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The aim of the study was the estimation of the lipid profile and prevalence of dyslipoproteinemia in patients with essential hypertension. The study group consisted of 108 outpatients (61 men and 47 women) with mild to moderate hypertension (HT), aged 35-64, who did not receive antihypertensive drugs for at least four weeks. The matched controls (MC) were randomly chosen for each HT patient from population of Warsaw inhabitants, covered by Pol-MONICA II screen. The concentrations of total cholesterol (CH) and triglycerides (TG) in serum and cholesterol in lipoprotein fractions and subfractions (LDL, HDL, HDL3) were measured by enzymatic methods. The levels of apolipoproteins (Apo A-I, Apo B) were estimated by immunoassay. Laboratory was under control of WHO-Lipid Reference Laboratory and CDC-NHLBI Lipid Standardization Program. In HT the concentration of cholesterol in LDL was significantly higher (p < 0.001) than in MC, both in men (by 15%) and in women (by 22%), but the concentrations of cholesterol in HDL and HDL3 and Apo A-I (in men only) were significantly lower (p < 0.001) in HT than in MC in men (by 21% and by 26%) as well in women (by 16% and by 25%). Also in HT group the mean levels of TG, CH and Apo B were higher than in MC, but these differences were significant only in TG level in men. In HT group the prevalence of normolipemia was twice lower than in MC (22% and 42%). Essential hypertension fractions is associated with abnormal levels of some lipoprotein fraction and with higher prevalence of hyperlipoproteinemia. The coexistence of both abnormalities may be particularly detrimental as important factor in the development of atherosclerosis.

HDL cholesterol (HDL-C) levels are inversely related to coronary heart disease (CHD) risk, and HDL-C distributions vary among countries. Poland is one of the few developed countries in which CHD rates are increasing at the same time that US rates have been falling, but whether these differences are explained by differences in risk factors such as HDL-C has not been determined. To examine this possibility, levels of HDL-C and its subfractions were compared in US and Polish urban and rural men and women aged 45 to 64 years. Age-adjusted HDL-C means were 0.20 mmol/L higher in urban Polish men and 0.37 mmol/L higher in rural Polish men than in their US counterparts (P < .0001); means in urban Polish women were 0.06 mmol/L higher (P < .05) and in rural Polish women 0.09 mmol/L higher (P < .001) than in their US counterparts. Adjustment for age, education, alcohol intake, smoking, BMI, heart rate, and menopause status (in women) had little effect on differences. Means of HDL2 and HDL3 levels showed similar between-country differences, although differences were minimal for HDL2 in urban men and women, and HDL3 means did not differ between rural women. BMI was inversely related to HDL-C and both subfractions in all gender-country-site strata (P < .001), and alcohol was directly related to HDL-C (P < .001) in all strata except Polish women. Cigarette smoking was negatively related to HDL-C and both subfractions in all US samples except HDL2 in urban men, whereas in Polish samples, significant associations were found only in urban women for HDL-C and in rural and urban women for HDL3. Age, heart rate, and education showed inconsistent or no association with HDL-C and its subfractions in either country. This profile of HDL-C and its subfractions in Polish samples contrasts sharply with the opposite trend in CHD mortality rates, which suggests either that other risk factors may account for the trends or that the relationship between HDL-C and CHD may differ between the two countries.

