Prevalence, awareness, treatment and control of hypertension in the adult Polish population - Multi-center National Population Health Examination Surveys - WOBASZ studies.

INTRODUCTION: Hypertension is one of the main risk factors of cardiovascular diseases. The first aim of the study was to evaluate the prevalence, awareness and treatment of hypertension as well as treatment effectiveness (blood pressure < 140/90 mm Hg) in a representative sample of the Polish population over the age of 19, examined in the WOBASZ II program. The second aim was to assess the changes in these parameters between 2003-2005 (WOBASZ study) and 2013-2014 in adults aged 20-74. MATERIAL AND METHODS: Sampling was performed in three stages, stratified according to voivodeship (province), type of commune, and gender. Finally, the study included 6163 persons (3406 women and 2757 men) examined in the years 2013-2014 (aged ≥ 19 years). For comparison the data from 14 755 persons (7783 women and 6452 men aged 20-74 years) examined in the years 2003-2005 were used. RESULTS: In the years 2013-2014, the age-standardized prevalence of hypertension, awareness, treatment and control was 42.7%, 59.3%, 46.1%, and 23% respectively. In the last decade an increase in the prevalence of hypertension (relative ratio (RR) 1.12; 95% confidence interval (CI): 1.07-1.18), treatment (RR = 1.26; 95% CI: 1.17-1.36) and control (RR = 2.16; 95% CI: 1.9-12.45) was found. In contrast, the awareness decreased nonsignificantly (RR = 0.98; 95% CI: 0.92-1.05). CONCLUSIONS: The prevalence of hypertension in Poland is high, and increased by about 12% in 10 years. Although the number of treated patients and blood pressure control improved nearly twofold over the last decade, this is still below expectations. Efforts to improve the diagnosis and effective treatment of hypertension in Poland should still be intensified.

Trends in hypertension prevalence, awareness, treatment, and control among Polish adults 75 years and older during 2007-2014.

BACKGROUND: The aim of this study was to assess changes in the prevalence, awareness, and treatment of hypertension and its effectiveness between 2007 (WOBASZ Senior study) and 2013-2014 (WOBASZ II) in a sample of the Polish population over the age of 75 years. METHODS: Sampling had three stages, stratified according to voivodeships, type of community, and gen-der. Finally, the WOBASZ II study included 467 persons (290 women and 177 men). For a comparison of the data, 1096 persons (538 women and 554 men) examined in the WOBASZ Senior study were used. RESULTS: Systolic and diastolic blood pressures significantly decreased from 153.0 ± 23.9 mmHg to 142.9 ± 22.3 mmHg and from 85.2 ± 11.9 mmHg to 78.4 ± 11.3 mmHg, respectively, from 2007 to 2014 (p < 0.0001). Prevalence of hypertension among people included in WOBASZ studies slightly decreased from 83.8% to 77.9% (rate ratio [RR]: 0.95; 95% confidence interval [CI]: 0.78-1.16) in men, and from 75.4% to 71.8% (RR: 0.93; 95% CI: 0.8-1.09) in women. Hypertension awareness was improved from 59.2% to 72.9% (RR: 1.23; 95% CI: 0.97-1.56) in men, and from 74,8% to 93% (RR: 1.26; 95% CI: 1.01-1.58) in women. The proportion of men and women, with implemented hypertension treatment, increased from 48.4% to 61.1% (RR: 1.26; 95% CI: 1.01-1.58), and from 63.2% to 82.0% (RR: 1.3; 95% CI: 1.1-1.53), respectively. The effectiveness of the treatment was improved over two-fold, there was an increase from 10.3% to 26.8% (RR: 2.65; 95% CI: 1.81-3.89) in men, and from 13.8% to 33.5% in women (RR: 2.44; 95% CI: 1.81-3.3). CONCLUSIONS: The prevalence of hypertension in Polish seniors remains high, but has decreased slightly in the perspective of the last 7 years. Although treatment and control has improved over the last decade, it remains below expectations. Efforts to improve the diagnosis and effective treatment of hypertension in Polish seniors should be intensified.

Tobacco smoking in Poland in the years from 2003 to 2014. Multi­centre National Population Health Examination Survey (WOBASZ).

INTRODUCTION    The reduction of tobacco smoking is a challenging problem of public health. OBJECTIVES    The main purpose of this work was to evaluate the prevalence and tobacco use patterns in the adult population of Poles and its changes in a period between year 2003 and 2014. Furthermore, changes in the smoking addiction, the declared reasons for smoking as well as readiness and motivation to stop smoking has been assessed.  PATIENTS AND METHODS    Based on data from the Polish studies - WOBASZ and WOBASZ II, the analysis covered a population of 14576 persons from the 1st study (6906 men and 7670 women) and 5696 persons from the 2nd study (2578 men and 3118 women), aged 20 - 74. RESULTS    According to the WOBASZ II study, in Poland 30% of men and 21% of women smoked,  the shares being 9 and 4 % lower for men and women respectively in comparison with the WOBASZ (p<0.001). The average number of cigarettes smoked daily per smoker significantly decreased in the period of observation among men (from 17.9 to 15.8 cigarettes/day) and women (from 13.7 to 12.1). The percentage of never smoking men rose from 29.8% to 36.1% (p<0.0001). The proportion of never smoking women no changed. However, the percentage of those expressing unwillingness to quit tobacco smoking nearly doubled in WOBASZ II vs WOBASZ. CONCLUSIONS    Although we found smoking rates in Poland have declined over the past decade, smoking remains prevalent among men and women. Therefore it is necessary to optimize the tobacco control in Poland including fiscal policy, counseling and tobacco addiction treatment, promotional and educational activities, with a special emphasis on the female population.

