[Dyslipoproteinemia in primary hypertension]. / Dyslipoproteinemia w pierwotnym nadcisnieniu tetniczym.

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.

Determinants of prognosis in nonischemic dilated cardiomyopathy.

BACKGROUND: Dilated cardiomyopathy, a heart muscle disease of unknown cause, is characterized by high mortality and is a major cause of cardiac transplantation. It has become, therefore, increasingly important to identify patients at higher risk. The aim of this study was to assess which of the data obtained at the time of diagnosis are the best predictors of survival. METHODS AND RESULTS: One hundred forty-four patients with dilated cardiomyopathy (118 men; mean age, 39 years) were assessed clinically, noninvasively, and hemodynamically. The effect of variables derived from the evaluation on outcome (death or heart transplantation) was examined. During a mean follow-up time of 4.1 years, 68 patients (47%) died and 9 (6%) underwent heart transplantation. The 1-, 2-, and 5-year transplant-free survival rate was 79, 69, and 44%, respectively. Cox multivariate regression analysis identified three variables as independent predictors of outcome: (1) pulmonary artery systolic pressure, P = .0001; (2) left ventricular ejection fraction, P = .0013; and (3) left ventricular end-diastolic dimension, P = .007. The prognostic index was constructed from regression coefficients and parameters significant in the Cox model. The minimal prognostic index in the study group was 1.4 and the maximal was 6.0 with a corresponding 1-year survival of 98 and 18%, respectively. The validity of the prognostic index was tested in the consecutive group of 81 patients, who were followed for a mean 2.3 years. The prognostic index of the poor outcome group differed significantly from that in survivors (3.7 vs 2.9, respectively, P < .01). The sensitivity and specificity of model predictions were 68 and 52%, respectively. CONCLUSIONS: The severity of pulmonary hypertension and left ventricular dysfunction provides an independent insight into the prognosis of patients with dilated cardiomyopathy. The prognostic index is useful when assessing prognosis and may be helpful in the timing of heart transplantation.

[Drug consumption by the patients with ischemic heart disease (IHD) studied by the Pol-Monica Warsaw and the effect of selected factors on the treatment of IHD]. / Spozycie leków przez chorych na chorobe niedokrwienna serca (CHNS) w badaniu Pol-Monica Warszawa oraz wplyw wybranych czynników na fakt leczenia CHNS.

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).

[Regional conditions of the smoking habit-- the POL-MONICA 1984 studies]. / Regionalne uwarunkowania nalogu palenia papierosów. Badanie POL-MONICA 1984.

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.

[Hypertension--diagnosis, treatment and the effectiveness of the treatment of Polish population participating in the POL-MONICA program]. / Nadcisnienie tetnicze--wykrywalnosc, leczenie oraz efektywnosc leczenia w populacji polskiej objetej programem POL-MONICA.

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.

Comparison of official mortality statistics with data obtained from myocardial infarction and stroke registers.

Two sources of information about deaths caused by myocardial infarction and stroke were compared: official statistical data obtained from the Central Statistical office (CSO), and data from the registers of myocardial infarction and stroke conducted under the POL-MONICA Warsaw Project. The completeness of the MONICA registers with respect to the CSO data was 78%, and the completeness of the CSO data with respect to the MONICA registers was 88%. The main causes of the differences were: lack of information in the registers on deaths outside Warsaw; lack of unequivocal identification markers in patients' records from different sources; and other errors in data processing. The agreement of the diagnoses in death certificates (in the CSO material) with the diagnoses in the MONICA registers was 70.4% for myocardial infarction, and 64.4% for stroke. The main cause of the disagreement between the diagnoses was a different methodological approach to the collection of data in the two information sources.

[Results of blood pressure measurements depending on the place and method of measurement in individuals with normal blood pressure and borderline hypertension]. / Wyniki pomiaru cisnienia tetniczego krwi w zaleznosci od miejsca i sposobu wykonania u osób z normotensja, nadcisnieniem i nadcisnieniem granicznym.

The analysis of systolic (SBP) and diastolic (DBP) blood pressure measurements in 2 positions (sitting, standing) X 2 subsequent measurements (order) X 2 places (right, left arm) was performed on the basis of the Pol-Monica I screening conducted in 1984 yr. There were 1309 examined men and 1327 women aged 35-64 yrs. The mean values of 2 measurements taken in the sitting position on the right arm were used for division of the total sample into 7 categories: 1. normotension, 2. borderline systolic hypertension, 3. borderline diastolic hypertension, 4. borderline systolic-diastolic hypertension, 5. systolic hypertension, 6. diastolic hypertension, 7. systolic-diastolic hypertension. For each sex X blood pressure category the 4-way mixed ANOVA was calculated: persons as random effect and position, order and place as fixed effects. The effects and variance components were estimated and tested. The effects of position, order and persons and interaction position X persons, places X persons and position X persons X places were significant for both sexes, all BP categories for SBP as well as DBP measurements.