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WO16-OR-5 RECENT CHANGES OF RISK FACTORS OF CHD IN THE CZECH POPULATION
Workshops WO16 Epidemiological changes of coronary heart disease risk in Europe
WO16-OR-5
groups, hyperlipidaemia was more common in South Asians(P<0.05) who were younger (P< 0.001), and had poorer survival at 30 days (P=.002).
WORKSHOPS
ultrasound in 767 individuals (95% of the population over the age of 40 in two regions in Cyprus). Plaques were considered to be present if IMTmax was greater than 1.2 mm. Clinical cardiovascular disease (CVD) was present in 113 (14.7%). Early atherosclerotic plaques were present in 553 individuals. The upper homocysteine quartile could identify a group with a higher prevalence of individuals with clinical CVD (29% vs 9.8%) (p<0.001) (OR 3.78; 95% CI 2.49 to 5.73) and TPT >0.4 cm (67% vs 33%) (p<0.001) (OR 4.07; 95% CI 2.88 to 5.76) than the rest. The MTHFR TT genotype was not associated with homocysteine higher than 12.0 μmol/L in the population as a whole. However, it was associated with homocysteine higher than 12.0 μmol/L in those who had a plasma folate less than 8 μmol/L (OR 1.86; 95% CI 1.07 to 3.24). After correcting for age, gender, smoking and hypertension in a logistic regression analysis the results remained significant (OR 1.25; 95% CI 1.00 to 1.57) (p=0.05). Homocysteine is an independent risk factor for early atherosclerosis. MTHFR 677TT homozygotes with low serum folate have high serum homocysteine. These findings should be used for risk stratification in future randomized intervention trials.
17
RECENT CHANGES OF RISK FACTORS OF CHD IN THE CZECH POPULATION
R. Poledne 1 , J. Valek 1 , Z. Skodova 2 , R. Cifkova 2 , P. Stavek 1 , D. Grafnetter 1 . 1 Laboratory for Atherosclerosis Research, IKEM, Prague, Czech Republic; 2 Department of Preventive Cardiology, IKEM, Prague, Czech Republic CHD mortality in the Czech population has decreased substantially during last 20 years partly due to a 12% decrease in serum cholesterol. At the same time, BMI increased from 27 to 29. Method: two groups of consecutive MI survivors admitted to the same coronary care unit in 1983 (n=107) and 2000 (n=284) were studied and compared to controls selected from 1% representative sample of the Czech population (age and sex matched) studied either in 1985 (n=230) or 2000-2001 n=566. Results: the most discriminating risk factor when MI survivors and controls were compared in the 80’s was total cholesterol (6.78 in patients and 6.18 mmol/l in controls, p<0.001). MI survivors were slightly heavier (difference in BMI, p<0.05). On the contrary, total cholesterol did not differ between MI survivors (5.85 mmol/l) and controls (5.83) when both groups were compared in 2000. The most discriminating risk factor between MI survivors and controls at this time was waist circumference (patients 102.7 cm, controls 97.4, p<0.001). Conclusion: After recent changes in dietary habits leading to a decrease of cholesterol concentration in the whole population, on the one side, and the increase of BMI,on the other side, substantial changes in the risk factors for myocardial infarction were documented. The difference in the cholesterol concentration in MI patients found in the 80’s disappeared whereas central obesity as the most discriminating factor of these two groups was confirmed. Project supported by grant No. 1M0510 awarded through Ministry of Education, Youth and Sports. WO16-OR-6
Conclusion: Hyperlipidaemia has increased, especially amongst South Asians. The reduced decline in stroke prevalence and 30-day survival of stroke in South Asians in recent years warrants further investigation and highlights the importance of a targeted health care approach in this group.
SECULAR TRENDS IN THE CARDIOVASCULAR RISK PROFILE AND MORTALITY OF STROKE ADMISSIONS IN AN INNER CITY MULTI ETHNIC POPULATION
A. Gunarathne 1 , J.V. Patel 1 , R. Potluri 1 , P. Gill 1 , B. Gammon 2 , N.C. Panja 2 , E.A. Hughes 1 , G.Y.H. Lip 1 . 1 University Department of Medicine,City Hospital, Birmingham, UK; 2 Sandwell Medical Research Unit,Sandwell General Hospital, Birmingham, UK Background: The excess of CVD ethnic groups in the UK is a continuing healthcare and research focus. An understanding of secular trends in ethnic risk profiles and mortality of stroke therein are needed for targeted healthcare approaches. Methods: Case note and registry data of 3262 patients admitted in a UK inner-city Hospital Trust with a first-onset stroke were reviewed (1997-2005). Secular trends in CVD risk, admission rate and 30-day mortality were analysed. Results: Non-haemorrhagic stroke rates declined over the period (P<0.001) but with no ethnic variation. Hypertension and hyperlipidaemia were increasingly prevalent (Table 1) in all, but on comparison with other 76th Congress of the European Atherosclerosis Society, June 10–13, 2007, Helsinki, Finland
WO16-OR-5
groups, hyperlipidaemia was more common in South Asians(P<0.05) who were younger (P< 0.001), and had poorer survival at 30 days (P=.002).