The relationship between physical activity level and selected cardiovascular risk factors and mortality of males ≤ 50 years in Poland - the results of follow-up of participants of National Multicenter Health Survey WOBASZ.

OBJECTIVES: The role of leisure-time physical activity in reducing all-cause and cardiovascular mortality is well explored. The knowledge on occupational and commuting physical activity continues to be ambiguous and misleading. The aim of the study is to assess the influence of different kinds of physical activity on cardiovascular mortality risk in men. MATERIAL AND METHODS: Data analysis on physical activity level and other selected cardiovascular risk factors acquired from 3577 men in the age between 50-80 years who participated in the National Multicenter Health Survey WOBASZ (Wieloosrodkowe Ogólnopolskie Badanie Stanu Zdrowia), Poland (2003-2005) was linked with male mortality in 2004-2009. Data about causes of deaths were obtained from the Central Statistical Office and the Population Electronic Register. RESULTS: Among males aged 50-59 years, the strongest risk factor was living in large settlements and provincial capitals as a place of residence and the most protective factor was occupational physical activity. In the age group 60-69 years and 70-80 years, the strongest protective effect was observed for leisure-time physical activity. In men aged between 70-80 years (unlike in the 50-59 years age group), the protective effect of large settlements and provincial capitals as a place of residence was noted. CONCLUSIONS: Occupational physical activity significantly reduced cardiovascular mortality in men aged 50-69 years, while for leisure-time activity the positive effect was observed in age group 60-69 years and 70-80 years. On the other hand, for the inhabitants of large settlements and provincial capitals, significantly higher risk of cardiovascular mortality in the age group 50-69 years and lower risk in the age group ≥ 70 years was noted, both in comparison with smaller places of residence.

Changes in the prevalence, treatment, and control of hypercholesterolemia and other dyslipidemias over 10 years in Poland: the WOBASZ study.

INTRODUCTION Lowering exposure to dyslipidemias is one of the biggest challenges in cardiovascular disease prevention.  OBJECTIVES The aim of the study was to describe the prevalence of dyslipidemias and treatment of hypercholesterolemia in Poland, and to assess changes since the period of 2003-2005. PATIENTS AND METHODS Two cross-sectional surveys of the random samples of the Polish population were performed in the years 2003-2005 (WOBASZ) and 2013-2014 (WOBASZ II). Interviews were carried out according to a standard questionnaire. Blood lipid levels were determined in a single laboratory in frozen samples using the enzymatic colorimetric method. RESULTS The analysis included 14151 participants aged 20-74 years (WOBASZ) and 5947 participants aged 20-99 years (WOBASZ II). In the 2013-2014 survey, hypercholesterolemia was found in 70.3% of men and 64.3% of women. Isolated hypertriglyceridemia was found in 5.6% of men and 2.4% of women. Isolated low levels of high-density lipoprotein cholesterol (HDL-C) were found in 5.1% of men and in 7.3% of women. The prevalence of hypercholesterolemia did not change significantly with regards to the 2003-2005 survey. An increase in the prevalence of hypertriglyceridemia was found in men (relative ratio [RR], 1.26; 95% confidence interval [CI], 1.03-1.55), and an increase in the prevalence of low HDL-C levels was observed in both sexes (men: RR, 2.26; 95% CI, 1.77-2.88; women: RR, 1.94; 95% CI, 1.61-2.33). There was an increase in the proportion of persons receiving high- or moderate-intensity statin therapy. However, 60,6% of persons with hypercholesterolemia were not aware of their condition, and only 6% were treated and achieved the treatment target.  CONCLUSIONS There is an urgent need for more effective strategies for the prevention and management of dyslipidemias.

Hypertension in patients with Alzheimer's disease--prevalence, characteristics, and impact on clinical outcome. Experience of one neurology center in Poland.

