Cor Vasa 2003, 44(2):73-79

A comparison of the risk profiles of CHD patients and a random Czech population sample

Markéta Plášková^1,*, Jaroslav Šimon², Renata Cífková¹, Otto Mayer jr.², Zdena Škodová¹, Věra Lánská³

¹ Pracoviště preventivní kardiologie, Institut klinické a experimentální medicíny, Praha

² Centrum preventivní medicíny, II. interní klinika, Lékařská fakulta Univerzity Karlovy, Plzeň

³ Oddělení statistiky, Institut klinické a experimentální medicíny, Praha, Česká republika

Introduction:
The EUROASPIRE II study is an international project designed to monitor the standard of secondary CHD prevention and the implications of the joint guidelines of European and international professional societies for CHD prevention. The aim of our analysis was to compare the prevalence of the risk factors for cardiovascular disease in patients enrolled into EUROASPIRE II and in a random Czech population sample.

Methods:
Screening was performed in two Czech centers (Pilsen University Hospital and the Prague-based Institute for Clinical and Experimental Medicine, IKEM) in 1999-2000. A total of 525 probands were selected in 4 diagnostic categories: coronary bypass, PTCA, acute myocardial infarction, and acute myocardial ischemia without evidence of infarction. In 1997-1998, IKEM's Department of Preventive Cardiology undertook screening of a 1% random sample of the population aged 25-64 years in nine districts of the Czech Republic. For the purpose of our analysis, only probands aged 55-64 years were selected from the sample.

Results:
Males in secondary prevention showed lower mean systolic blood pressure (135.0 ± 19.2 vs. 141.8 ± 18.5 mm Hg; p < 0.001), diastolic blood pressure (80.9 ± 10.4 vs. 87.0 ± 10.5 mm Hg; p < 0.001), total cholesterol (5.5 ± 1.1 vs. 5.9 ± 1.2 mmol/L; p < 0.001), triglycerides (1.7 ± 0.9 vs. 2.2 ± 1.4 mmol/L; p < 0.001), HDL-cholesterol (1.2 ± 0.4 vs. 1.3 ± 0.3 mmol/L; p < 0.05), but higher glycemia (6.9 ± 2.3 vs. 6.4 ± 2.2 mmol/L; p < 0.01). Females in secondary prevention showed higher mean body mass index (31.1 ± 5.9 vs. 29.4 ± 5.4 kg/m2; p < 0.01) and glycemia (6.9 ± 2.4 vs. 6.0 ± 1.7 mmol/L; p < 0.001), but lower mean diastolic blood pressure (79.1 ± 10.9 vs. 83.5 ± 8.6 mm Hg; p < 0.001). There were more male smokers in the random population sample (25.5% vs. 14.3%; p < 0.01); the difference was not significant in females. Ex-
-smokers prevailed among those in secondary prevention (males: 62.8% vs. 37.2%; p < 0.001; females: 33.3% vs. 9.2%; p < 0.001). The differences in the other monitored risk factors were not statistically significant.

Conclusions:
Except for glycemia in both sexes and body mass index in females, the values of the monitored risk factors were lower in the group of patients in secondary prevention. This difference seems to be related to more consistent intervention and more frequent treatment of patients. Still, the study demonstrated high values of the risk factors in CHD patients. The results suggest the need for lifestyle modifications, more consistent intervention of overweight and obesity, and more aggressive drug therapy of the risk factors (hypertension, diabetes, hyperlipidemia).

Keywords: EUROASPIRE II; CHD; Risk factors; Secondary prevention

Published: February 1, 2003  Show citation