Primary prevention of ischemic heart disease in middle-aged men living in Prague: Results of twenty-year research

Česká verzia

Authors: F. Boudík ¹; J. Reissigová ² ; K. Hrach ²; M. Tomečková ^1,2; J. Bultas ¹; Z. Anger ¹; M. Aschermann ¹; J. Zvárová ²
Authors place of work: II. interní klinika 1. lékařské fakulty UK a VFN, Praha, přednosta prof. MUDr. Aleš Linhart, DrSc. ¹; EuroMISE centrum-Kardio, Ústav informatiky Akademie věd ČR, Praha, ředitelka prof. RNDr. Jana Zvárová, DrSc. ²
Published in the journal: Vnitř Lék 2006; 52(4): 339-347
Category: Original Contributions

Summary

Introduction:
Ischemic Heart Disease (IHD) represents the most frequent cause of mortality and morbidity in the Czech Republic. The aim of this study is to analyze long-term mortality of cardiovascular disease (CVD), identify its predictors and verify the validity of Framingham risk function for Czech patients.

Design and methods:
The twenty-year study (STULONG) of primary prevention of risk factors of atherosclerosis in 1419 men aged 38 to 53 years living in Prague was started in 1975. Results: CVD mortality analysis showed a higher risk of death for heavy smokers vs. non-smokers or light smokers (p < 0.0001), hypertensive patients vs. patients with normal blood pressure (p < 0.0001), men with hypercholesterolemia vs. men with normal cholesterol level (p = 0.0432), and a lower risk for university graduates vs. men with elementary education (p = 0.0006). Between 1980 and 1984, age-specific CVD mortality rates of men from STULONG study were higher (p = 0.0132) than national CVD mortality rates; between 1985 and 1994, they were insignificantly lower. Framingham risk function underestimated absolute ten-year risk of IHD in all risk quintiles (p < 0.0001) with discrimination of 63%.

Conclusion:
CVD mortality observed within STULONG study was significantly affected by known risk factors (hypertension, smoking, hypercholesterolemia, lower education); Framingham risk function underestimated absolute ten-year risk of IHD.

Key words:
primary prevention of Ischemic Heart Disease – Cardiovascular disease

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