The aim of the study was to analyse the changes in pharmacotherapy of ischaemic heart disease (HD) and arterial hypertension (AH) between 1984 and 1988 using the results of screenings of two independent samples of Warsaw inhabitants. In this period the prevalence of IHD in Warsaw population aged 35-64 increased by 4.3% (from 30.3% to 31.6%) as well as the percentage of treated subjects by 19.5% (from 39.0% to 46.6%). Prevalence of arterial hypertension (AH) decreased in this period by 4.7% (from 35.8% to 34.1%) whereas the percentage of undertaking pharmacotherapy in these patients increased by 47.9% (from 33.8% to 50.0%) as well as the effectiveness of undertaken treatment (goal of treatment: < or = 160/95 mmHg) increased by 115.8% (from 22.8% to 49.2%). In subjects with IHD selected from general population the consumption of nitrates, beta blockers and calcium channel blockers increased and these drugs were the most frequently taken in IHD. In treatment of AH diuretics, the most frequently used in 1984, were replaced, to some extent, in 1988 by beta blockers and calcium channel blockers. Consumption of drugs by general population, expressed in DDD/1000 i/day, changed too--the consumption of beta blockers increased in 1988 twice, of calcium channel blockers 3-fold and of nitrates 1.5 fold, whereas that of dipyridamole decreased by 60%, while comparing of these consumption in 1984.

Changes in risk factor levels associated with menopause have been reported in many studies in the United States and western Europe, where estrogen replacement therapy and surgical menopause are common. We studied risk factor associations in Polish women, for whom estrogen replacement therapy and surgical menopause are uncommon. The 357 postmenopausal women had higher total cholesterol levels (0.43 mmol/L) and low-density-lipoprotein cholesterol levels (0.36 mmol/L than did the 372 premenopausal women of similar ages. Triglycerides, high-density-lipoprotein cholesterol, body mass index, and blood pressure did not differ by menopausal status. We conclude that natural menopause is associated with higher levels of total and low-density-lipoprotein cholesterol levels. Natural menopause is not associated with large changes in other risk factors in this sample.

Analysis of the efficacy and tolerability of gemfibrozil (Gevilon-Parke Davis) was performed including 29 patients aged 19-69 years with primary hyperlipoproteinemia (HLP) type IIb-16 persons, IV-13 persons. All patients got dietary recommendations and received gemfibrozil 450-900 mg/day for 3 months. In both types of HLP a significant reduction of serum cholesterol (TCh)--15.5% triglycerides (TG)--32.1% VLDL-Ch--34.9% and VLDL-TG concentration--36.6% was observed as well as an increase of HDL3 fraction-16.3%. The greatest reduction of serum TCh concentration and VLDL-Ch were observed in type IIb, while that of TG and VLDL-TG in type IV HLP. The best therapeutic effect was obtained during the first month of treatment. The percent of TCh, TG, VLDL-Ch, VLDL-TG reduction correlated with their initial level. Tolerability of gemfibrozil was very good. Only in 2 patients transient abdominal pain was observed.

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. USNCEP guidelines used total cholesterol, low density lipoprotein cholesterol and the same additional nine risk factors used in EAS Method 2 in classifying hyperlipidemics. Classification differences between the two sets of guidelines were high when EAS Method 1 guidelines were compared with USNCEP guidelines. However, EAS Method 2 which included risk factors, compared favorably with USNCEP guidelines in all three populations under study.

As part of a multicentre WHO MONICA-Project the present drug consumption by Warsaw population was assessed (evaluated by DDD). In Warsaw population 2646 inhabitants aged 35-64 years were examined. Ischaemic heart disease was diagnosed in 30% screened persons. Only 39% of subjects were involved in taking cardiovascular drugs. In ischaemic heart disease the drugs used most frequently were pentaerythritol tetranitrate and dipyridamole. The influence of several psychosocial factors on the fact of undertaking of pharmacological therapy was analysed using multivariant logistic function method. Significant relationships were found for age, health self-care self-estimation of health status and fact of medical consultation. Persons with high values of MLF (fifth quintile) underwent drug treatment six time more often, then persons with low values of MLF (first quintile).

