Cascade of care for hypertension among apparently healthy and unhealthy individuals of 25-64 years in the Czech Republic.

BACKGROUND: Despite accessible diagnostics and treatment of hypertension, a high proportion of patients worldwide remain unaware of their diagnosis, and even more remain untreated. Several studies suggest that absence of comorbidities is a predictive factor for unawareness and consequently non-treatment of hypertension. There are only a few studies that have assessed the hypertension prevalence and management among apparently healthy individuals. OBJECTIVE: The aim of the study was to assess and compare hypertension prevalence, awareness, treatment and control among apparently healthy individuals, patients with internal diseases, and patients with non-internal diseases. METHODS: Data from standardised blood pressure measurements conducted during the Czech European Health Examination Survey 2014 and information on health status and health care use collected during the Czech European Health Interview Survey 2014 were analyzed. We focused on participants aged 25-64. Data were weighted on sex and age to ensure an appropriate sex and age structure of the population. The χ2-test and binary logistic regression analyses were used to compare distribution of cascade of care for hypertension between the health-status groups of respondents. RESULTS: The final eligible sample consisted of 1121 participants. The prevalence of hypertension was 32.8% in the healthy group, 29.8% in the non-internal disease group and 52.4% in the internal disease group, (p < 0.001). Awareness was 54.1%, 59.1% and 85.2% respectively, (p < 0.001). Treatment was 44.2%, 52.6% and 86.4%, respectively, (p < 0.001). Among apparently healthy respondents 62.6% had their blood pressure measured by a medical professional in the last year, compared to 71.1% in the non-internal disease group and 91.7% in the internal disease group, (p < 0.001). Differences in hypertension control were not statistically significant. CONCLUSIONS: Generally, our data show a discordance in hypertension management within the Czech population. Apparently healthy individuals are the least aware of their diagnosis and the highest proportion of them remain untreated.

Association among serum per- and polyfluoroalkyl substances, lipid profile and metabolic syndrome in Czech adults, HBM-EHES survey 2019.

OBJECTIVES: Per- and polyfluoroalkyl substances (PFASs) are a large group of persistent synthetic chemicals widely used commercially. They accumulate increasingly in all environmental components and enter the organisms, including humans. Some of them are associated with the risk of harm to health, among others with metabolic disorders. To test the associations between blood serum levels of PFASs and blood lipid profile as well as metabolic syndrome, we linked human biomonitoring with the Czech Health Examination Survey (CZ-EHES) conducted in 2019. METHODS: A total of 168 participants of the CZ-EHES survey aged 25-64 years were examined including anthropometrical data and analyses for serum PFAS and blood lipid levels. Extended model approach in multiple linear regression models was used for identification of the associations between serum levels of 11 PFASs and lipid profile components. The relation between PFAS serum levels and metabolic syndrome prevalence was tested using a logistic regression model. RESULTS: Six PFASs were detected over the limit of quantification in at least 40% cases and were examined in subsequent analyses: perfluorodecanoic acid (PFDA), perfluorohexane sulfonic acid (PFHxS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorooctane sulfonic acid (PFOS), perfluoroundecanoic acid (PFUdA). The most dominant was PFOS with the mean value amounting to 4.81 ng/ml. After adjusting for potential confounders, we found a significant positive association between serum PFHxS and blood total cholesterol (p = 0.005) as well as LDL-cholesterol (p = 0.008). Significant positive association was also found between PFDA and HDL-cholesterol levels (p = 0.010). No significant associations were detected between PFASs and triglycerides, and between PFASs and metabolic syndrome. CONCLUSIONS: We found some evidence of a significant association between blood serum PFAS levels and blood cholesterol levels. Our results did not confirm an association between serum PFASs and the metabolic syndrome prevalence.

Prevalence of diabetes and prediabetes and its risk factors in adults aged 25-64 in the Czech Republic: A cross-sectional study.

AIMS: The aim of this study is to establish the prevalence of diabetes (DM) and prediabetes in the Czech population aged 25-64 years and to evaluate the relationships with various cardiometabolic, sociodemographic, and lifestyle risk factors. METHODS: This was an epidemiological study with a stratified, crosssectional, random sampling design. Sociodemographic, lifestyle, and anamnestic data were collected through interviewer-administered questionnaires, medical examination, and biochemical assays. RESULTS: Among the 1189 participants, 114 were diagnosed with DM (9.6%), 330 with prediabetes (27.8%) and 745 were non-diabetes/non-prediabetes individuals (62.7%). Logistic regression analysis showed that overweight, general and abdominal obesity, hypertension, and lower level of HDL (increased risk) significantly increased the risk of both prediabetes and DM, while living in the cities diminished risk of DM. Among lifestyle variables the significant increased risk of prediabetes and DM was found for smokers and ex-smokers. In other lifestyle variables (marijuana lifetime prevalence, physical activity and frequency of alcohol drinking) the significantly higher or lower risk for prediabetes or DM was not found. CONCLUSIONS: The study shows a high prevalence of DM and prediabetes in the Czech population of age between 25 and 64, providing data on their association with several risk factors.

