[Disorders of glucose tolerance and ischemic heart disease]. / Narushenie tolerantnosti k gliukoze i ishemicheskaia bolezn' serdtsa.

The incidence of impaired glucose tolerance, the relation of blood glucose levels to the prevalence of risk factors for coronary heart disease (CHD) and to myocardial infarction morbidity and mortality were studied over 15 years among males aged 45-59 years, excluding patients with diabetes mellitus. The data analysis was made in quintils of glucose levels. Impaired glucose tolerance was detected in 20.6% of the males. In the fifth versus the first quintil, there was an increase in the prevalence of systolic and diastolic arterial hypertension (p less than 0.001), obesity (p less than 0.001), low physical activity and hypercholesterolemia (p less than 0.05). As compared with the first, the fifth quintil showed higher total mortality rates and higher myocardial infarction morbidity and cardiovascular disease and CHD morbidity rates. But for age, and major risk factors, the risk for CHD, total and cardiovascular mortality increase at low and high blood glucose concentrations.

[Effectiveness of the cooperative program of multifactorial prevention of ischemic heart disease (results of the 3-year study)]. / Effektivnost' kooperativnoi programmy mnogofaktornoi profilaktiki ishemicheskoi bolezni serdtsa (rezul'taty 3-letnego nabliudeniia).

The paper provides the results obtained in the course of the cooperative All-Union programme on multifactor prevention of coronary heart disease (CHD), which has been implemented over 3 years to examine the efficiency of preventive actions aimed at correcting the levels of CHD risk factors. The study was conducted in 6 centers of the country among a non-organized male population aged 40-59 years. The outcome of the preventive measures, largely nonpharmacological ones, made during 3 years suggests that the prevalence of the major CHD risk factors may be reduced in the population. The preventive actions are the most beneficial in arterial hypertension and smoking.

[Improving the organizational forms of early detection of arterial hypertension]. / Sovershenstvovanie form organizatsii rannego vyiavleniia arterial'noi gipertenzii.

Within scientific and practical integral programme of chronic noninfectious diseases prevention and control scientifically substantiated prevention procedures are being developed and introduced into applied public health with the object of reducing morbidity and mortality in the republic from leading non-infectious diseases. Proceeding from the assumption that each fifth or sixth adult inhabitant of the republic has elevated arterial blood pressure and during recent years the indices of effectively controlled arterial hypertension are not improving, the search for new forms of arterial hypertension control is quite timely. The results of work of the prevention unit established at the regional department store suggests great opportunities for increasing the volume of screening for arterial hypertension, increasing population's awareness of the necessity of arterial hypertension correction. Enlisting medical students and sometimes senior pupils from secondary school to work in the prevention units established at non-medical institutions serves as an example of using additional resources for the control of arterial hypertension at the community level.

[Detection of ischemic heart disease in a survey of a male population 40-59 years of age (data of cooperative studies performed in Moscow, Kaunas, Kiev and Kharkov)]. / Vyiavlenie ishemicheskoi bolezni serdtsa pri obsledovanii muzhskogo naseleniia 40-59 let (dannye kooperativnogo issledovaniia v Moskve, Kaunase, Kieve, Khar'kove).

The authors analyzed the prevalence of coronary heart disease (CHD) and its various types detected by routine epidemiological methods among the examinees in four cities (Moscow, Kaunas, Kiev, and Kharkov). The results were obtained in the collaboration study, adhering to the rigid standardization of all the procedures applied. Examination of 17, 168 males aged 40-59 years revealed signs of CHD in 13.8%; 3.3% had a history of myocardial infarction; 5.3% suffered from exertional angina without prior myocardial infarction; 5.2% showed a painless course of CHD. The analysis demonstrated that simultaneous use of the standard epidemiological methods is the only way of ensuring a more complete detection of CHD. In different cities, from 36.4 to 60.8% were not aware of the presence of the disease. Secondary preventive measures should involve methods for identifying the major risk factors and eliminating the latter.

