Heart failure in patients seeking medical help at outpatients clinics. Part I. General characteristics.

Background: During the last decade, the beneficial changes in lifestyle and in medical care increased average life expectancy, particularly in patients with chronic diseases such as hypertension and coronary heart disease. Unfortunately this also increased the number of patients, particularly among the elderly, who are susceptible to complications of these conditions such as heart failure. Uncontrolled hypertension is known to be a primary cause of heart failure and is also known to be very prevalent and frequently uncontrolled in the Polish population.

Poland-US collaborative study on cardiovascular epidemiology: classification agreement between US National Cholesterol Education Program and European Atherosclerosis Society hyperlipidemia guidelines in selected Polish and US populations.

Data from two epidemiological studies are used to measure the degree to which two well-known guidelines agree in measuring hyperlipidemia in population samples in the US and Poland. The epidemiological studies are the US Lipid Research Clinics Program Prevalence Study and the Pol-MONICA project in Poland and the guidelines are those adopted by the US National Cholesterol Program (USNCEP) and by the European Atherosclerosis Society (EAS). EAS guidelines were analyzed in two ways: Method 1 used triglycerides and total cholesterol only in classifying persons as hyperlipidemics or non-hyperlipidemics; Method 2 used triglycerides, total cholesterol and nine additional risk factors in the classification process.

[Long-term Pol-MONICA-Warsaw project: distribution of lipids in the population and the effect of selected factors on their levels].

The authors present the results of first screening of random sample of population aged 35-64 years of two Warsaw districts (Praga South and Praga North). The screening was performed within framework of the international WHO-MONICA Project in 1984. 1309 men and 1337 women were screened (response rate 72.

[Prevalence of hypertension in the population of the right-bank Warsaw districts based on research from the Pol-Monica study].

In 1984 a group of 1309 men and 1337 women aged 35-64 years were studied in the population of Warsaw. The standardized mean systolic blood pressure was 143.4 mm Hg in men and 144.

[Pharmacologic control of hypertension in the population of the right-bank Warsaw districts based on research from the Pol-Monica study].

The results of a number of Polish epidemiological studies raised the importance of hypertension in the Polish population. In view of a high frequency and insufficient control of it. The detection rate of hypertension in the Warsaw population was not exceeding 59% in men and 73% in women, and treatment was undertaken in 42% and 64% of them respectively.

[Comparison of parameters and factors affecting the differences in obesity among urban population of Warsaw and the rural agricultural-industrial population of the Tarnobrzeg province].

Comparison of the parameters of obesity between two populations, urban from Warsaw and agricultural-industrial from Tarnobrzeg province revealed that skinfolds thickness, Quetelet index and body fat index, and per cent of overweight were statistically significantly higher in men from urban population. In the group of women these parameters were also statistically higher in Warsaw population with the exception of triceps skinfold and Quetelet index--differences of no statistical significance. There were also differences in the set of variables which correlate with the parameters of obesity between these two tested populations.

[Stroke incidence and mortality among urban and rural populations during the 3-year period].

In years 1984-1986 582 men and 338 women have been registered with clinical diagnosis of cerebral stroke. The respective numbers in the Tarnobrzeg province were 340 and 263. Preliminary diagnosis of cerebral stroke was confirmed according to criteria of registration in 82% of men or women from Warsaw and in 81% of men and 84% of women in the Tarnobrzeg province .

[Myocardial infarction incidence and mortality among urban and rural populations during the 3-year period].

In years 1984-1986 3639 men and 1885 women were registered with suspected myocardial infarction from right-side Warsaw, simultaneously 2371 men and 917 women with the same suspected disease were registered from the Tarnobrzeg province population. The myocardial infarction diagnosis was confirmed in 54% of men and 43% of women from the Warsaw population as well as in 77% of men and 66% of women from Tarnobrzeg province population. In Warsaw the standardized incidence due to myocardial infarction increased during years of study from 466 to 588/100,000 among men and from 178 to 206/100,000 among women.

[12-year trends in cardiovascular disease mortality].

The coefficients and trends of mortality in years 1976-1987, based on data of Central Statistical Office, has been estimated in population of men and women aged 25 to 64 years, inhabitants of the Warsaw city region or the county region of Tarnobrzeg province . The trend of decrease of general mortality due to diseases of circulatory system has been statistically significant one similarly as that of mortality due to other heart diseases or ischaemic heart disease in men (group aged 25-34 or 35-44 years) in the Tarnobrzeg province . The analogously significant trend of mortality due to diseases of circulatory system or ischemic heart diseases in men aged 35-44 years has been stated in the Warsaw inhabitants.

