Magdalena Kwaśniewska
Publications
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3.08Impact points
Smoking status, the menopausal transition, and metabolic syndrome in women.
Menopause (New York, N.Y.). 02/2012; 19(2):194-201.
Data on the relationship between tobacco use and metabolic risk among women with regard to their menopause status are scarce. This study assessed the prevalence of metabolic disorders in relation to smoking status in premenopausal and postmenopausal women. A cross-sectional analysis of 7,462 randoml... [more] Data on the relationship between tobacco use and metabolic risk among women with regard to their menopause status are scarce. This study assessed the prevalence of metabolic disorders in relation to smoking status in premenopausal and postmenopausal women. A cross-sectional analysis of 7,462 randomly selected women aged 20 to 74 years who are participating in the WOBASZ (Polish National Multicentre Health Survey) was carried out. Lifestyle and menopause status details were collected via an interviewer-administered questionnaire. Weight, height, waist circumference, blood pressure, fasting plasma glucose, triglycerides, and high-density lipoprotein cholesterol (HDL-C) levels were measured by standard methods. Metabolic syndrome (MetS) was defined according to the International Diabetes Federation criteria. The prevalence of MetS was 3.3-fold higher among postmenopausal than premenopausal women. Regardless of menopause status, the prevalence of central obesity was significantly higher among never and past smokers versus current smokers (P < 0.001). Past smoking was associated with a significantly higher probability of elevated blood pressure, fasting plasma glucose, and MetS (P < 0.05). However, premenopausal never and past smokers had a substantially lower prevalence of decreased HDL-C than did current smokers. Among postmenopausal nonsmoking women, high levels of leisure time and commuting physical activity were associated with a reduced likelihood of MetS (P < 0.01). Making an additional adjustment for calorie consumption did not substantially influence the results. Except for HDL-C level, not smoking is associated with an unfavorable metabolic profile in women, regardless of menopause status. High level of physical activity may reduce the prevalence of MetS among never and past smokers after the menopausal transition.
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Awareness of cardiovascular prevention methods among residents of post-communist Polish provinces with highest mortality rates.
Central European journal of public health. 12/2011; 19(4):183-9.
The aim of the study was to estimate the awareness of healthy lifestyle behaviours in cardiovascular diseases (CVD) prevention and to find out possible determinants of this knowledge among adult residents of Polish provinces with the highest CVD mortality rates. A cross-sectional analysis of randoml... [more] The aim of the study was to estimate the awareness of healthy lifestyle behaviours in cardiovascular diseases (CVD) prevention and to find out possible determinants of this knowledge among adult residents of Polish provinces with the highest CVD mortality rates. A cross-sectional analysis of randomly selected representative sample of 2,211 (51.9% women) aged 20-74 years from Łódź and Lublin voivodeships participating in the National Polish Health Survey WOBASZ. Knowledge on CVD prevention, sociodemographic and lifestyle characteristics were collected by an interviewer-administered questionnaire. Blood pressure, anthropometrics, plasma lipids and glucose were measured according to the WHO MONICA protocol. Approximately 68% of participants, had poor awareness of preventive methods and majority of them were not able to name any specific approach. Most often mentioned method of CVD prevention was relaxing/avoiding stress (51.2%). The least known healthy behaviour was a reduction of salt intake and adequate fruit/vegetables consumption, mentioned by 18.2% and 23%, respectively. About 16.4% of women and 23% of men with risk factors of CVD were not aware of any non-pharmacological preventive method. Poor knowledge of CVD prevention was significantly more prevalent among persons aged > or = 65 years, with elementary education level, lower income, living in the rural settings, declaring poor self-rated health. Dietary and physical activity advice given by a primary care physician was significantly related to better knowledge among men with CVD risk factors. There is a need to focus on increasing educational level in this regions, especially in rural settings. Due to important role of primary care physicians in health education, more attention should be paid to individuals with CVD risk factors as their preventive knowledge level is very low and comparable to the level of low-risk individuals.