[Prevalence of risk factors and indicators of mortality among males 40-59 years of age with various forms of ischemic heart disease (data of a 5-year prospective study)]. / Rasprostranennos't faktorov riska i pokazateli smertnosti u muzhchin 40-59 let s razlichnymi formami ishemicheskoi bolezni serdtsa po dannym prospektivnogo nabliudeniia).

A collaborative study was undertaken to assess the efficacy of multifactor prevention of myocardial infarction and cerebral stroke. A representative group of 5951 males aged 40-50 years was examined in Kaunas. Coronary heart disease (CHD) was detected in 11.1%, including 2.7% who had a history of myocardial infarction, 2.5% had exertional angina, its painless type was found in 5.9%. In males with CHD, arterial hypertension, hypercholesterolemia, obesity were more common and smoking was more infrequent than in those without the disease. The results of the 5-year follow-up showed that CHD males had higher total and cardiovascular mortality and myocardial infarction morbidity rates than males without CHD. Males with prior MI and pain-free CHD significantly differed from those from the control group in total and cardiovascular mortality rates. No statistically significant difference was found in MI mortality and morbidity rates between male patients with exertional angina and controls.

[A program for the prevention of diabetes mellitus in Lithuania]. / Programma bor'by s sakharnym diabetom v Litovskoi SSR.

The Programme on Diabetes Mellitus Control is a constituent part of Integrated Programme on Chronic Non-infectious Diseases Control. The epidemiological evidence has demonstrated the high prevalence of deranged carbohydrate metabolism in the republic. Registers of carbohydrate metabolism disorders were created for the children's population of the Republic and the adult population of Kaunas and two agricultural-industrial regions. A school for diabetic patients and the society 'Insula' were organised. The research-practical programme is implemented in stages.

[Attitude of specialists in different occupational groups to their health]. / Otnoshenie spetsialistov razlichnykh professional'nykh grupp k svoemu zdorov'iu.

A study was made of behavioral, psychological and somatic risk factors of development of coronary heart disease in 1311 specialists with higher education in 6 occupational groups within the framework of the cooperative program on multifactor prevention. There were no significant differences among groups with relation to smoking, physical activity and a balanced diet. Significant changes were established with relation to psychological stress and prevalence of cardiac diseases. There is no need to differentiate preventive measures for specialists of different occupations.

[Role of heredity in the prevalence of ischemic heart disease and its risk factors]. / Rol' nasledstvennosti v rasprostranennosti ishemicheskoi bolezni serdtsa i ee faktorov riska.

The relationship of heredity with CHD prevalence and the main risk factors (RF) was analyzed on the basis of the results of a primary cardiological screening of the male population aged 40 to 59 in Minsk and Kaunas (10012 persons). The results of the analysis were in favor of hereditary predisposition to CHD. The prevalence of CHD and the main RF in probands with aggravated heredity was much higher than that in probands with favorable heredity. CHD prevalence in the compared groups was 12.4 and 10.7%; SK 3.9 and 0.2%; cerebral stroke 1.6 and 0.6%, respectively. Statistically significant changes were also revealed in RF frequency: AH--32.6 and 27.1%; HCS--27.7 and 24.1%; EBM--16.6 and 13.8%; smoking--43.6 and 47.0%. Over 1/3 of all types of CHD and AH were found in the persons with hereditary predisposition to CHD on the maternal side with a tendency to CS.

[Chief risk factors of ischemic heart disease and mortality of the middle-aged male population of Kaunas]. / Osnovnye faktory riska ishemicheskoi bolezni serdtsa i smertnost' muzhskogo naseleniia srednego vozrasta Kaunasa.

