Primary prevention strategy for cardiovascular disease in Lithuania (original) (raw)
Related papers
Lithuanian High Cardiovascular Risk (LitHiR) primary prevention programme - rationale and design
Seminars in Cardiovascular Medicine, 2012
Objectives: According to the latest WHO data, coronary heart disease deaths in Lithuania reached 38.3% of total deaths. Based on the unfavourable situation with cardiovascular morbidity and mortality in Lithuania the Lithuanian High Cardiovascular Risk (LitHiR) programme aimed at estimation and aggressive managing of cardiovascular risk factors. This paper describes the Lithuanian High Cardiovascular Risk programme protocol.
Primary Prevention of Cardiovascular Risk in Lithuania—Results from EUROASPIRE V Survey
Medicina-lithuania, 2020
Background and Objectives: Cardiovascular disease (CVD) prevention guidelines define targets for lifestyle and risk factors for patients at high risk of developing CVD. We assessed the control of these factors, as well as CVD risk perception in patients enrolled into the primary care arm of the European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE V) survey in Lithuania. Materials and Methods: Data were collected as the part of the EUROASPIRE V survey, a multicenter, prospective, cross-sectional observational study. Adults without a documented CVD who had been prescribed antihypertensive medicines and/or lipid-lowering medicines and/or treatment for diabetes (diet and/oral antidiabetic medicines and/or insulin) were eligible for the survey. Data were collected through the review of medical records, patients' interview, physical examination and laboratory tests. Results: A total of 201 patients were enrolled. Very few patients reached targets for low-density lipoprotein cholesterol (LDL-C) (4.5%), waist circumference (17.4%) and body mass index (15.4%). Only 31% of very high CVD risk patients and 52% of high-risk patients used statins. Blood pressure target was achieved by 115 (57.2%) patients. Only 21.7% of patients at very high actual CVD risk and 27% patients at high risk correctly estimated their risk. Of patients at moderate actual CVD risk, 37.5% patients accurately self-assessed the risk. About 60%-80% of patients reported efforts to reduce the intake of sugar, salt or alcohol; more than 70% of patients were current nonsmokers. Only a third of patients reported weight reduction efforts (33.3%) or regular physical activity (27.4%). Conclusions: The control of cardiovascular risk factors in a selected group of primary prevention patients was unsatisfactory, especially in terms of LDL-C level and body weight parameters. Many patients did not accurately perceive their own risk of developing CVD.
Blood Pressure, 2015
Prevalence of cardiovascular risk factors in Lithuanian middle-aged subjects participating in the primary prevention program, analysis of the period Abstract Background. The aim of this study was to assess the prevalence and changes of cardiovascular risk factors in the middleaged Lithuanian subjects after conducting the primary prevention program. Design and methods. Four cross-sectional investigations of cardiovascular risk factors were conducted in 2009 ( n ϭ 9625), 2010 ( n ϭ 7716), 2011 ( n ϭ 5018) and 2012 ( n ϭ 4348). The program recruited men aged 40 -54 and women aged 50 -64 without overt cardiovascular disease. Results. During the period 2009 -2012, the mean number of risk factors signifi cantly increased (from 3.95 to 4.03, p Ͻ 0.001), while the numbers of people having metabolic syndrome (from 34.1% to 28.7%; p Ͻ 0.001), arterial hypertension (from 60.2% to 54.5%; p Ͻ 0.001), the average body mass index (BMI) value (from 29.17 to 28.92 kg/m 2 ; p ϭ 0.001) and abdominal obesity (from 48.4% to 45.3%; p Ͻ 0.001) signifi cantly decreased. The percentage of subjects with dyslipidemia, as well as the average values of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and triglycerides, remained unchanged. The percentage of smoking subjects have signifi cantly increased (from 19.3% to 22.7%; p Ͻ 0.001). Conclusions. The analysis showed that the prevalence of arterial hypertension, metabolic syndrome and obesity in Lithuania is slowly decreasing while conducting the primary prevention program; however, dyslipidemia, diabetes mellitus and smoking are still hard to manage for both genders.
PLoS ONE, 2014
Aims: This study investigated the trends and levels of the prevalence of health factors, and the association of all-cause and cardiovascular (CVD) mortality with healthy levels of combined risk factors among Lithuanian urban population. Methods: Data from five general population surveys in Kaunas, Lithuania, conducted between 1983 and 2008 were used. Healthy factors measured at baseline include non-smoking, normal weight, normal arterial blood pressure, normal level of total serum cholesterol, normal physical activity and normal level of fasting glucose. Among 9,209 men and women aged 45-64 (7,648 were free from coronary heart disease (CHD) and stroke at baseline), 1,219 death cases from any cause, 589 deaths from CVD, and 342 deaths from CHD occurred during follow up. Cox proportional hazards regression was used to estimate the association between health factors and mortality from all causes, CVD and CHD. Results: Between 1983 and 2008, the proportion of subjects with 6 healthy levels of risk factors was higher in 2006-2008 than in 1983-1984 (0.6% vs. 0.2%; p50.09), although there was a significant increase in fasting glucose and a decline in intermediate physical activity. Men and women with normal or intermediate levels of risk factors had significantly lower all-cause, CVD and CHD mortality risk than persons with high levels of risk factors. Subjects with 5-6 healthy factors had hazard ratio (HR) of CVD mortality 0.35 (95% confidence interval (CI) 0.15-0.83) compared to average risk in the whole population. The hazard ratio for CVD mortality risk was significant in men (HR 0.34, 95% CI 0.12-0.97) but not in women (HR 0.38, 95% CI 0.09-1.67).
