30-year trends in major cardiovascular risk factors in the Czech population, Czech MONICA and Czech post-MONICA, 1985 – 2016/17

Cífková, Renata; Bruthans, Jan; Wohlfahrt, Peter; Krajčoviechová, Alena; Šulc, Pavel; Jozífová, Marie; Eremiášová, Lenka; Pudil, Jan; Linhart, Aleš; Widimský, Jiří; Filipovský, Jan; Mayer, Otto; S̆kodová, Z; Poledne, R.; Stávek, P.; Lánská, Věra

doi:10.1371/journal.pone.0232845

Cited by 42 publications

(48 citation statements)

References 29 publications

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“…The CR, the postcommunist country in Central Europe, underwent extensive changes in lifestyle, stroke management, and treatment of stroke risk factors after the collapse of the Iron Curtain in 1989. Specialized stroke centers were accredited in 2010 [4], quality control is being performed, and the management of stroke risk factors improved significantly (decrease in the prevalence of smoking, in total cholesterol, and in blood pressure and improved hypertension control) [5]. It would be anticipated that such socioeconomic changes may be reflected in stroke incidence.…”

Section: Introductionmentioning

confidence: 99%

Incidence of Stroke and Ischemic Stroke Subtypes: A Community-Based Study in Brno, Czech Republic

et al. 2020

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Background: There are few contemporary epidemiological data on stroke for Central Europe. We performed a population-based study evaluating the incidence of stroke, stroke types, and ischemic stroke (IS) subtypes in Brno, the second biggest city in the Czech Republic (CR). Methods: Using the National Registry of Hospitalized Patients, and hospital databases, we identified all patients hospitalized with a stroke diagnosis in Brno hospitals in 2011. For Brno residents with validated stroke diagnosis, we calculated (a) the overall incidence of hospitalized stroke, (b) incidence rates for IS, subarachnoid hemorrhage (SAH) and intracerebral hemorrhage (ICH), and (c) incidence rates for IS subtypes. We calculated the average annual age- and sex-standardized incidence (European Standard Population and World Health Organization), to compare our results with other studies. Results: The overall crude incidence of stroke in Brno was 213/100,000 population. The incidence of stroke for stroke types were as follows: SAH, 6.9; ICH, 26.4; and IS, 180 cases per 100,000 population, respectively. The WHO-standardized annual stroke incidence was 107 for all strokes and 88 for IS, 14.4 for ICH, and 5 for SAH. For IS subtypes, the WHO-standardized incidence was large artery atherosclerosis 25.8, cardioembolism 27.8, lacunar 21.6, other determined etiology 6.2, and undetermined etiology 6.5 cases per 100,000 population. Conclusions: The stroke incidence is lower than that previously reported for the CR and Eastern Europe probably reflecting socioeconomic changes in post-communistic countries in the region. These findings could contribute to stroke prevention strategies and influence health policies.

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Section: Introductionmentioning

confidence: 99%

Incidence of Stroke and Ischemic Stroke Subtypes: A Community-Based Study in Brno, Czech Republic

et al. 2020

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“…The use of lipid-lowering medications increased more than two-fold in both sexes and reached 14.6% in men and 10.0% in women in 2016 (with statins comprising 78.8% of all the prescribed lipid-lowering drugs). The number of individuals treated by antihypertensive drugs has increased in both genders, and a rate of hypertension control improved from 3.9% in 1985 to 32.9% in 2017 [ 17 ].…”