A prospective study, averaging 11 years, of a representative sample of 2455 male residents of Kaunas between 45 and 59 years of age has explored relationships between coronary risk factors and mortality due to coronary heart disease (CHD), cancer, injuries, as well as total mortality rates. An original analytical approach has been developed for the analysis of associations between individual risk factors and mortality that allows to exclude the effects of age and other examined factors. A marked relationship has been demonstrated between: coronary mortality and age, arterial blood pressure, cholesterol, glucose tolerance, smoking, body weight, the presence and clinical form of CHD; cancer-related mortality, and age or smoking; traumatic mortality and smoking; total mortality and age, arterial blood pressure, glucose tolerance, body weight, smoking, and the presence and type of CHD.

[Physicians' knowledge on the questions of primary prevention of cardiovascular and other chronic noninfectious diseases]. / Osvedomlennost' vrachei v voprosakh pervichnoi profilaktiki serdechno-sosudistykh i drugikh khronicheskikh neinfektsionnykh zabolevanii.

The attitude of physicians to the problems of primary prevention, their knowledge of general risk factors (RF) of chronic noncommunicable diseases (CNCD) and the presence of RF among physicians were studied using the questionnaire method. Altogether 275 physicians from 5 rural areas were interviewed within the framework of the Integrated Program on CNCD Prevention in the Lithuanian SSR, i. e. 74.5% of the total number of physicians. Half of them took a positive attitude to primary preventive measures of CNCD. Therapeutists were better aware of risk factors and the criteria of their assessment as compared to physicians of the other specialities. The assessment of RF levels among physicians (filling in questionnaire forms) showed that 29.6% of men and 2.4% of women were regular smokers, 7.3% of women and 4.6% of men had excess body mass (a body mass index exceeding 30 kg/m2). A high prevalence of smoking among male physicians pointed out a necessity of preventive measures among them.

[Arterial hypertension and its control in therapeutic districts of various polyclinics of the Lithuanian S.S.R]. / Arterial'naia gipertoniia i sostoianie ee kontrolia na vrachebnykh terapevticheskikh uchastkakh nekotorykh poliklinik Litovskoi SSR.

Within the framework of integrated chronic noncommunicable disease prevention program, a study of the prevalence and control of hypertension was carried out in five randomly selected therapeutic districts of the Lithuanian SSR using the rapid diagnosis method of the Institute of Preventive Cardiology at the National Cardiology Center. In all, 2271 persons aged 15 years and more, were examined simultaneously in all therapeutic districts within five days by specially trained teams of investigators. Our findings showed high prevalence of hypertension among the population of the therapeutic districts (21.6%) and failure to attain its effective control. The comparison of the data obtained by this method with those of screening tests provided a convincing proof of the feasibility of rapid identification of risk factors as whole, and those relating to hypertension in particular, in large populations, thus making it useful for following the effectiveness of intervention trials.

[Incidence of risk factors for chronic noninfectious diseases among the population of 2 rural therapeutic districts in the Lithuanian SSR and the knowledge of the inhabitants of the presence of their risk factors]. / Rasprostranennost' faktorov riska khronicheskikh neinfektsionnykh zabolevanii u naseleniia dvukh sel'skikh terapevticheskikh uchastkov Litovskoi SSR i osvedomlennost' zhitelei o nalichii u nikh faktorov riska.

During examination of the adult population of two rural communities: 1558 inhabitants of a settlement of Salantai and 1713 inhabitants of a settlement of Merkine their arterial pressure was measured and they were interviewed. A high prevalence of risk factors of chronic noncommunicable diseases was established. Arterial hypertension was detected almost in 1/3 of the examined population, 50% of the male population smoked, 40.7% of the Salantai inhabitants and 32.2% of the Merkine inhabitants had excess body mass. The people were unaware of risk factors. Those who thought to be healthy, often had risk factors. Only 28.3% of the Salantai inhabitants and 25.5% of the Merkine inhabitants knew their arterial pressure, 74.8% and 79.3% respectively knew their height and body mass. With age the prevalence of risk factors grew and knowledge of them decreased.

