Ten-year risk of fatal cardiovascular disease in the Polish population and medical care. Results of the WOBASZ study.
BACKGROUND
An individual assessment of global risk of death from cardiovascular diseases (CVD) should guide management, both life style changes and medical therapy, in order to decrease risk factors and improve prognosis.


OBJECTIVE
We assessed global risk in the Polish population and its relation to medical care, including blood pressure and cholesterol measurements, smoking cessation and dietary advice, and recommendations regarding increased physical activity.


METHODS
A sample of the Polish population including 6392 men and 7153 women aged 20-74 years was screened in 2003-2005. We calculated global risk for subjects aged 40-70 years using the SCORE function for high-risk regions of Europe.


RESULTS
We found high global risk (> or = 5%) in 46% of men and 21% of women. Compared to low risk subjects, high risk subjects more often had hypercholesterolaemia, hypertension or were obese, and they more often visited their primary care physicians. Dietary advice was given to 36% of high global risk men compared to only 20% of low global risk men with hypercholesterolaemia (47% vs 23% among women, respectively p < 0.0001), and cholesterol measurement was made in 31% of high global risk men and 19% of low global risk men with hypercholesterolaemia (38% vs 27% among women, respectively p < 0.0001). Smokers with high global risk received smoking cessation advice significantly more often than low global risk smokers (men: 72% vs 55%; women: 63% vs 52%). Subjects with hypertension and high global risk had their blood pressure measured significantly more often than those with hypertension and low global risk (men: 83% vs 68%; women: 87% vs 79%). High-risk obese persons significantly more often received both dietary advice (men: 55% vs 36%; women: 60% vs 34%) and recommendations regarding higher physical activity (men: 43% vs 32%; women: 40% vs 27%). In the logistic regression analysis, the quality of medical care was significantly associated with the global risk.


CONCLUSIONS
The Polish population is characterised by a high proportion of subjects with high global risk especially among men. The quality of medical care was found to be associated with the global risk level: the higher was the global risk, the better was the medical care, although it is still insufficient compared to current standards.
Piwońska
Aleksandra
A
Department of Epidemiology, Cardiovascular Diseases Prevention and Promotion of Health, Institute of Cardiology, Warsaw, Poland. apiwonska@ikard.pl
Piotrowski
Walerian
W
Broda
Grazyna
G
D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D011044:Poland / Q000453:epidemiology; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012907:Smoking / Q000453:epidemiology; D000074606:Smoking Prevention