This article is the initial report on the Multiple Sclerosis (MS) Society of New South Wales (NSW) Client Census Database study, a telephone-based cohort study of registered clients of the society in 2001. The final database sample comprised 2618 respondents with a diagnosis of MS from the registered client database, representing 73% of this target client population and an estimated 70% of all people with MS in NSW, Australia. The mean age was 49 years, and mean time since diagnosis was 11 years, with 36% diagnosed in the past 5 years. Approximately three-quarters (74%) were women. The mobility disability profile of the sample covered the entire spectrum, with half reporting being able to walk without a mobility aid and only 17% being confined to a wheelchair. The average age of respondents confined to a wheelchair was 56 years. Most respondents reported other MS symptoms they felt were disabling, such as fatigue and abnormal sensory symptoms. Most were living with a partner or spouse but were less likely to be living with children in the family home than the general NSW population. Only 5% were living in supported accommodations. Only a third of respondents were employed, with greater levels of disability leading to greater levels of unemployment—full-time employment being more adversely affected than part time and men being more disadvantaged than women with MS compared with their general NSW population counterparts. Essential medical care and personal support needs were mostly well met but less reliably so for the most severely disabled respondents and those living farther from major cities. The most frequently reported unmet needs were for breaks from home and employment support. Less than half of the sample reported being on immunotherapy. Those who were on immunotherapy were more likely to be women, employed part time, and experiencing only mild or moderate mobility disability.

Objective: Arterial stiffness (cfPWV) is acknowledged biomarker of ageing. It was reported that ePWV correlated almost identical with the measured cfPWV and had significant predictive value for cardiovascular (CV) events in hypertensive patients. In a subgroup of population ageing process is faster (EVA), while slower in subjects with HVA). Our aim was to analyze characteristics of EVA and HVA in general Croatian population using ePWV. Design and method: In a stratified random sample of 1087 subjects from the general Croatian adult population which was enrolled in a nationwide survey (EH-UH 1) from 2000–2005 analyses on ePWV were done and subjects were followed-up for 17 years. ePWV was calculated using this formula: ePWV = 9.587–0.402 × age+4.560 × 10-3 × age2–2.621 × 10-5 × age2 × MBP+3.176 × 10-3 × age × MBP-1.832 × 10-2 × MBP. MBP = (DBP)+ 0.4 (SBP - DBP). HVA was defined as the lowest 10% and EVA as the highest 10% of the standardized PWV distribution, adjusted for age quintiles. Subjects with MI, stroke/TIA and DM were excluded. Mortality data were collected from National Public Health Institute records. Results: Subjects with EVA were older with higher systolic/diastolic BP, heart rate and ePWV, more obese, having more frequently dyslipidemia and hypertension, were less educated and less physically active (all p < 0.001). Contrary to women, EVA in men was not associated with age, obesity, level of education and dyslipidemia (p > 0.05). In the whole group, and in both gender, there were no differences between HVA and EVA in income, smoking, alcohol consumption, residency (urban vs.rural; continental vs. Mediterranean) (p > 0.05). More women than men had HVA till the menopause (X2 = 13.867;p = 0.001) but after that we failed to find difference between genders. There were significantly more CV/stroke deaths in EVA vs. HVA in the women (X2 = 8.743; p = 0.003) but not in men. Conclusions: High BP and heart rate, and physical inactivity were found to be associated EVA in both gender. Obesity, older age (menopause), dyslipidemia and lower level of education were characteristics of EVA in women but not in men. EVA in women but not in men was associated with more CV/stroke deaths.

Objective: Carotid-femoral pulse wave velocity (cfPWV) was recommended by guidelines as biomarker and independent predictor of cardiovascular (CV) events. Measurements of cfPWV is demanding and expensive method. It was suggested that an estimated PWV (ePWV) could be used. Our aim was to analyze the predictive role of ePWV for CV and all-cause mortality in general population. Design and method: In stratified random sample of 1087 subjects from the general Croatian adult population (EH-UH study) (men 42.4%, average age 53 +/-16) subjects were followed for 17 years. Mortality data were obtained from Croatian Institute of Public Health. In the follow-up period 1060 patients had all the data on death. ePWV was calculated using formula: ePWV = 9.587-0.402 × age + 4.560 × 10-3 × age2-2.621 × 10-5 × age2 × MBP + 3.176 × 10-3 × age × MBP-1.832 × 10-2 × MBP. MBP = (DBP) + 0.4(SBP-DBP). Results: At the end of follow up period 228 deaths (all-cause mortality 20.9%; CV, stroke, cancer, dementia and degenerative diseases, cold, others 43.4%, 10.5%, 28.5%, 5.2%, 3.1%, 9.3%, respectively). In the 2nd ePWV tertile there were more deaths due to cancer than from CV disease (46% vs. 30%), while in the 3rd tertile we observed opposite (20.5% vs. 51.04%). In the analysis of survival of subjects classified into the ePWV tertiles when all-cause and CV death and mortality were observed, the probability of survival of the 3rd tertile compared to the 2nd and 1st tertiles were significantly lower (p< 0.001 Log Rank test (Mantel-Cox)) (Figure 1). In unadjusted model, in Cox regression ePWV was significant predictor for CV death and for each increase of 1m/s there was 14% increase risk for CV death. In multivariate analyses ePWV was neither independent predictor for all-cause nor for CV mortality (p>0.05). However, in u subgroup of subjects with higher CV risk we found ePWV to be a significant predictor of CV deaths (ePWV (m/s) β 1.108; p<0.029; HR 3.03,95% CI 1.118-8.211). Conclusions: In general population ePWV is associated with higher all-cause and CV mortality, although not independently of other risk factors. However, in a subgroup of subjects with high CV risk, ePWV was significant and independent predictor of CV mortality. Further studies are needed before ePWV could be recommended in general clinic work.

