucose (G)]. METHODS: 6977 men and 7792 women, aged 20-74, randomly selected from the Polish population, were screened in 2003-2005 within the framework of the National Multicentre Health Survey (WOBASZ). Resting HR and blood pressure were measured 3 times using an automatic device and for analyses only the mean value of the 2nd and 3rd measurement was used. RESULTS: Out of screened subjects, HR <60/min was found in 11% of men and 7% of women, and HR >90/min - in 6% and 5% respectively. Medication that influenced HR was taken by 16% of men and 17% of women. Resting HR was correlated (p <0.0001) with BMI, SBP, DBP, hsCRP, LDL and G in men and with SBP, DBP, hsCRP and G in women. After adjustment for medication significantly higher HR was observed both in men and in women with obesity, diabetes, hypertension, high hsCRP and in smoking persons. The prevalence of obesity, diabetes, hypertension, high hsCRP and smoking habit rose with increasing HR and the highest one was found in persons with HR >90/min. In multivariate logistic regression models resting HR was positively associated with hypertension, obesity and diabetes. In men, with every increase in HR by 10 beats/min, OR for hypertension was 1.28 (95% CI: 1.22-1.35), for obesity 1.24 (95% CI 1.17-1.30) and for diabetes 1.36 (95% CI: 1.26-1.48) after adjustment for age, medication and other factors (in women: 1.42 for hypertension, 1.14 for obesity and 1.47 for diabetes). CONCLUSIONS: Resting heart rate is correlated with cardiovascular risk factors (body mass index, blood pressure, glucose and cholesterol level) and with high hsCRP. Heart rate is positively associated with hypertension, obesity and diabetes which indirectly confirms the autonomic nervous system contribution to the pathogenesis of these diseases.

Cardiovascular diseases prevention in Poland: results of WOBASZ and WOBASZ II studies.

BACKGROUND: Cardiovascular diseases are the main cause of morbidity and an important cause of disability and premature death in European countries. Current guidelines recommend prevention delivery by physicians during medical consultations. AIM: We sought to evaluate the prevention support offered by Polish physicians in 2013-2014 compared to 2003-2005, and its determinants. METHODS: The data from two population surveys were analysed: WOBASZ (6392 men and 7153 women, aged 20-74 years, screened in 2003-2005) and WOBASZ II (2751 men and 3418 women, aged ≥ 20 years, screened in 2013-2014). For comparison analysis, the population of WOBASZ II was restricted to persons aged 20-74 years. Prevention delivery was assessed using a questionnaire. RESULTS: Overall, 64% of men and 75% of women screened in 2003-2005 consulted their physicians at least once in the preceding year; 10 years later these rates were 70% and 82%, respectively. In both studies, 70% of respondents recalled having received one piece of prevention advice during a medical consultation. One-third of participants neither received any prevention advice nor had their blood pressure or cholesterol level measured. In WOBASZ II we observed a significant increase in the frequency of counselling regarding smoking cessation, nutrition, and increased physical activity, as well as in the frequency of cholesterol measurements, compared to WOBASZ. The prevention support was related to the health status. CONCLUSIONS: The prevention support in the years 2013-2014 was better than in 2003-2005, but was still insufficient. About one-third of participants did not receive any preventive advice. The prevention support was offered more often to patients with worse health status.

New mtDNA Association Model, MutPred Variant Load, Suggests Individuals With Multiple Mildly Deleterious mtDNA Variants Are More Likely to Suffer From Atherosclerosis.

The etiology of common complex diseases is multifactorial, involving both genetic, and environmental factors. A role for mitochondrial dysfunction and mitochondrial DNA (mtDNA) variation has been suggested in the pathogenesis of common complex traits. The aim of this study was to investigate a potential role of mtDNA variants in the development of obesity, diabetes, and atherosclerosis in the Polish population. Whole mtDNA sequences from 415 Polish individuals representing three disease cohorts and a control group were obtained using high-throughput sequencing. Two approaches for the assessment of mtDNA variation were applied, traditional mitochondrial haplogroup association analysis and the mutational or variant load model using the MutPred pathogenicity prediction algorithm for amino acid substitutions in humans. We present a possible association between mildly deleterious mtDNA variant load and atherosclerosis that might be due to having more than one likely mildly deleterious non-synonymous substitution. Moreover, it seems largely dependent upon a few common haplogroup associated variants with MutPred score above 0.5.

Screening for major cardiovascular risk factors among Members of Polish Parliament as a continuation of health marketing for effective cardiovascular prevention in Poland. Warsaw, May 2006.