The effect of six months' treatment with bezafibrate (400-600 mg daily) on serum lipids, lipoproteins and apolipoproteins concentrations was investigated in 32 patients with primary hyperlipoproteinemia (HLP) type IIa, IIb and IV. In all types of HLP the reduction of serum cholesterol (CH), triglycerides (TG), very low density lipoprotein (VLDL) fraction and increase in high density lipoprotein (HDL) cholesterol, HDL3-CH and apolipoprotein AI concentrations was observed. In type IIa and IIb HLP low density lipoprotein (LDL) cholesterol and apolipoprotein B levels decreased while in type IV increased. The greatest fall of serum CH concentrations was observed in type IIb while of serum TG level--in type IV. In 15 (46.9%) patients the side effects were noted. They were: abdominal pain, skin rash, myalgia, moderate increase in CPK and aminotransferase activities. Most of there side effects disappeared spontaneously without treatment cessation.

The dietary habits of 1265 men and 1309 women aged 35-64 years were assessed by food frequencies and 24-h recall. The consumption of fat was high relative to Recommended Dietary Allowances (mean 137% of RDA in the diet of men and 108% in women). The diet was deficient in carbohydrates (80 and 67% respectively), calcium (81 and 64%), vitamin A (84% for both sexes), vitamin B1 (91 and 74%), and vitamin C (41 and 30%). Energy, protein, dietary fibre, iron and vitamin B2 were at the RDA or exceeded it in the men's diet but were insufficient in the women's diet. Fat accounted for 38.5% (men) and 37.7% (women) of energy, with 15.8% of the energy derived from saturated fatty acids and 4.2% from polyunsaturates. The amount of cholesterol consumed was 641 and 452 mg, respectively. This type of diet may contribute to increased incidence of ischaemic heart disease. Only three meals a day were taken by over 83% of the respondents, with over 5-h intervals between meals which may, in addition, contribute to obesity.

The Multivariate risk of developing Ischaemic Heart Disease (IHD) during period of 6 years was estimated for men aged 40-59 years on the basis of 2 Polish populations. Coefficients of multivariate logistic function (MLF) were calculated using sample of 4831 men with 240 cases of IHD. The significant risk factors were: age, total serum cholesterol level, diastolic blood pressure, number of cigarettes smoked, familial history of IHD. For these five significant factors new MLF coefficients were calculated. Discriminant power and goodness of fit for both functions were analysed and no significant differences found. The reduced MLF was applied to construct a simple questionnaire of IHD risk test.

Mean values of cholesterol contents in low- and high-density lipoproteins, and the 10% and 90% cut-off points of their distribution were determined in random samples of men aged 35-64 years and resident in three Soviet cities (Kiev, Moscow, Novosibirsk) and two Polish regions (Warsaw, and Tarnobrzeg province). Comparative analysis revealed that, while having identical mean total cholesterol levels, the studied populations differ both in the character of cholesterol distribution in atherogenic and nonatherogenic lipoproteins and in their age dynamics. The lipoprotein spectrum was also compared with data of overall mortality and that from ischaemic heart disease and stroke in the respective areas. The comparison suggested a potential association between the incidence of these diseases and the incidence of individual lipid risk factors in the population. The regional specifics of the blood lipoprotein spectrum must also be considered when developing programmes of atherosclerosis prevention.

The results of 12 weeks treatment of primary hyperlipidemias with Lovastatin are presented. This drug belonging to a new generation of hypercholesterolemic drugs inhibits the endogenous synthesis of cholesterol by means of inhibiting the HMG-CoA reductase. The sample consisted of 30 men aged 28-68 years: in 17 of them heterozygotic familial hypercholesterolemia (FH) was diagnosed and in 13--primary non familial hypercholesterolemia (NFH). After 12 weeks of treatment in both groups a significant reduction of total serum cholesterol concentration was observed--(-28%) and--(-32%) as well as LDL-cholesterol concentration (in both groups about -37%) and apo B concentration--(-32%) and -34%. Only in one patients with NFH a significant reduction of VLDL-cholesterol (-29%) and or triglycerides (-15%) concentrations was observed. In this group also a 9% increase of HLD-cholesterol, mainly HDL-2 concentration, was found. Side effects were observed in 6 patients--in 4 of them a minor increase of ALAT, AsPAT or CPK activities (less than 3 times above norm were observed) without any symptoms and with a spontaneous normalization with no need to stop treatment, and in 2 of them abdominal pains not causing drug treatment cessation.