Objective: Arterial stiffness (cfPWV) is acknowledged biomarker of ageing having significant predictive value for cardiovascular (CV) events in hypertensive patients. It was observed that ePWV calculated by equation using age and mean blood pressure (MBP) improved risk prediction compared with traditional risk scores in healthy subjects, untreated hypertensives and very high risk patients. Our aim was to analyze association of ePWV with mortality in subjects with EVA and HVA in general Croatian population. Design and method: In a stratified random sample of 1087 subjects from the general Croatian adult population which was enrolled in a nationwide survey (EH-UH 1) from 2000–2005 analyses on ePWV were done and subjects were followed-up for 17years. ePWV was calculated using formula: ePWV = 9.587–0.402 × age+4.560 × 10-3 × age2–2.621 × 10-5 × age2 × MBP+3.176 × 10-3 × age × MBP-1.832 × 10-2 × MBP. MBP = (DBP)+0.4(SBP-DBP). HVA was defined as the lowest 10%, EVA as the highest10% of the standardized PWV distribution, adjusted for age quintiles. Subjects with MI, stroke/TIA, DM were excluded. Mortality data were collected from National Public Health Institute records. Results: At the end of follow up period 228 deaths (20.9%) were recorded in the whole group (CV43.4%, stroke10.5%, cancer28.5%, dementia and degenerative diseases5.2%, COPD3.1%). There were 16.5% and 14.2% deaths in EVA and HVA groups, respectively (p > 0.05). Significantly more CV/stroke deaths were observed in EVAvs.HVA (X2 = 5.488;p = 0.0019). In a subgroup of subjects who died, at basal EVA subjects were older, obese, more frequently hypertensives, had higher BMI, BP, heart rate and ePWV compared to HVA (13.8 ± 1.1vs.10.5 ± 2.5;p < 0.0001). Both died HVA and EVA were at basal less physically active than survivors. In a subgroup of EVA subjects, those who died, at basal were older, had higher systolic BP, lower eGFR and higher ePWV (13.8 ± 1.1vs.9.9 ± 2.3;p < 0.0001) and were less physically active (X2 = 1.54;p = 0.01) compared to survivors. We failed to find differences between dead and alive EVA in basal diastolic BP, BMI, heart rate, prevalence of hypertension. Conclusions: Age, systolic BP, eGFR and ePWV were associated with mortality risk in EVA subjects. Physical inactivity was associated with higher mortality both in EVA and HVA participants. Comparing to HVA, in addition to aforementioned parameters, EVA subjects had higher BMI, diastolic BP and heart rate.

Objective: Carotid-femoral pulse wave velocity (cfPWV) was recommended by guidelines as a biomarker of arterial stiffness and an independent predictor of future cardiovascular (CV) events. However, due to practical and logistic reasons it was not become a routine in clinical work. Recently, it was shown that estimated PWV (ePWV) which is much more convenient for everyday work correlates excellent with cfPWV and had predictive role in hypertensive patients with various degrees of CV risk. Our aim was to determine the distribution of ePWV values in general Croatian population. Design and method: In a stratified random sample of 1087 subjects from the general Croatian adult population which was enrolled in a nationwide survey (EH-UH 1) from 2000–2005 analyses on ePWV were done and subjects were followed-up for 17 years. ePWV was calculated from age and mean BP (MBP): ePWV = 9.587 - 0.402 × age + 4.560 × 10-3 × age2 - 2.621 × 10-5 × age2 × MBP + 3.176 × 10-3 × age × MBP - 1.832 × 10-2 × MBP. MBP = diastolic BP (DBP) + 0.4(SBP - DBP). Results: Mean values of ePWV according to the age and BP categories are shown in Figure 1. Distribution of PWV according to the age category in the normal values European population (European Heart Journal 2010; 31: 2338) and ePWV in general Croatian population are presented in Table 1. Concordance between cfPWV and ePWV was found in younger subjects with less stiffed arteries. Discrepancies between cfPWV and ePWV increased with levels of cfPWV Conclusions: According to our knowledge this is the first study presenting the distribution of ePWV by age category in a population-based survey. Observed differences between cfPWV and ePWV in older subjects could be explained with differences between groups (normal population vs. general population) but also by the fact that our participants were not classified according to levels of BP what is in line with the results of other authors (J of Hypertension 2016, 34:1279)