Risk factor control in treated hypertensives from Estonia and Sweden. Why the difference?

Nilsson, Peter M.; Journath, Gunilla; Palm, Kairit; Viigimaa, Margus

doi:10.1080/08037050701517224

Cited by 4 publications

(3 citation statements)

References 15 publications

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“…The proportion of hypertensive population in Estonia is increasing hand-in-hand with its economic status, consistent with studies showing that introducing the westernized life style contributes to generally elevated BP levels [1,5]. Despite major public health problems caused by hypertension, only limited data are available on its epidemiology, etiology and risk factors in Estonian population [6,7]. To provide a better understanding of lifestyle, environmental and genetic risk factors leading to elevated BP in Estonian population, we have established the country's first hypertension-targeted sample collection HYPEST ( HYPertension in ESTonia ).…”

Section: Introductionsupporting

confidence: 54%

“…Finally, the retrospective BP data extracted from patient's clinical records were measured with different clinical settings (investigators, devices, laboratories) and thus, certain undefined measurement variability could have been introduced into the estimates. Despite these limitations, the present study gives a profile of Estonian hypertensive patients by analyzing considerably larger number of subjects than earlier investigations [6,7,24]. …”

Section: Discussionmentioning

confidence: 99%

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HYPEST study: profile of hypertensive patients in Estonia

Org

Veldre

Viigimaa

et al. 2011

BMC Cardiovasc Disord

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BackgroundMore than one third of adult population in Estonia has problems with elevated blood pressure (BP). The Hypertension in Estonia (HYPEST) study represents the country's first hypertension-targeted sample collection aiming to examine the epidemiological and genetic determinants for hypertension (HTN) and related cardiovascular diseases (CVD) in Estonian population. The HYPEST subjects (n = 1,966) were recruited across Estonia between 2004-2007 including clinically diagnosed HTN cases and population-based controls. The present report is focused on the clinical and epidemiological profile of HYPEST cases, and gender-specific effects on the pathophysiology of hypertension.MethodsCurrent analysis was performed on 1,007 clinically diagnosed HTN patients (617 women and 390 men) aged 18-85 years. The hypertensives were recruited to the study by BP specialists at the North Estonia Medical Center, Centre of Cardiology, Tallinn or at the Cardiology Clinic, Tartu University Hospital, Estonia. Longitudinal BP data was extracted retrospectively from clinical records. Current and retrospective data of patient's medical history, medication intake and lifestyle habits were derived from self-administrated questionnaire and each variable was examined separately for men and women. Eleven biochemical parameters were measured from fasting serum samples of 756 patients.ResultsThe distribution of recruited men and women was 39% and 61% respectively. Majority of Estonian HTN patients (85%) were overweight (BMI ≥ 25 kg/m2) and a total of 79% of patients had additional complications with cardiovascular system. In men, the hypertension started almost 5 years earlier than in women (40.5 ± 14.5 vs 46.1 ± 12.7 years), which led to earlier age of first myocardial infarction (MI) and overall higher incidence rate of MI among male patients (men 21.2%, women 8.9%, P < 0.0001). Heart arrhythmia, thyroid diseases, renal tubulo-intestinal diseases and hyperlipidemia were more prevalent in hypertensive women compared to men (P < 0.0001). An earlier age of HTN onset was significantly associated with smoking (P = 0.00007), obesity (BMI ≥ 30 kg/m2; P = 0.0003), increased stress (P = 0.0003) and alcohol consumption (P = 0.004).ConclusionUnderstanding the clinical profile of HTN patients contributes to CVD management. Estonian hypertension patients exhibited different disease and risk profiles of male and female patients. This well-characterized sample set provides a good resource for studying hypertension and other cardiovascular phenotypes.

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Section: Introductionsupporting

confidence: 54%

Section: Discussionmentioning

confidence: 99%

HYPEST study: profile of hypertensive patients in Estonia

Org

Veldre

Viigimaa

et al. 2011

BMC Cardiovasc Disord

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“…Also compared to international standards CVD readings (risk factors) in Estonia are considered to be higher (4,5). …”

Section: Introductionmentioning

confidence: 99%

Cardiovascular disease risk factors in homeless people

Kaldmäe

Zilmer

Viigimaa

et al. 2011

Upsala Journal of Medical Sciences

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BackgroundCardiovascular diseases (CVD) are associated with significant morbidity and mortality, which is highest in Eastern Europe including Estonia. Accumulating evidence suggests that life-style is associated with the development of CVD. The aim of this study was to evaluate the informative power of common CVD-related markers under unhealthy conditions.SubjectsSubjects (n = 51; mean age 45 years; 90% men) were recruited from a shelter for homeless people in Tallinn, Estonia, and consisted of persons who constantly used alcohol or surrogates, smoked, and were in a bad physical condition (amputated toes, necrotic ulcers, etc.).MethodsBlood pressure, pulse rate, and waist circumference were measured, and body mass index (BMI) was calculated. The following markers were measured in blood serum: total cholesterol (TChol), high-density lipoprotein cholesterol (HDL-Chol), low-density lipoprotein cholesterol (LDL-Chol), plasma triglycerides (TG), apolipoproteins A-l (ApoA1) and B (ApoB), lipoprotein(a) (Lp(a)), glycated hemoglobin (HbA1c), glucose (Gluc), high-sensitivity C-reactive protein (hsCRP), serum carbohydrate-deficient transferrin (CDT), gamma-glutamyltransferase (GGT), alanine aminotransferase (ALT), and aspartate aminotransferase (AST). Except smoking, the anamnestic information considering eating habits, declared alcohol consumption and medication intake were not included in the analysis due to the low credibility of self-reported data.ResultsMore than half of the investigated patients had values of measured markers (hsCRP, TChol, LDL-Chol, TG, HbA1c, ApoA1, ApoB, Lp(a), Gluc) within normal range. Surprisingly, 100% of subjects had HDL-Chol within endemic norm.ConclusionThis study demonstrates that traditional markers, commonly used for prediction and diagnosis and treatment of CVD, are not always applicable to homeless people, apparently due to their aberrant life-style.

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