Out of 1800 men and 1800 women being the random sample of population of two Warsaw districts aged 35-64 years, 1309 men and 1337 women (response rate 72.7% and 74.3% were screened in 1984 within the framework of the Pol-MONICA Warsaw Project. Standardized mean values of systolic blood pressure did not differ between men and women but the mean values of diastolic blood pressure were higher in men. Mean values of systolic and diastolic blood pressure increased in both sexes with age, however diastolic blood pressure increased only up to age 45-54 years. Prevalence of hypertension according to WHO criteria was higher in men than in women and in both sexes increased with age. Among subjects with hypertension the mild diastolic hypertension was most frequent. The high percentage of subjects with hypertension at screening was not previously detected (47.4% men and 27.6% women). The fact of hypertension detection was not equal with undertaking therapy because 58.9% men and 46.6% women with detected hypertension were never treated. The effectiveness of therapy (achieving goal) was 24% in men and 27.4% in women. The performed multiple regression analysis indicated that Quetelet index and pulse rate were independently related with systolic blood pressure in both sexes and additionally education level, alcohol consumption and HDL-cholesterol concentration in men and age and family history of hypertension in women. As far as the diastolic blood pressure is concerned the Quetelet index, pulse rate and family history were significantly related in both sexes and additionally in men ethanol consumption and HDL-cholesterol concentration.

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 72.7% and 74.3%). Standardized mean values of plasma triglycerides concentration were found significantly higher and those of plasma HDL-cholesterol concentration significantly lower in male than in female sample. In men there was also higher the prevalence of hypertriglyceridemia, and hypoalphalipoproteinemia. Standardized mean values of plasma total cholesterol concentration and prevalence of hypercholesterolemia did not differ significantly between men and women. The mean values of lipid concentration and prevalence of lipid metabolism disturbances increased with age in men whereas in men such trend was not observed. The influence of selected factors on lipids and lipoproteins plasma concentration was evaluated by means of multivariate regression analysis. Quetelet index, cigarettes smoking and level of education were the most strongly associated with a lipid pattern which increases risk of cardiovascular diseases both in men and women.

Starting from large differences in rates and trends of mortality between European countries, an ecological type of comparative study was launched between five population samples in so-called Eastern European countries: Krakow, Warsaw, Novosibirsk, Kaunas, and the German Democratic Republic (GDR). The purpose was to look into dietary data as a possible explanation for varying risk factor and mortality data. It was found that high energy and fat consumption but low carbohydrate intake are common in these populations. The sources of energy and fat however vary markedly. An association was found between diet-related cardiovascular risk factors like the mean total cholesterol value and excess energy or fat intake both in males and in females. It was concluded that changes in diet might be the most important prerequisite for a number of lifestyle changes in these communities, and that those diet changes need to be monitored on a regular basis as part of the national health reports.

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. The effectiveness of pharmacological control was 5.9% in men and 10.3% in women. The study was carried out in a representative population sample of 1309 men and 1337 women living in right-bank Warsaw districts aged 35-64 years. Hypertension was found in 515 men and 457 women. Only 132 men and 188 women were currently treated. Drugs were recorded which were taken in the last 14 days, and were grouped into pharmacological classes. The most frequently taken drugs were those blocking the sympathetic system activity (78%) and diuretics (34%). Monotherapy was used by 38.5% of patients, 32.5% took two drugs, and 7.5% took three drugs. Drug consumption was expressed in DDD for comparing the obtained data with those reported from other centres.