WORKSHOPS
ultrasound in 767 individuals (95% of the population over the age of 40 in two regions in Cyprus). Plaques were considered to be present if IMTmax was greater than 1.2 mm. Clinical cardiovascular disease (CVD) was present in 113 (14.7%). Early atherosclerotic plaques were present in 553 individuals. The upper homocysteine quartile could identify a group with a higher prevalence of individuals with clinical CVD (29% vs 9.8%) (p<0.001) (OR 3.78; 95% CI 2.49 to 5.73) and TPT >0.4 cm (67% vs 33%) (p<0.001) (OR 4.07; 95% CI 2.88 to 5.76) than the rest. The MTHFR TT genotype was not associated with homocysteine higher than 12.0 μmol/L in the population as a whole. However, it was associated with homocysteine higher than 12.0 μmol/L in those who had a plasma folate less than 8 μmol/L (OR 1.86; 95% CI 1.07 to 3.24). After correcting for age, gender, smoking and hypertension in a logistic regression analysis the results remained significant (OR 1.25; 95% CI 1.00 to 1.57) (p=0.05). Homocysteine is an independent risk factor for early atherosclerosis. MTHFR 677TT homozygotes with low serum folate have high serum homocysteine. These findings should be used for risk stratification in future randomized intervention trials.
17
RECENT CHANGES OF RISK FACTORS OF CHD IN THE CZECH POPULATION
R. Poledne 1 , J. Valek 1 , Z. Skodova 2 , R. Cifkova 2 , P. Stavek 1 , D. Grafnetter 1 . 1 Laboratory for Atherosclerosis Research, IKEM, Prague, Czech Republic; 2 Department of Preventive Cardiology, IKEM, Prague, Czech Republic CHD mortality in the Czech population has decreased substantially during last 20 years partly due to a 12% decrease in serum cholesterol. At the same time, BMI increased from 27 to 29. Method: two groups of consecutive MI survivors admitted to the same coronary care unit in 1983 (n=107) and 2000 (n=284) were studied and compared to controls selected from 1% representative sample of the Czech population (age and sex matched) studied either in 1985 (n=230) or 2000-2001 n=566. Results: the most discriminating risk factor when MI survivors and controls were compared in the 80’s was total cholesterol (6.78 in patients and 6.18 mmol/l in controls, p<0.001). MI survivors were slightly heavier (difference in BMI, p<0.05). On the contrary, total cholesterol did not differ between MI survivors (5.85 mmol/l) and controls (5.83) when both groups were compared in 2000. The most discriminating risk factor between MI survivors and controls at this time was waist circumference (patients 102.7 cm, controls 97.4, p<0.001). Conclusion: After recent changes in dietary habits leading to a decrease of cholesterol concentration in the whole population, on the one side, and the increase of BMI,on the other side, substantial changes in the risk factors for myocardial infarction were documented. The difference in the cholesterol concentration in MI patients found in the 80’s disappeared whereas central obesity as the most discriminating factor of these two groups was confirmed. Project supported by grant No. 1M0510 awarded through Ministry of Education, Youth and Sports. WO16-OR-6
Conclusion: Hyperlipidaemia has increased, especially amongst South Asians. The reduced decline in stroke prevalence and 30-day survival of stroke in South Asians in recent years warrants further investigation and highlights the importance of a targeted health care approach in this group.
SECULAR TRENDS IN THE CARDIOVASCULAR RISK PROFILE AND MORTALITY OF STROKE ADMISSIONS IN AN INNER CITY MULTI ETHNIC POPULATION
A. Gunarathne 1 , J.V. Patel 1 , R. Potluri 1 , P. Gill 1 , B. Gammon 2 , N.C. Panja 2 , E.A. Hughes 1 , G.Y.H. Lip 1 . 1 University Department of Medicine,City Hospital, Birmingham, UK; 2 Sandwell Medical Research Unit,Sandwell General Hospital, Birmingham, UK Background: The excess of CVD ethnic groups in the UK is a continuing healthcare and research focus. An understanding of secular trends in ethnic risk profiles and mortality of stroke therein are needed for targeted healthcare approaches. Methods: Case note and registry data of 3262 patients admitted in a UK inner-city Hospital Trust with a first-onset stroke were reviewed (1997-2005). Secular trends in CVD risk, admission rate and 30-day mortality were analysed. Results: Non-haemorrhagic stroke rates declined over the period (P<0.001) but with no ethnic variation. Hypertension and hyperlipidaemia were increasingly prevalent (Table 1) in all, but on comparison with other 76th Congress of the European Atherosclerosis Society, June 10–13, 2007, Helsinki, Finland