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[Physical activity and subclinical coronary atherosclerosis in asymptomatic middle-aged men].
Przegla̧d lekarski. 01/2011; 68(9):571-5.
Few studies have examined the effect of physical activity (PA) on subclinical atherosclerosis. Those that have been conducted were not based on longitudinal observation of lifestyle and objective measures of cardiorespiratory fitness. The aim of the study was to assess the influence of PA level on s... [more] Few studies have examined the effect of physical activity (PA) on subclinical atherosclerosis. Those that have been conducted were not based on longitudinal observation of lifestyle and objective measures of cardiorespiratory fitness. The aim of the study was to assess the influence of PA level on subclinical atherosclerosis in a long-term prospective observation (mean 17.9 +/- 4.21 years) of asymptomatic middle aged-men. We studied 27 men with stable high PA level (mean age 57.1 +/- 6.6 years) and 27 pair matched controls with sedentary lifestyle (mean age 56.1 +/- 6.6 years). PA level was assessed by detailed questionnaire based on the CINDI Health Monitor Questionnaire. Objective measurements of aerobic capacity was evaluated by exercise tests. Subclinical atherosclerosis was measured by assessing coronary calcification score (CCS) according to Agatston's method by means of the multi-slice computed tomography. Mean CCS was significantly lower among highly active men than among sedentary controls (28.3 +/- 70.6 vs 211.4 +/- 344.9; respectively, p<0.02). Active men had also more often CCS=0 (15 vs 7 persons). Not even one case of advanced calcification (CCS > 400) was noted among active men. Additional analysis of the active men group revealed that persons with CCS=0 had significantly higher energy expenditure, PA volume and better aerobic capacity as compared to other active men, but with CCS>0. Long-term high PA may be associated with a lower risk of developing subclinical atherosclerosis in asymptomatic middle-aged men.
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3.17Impact points
Commuting physical activity and prevalence of metabolic disorders in Poland.
Preventive medicine. 12/2010; 51(6):482-7.
The aim of this study was to examine the relationship between walking or cycling to work and prevalence of metabolic syndrome (MetS) and its components. Cross-sectional analysis of 6401 randomly selected individuals (3297 men and 3104 women) aged 20-74 years, who participated in the National Multice... [more] The aim of this study was to examine the relationship between walking or cycling to work and prevalence of metabolic syndrome (MetS) and its components. Cross-sectional analysis of 6401 randomly selected individuals (3297 men and 3104 women) aged 20-74 years, who participated in the National Multicentre Health Survey WOBASZ, Poland (2002-2005). Commuting physical activity (PA) was assessed by asking about type and time spent on transportation to/from work using an interviewer-administered questionnaire. Weight, height, waist circumference (WC), blood pressure (BP), fasting plasma glucose (FPG), triglycerides (TG) and high-density cholesterol, (HDL-C) were measured by standard methods. MetS was defined according to the NCEP-ATP III and IDF criteria. Active commuting was associated with decreased likelihood of abdominal obesity (WC≥94 cm), lower HDL-C and elevated TG in men and abdominal obesity (WC≥80 cm) in women. In a subgroup of postmenopausal women (n=317) active commuting was favourably associated with abdominal obesity, low HDL-C and elevated FPG. Prevalence of MetS was significantly lower among those who spent above 30 min/day daily on walking/cycling to work than among other gender subgroups. Increasing of commuting PA level may have an important influence on reducing the prevalence of metabolic disorders.
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Effective protection from exposure to environmental tobacco smoke in Poland: The World Health Organization perspective.
International journal of occupational medicine and environmental health. 01/2010; 23(2):123-31.