The aim of the study was to evaluate hypertension (HT) prevalence, characteristics, and impact on clinical outcome in patients with Alzheimer's disease (AD). We evaluated 701 patients with AD (249 males, 452 females, and mean age 74.9 ± 7.5 years). As a group representing general population matched with regard to age, education level, and place of residence, we included 762 subjects (438 males, 324 females, and mean age 74.7 ± 4.4 years) from the Polish National Multicenter Health Survey (WOBASZ) studies. The patients with AD were characterized by lower systolic blood pressure (BP) and diastolic BP values (134 ± 21 vs. 151 ± 23 mm Hg, P < .001 and 77 ± 11 vs. 86 ± 12 mm Hg, P < .001, respectively) as well as lower HT prevalence (66% vs. 78.6%, P < .001) compared with the WOBASZ group. In long-term follow-up of AD group, HT and BP levels were not associated with the decline in cognitive functions nor the increased risk of death. Patients with AD were characterized by lower prevalence of HT and other vascular risk factors. BP levels and HT had no impact on clinical outcome.

Sudden cardiovascular death rate and ischaemic heart disease death rate changes during the 5-year period of 2003-2008.

BACKGROUND: A decrease in cardiovascular mortality rates, including deaths due to ischaemic heart disease (IHD), has been observed in Poland since mid-1990s, and at the same time a rapid increase in sudden cardiovascular death (SCD) rate was noted. AIM: To evaluate changes in mortality due to SCD, IHD and SCD+IHD that occurred in 2003-2008 in the Polish population aged 25-64 years. METHODS: Individual data from death certificates and demographic data were obtained from the Central Statistical Office and all analyses were performed in the Department of Cardiovascular Disease Epidemiology, Prevention and Health Promotion. SCD was defined as codes I46.1 and R96, and IHD as codes I20-I25 according to the Tenth Revision of the International Classification of Diseases (ICD-10). Calculated mortality rates per 100,000 inhabitants for 5-year age groups were standardised for the European population structure. RESULTS: In 1997-2008, premature mortality due to SCD among adult men and women aged 25-64 years showed only small variations until 2003, and later an upward trend was observed. In 2005-2008, mortality due to SCD increased by 40% among men and 45% among women, but total mortality due to SCD+IHD remained stable. There was no marked variation in the proportion of mortality due to IHD+SCD in total cardiovascular disease (CVD) mortality both in men and in women. The rate of SCD was related to age. A notable finding was the equalisation of mortality rates due to IHD+SCD per 100,000 in nearly all age groups except for the oldest men and women. In the whole adult Polish population, no clear difference in standardised mortality rates could be noted between 2003 and 2008. SCD mortality rate and its proportion in total CVD mortality differed significantly in relation to the region of Poland. SCD mortality rate among men in the Lubusz and Lesser Poland voivodeships decreased by more than 25% (in women only in the Lubusz voivodeship). In the remaining voivodeships, increases in SCD mortality rate were observed (among men, by 171% in the Pomeranian voivodeship, 66% in the Swietokrzyskie voivodeship, and 60% in the Opole voivodeship; among women, by 248% in the Pomeranian voivodeship, 88% in the Silesian voivodeship, and 85% in the Opole voivodeship). No differences in mortality rates due to IHD+SCD in relation to the region of Poland were observed. CONCLUSIONS: IHD mortality rates in the Polish population aged 25-64 years were underestimated in the majority of voivodeships. At the same time, SCD mortality rates were overestimated. These results indicate deficiencies in our medical care system regarding the diagnosis and prevention of sudden deaths, and awareness of symptoms of life-threatening conditions.

Incidence of diabetes in the Polish population: results of the Multicenter Polish Population Health Status Study--WOBASZ.

INTRODUCTION: Incidence of diabetes is increasing at an alarming rate worldwide. It has been estimated that 2.2 to 2.5 million of Poles will be affected by this disease by 2030. OBJECTIVES: The aim of the study was to conduct an epidemiological analysis of the incidence of diabetes and impaired fasting glucose (IFG) in the Polish population. PATIENTS AND METHODS: A sample of 21,600 individuals (men and women) aged 20-74 years was randomly selected from the general Polish population. A total of 14,769 individuals took part in the study (6977 men and 7792 women). Diabetes was identified in individuals with fasting glucose equal to or exceeding 7 mmol/l and in those with previously diagnosed diabetes. IFG was identified in nontreated individuals with fasting glucose between 5.6 and 6.9 mmol/l. RESULTS: Diabetes was diagnosed in 1000 individuals (6.8%), including 518 men (7.4%) and 482 women (6.2%). IFG was detected in 1401 individuals (9.5%), including 864 men (12.4%) and 537 women (6.9%). Incidence of diabetes increases with age: in men from 0.7% in those aged 20-29 years to 16.3% in those aged >60 years; in women from 0.5% in the youngest age group to 17.8% in the oldest group. Incidence of diabetes in Poland varies between the provinces--from 5.3% to 9% among men and from 4.2% to 7.5% among women. There was no significant correlation between the incidence of diabetes and the size of a particular local district (commune; gmina). Similar territorial differences were observed for IFG, i.e., from 5.8% to 20.8% among men and from 2.8% to 11.7% among women. As with diabetes, the incidence of IFG was not associated with the size of a commune. CONCLUSIONS: Incidence of diabetes and IFG in the study population varies depending on age, sex, and region. Incidence of diabetes in Poland is comparable to the average values observed worldwide.