Do participants with depression receive more counseling on cardiovascular disease risk factors? The results of the WOBASZ II study.

Background Depression was found to increase the risk of cardiovascular disease (CVD). In terms of CVD prevention in people with depressive symptoms, the main goal is to successfully control classic CVD risk factors. Aims: The aim of the study was to assess the relationship between depression and 1) the frequency of healthcare utilization, 2) counseling on main CVD risk factors during usual medical visits, 3) compliance with pharmacotherapy in primary and secondary prevention. Methods WOBASZ II was a cross­sectional study targeting a representative sample of the Polish population. Trained nurses obtained information on depression (using the Beck Depression Inventory), education, healthcare utilization, counseling on CVD risk factors, and compliance with the recommended pharmacotherapy. Results As many as 5531 participants completed the Beck Depression Inventory questionnaire and provided information on CVD. After adjustment for age, sex, and education, participants without CVD but with depression had blood pressure measured slightly more often and received more frequent counseling on: nutrition (40% more), physical activity (43% more), and smoking cessation (nearly 30% more). Counseling on main CVD risk factors during typical visits and compliance with the recommended  pharmacotherapy did not differ with regards to depression in patients with a history of CVD. Conclusions The recommendations from the European Society of Cardiology for particularly careful control of CVD risk factors in people with depression are to some extent reflected in primary prevention. The relationship between depression and counseling on CVD risk factors in patients with CVD was insignificant. Compliance with the recommended pharmacotherapy was not related to depression.

Assessment of knowledge on cardiovascular disease risk factors by postal survey in residents of Malopolska Voivodeship. Malopolska CArdiovascular PReventive Intervention Study (M-CAPRI).

[b]Introduction.[/b] Education is a key tool in the prevention of cardiovascular disease (CVD). Education programmes require monitoring of their effectiveness. [b]Objectives. [/b]1) to introduce postal screening for the assessment of knowledge on CVD risk factors (RFs) for the Polish population, 2) to assess this knowledge in adult residents of Malopolska Voivodeship, and 3) to assess whether knowledge on RFs is related to age, gender, place of residence, level of education and family history of CVD. [b]Materials and method.[/b] Anonymous questionnaires were posted to a random sample of 5,000 residents of Malopolska Voivodeship in Poland. Results were presented as proportions of participants who listed RFs correctly. A series of multiple logistic regression models was used to assess the associations of knowledge on RFs with the potential determinants. [b]Results.[/b] 1,126 completed questionnaires were returned. Over 35% of respondents could not list a single RF and 14 % listed only 1-2 RFs. About 40% named 3-5 and only 12% listed 6 or more RFs. About a half of the respondents listed incorrectly from 1-8 characteristics as being associated with higher risk of CVD. In the multivariate analysis, knowledge on RFs was not significantly associated with age. Level of education was the strongest determinant of knowledge. Male rural and small town residents had less knowledge, whereas women with a family history of CVD had more knowledge on some CVD RFs. [b]Conclusions.[/b] Using a postal questionnaire for the assessment of knowledge of CVD RFs in the population of Malopolska Voivodeship appeared to have serious limitations due to low participation in the study. Despite this, the results of the study indicate that knowledge on CVD RFs is insufficient. Female gender and higher education were related to more prevalent knowledge on RFs. Family history of CVD was related to better knowledge in women only. Male residents of rural areas and small towns had slightly less knowledge on CVD RFs.

Perceived control as a predictor of cardiovascular disease mortality in Poland. The HAPIEE study.

BACKGROUND: Neither the development in methods of treatment of coronary heart disease nor the changes in exposure to main cardiovascular disease (CVD) risk factors do not fully explain the trends in CVD mortality in Poland. An influence of psychosocial factors is considered. The aims of the study were: (1) to assess the relationship between perceived control and the prevalence of classic CVD risk factors; (2) to assess the relationship between perceived control and the risk of death from all causes and from CVD. METHODS: A cohort study with 5-year follow-up was conducted. Random sample of 10,728 permanent residents of Krakow aged 45-69 was examined. Perceived control was measured using a standard 11-item scale. The studied group was divided into four subgroups of people with very high, high, moderate, and low perceived control according to quartile values. Data on deaths and causes were obtained from the local register, death certificates and participants' families. An independent effect of perceived control on CVD mortality was assessed using Cox proportional hazards models. RESULTS: Low perceived control was strongly associated with a higher CVD mortality, independently of age, education, marital status, history of CVD, hypertension, hypercholesterolemia, smoking, body mass index, physical activity or diabetes in both men and women (HR 2.68, 95% CI 1.36-5.31 and HR 5.18, 95% CI 1.17-22.96, respectively). After adjustment for age, both in men and women, the highest risk of death from all causes was observed in persons with low perceived control. Further adjustment for covariates attenuated the relationship. CONCLUSIONS: Perceived control is a strong independent predictor of CVD mortality and may be considered a CVD risk factor in the Polish urban population.