Childhood respiratory allergies and symptoms in highly polluted area of Central Europe.

The study investigated the associations between the prevalence of the childhood respiratory diseases and the long-term exposure to air pollution in the burdened area of Moravian-Silesian Region in the Czech Republic. The health data were collected during 2014 in 7,239 children 5, 9, 13 and 17 years of age. Exposure to PM10 and NO2 in the residence addresses was based on dispersion models and GIS based traffic-related indicators. PM10 levels were positively associated with both lifetime (OR 1.35; 95%CI 1.09-1.67) and current (OR 1.32; 95%CI 1.05-1.67) allergic rhinitis; current asthma was associated negatively. The associations between traffic indicator and respiratory health were not found. On the other hand, marked positive associations were found between the respiratory diseases and symptom severity structured into ordinal variables, and PM10 and NO2. Modelled long-term exposure to air pollution was associated with childhood allergic rhinitis and deterioration of the respiratory symptoms.

Prevalence and risk factors of poor posture in school children in the Czech Republic.

BACKGROUND: The purpose of this study was to identify the prevalence and the main risk factors of poor posture in school children in the Czech Republic. METHODS: The cross-sectional study examined representative sample of children aged 7, 11, and 15 years in the year 2003. From the overall number of 3600 children, 3520 (97.7%) attended and were examined in preventive checkups. Data were obtained from medical examinations and from screening questionnaires. RESULTS: Poor posture was diagnosed in 38.3% children, more frequently in boys. A significantly different occurrence of poor posture was found between 7-year-old and 11-year-old children (33.0% and 40.8%, respectively). The most frequently detected defects were as follows: protruding scapulae (50% of all children), increased lumbar lordosis (32%), and round back (31%). Children with poor posture reported headache and pain in the cervical and lumbar spine more frequently. A total of 14% of children had body mass index levels over the 90th percentile, and the occurrence of poor posture was significantly less likely. On average, children spent 4 hours weekly performing sports activities and 14 hours weekly watching TV/VCR and playing computer games. No sports activities were reported by 20% of children, and these children had a significantly higher probability of poor posture than children performing sports. CONCLUSIONS: The results of our study can be used as an evidence with officials in the area of prevention, to support efforts to improve the health of our school children and to reduce the risk of postural damage to children's health.

Levels of PCDDs, PCDFs, and PCBs in the blood of the non-occupationally exposed residents living in the vicinity of a chemical plant in the Czech Republic.

In 2003, concentrations of altogether 17 PCDD/Fs congeners and 12 non-ortho and mono-ortho dioxin-like PCBs were measured in the blood of 60 randomly selected adults who lived in three settlements surrounding a chemical plant that had been producing chlorinated herbicides (mainly HCHs, HCB, pentachlorophenole, 2,4,5-T) in the 1960's; subjects consuming home-produced animal foods were chosen. Twenty blood donors with similar characteristics from the locality with about 80 km distance were used as control subjects. The factors that influenced the dioxin levels were investigated on the basis of a questionnaire. The aim of our study was to find out whether the residents living in the surroundings of the chemical plant are at a greater exposure risk than the controls. To calculate TEQ values, WHO-TEFs were used. The concentrations of four PCDD and six PCDF congeners were below the LOD in more than 50% of samples. Significantly higher WHO-TEQ levels (p<0.05) were found for PCDDs, PCDFs, or PCBs in all three followed up groups compared with controls. The geometric means of the total TEQ values for PCDD/F/PCBs were 43.8, 50.2, and 40.0 pg/g fat compared to 23.2 pg/g fat in the control. The percentages of TEQ due to the measured congeners in exposed groups were 9-10.3% for PCDDs, 20.5-26.9% for PCDFs, 19.2-23.1% for coplanar and 43.6-47.2% for mono-ortho PCBs. In control, the percentage of TEQ was 11.6, 26.7, 24.1, and 37.5%. PCBs, predominantly PCB156, followed by PCB126 contributed 60 to 70% of the total TEQ value. Positive correlation of the PCDD/PCDF/PCB blood levels with age and with consumption of locally produced eggs was found.