BACKGROUND: Cardiovascular diseases are the most common cause of mortality in Poland. To improve the situation in this area, a national cardiovascular preventive project is necessary, and it can be done by close cooperation between medical and political agencies. AIM: To present the current epidemiological situation in Poland to political and key opinion leaders and also to assess individual cardiovascular risk among Members of Polish Parliament. METHODS: The Project was carried out on 23-24 May 2006 in the residence of the Polish Parliament. Anthropometric, blood pressure and cholesterol measurements and a short questionnaire were performed. RESULTS: Survey and educational programme were carried out on 310 out of 460 Members of the Polish Parliament (females 59, males 251). Awareness of one's own blood pressure was declared by 70% of subjects, 39% declared earlier detected arterial hypertension, 21% had new detected elevated blood pressure, 31% declared earlier detected elevated cholesterol level and 32% had new detected elevated cholesterol level. Obesity was found in 40%, smoking was declared by 16.5%. The results were compared with those obtained in corresponding age-groups in the general population. CONCLUSIONS: 1. The results of screening survey in the Polish Parliament in 2006 indicate that, in comparison with nationwide adult population and Parliament Members examined in the year of 2000, present Parliament Members are more often diagnosed with obesity. However, they present with a better awareness of their own blood pressure and better control of arterial hypertension, as well as much lower percentage of those who admit smoking cigarettes. 2. Drawing Parliament Members attention to the problem of high prevalence and insufficient control of cardiovascular risk factors should result in positive outcome of future legislation process and make the battle with the epidemic of heart attacks and strokes in Poland more successful.

Cardiovascular health knowledge of the Polish population. Comparison of two national multi-centre health surveys: WOBASZ and WOBASZ II.

BACKGROUND AND AIM: To compare the cardiovascular health knowledge (CHK) of the adult Polish population in the years 2003-2005 and 2013-2014, and to evaluate the CHK determinants in the Polish adult population. METHODS: Data came from the two random samples of the Polish population, screened in 2003-2005 in the WOBASZ health survey (6392 men and 7153 women, aged 20-74 years) and in 2013-2014 in the WOBASZ II health survey (2751 men and 3418 women, aged 20+ years). For the present analysis, the population of WOBASZ II was limited to persons aged 20-74 years. A CHK score (CHKs) was constructed based on questionnaire answers of responders, and the results of physical examination and ranged from -1 (lowest knowledge) to +6 (highest knowledge). RESULTS: Women had greater CHK than men. In both studies, about 30% of women and 40% of men did not know their blood pressure (BP). About 20% of men and women that declared their BP awareness was not able to classify it correctly to the normal or high category. Most persons that declared body weight awareness could give their body weight to within 2 kg and could correctly classify it as normal or overweight/obesity. The mean CHKs raised in men from 1.74 in WOBASZ to 1.93 in WOBASZ II (in women, respectively, from 2.10 to 2.23). The chance of having CHK greater than mean value of CHKs increased in men by 31% and in women by 27% in WOBASZ II compared to WOBASZ (ORCHK = 1.31, p < 0.0001 in men; ORCHK = 1.27, p < 0.0001 in women). Younger, better educated persons and men with coronary artery disease history and persons with familial history of death from myocardial infarction or stroke had greater health knowledge. CONCLUSIONS: Since 2003 Polish adults significantly advanced their knowledge and awareness of cardiovascular risk factors. Gender, age, education level, coronary artery disease history, and family history of cardiovascular disease death are significant determinants of CHK. From 20% to 30% of studied persons who declared their awareness, were shown to be unaware of their own cardiovascular disease risk factors.

Multi-centre National Population Health Examination Survey (WOBASZ II study): assumptions, methods, and implementation.

BACKGROUND: Cardiovascular diseases (CVDs) are the main cause of morbidity and mortality in developed countries. Despite the progress in diagnostics and treatment, it is expected that CVD will still be the main cause of death worldwide until at least 2030. From 1991 CVD mortality in Poland systematically decreased, but it is still higher than the average in Western Europe. In 2013 CVDs were the cause of 46% of all deaths in Poland (40.9% in men and 51.1% in women) and 26.9% of deaths among persons under 65 years of age. The epidemiologic assessment of prevalence, control and treatment of CVD risk factors, and monitoring of healthy behaviour and morbidity due to diseases like coronary artery disease, hypertension and diabetes is very important for health policy planning. The WOBASZ II is the newest Polish population based survey, performed in 2013-2014 to evaluate prevalence, control, treatment, and morbidity. The study was the continuation of WOBASZ (2003-2005). AIM: To describe the goals and methods of the WOBASZ II study and to present the results of the recruitment. METHODS: The WOBASZ II study was planned as a cross-sectional survey of a random sample of Polish residents aged over 20 years. The selection, using the National Identity Card Registry of the Ministry of Internal Affairs, was made as a three-stage sampling, stratified according to administrative units (voivodeships), type of urbanisation (commune), and gender. The study protocol consisted of a questionnaire used in face-to-face interviews, physical examination, and blood samples. WOBASZ II was coordinated by the Department of Epidemiology, Cardiovascular Diseases Prevention and Health Promotion of the Institute of Cardiology in Warsaw in cooperation with medical universities in Gdansk, Katowice, Krakow, Lodz, and Poznan. RESULTS: Out of 15,120 persons, 1557 persons were not eligible. Out of eligible persons, 6170 (2760 men and 3410 women) were examined (the response rate 45.5%). The highest response rates were observed in Warminsko-Mazurskie (64.2%), Zachodniopomorskie (58.1%), and Kujawsko-Pomorskie (53.1%). CONCLUSIONS: The importance of the WOBASZ study for the monitoring of the health state of Polish society, and for the as-sessment of prophylaxis efficiency and treatment of CVD and metabolic diseases, as well as for the evaluation of the actions in the field of health promotion, is difficult to overstate.