Tobacco is the single greatest preventable cause of death in the world today, killing approximately half of the people who use it. Several strategies have been proved to reduce tobacco use. However, more than 50 years after the health effects of smoking were scientifically proven, and more than 20 y... [more] Tobacco is the single greatest preventable cause of death in the world today, killing approximately half of the people who use it. Several strategies have been proved to reduce tobacco use. However, more than 50 years after the health effects of smoking were scientifically proven, and more than 20 years after evidence confirmed the hazards from exposure to second-hand smoke, few countries have implemented effective and recognized strategies to control the tobacco epidemic. This paper summarizes the World Health Organization recommendations for effective protection from exposure to environmental tobacco smoke along with the existing tobacco control programs and legislation in force in Poland.
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Healthy behaviours, lifestyle patterns and sociodemographic determinants of the metabolic syndrome.
Central European journal of public health. 04/2009; 17(1):14-9.
AIM: The aim of this study was to examine the influence of healthy behaviours, lifestyle patterns and sociodemographic factors on risk of the metabolic syndrome (MS) in adult residents of rural, small town and large urban areas in Poland. MATERIAL AND METHODS: Cross-sectional analysis of randomly se... [more] AIM: The aim of this study was to examine the influence of healthy behaviours, lifestyle patterns and sociodemographic factors on risk of the metabolic syndrome (MS) in adult residents of rural, small town and large urban areas in Poland. MATERIAL AND METHODS: Cross-sectional analysis of randomly selected representative sample of 1,187 men and women aged 20-74 years participating in the nationwide health survey WOBASZ. Metabolic syndrome was defined by AHA/NCEP criteria (2005). Analysed healthy behaviours included nonsmoking, healthy weight, adequate fruits and vegetables consumption, regular leisure-time physical activity. The 4 lifestyle factors were summed to create a lifestyle index (range 0-4). RESULTS: Regardless of gender healthy weight, adequate fruits and vegetables consumption and physical activity were associated with lower odds of MS. Non-smoking was significantly related to the lower odds ratio of MS only among men. Following all 4 lifestyle factors was the strongest protective factor against having MS. Being higher educated, in the 20- 34-years-old cohort, living in the rural area were the most important sociodemographic factors reducing risk of MS. CONCLUSIONS: The obtained results support the need for effective promotion of healthy behaviors and lifestyle patterns, especially in demonstrated high-risk sub-populations. Due to important differences in metabolic risk between various sociodemographic groups, health promotion interventions should be specific in respect to the targeted subpopulations.
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[Arterial hypertension as a medical and social problem in the older urban population. The CINDI WHO Program study]
Przegla̧d lekarski. 02/2008; 65(12):838-43.
Increasing lifespan and progressive aging of the Polish population results in rising demands on health care. Chronic diseases with a leading position of arterial hypertension (HA) prevail in morbidity rates of adult seniors. The aim of the study is to characterize hypertension in the elderly with re... [more] Increasing lifespan and progressive aging of the Polish population results in rising demands on health care. Chronic diseases with a leading position of arterial hypertension (HA) prevail in morbidity rates of adult seniors. The aim of the study is to characterize hypertension in the elderly with regard to other risk factors, complications and therapeutic control. The study was carried out in 2002 within the framework of the CINDI WHO Programme. A total of 1460 persons were randomly selected among residents of Lodz aged > or = 65 years. The response rate was 57%. All participants underwent questionnaire interview, two blood pressure (BP) measurements, anthropometric and physical examination, ECG and laboratory tests. After final verification, we analysed data collected from 828 persons (289 men and 539 women). Mean values of systolic and diastolic BP were 147.6 and 83.6 mmHg, respectively. The increase of systolic BP with age of studied seniors was observed. Hypertension was diagnosed in 669 persons (79% men, 82% women). In most cases there were systolic-diastolic or isolated systolic hypertension. About 60% of seniors with elevated BP declared suffering from HA, while 73% were under antihypertensive treatment. Normalization of BP (< 140/ 90 mmHg) was achieved in 28% of treated patients. Most often prescribed medications were: ACE-inhibitors (51%), beta-blockers (40%), calcium channel blockers (31%) and diuretics (30%). Mean values of plasma lipids and prevalence of lipid disorders were comparable in hypertensive and normotensive persons. Among patients with HA there were significantly smaller percentage of smokers (8.6% vs 18.7%, p < 0.05). The prevalence of obesity, visceral obesity and metabolic syndrome was higher in hypertensive seniors. As a result, incidents of myocardial infarction and morbidity due to coronary artery disease were twice as cantly more often hospitalised and visited family doctors (7 vs 4.6 visits/year) in comparison to normotensive subjects.
