Search

Abstract Background This study aimed to assess the trends in the prevalence and levels of risk factors and mortality from main non-communicable diseases in the Lithuanian population aged 45–64 years during 1985 to 2013. Methods Data from four general population surveys conducted between 1985 and 2008 were used. All these surveys were carried out in Kaunas city and five randomly selected municipalities of Lithuania. Risk factors measured at each survey included regular smoking, overweight, obesity, arterial hypertension, and high levels of blood lipids. In total, data of 10,719 subjects (4,965 men and 5,754 women) aged 45–64 were analysed. Trends in standardized all-cause mortality and mortality from cardiovascular disease (CVD), coronary heart disease (CHD), and malignant neoplasms were estimated for both sexes by joinpoint regression analysis. Results In 1985–2013, some favourable trends were observed in the age-standardized mean levels and prevalence of risk factors and mortality from main non-communicable diseases in the Lithuanian middle-aged population. The mean values of blood lipids (with the exception of triglycerides) and the prevalence of dyslipidemias declined. In women, mean levels of systolic blood pressure and body mass index decreased, while in men, the levels of these factors increased. The prevalence of arterial hypertension and obesity increased in men. The proportion of obese women decreased. Smoking prevalence increased in both men and women. From 2007 to 2008, significant downward trends, which were steeper in women than in men, were observed in all-cause, CVD, and CHD mortality. Conclusions Despite the favourable changes in some risk factors and mortality rates, the prevalence of risk factors and mortality from main non-communicable diseases in Lithuania are still high. This indicates the importance of the ongoing primary and secondary prevention and optimal treatment of these diseases.

To evaluate the additional prognostic value of family history for the estimation of cardiovascular (CVD) mortality risk in middle-aged urban Lithuanian men.The association between family history of CVD and the risk of CVD mortality was examined in a population-based cohort of 6,098 men enrolled during 1972-1974 and 1976-1980 in Kaunas, Lithuania. After up to 40 years of follow-up, 2,272 deaths from CVD and 1,482 deaths from coronary heart disease (CHD) were identified. Multivariate Cox proportional hazards models were used to estimate hazard ratios (HR) for CVD and CHD mortality.After adjustment for traditional CVD risk factors, the HR for CVD mortality was 1.24 (95% CI 1.09-1.42) and for CHD mortality 1.20 (1.02-1.42) in men with first-degree relatives having a history of myocardial infarction (MI), compared to men without positive family history. A significant effect on the risk of CVD and CHD mortality was also observed for the family history of sudden cardiac death and any CVD. Addition of family history of MI, sudden death, and any CVD to traditional CVD risk factors demonstrated modest improvement in the performance of Cox models for CVD and CHD mortality.Family history of CVD is associated with a risk of CVD and CHD mortality significantly and independently of other risk factors in a middle-aged male population. Addition of family history to traditional CVD risk factors improves the prediction of CVD mortality and could be used for identification of high-risk individuals.

The SCORE scale predicts the 10-year risk of fatal atherosclerotic cardiovascular disease (CVD), based on conventional risk factors. The high-risk version of SCORE is recommended for Central and Eastern Europe and former Soviet Union (CEE/FSU), due to high CVD mortality rates in these countries. Given the pronounced social gradient in cardiovascular mortality in the region, it is important to consider social factors in the CVD risk prediction. We investigated whether adding education and marital status to SCORE benefits its prognostic performance in two sets of population-based CEE/FSU cohorts.The WHO MONICA (MONItoring of trends and determinants in CArdiovascular disease) cohorts from the Czech Republic, Poland (Warsaw and Tarnobrzeg), Lithuania (Kaunas), and Russia (Novosibirsk) were followed from the mid-1980s (577 atherosclerotic CVD deaths among 14,969 participants with non-missing data). The HAPIEE (Health, Alcohol, and Psychosocial factors In Eastern Europe) study follows Czech, Polish (Krakow), and Russian (Novosibirsk) cohorts from 2002-05 (395 atherosclerotic CVD deaths in 19,900 individuals with non-missing data).In MONICA and HAPIEE, the high-risk SCORE ≥5% at baseline strongly and significantly predicted fatal CVD both before and after adjustment for education and marital status. After controlling for SCORE, lower education and non-married status were significantly associated with CVD mortality in some samples. SCORE extension by these additional risk factors only slightly improved indices of calibration and discrimination (integrated discrimination improvement