The purpose of the study was in comparison of drug use in the treatment of coronary disease or hypertension in the random selected representative population sample of Warsaw and Tarnobrzeg province . In the study women and men aged 35 to 64 years were included according to POL-MONICA studies. Among 2646 subjects studied in Warsaw 23% used drugs whereas among 2722 subjects from the Tarnobrzeg province the drug users represented 12.1%. The most frequently used drugs in the treatment of coronary disease were nitrates, curantyl and beta-blockers. The drug use in subjects with coronary disease (DDD/1000 inhabitants/day) was 4.5-fold higher in Warsaw than in the Tarnobrzeg province . The most frequently drug used in treatment of hypertension in Warsaw were beta-blockers and diuretics, whereas in the Tarnobrzeg province among men diuretic and composed drug preparations; women in the last region used frequently composed drug preparations and smooth muscle relaxants. The relationship between the use of particular drug groups and the region was significant in women. The hypotensic drug use in Warsaw was twice as high as in the Tarnobrzeg voivodship despite similar frequency of hypertension in both regions.

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 . Standardized incidence due to cerebral stroke was significantly higher in every of analysed years in the Warsaw population both among men and women in compare with that in the Tarnobrzeg province . In both population studied the incidence was significantly higher among men than among women. Standardized fatality during 28 days from the start of sickness was higher in the Tarnobrzeg province population than in the Warsaw population so far as both men and women are concerned. In both populations among men and women the most frequently diagnosis was acute disease of cerebral vessels.

There are significant differences in plasma total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides and blood pressure, prevalence of cigarette smoking, obesity, education level and alcohol consumption found between the rural and industrial populations in Poland. It was found that the differences in plasma lipids and lipoproteins concentration are related to the differences in age, sex, education level, alcohol consumption, obesity, cigarette smoking and blood pressure. Increase of education level was related to increase in plasma concentration of total cholesterol. LDL-cholesterol and triglycerides but it was related to decrease of HDL-cholesterol. After the adjustment to all above factors the differences in total cholesterol and LDL-cholesterol between the studied populations appeared insignificant. The differences in HDL-cholesterol and triglycerides remained significant.

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 144.0 mm Hg in women (p less than 0.05), the mean values for the diastolic pressure were 89.7 mm Hg in men and 85.8 mm Hg in women (p less than 0.05). The standardized per cent values of borderline hypertension were 23.4% for men and 21.9% for women (p less than 0.05), according to WHO criteria the prevalence of hypertension was 35.8% in men and 28.0% in women (p less than 0.05). Only 55% of hypertensive men and 73% of hypertensive women knew that they had had hypertension, and 42% of male patients and 64% of female patients had had any treatment for hypertension. In the present study a correlation was demonstrated between hypertension and socioeconomic class (significantly higher blood pressure was found in people at lower educational level), besides that higher pressure was noted in married men and in women working artisans in relation to hose doing clerical work. The proportion of hypertensive subjects increased with increasing cholesterol level and with increasing overweight. A negative correlation was showed between hypertension and cigarette smoking. Ischaemic heart disease was significantly more frequent in hypertensive subjects as in normotensive ones.

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.

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. The analogous increase among the Tarnobrzeg province population was 302 to 559/100,000 among men and 64 to 195 among women. Fatality during 28 days from the onset of the disease did not show any relationship with year of study and corresponded yearly among men to 45% and among women to 37% in Warsaw and to 42% among men and 33% among women in the Tarnobrzeg province . High fatality was noted during first 24 hours of hospitalization (Warsaw: 36% among men and 26% among women, Tarnobrzeg: 39% among men and 32% among women). The highest fatality was noted in the youngest of analysed groups.

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. Women with a lower educational level had a higher mean plasma triglyceride concentration, higher values of systolic and systolic blood pressures, a greater probability of IHD development, and higher prevalences of hypertension, obesity and ischaemic heart disease symptoms. And for women, a negative relationship with educational level was noted for plasma LDL-cholesterol concentration and for the mean value of the overall risk score according to Rose.

