[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.

[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.

Relationship between risk factors and ischaemic heart disease mortality in a representative sample of men aged 45-59 years in Kaunas.

The results of a 7-year prospective follow-up of a representative sample of men aged 45-49 years living in Kaunas, who were initially examined within the framework of the Kaunas-Rotterdam Intervention Study, are presented. The relationship was investigated between systolic and diastolic hypertension, hypercholesterolaemia, smoking impaired glucose tolerance on the one hand, and mortality (total and from ischaemic heart disease) on the other hand. The main cause of death in the studied series were cardiovascular diseases (38.7%); of these, in 62% of cases ischaemic heart disease. Among subjects who had been found healthy at screening, the most unfavourable prognosis as regards mortality from ischaemic heart disease, had men with hypertension.

Attitude of men aged 45-59 years to health and disease prevention (preventive study in Kaunas).

2,630 men aged 45-59 years--participants in the international Kaunas-Rotterdam Study programme, were interviewed at home by using a questionnaire ascertaining their attitude towards health and preventive measures. The survey showed the existence of a certain discrepancy between the attitude towards health as a human value, and care for the preservation of health. It was also found that a positive attitude towards health and medicine has a favourable influence on the realization of preventive measures within the framework of the fight against ischaemic heart disease.

A lowering of the risk of ischaemic heart disease among the population (according to the results of the Kaunas preventive study).

Out of the total number of 2455 individuals who had passed a primary screening, a group of men aged 45--59 years, with average (borderline) values of arterial pressure (AP), serum cholesterol (CH), and glucose levels after the glucose load, was selected for studies of potential lowering of the level of risk factors of ischaemic heart prevention. The enrollment of the probands lasted 9.4 months on the average (+/- 6.0 months); the preventive double-blind study proper lasted 12 months. The levels of the three specified risk factors sank both during the enrollment period and during the proper 1-year preventive therapy period. The risk factor levels were substantially lowered both in consequence of repetitive regular examinations and by the action of drug treatment (this applies especially to the CH level). In the evaluation of the results of the preventive study, therefore, also the effects of the lowering of the AP and of the CH and glucose levels even to the average values have to be taken into account. The results of the preventive study confirm that it is possible to lower the risk of IHD among the population.

The incidence of arterial hypertension in the male population aged 40-59 years in Moscow and Kaunas.

The authors examined 1480 Moscow and 1568 Kaunas male residents aged between 40 and 59 years. The incidence of arterial hypertension (AH) in Moscow and Kaunas amounted to 27.9 and 21.8% respectively. Of the total number of subjects examined in the two cities 24.5% (Moscow) and 59.4% (Kaunas) were unaware of their condition. Only 12.8% of the Moscow residents and 3.2% of the Kaunas residents were treated. The results are analyzed with respect to earlier therapy, its efficacy and standardization of measurement of arterial pressure in the course of cooperative studies. The high incidence of AH, ignorance of the patients of their condition, the low percentage of patients with an established diagnosis of AH emphasize the need for devising a system of identifying hypertensive patients and for treating them appropriately.

[Comparison of the behavior characteristics of men smokers and nonsmokers]. / Sopostavlenie povedencheskikh kharakteristik kuriashchikh i nekuriashchikh muzhchin.

The authors studied the relationship of smoking with the behavioristic and psychological parameters in men aged 40-59, 3713 inhabitants in Kaunas who participated in the program of multifactorial prevention of ischaemic heart disease. The comparison of groups of men who had never smoked, of those who gave up the habit and the smoking group showed that the smokers had a lower intellectual level and exhibit a negativistic attitude toward medicine and the preventive measures. It is difficult to convince the smokers to come for the health check-ups (p less than 0.0001) as compared to the other groups. Individuals who gave up smoking show themselves to be more cooperative, however their anamnestic data as to health are worse than in the other two groups.

[Risk of ischemic heart disease development in 45- to 59-year-old men. The results of a 5-year observation in the Kaunas population study]. / Risk razvitiia ishemicheskoi bolezni serdtsa u 45-59-letnikh muzhchin. Rezul'taty 5-letnego nabliudeniia Kaunasskogo populiatsionnogo issledovaniia.

