Primary prevention of coronary artery disease among middle aged men in Prague: twenty-year follow-up results.
BACKGROUND
Coronary artery disease (CAD) represents the most common cause of morbidity and mortality in the Czech Republic. The aim of this study is to analyze long-term cardiovascular diseases (CVD) mortality, identify predictors of outcome and to validate the Framingham risk function in men from the Czech Republic.


METHODS
A 20-year primary prevention study of atherosclerosis risk factors in 1417 men from Prague aged 38-53 years was launched in 1975 (STULONG).


RESULTS
When analyzing CVD mortality, heavy smokers had hazard higher than non-smokers and light smokers (p < 0.0001); hypertensives higher than normotensives (p < 0.0001); men with hypercholesterolemia higher than those with normal cholesterol (p = 0.0432), and university-educated men lower than elementary-educated men (p = 0.0006). In 1980-1984, the age specific mortality from CVD in men from STULONG was higher (p = 0.0132) than in the Czech Republic, in 1985-1994 insignificantly lower. The Framingham risk function underestimated the absolute 10-year risk of CAD across the quintile of the risk (p < 0.0001), with 63% discrimination.


CONCLUSIONS
In STULONG, the mortality from CVD was significantly associated with known risk factors (hypertension, smoking, hypercholesterolemia, education); the Framingham risk function underestimated the absolute 10-year risk of CAD.
Boudík
F
F
2nd Department of Internal Medicine, Charles University Hospital, U nemocnice 2, Prague 2, Czech Republic. fboud@lf1.cuni.cz
Reissigová
J
J
Hrach
K
K
Tomecková
M
M
Bultas
J
J
Anger
Z
Z
Aschermann
M
M
Zvárová
J
J
D000328:Adult; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D018153:Czech Republic / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications / Q000453:epidemiology; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D011322:Primary Prevention; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014505:Urban Population