Relationship between IHD risk factors and educational level in the Warsaw Pol-MONICA population.

In the paper presented, the relationship was analysed between the educational level and the level of risk of ischaemic heart disease (IHD) in a random sample of the Warsaw population aged 35-64 years. Men with a lower educational level (elementary or basic vocational) were found to have a significantly higher means for systolic blood pressure level, for plasma high-density lipoprotein (HDL) cholesterol concentration, for the numbers of cigarettes smoked daily, and for the probability of IHD development according to the multivariate logistic function of Farchi and Menotti, and also significantly greater prevalences of cigarette smoking, hypertension and overweight. And for men, a negative relationship was noted between educational level and plasma low-density lipoprotein (LDL) cholesterol concentration.

Epidemiology of cardiovascular diseases in Warsaw Pol-MONICA area.

In the Warsaw Pol-MONICA area, which is inhabited by 274,000 people of ages 25-64, trends in total mortality showed increases similar to those for the whole of Poland. In Warsaw, mortality from cardiovascular disease in men and from ischaemic heart disease (IHD), myocardial infarction (MI), and cerebrovascular disease in both sexes decreased from 1976 to 1986, whereas trends for these diseases were increasing for the whole of Poland. Within the last 11 years, the MI attack rate and case-fatality rate increased in Warsaw.

[Risk of developing coronary disease in relation to the level of education and type of work in a male population of Warsaw factories. III. Evaluation of the relation of the level of education and type of work and changes in the degree of risk during the conduction of a prevention program].

There was analyzed acceptation degree of popularized preventive rules according to the education level and the taking a part. Significant netto lowering of mean body mass, both blood pressures and values of multivariable logistic function (MLF) was obtained in the intervention group in comparison to the control one among mean with the elementary education. While in the group of persons with the secondary and university education lowering of mean body mass in persons with initially stated overweight, mean number of smoked cigarettes and the risk coefficient by Rose was obtained in the intervention group in comparison to the control one.

[Risk of developing coronary disease in relation to the level of education and type of work in a male population of Warsaw factories. II. Relation of the type of work and analyzed risk factors of coronary disease].

The relation of developing coronary artery disease risk factors to the taking a post were assessed. 5438 males aged 40-59 underwent the study. Significantly greater mean body mass, total cholesterol level, diastolic blood pressure and risk coefficient by Rose were stated in the group of office workers, whereas in the group of factory workers the percentage of overweighted men and smokers was significantly more frequently observed.

[Risk of developing coronary disease in relation to the level of education and type of work in a male population of Warsaw factories. I. Evaluation of the relation of the level of education and analyzed risk factors of coronary disease].

5426 males aged 40-59 of 14 Warsaw factories underwent the study to evaluate the relationship between coronary artery disease risk factors and education levels. Greater mean body mass, total cholesterol level and greater mean value of Rose's coefficient were significantly more frequently observed in men with secondary and university education. Persons with technical or elementary education have been significantly more frequently smoking cigarettes and overweighted.

[Basic principles of the prevention of cardiovascular diseases in light of knowledge and opinions of the Polish community. II. Knowledge of coronary disease risk factors].

The study was carried out in 1986, by means of two separated questionnaires, each comprising a 1000-person random sample of the whole Polish population aged above 15 years. The interview showed that 54% of men and 28% of women habitually smoked cigarettes, and 6% of men and 4% of women--occasionally. About 85% of men and 80% of women consumed at least 3 meals per day.

Mortality, morbidity and case fatality from myocardial infarction and the cardiovascular risk profile in the Warsaw population.

The present study, based on the World Health Organization (WHO) MONICA Project design, covers two Warsaw districts inhabited by 274442 people, aged 25-64. In the studied population over the years 1976-1985, no significant time-trends were found of cardiovascular disease (CVD), ischemic heart disease (IHD), myocardial infarction (MI) and cerebrovascular mortality, whereas the hypertension mortality trends increased significantly. The MI attack rate in 1984/85 in men aged 25-64 was 466/100,000 and that of women 173/100,000.