According to the POL-MONICA program basing on screening studies of random population samples of two Warsaw districts and the Tarnobrzeg provinceip the detectability of arterial hypertension (AH), the AH treatment fact, the effectiveness+ of AH treatment and the populational control of AH has been evaluated. The AH control was better in Warsaw (men 55%, women 73%) than in the Tarnobrzeg province (men 44%, women 65%). In both populations the control was better among women than among men and increased with the age of subjects investigated. In both populations the treatment was introduced only in half of detected AH and increased also with the age of subjects studied. Only 20% men and 25% of women in Warsaw and 35% of men and 42% of women in the Tarnobrzeg province was effectively treated. The AH control in the Warsaw population was twice a lower than in the Tarnobrzeg province (Warsaw: men 5%, women 10%, Tarnobrzeg: men 7%, women 16%). Exceptionally bad control of HT has been stated in the youngest and the middle age men group in Warsaw (2.9%). The patterns studied with the use of MLF functions in both population studied have significant influence on the detectability and the AH treatment fact and remain without the influence of effectivity of treatment.

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. In the group of women an increase of general mortality has been noted in the youngest age group in Warsaw. In Warsaw and the Tarnobrzeg province in 1987 deaths due to diseases of circulatory system represented 33.2% and 39.9%, respectively, of total death pool among subjects aged 25 to 64 years. The respective percentages in the group of women were 29.1% and 39.4%.

Basing on results of first screening of the Pol-MONICA Project in 1984 in two centres that is the Tarnobrzeg province and two districts of Polish capital Warsaw (Praga South and Praga North) the level of 11 main coronary disease risk factors was compared in 2469 men and 2729 women. The following 5 risk factors were statistically significant for both men and women: the Durnin index of body fat content, the total cholesterol concentration in the plasma, triglyceride level, numbers of daily meals. The mean level of two factors that is the HDL-cholesterol concentration and the HDL-cholesterol/total cholesterol ratio was lower in the Warsaw sample what speaks in favor of concept that the ischemic heart disease threat is greater in that population. Among men the Warsaw population exhibited moreover the significantly higher value of diastolic blood pressure as well as of Quetelet body mass index; age and numbers of cigarettes smoked daily has also been higher in that population. In women from the Tarnobrzeg province ++ the diastolic blood pressure was higher than that in the Warsaw population. The two populations studied showed also highly significant differences so far as the complex of all 11 features is concerned what enabled the qualification of 72.3% of men, and 68.4% of women as belonging to the big city population or to the agricultural-industrial population using the discriminant Fisher function.

The POL-MONICA Project screened in 1984 1309 men and 1337 women aged 35 to 64 years, inhabitants of Warsaw (the Warsaw centre) and 1250 men and 1472 women aged 35 to 64 years, inhabitants of the Tarnobrzeg province (the Cracow centre). In both environments the percentage of smoking men was similar (about 57%). Women from big city environment smoked three times more frequently (33.1%) than in the agricultural areas (10.7%). The smoking intensity was higher in the agricultural areas both among men and women. It has been stated that smoking habit depends on such social or demographic patterns as age, sex, civil state, education, physical activity related to work. Smoking influenced significantly the level of such risk factors as systolic arterial blood pressure, the fat body content in both men and women, and the HDL-cholesterol in women from both environments.

According to the Pol-MONICA program the random selected population samples were studied in inhabitants of Warsaw or the Tarnobrzeg province . After excluding from analysis the subjects treated with the hypotensive++ or hypolipemic drugs the differences between populations studies with regard to range of mean pressure value, except systolic pressure (RRs) in women, appeared significant ones. In populations studied the arterial blood pressure (CTK) was influenced by: age, sex, education, family history with regard to the circulatory system, the alcohol intake, smoking, heart action frequency the Quetelet coefficient value, triglyceride concentration and daily sodium intake. After analysis of inter-population differences in values of above factors the mean RRs values in populations studied did not differed significantly whereas differences in mean values of diastolic pressure (RRr) were highly statistically significant.