Section: Resultsmentioning

confidence: 99%

“…The prevalence of obesity in men has shown an increasing trend over the past 30 years (from 19.7% in 1985 to 37.7% in 2016) [ 17 ], while in women, there was no change (28.0% in 1985 to 27.6% in 2016) [ 17 ] ( Table 2 ). The prevalence of diabetes has shown an increasing trend in both sexes from 6.9% and 5.4% in 1985 [ 17 ] to 11.5 % and 8.3 % in 2014 [ 18 ] in men and women, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…A summary of important biological determinants for dysglycemia and abnormal adiposity in the Czech population is presented in Table 1. Cardiovascular disease mortality decreased in Czechia from 1989 to 2019, and this downward trend can be attributed to a decreasing prevalence of CMBCD risk factors and lower impact of CMBCD drivers [17] (Table 2). Among the major risk factors with declining rate are the prevalence of tobacco use in men (from 45% in 1989 to 23.9% in 2016), hypertension in women (from 42.5% in 1989 to 33.5% in 2016), and dyslipidemia in both sexes (men: from 87.7 % in 1989 to 74.8% in 2016; women: from 87.5% in 1989 to 69.9% in 2016).…”

Section: Epidemiology Of Cardiometabolic Risk Factorsmentioning

confidence: 99%

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Dysglycemia and Abnormal Adiposity Drivers of Cardiometabolic-Based Chronic Disease in the Czech Population: Biological, Behavioral, and Cultural/Social Determinants of Health

et al. 2021

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In contrast to the decreasing burden related to cardiovascular disease (CVD), the burden related to dysglycemia and adiposity complications is increasing in Czechia, and local drivers must be identified. A comprehensive literature review was performed to evaluate biological, behavioral, and environmental drivers of dysglycemia and abnormal adiposity in Czechia. Additionally, the structure of the Czech healthcare system was described. The prevalence of obesity in men and diabetes in both sexes has been increasing over the past 30 years. Possible reasons include the Eastern European eating pattern, high prevalence of physical inactivity and health illiteracy, education, and income-related health inequalities. Despite the advanced healthcare system based on the compulsory insurance model with free-for-service healthcare and a wide range of health-promoting initiatives, more effective strategies to tackle the adiposity/dysglycemia are needed. In conclusion, the disease burden related to dysglycemia and adiposity in Czechia remains high but is not translated into greater CVD. This discordant relationship likely depends more on other factors, such as improvements in dyslipidemia and hypertension control. A reconceptualization of abnormal adiposity and dysglycemia into a more actionable cardiometabolic-based chronic disease model is needed to improve the approach to these conditions. This review can serve as a platform to investigate causal mechanisms and secure effective management of cardiometabolic-based chronic disease.

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“…Two phenomena can explain the improvements in cardiovascular mortality: improved cardiovascular treatments and changes in health-related behaviours. According to Cíková et al (2020), developments in cardiovascular treatments accounted for more than half (52 per cent) of the decrease in the related mortality, while 43 per cent can be ascribed to the drop in major cardiovascular risk factors in the Czech population. The reforms experienced by the health care system after the collapse of the communist regime led to higher efficiency, encouraging the adoption of modern cardiovascular treatments such as coronary angioplasty and surgery, and the use of ACE inhibitors, In the second decade of the 2000s, further reductions have been possible because of the FIGURE 5A Mortality rates by causes of death for women aged 20-29 Note: Mortality rates by cause of death for three different age groups are plotted across district groups ranked by their poverty index.…”

Section: Mortality By Causes Of Deathmentioning

confidence: 99%

Mortality Inequality in the Czech Republic*

Bertoli

Grembi

2021

Fiscal Studies

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We examine the evolution of mortality and mortality inequality among the 77 districts of the Czech Republic ranked by a new poverty index, from 1994 to 2016. The country experienced dramatic improvements in mortality for all age categories and both genders, but with very little variation in inequality. Inequality in mortality has remained substantially stable, increasing only for females aged 20-64.

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30-year trends in major cardiovascular risk factors in the Czech population, Czech MONICA and Czech post-MONICA, 1985 – 2016/17

Cited by 42 publications

References 29 publications

Incidence of Stroke and Ischemic Stroke Subtypes: A Community-Based Study in Brno, Czech Republic

Incidence of Stroke and Ischemic Stroke Subtypes: A Community-Based Study in Brno, Czech Republic

Dysglycemia and Abnormal Adiposity Drivers of Cardiometabolic-Based Chronic Disease in the Czech Population: Biological, Behavioral, and Cultural/Social Determinants of Health

Mortality Inequality in the Czech Republic*

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