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[Risk factors for smoking among the adult population--results of WOBASZ study in Lódź district].
Medycyna pracy. 01/2008; 59(2):143-8.
Nowadays, tobacco smoking is the single most preventable cause of death all over the word. Now it kills annually more than five million people and this number will increase to over 8 million by 2030. The aim of this study was to assess the prevalence of smoking and risk factors for smoking in the ad... [more] Nowadays, tobacco smoking is the single most preventable cause of death all over the word. Now it kills annually more than five million people and this number will increase to over 8 million by 2030. The aim of this study was to assess the prevalence of smoking and risk factors for smoking in the adult population of the Lódź district. We included into the study a representative group of the adult population (1037 people) living in this district. The sampling and all study procedures were based on the methods for Multi-Center Representative Nationwide Study--WOBASZ. A questionnaire was employed to determine the smoking status. Logistic regression models were applied to assess the factors related to the smoking habit. In the study population, 40.8% of men and 19.5% of women were active smokers. The following factors were associated with the smoking status: lower educational level (OR = 3.1; 95% CI: 1.4-6.8) and lower level of income (OR = 2.4; 95% CI: 1.2-4.9) in men, and marital status--widow (OR = 3.3, 95% CI: 1.4-7.5) in women. People living in small districts showed a higher risk for smoking than those living in larger urban areas (men, OR = 2.1; 95% CI: 1.3-3.6; women, OR = 2.8, 95% CI: 1.5-5.2) Older persons smoke less frequently than younger ones (men, OR = 0.3; 95% CI: 0.1-0.8; women, OR = 0.1; 95% CI: 0.02-0.5). The lower levels of education and income, as well as living in small districts are the risk factors for cigarette smoking.
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[Prevalence of healthy lifestyle in adult residents of Lódź and Lublin voivodeships--project WOBASZ]
Przegla̧d lekarski. 02/2007; 64(2):61-4.
BACKGROUND: Recent epidemiologic studies have provided clear evidence of the substantial health benefits of following a healthy lifestyle. The objective of this study was to assess the prevalence of healthy lifestyle behaviors in the representative sample of adult inhabitants of two Polish counties ... [more] BACKGROUND: Recent epidemiologic studies have provided clear evidence of the substantial health benefits of following a healthy lifestyle. The objective of this study was to assess the prevalence of healthy lifestyle behaviors in the representative sample of adult inhabitants of two Polish counties (Lodz and Lublin voivodships). METHODS: We analyzed data from 1237 randomly selected persons (645 women, 592 men) aged 20-74 years participating in the National Health Survey in Poland - Project WOBASZ. The following 4 healthy lifestyle behaviors were analyzed: nonsmoking, healthy weight, adequate consumption of fruit and vegetables, and regular physical activity. The 4 behaviors were summed to create a lifestyle index (range 0-4), and following all 4 behaviors were defined as a healthy lifestyle index. RESULTS: The prevalence of the individual health behaviors was as follows: nonsmoking--67%, healthy weight--43%, fruit and vegetables consumption--58%, and regular physical activity--35% of the studied population. The overall prevalence of the healthy lifestyle index (following all 4 behaviors) was 5.4% while in 3.8% the index was 0, in 25.6% was 1, and in 38.2% and 26.9% was 2 and 3, respectively. The prevalence of healthy lifestyle was significantly higher in women, younger, better educated, living in the country and small towns, with higher subjective health state. CONCLUSIONS: Extremely low prevalence of adults following 4 common modifiable healthy behaviors supports the need for more intensive and comprehensive primary prevention activities with special attention paid to significant differences in everyday lifestyle between various sociodemographic groups.