The aim of the study was to determine the distribution of blood pressure and to evaluate the prevalence of hypertension in the Polish and Slovak populations. This report is a continuation of searching for causes of different ischaemic heart disease death rates observed in both compared populations. The studied male population aged 45-54 years consists of 2944 men from Warsaw (response rate 88.4%) and of 698 men from Bratislava's factories (response rate 64.5%). The mean of systolic and diastolic blood pressure in the 45-49 years group was significantly higher in Warsaw than in Bratislava although the prevalence of hypertension was similar in both populations in this age-group. In the older group the mean systolic blood pressure was similar in both populations but the mean diastolic pressure and the prevalence of hypertension were higher in Bratislava. The prevalence of hypertension was found to be similar to the rates observed in some other industrialized countries. The authors conclude that the finding of high proportions of hypertension in both populations proves that hypertension control is unsatisfactory, which has been confirmed by the results of additional investigations carried out in Warsaw.

This study evaluated ischaemic heart disease risk factors specific for Warsaw's population, including those with the strongest prognostic value for the incidence of myocardial infarction. Out of a population of 5874 men aged 40 - 59 years employed in seven Warsaw enterprises, 4330 men without any symptoms of ischaemic heart disease were followed up for six years. The computed multivariate logistic function finally included five risk factors, among which age, diastolic blood pressure and the number of cigarettes smoked remained statistically significant; serum cholesterol levels and body mass index had no significant influence. This function predicted correctly the myocardial infarction incidence in the general male population of Warsaw aged 35 - 64 years; the ratio of expected to observed cases was 0.93.

At the Polish Trial on Ischaemic Heart Disease Prevention begun in 1976-77 the dietary habits of 5,484 male workers aged 40-59 years working in 14 Warsaw plants were assessed by 24-hour recall. After two and four years of follow-up in 1978-79 and 1980-81 this study was repeated in random samples of the previously screened population still in employment in these plants i.e., 652 men (response rate after two years=70.4%) and 574 men (response rate after four years=65.0%). In the initial screening the mean energy value of the reported daily food ration was 2,700 kcal/11,296 kJ. This energy derived 13.6% from protein, 37.1% from fat, and 49.3% from carbohydrate. After two years the mean energy value of the daily food ration as well as the amounts of the daily consumed fat and carbohydrate and vitamin B1 had decreased significantly. The amounts of the remaining nutrients were not significantly changed. After four years only the mean daily consumption of vitamin C was decreased significantly. The mean values of the total energy value of the food ration as well as of the amounts of nutrients were not significantly different. On the other hand, differences were found in the amount of food products--the reported consumption of cereals and bread as well as animal fat increased significantly, while the consumption of meat and meat products, vegetable fats, fruits and sugar decreased.

The growing incidence and importance of cardiovascular diseases in a number of countries calls for systematic quest for most efficient methods of treatment, which besides prevention and drug therapy include also surgical treatment. A group of experts from member countries of the Council for Mutual Economic Assistance (CMEA) has worked out a scientific prognosis of trends of the development of cardiovascular surgery, which include surgical treatment of ischaemic heart disease, congenital and acquired heart defects, renovascular hypertension and affection of the aortic arch. The prognosis includes also an estimate of the number of operations which will have to be performed in the mentioned diseases per 1 million inhabitants of the CMEA member countries.

The reported data point to a clear trend of increasing coronary heart disease (CHD) mortality in Poland with a tendency toward its reduction in recent years. The mortality is higher in urban than rural areas, but the increase has been greater in the rural population, especially in males. Recent reduction in the trend of increasing mortality has not been found in middle-aged men and women. The trend showed a correlation with changes in the levels of risk factors, especially in the usual diet consumed by the population. The authors suggest that the increased mortality is due to an increased incidence of CHD.