[Risk factors in chronic noninfectious diseases among the population of the Lithuanian SSR]. / Faktory riska khronicheskikh neinfektsionnykh zabolevanii sredi naseleniia Litovskoi SSR.

Prevalence of risk factors (RF) for chronic noncommunicable diseases (CND) such as hypertension, overweight and smoking among random samples of the representative population of various age groups in the Lithuanian SSR was considered. A total of 12126 males and females were examined. CND risk factors were found in all age groups without significant differences among separate administrative areas of the republic. Age-adjusted rates of RF levels were presented. Hypertension was found in 16.18% of males and 16.19% of females. There was a 2.7-fold and 8.2-fold age-linked increase in hypertension among the male and female population, respectively. Smoking was the most common RF among males (54.3%) while in females it reached 8.9%. With age the number of smokers tended toward reduction: among males 1.5 times and in females 2.2 times. Overweight was found to be the most prevailing RF among females (48.33%) while among the male population it was 27.9%. In the older age group overweight was observed in every other male and in two out of three women.

[Cooperative study on the multifactor prevention of ischemic heart disease and its development into an integral program for the prevention of noninfectious diseases]. / Kooperativnoe issledovanie po mnogofaktornoi profilaktike ishemicheskoi bolezni serdtsa i ego razvitie v integral'nuiu programmu profilaktiki neinfektsionnykh zabolevanii.

The authors presented a preliminary analysis of the 5-year implementation of a cooperative trial of multifactor prophylaxis of CHD in Moscow and Kaunas. A stable decrease in the prevalence of arterial hypertension (AH) by 20-25% and smoking by 22%, a decrease in SAP and DAP mean levels and the number of smoked cigarettes as compared to initial levels were noted in the group of active prophylaxis (the 1st group). It caused the reduction of CHD death risk by 13.6%. In the group of comparison with common treatment (the 2nd group) the prevalence of smoking decreased by 11% and arterial hypertension tended towards a rise. The comparison of mortality rates in the 1st and 2nd groups showed that in the 1st group total mortality rates were lower by 21% and CVD mortality rates were lower by 41% as compared to the 2nd group. The most noticeable decrease in 5-year mortality rates was observed among the persons initially attributed to the CHD group. Analysis of mortality with relation to the presence and intensity of smoking habits in Moscow and Kaunas indicated to the association of smoking not only with CHD mortality but also with cancer and total mortality making appropriate the development of an integral approach to the prophylaxis of the main chronic noncommunicable diseases.

[Attitude to health matters among middle-aged men in a program to prevent ischemic heart disease]. / Otnoshenie k voprosam zdorov'ia u muzhchin srednego vozrasta v programme po profilaktike ishemicheskoi bolezni serdtsa.

The authors studied the health-related attitudes (to prophylaxis, one's own health, physicians, bad habits) in men aged 40-59 years invited to participate in the programme of the multifactorial prophylaxis of myocardial infarction and cerebral stroke among the population. A total of 6803 men filled in a questionnaire consisting of 47 points mailed to them together with an invitation to take part in a screening examination. The results obtained showed that the elderly men responded favourably to the conduction of preventive procedures and to advice to change the smoking habits but less favourably toward recommendations to increase physical activity and change the diet.

[Various characteristics of persons with behavior-related risk of ischemic heart disease]. / Nekotorye osobennosti lits s povedencheskim riskom ishemicheskoi bolezni serdtsa.

In the framework of the programme on the multi-factorial prophylaxis of myocardial infarction and cerebral stroke in males aged 40-59 years, the authors studied the relationship between type A behaviour pattern as a risk factor for coronary heart disease and somatic and history indices. A study of 5698 men showed that group A was characterized by a greater percentage of subjects with elevated cholesterol and triglyceride levels and with hypercoagulatory changes in the hemostatic system. Group A subjects more frequently complained of chest pain and had a larger proportion of relatives with cardiovascular disease.