The possibility of prognosticating the development of ischemic heart disease in persons clinically healthy in respect of this illness was studied. The data on 1,977 males were used, among whom, according to the registers of myocardial infarction and deaths, 34 had suffered from ischemic heart disease in a follow-up period of 5 years. The prognosis was made on the basis of logistic function and the following 6 signs: age, systolic pressure, cholesterol content, smoking, blood sugar level, body mass index. In the upper decile of the assessment of the probability of ischemic heart disease development, 47% of cases with this disease were encountered, i. e. 10% of clinically healthy individuals were distinguished among whom the risk of the development of ischemic heart disease was 8 times that among the remaining persons (0.081 and 0.01, respectively).

[Division of the 45- to 59-year-old male population into groups depending on the risk factors in a prophylactic study of ischemic heart disease]. / Delenie 45--59-letnego muzhskogo naseleniia na gruppy v zavisimosti ot faktorov riska v profilakticheskom issledovanii ishemicheskoi bolezni serdtse.

A prospective study was conducted from March 1972 to November 1976 in a group of Kaunas male population ranging in age from 45 to 59 years. At the beginning of the study it consisted of 3,553 individuals. They were divided into groups of low, moderate, and high risk according to the presence of a risk factor (hypertension, hypercholesteremia, impaired glucose tolerance test) and a pathologic condition. The ratio of the total mortality rate per 1,000 of the population during the observation period in these groups was 1 : 2 : 3, while that of the mortality of ischemic heart disease was 1 : 3 : 5. The rate of out-patient coronary mortality and the occurrence of new cases with myocardial infraction according to their number registered in the groups of low, moderate, and high risk was 1 : 2 : 5. All the indices in the group of individuals who refused to take part in the study were close to those in the high risk group. The data obtained point to the possibility of defecting by means of preventive study individuals exposed to a greater or lesser risk of the development of ischemic heart disease and death, which makes it possible for the Public Health Service to concentrate attention of definite groups of the population so as to apply differentiated preventive measures.

[Participation of the population in mass screening and the role of complete population surveillance for detection of the disease studied (from the experience of the methodical measures for the prevention of ischemic heart disease in Kaunas)]. / Ob uchasti naseleniia v massovykh profilakticheskikh osmotrakh i roli polnoty okhvata naseleniia obsledovaniem dlia vyiavleniia izuchaemogo zabolevaniia (iz opyta kaunasskogo metodicheskogo issledovaniia po profilaktike ishemicheskoi bolezni serdtsa.

A comparison of the results of examination of 100 individuals, some of whom had taken part in the survey while the others had refused it and information about them was specially obtained by other means (in some cases by collecting the medical documentation), is presented. Factors conducive to the development of ischemic heart disease predominated among individuals who refused to take part in the survey. The incidence of ischemic heart disease and arterial hypertension was also higher among them. It is concluded that individuals who refuse examination during preventive survey form a group with a high risk of the development of ischemic heart disease; this group should be taken into account when therapeutic and preventive measures are conducted among the population.

[Methodical study of multifactorial prevention of ischemic heart disease]. / Metodicheskoe issledovanie po mnogofaktornoi profilaktike ishemicheskoi bolezni serdtsa.

The purpose of the investigation was to study the possibilities of involving the population at large in mass screening procedures, the possible classification of the population with regard the degree of risk of ischaemic heart disease, and the potentials of its preventive therapy. The examined contingent was classified with due regard to some risk factors (arterialy hypertension, hypercholesterolemia, imparied glucose tolerance) and pathological states. The final grouping of the contingent was as follows: the group of "normal" was comprised by 53.4% of the examined, the "intermediate"-18.6%, the "pathological"-28%. The "intermediate" group comprised 350 persons selected for preventive therapy by a double blind method. Surveillance of 10% of those in the "normal" group and the whole "pathological" group was arranged.