Trends and pattern of the utilization of cardiovascular medicines in Lithuania in 2003–2012
Acta medica Lituanica, 2014
Background. Despite the wide use of cardiovascular (CV) drugs, CV diseases are still the leading cause of mortality and morbidity. Analysis of drug utilization gives a possibility to evaluate effectiveness of interventions. Materials and methods. The aim of the study was to evaluate CV medicines consumption in Lithuania in 2003–2012. Data was retrieved from the SVEIDRA database of the National Health Insurance Fund. Utilization of the following groups of CVM (ATC group C) was analyzed: C02 – antihypertensive drugs, C03 – diuretics, C07 – beta blocking agents (BBs), C08 – calcium channel blockers (CCBs), C09 – agents acting on the renin–angiotensin system, C10 – lipid modifying agents. ATC/DDD methodology was used. Data was expressed as a number of DDD per 1 000 inhabitants per day (DDD/TID). Results. Consumption of CVM went from 134.5 DDD/TID in 2003 to 352.2 in 2012. Angiotensin converting enzyme inhibitors (ACEI) were the most consumed ones (66–114.8 DDD/TID), followed by CCBs (1...
High-risk profile in a region with extremely elevated cardiovascular mortality
Hellenic journal of cardiology : HJC = Hellēnikē kardiologikē epitheōrēsē
Although mortality rates from cardiovascular diseases have shown a remarkable decline in many western countries, cardiovascular mortality in Lithuania has remained high. It is widely accepted that half of the decline in cardiovascular mortality can be attributed to favourable changes in modifiable risk factors. In 2006, the Lithuanian High Cardiovascular Risk Programme was started. A two-level approach--primary health care institutions and specialised cardiovascular prevention units--was applied. The cardiovascular risk profile was evaluated for a group of 17,031 middle-aged subjects enrolled into the programme at a primary level and 2908 at a specialised level. Among the persons examined, 61.8% (10,519) were female. Arterial hypertension was present in 60.2% of the subjects. Dyslipidaemia was present in 88.8%. Total cholesterol was 6.02 ± 1.23 mmol/L, LDL cholesterol 3.74 ± 1.09 mmol/L, HDL cholesterol 1.53 ± 0.52 mmol/L, and triglycerides 1.61 ± 1.27 mmol/L. Diabetes mellitus was ...
Kardiologia polska, 2007
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. 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. 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. 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...
Cardiovascular diseases, risk factors and barriers in their prevention in Croatia
Collegium antropologicum, 2009
Cardiovascular diseases are the leading cause of death in Croatia, with significant regional differences. Despite high mortality rates, high prevalence of various cardiovascular risk factors and well organized public health network, comprehensive system for cardiovascular disease monitoring and interventions does not exist. In this study we analyzed legislation framework and responsibilities of stakeholders relevant for cardiovascular disease surveillance and prevention. According to the international experiences we analyzed characteristics of cardiovascular disease prevention in Croatia and causes of the problems appeared in the preventive programs in Croatia. Analysis showed that primary problem is not inefficiency, but the existence of barriers in preventive activities definition, responsibilities distribution and task implementation. Main cause for such situation is incompatibility of the existing practices in clinical medicine and public health with recommendations from other c...
Proceedings of the Latvian Academy of Sciences. Section B, Natural, Exact and Applied Sciences, 2020
The present review is designed to provide insight into population-based investigations of cardiovascular risk factors in Latvia. Most of them represent urban, rural and mixed populations. The results are age-standardised using the European Standard Population. All of the studies confirm a high prevalence of cardiovascular risk factors with wide differences across the studies. The differences are not consistent or regular and some of the underlying reasons are discussed. Analysis of the previous studies justifies the need for a nationwide cross-sectional epidemiological study, which in a small country can be carried out in compliance with all the requirements for a population-based epidemiological study.
BMC Public Health, 2016
Background: This study aimed to assess the trends in the prevalence and levels of risk factors and mortality from main non-communicable diseases in the Lithuanian population aged 45-64 years during 1985 to 2013. Methods: Data from four general population surveys conducted between 1985 and 2008 were used. All these surveys were carried out in Kaunas city and five randomly selected municipalities of Lithuania. Risk factors measured at each survey included regular smoking, overweight, obesity, arterial hypertension, and high levels of blood lipids. In total, data of 10,719 subjects (4,965 men and 5,754 women) aged 45-64 were analysed. Trends in standardized all-cause mortality and mortality from cardiovascular disease (CVD), coronary heart disease (CHD), and malignant neoplasms were estimated for both sexes by joinpoint regression analysis. Results: In 1985-2013, some favourable trends were observed in the age-standardized mean levels and prevalence of risk factors and mortality from main non-communicable diseases in the Lithuanian middle-aged population. The mean values of blood lipids (with the exception of triglycerides) and the prevalence of dyslipidemias declined. In women, mean levels of systolic blood pressure and body mass index decreased, while in men, the levels of these factors increased. The prevalence of arterial hypertension and obesity increased in men. The proportion of obese women decreased. Smoking prevalence increased in both men and women. From 2007 to 2008, significant downward trends, which were steeper in women than in men, were observed in all-cause, CVD, and CHD mortality. Conclusions: Despite the favourable changes in some risk factors and mortality rates, the prevalence of risk factors and mortality from main non-communicable diseases in Lithuania are still high. This indicates the importance of the ongoing primary and secondary prevention and optimal treatment of these diseases.