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Lifestyle index and self-rated health status.
International journal of occupational medicine and environmental health. 01/2007; 20(4):349-56.
The aim of the study was to analyze the influence of selected lifestyle factors on self-rated health status in working age population. The study population derived from the national Polish representative WOBASZ study. The sample consisted of 1222 randomly selected residents of two Polish districts, ... [more] The aim of the study was to analyze the influence of selected lifestyle factors on self-rated health status in working age population. The study population derived from the national Polish representative WOBASZ study. The sample consisted of 1222 randomly selected residents of two Polish districts, aged 20-64 years (52.3% women and 47.7% men). We analyzed four health-related behaviors as lifestyle factors that made up the lifestyle index: non-smoking, adequate fruit and vegetable intake, healthy weight, and sufficient physical activity. Logistic regression was used to estimate odds ratios and 95% confidence intervals to investigate the impact of lifestyle on self-rated health. The findings revealed that 4.2, 17.6, 37 and 35.2% of women and 6.4, 19.9, 36.5 and 34.1% of men had the lifestyle index score of 0, 1, 2, 3 points, respectively. Only 6.1% of women and 3.1% of men met all the four criteria of a healthy lifestyle (score 4). Self-rated health was regarded as poor/fair, good or very good by 39.1, 54.3, 6.6% of women and 31.6, 60.7, 7.7% of men, respectively. Poor/fair self-rated health was strongly associated with obesity both in the male and female population. Among men with the lifestyle index score of 0 points, the risk of poor/fair self-rated health was 3.5 times as high (OR = 3.52; 95% CI: 1.36-9.12) as in men with the index score of 4. For women with the scores of 3, 2, 1, and 0, the risk of poor/fair self-rated health was nearly three (OR = 2.89; 95% CI: 1.5-5.56), four (OR = 3.61; 95% CI: 1.88-6.93), six (OR = 5.93; 95% CI: 2.88-12.21) and seven times (OR = 6.67; 95% CI: 1.97-22.51) as high as for those with the lifestyle index score of 4. There is a need for implementing more effective health promotion interventions in the society, with special regard to weight reduction programs.
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[Nutrition and physical activity in prevention of prostate cancer]
Przegla̧d lekarski. 02/2005; 62(8):821-4.
Prostate cancer is one of the most common cancers among Polish men. The precise causes of prostate cancer remain unclear. Apart from age, ethnic origin and genetic factors, also diet and physical activity level seem to be important. This paper presents actual opinions on the role of nutrition and ph... [more] Prostate cancer is one of the most common cancers among Polish men. The precise causes of prostate cancer remain unclear. Apart from age, ethnic origin and genetic factors, also diet and physical activity level seem to be important. This paper presents actual opinions on the role of nutrition and physical activity in the primary prevention of prostate cancer. According to scientific investigation lifestyle modification may be a promising strategy in prostate cancer prevention. However, the present evidence for elaborating clear recommendations is still insufficient.
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[Quality of life in patients with risk factors of coronary heart disease]
Przegla̧d lekarski. 02/2005; 62(9):863-70.
AIM: The objective of the study was to assess the subjective health state and selected parameters of health-related quality of life (QL) in subjects with risk factors of coronary heart disease (CHD). Demographic and clinical variables were analyzed in order to determine factors influencing an indivi... [more] AIM: The objective of the study was to assess the subjective health state and selected parameters of health-related quality of life (QL) in subjects with risk factors of coronary heart disease (CHD). Demographic and clinical variables were analyzed in order to determine factors influencing an individual's satisfaction. MATERIAL AND METHODS: The study enrolled a total of 541 persons (278 women and 263 men; mean age 52 +/- 16.5 years). All the participants were divided into four groups i.e. healthy subjects, persons with one risk factor (hypertension), persons with three risk factors (hypertension, smoking, hypercholesterolemia) and patients with CHD. Quality of life assessment was carried out by means of the international, standardized general questionnaire analyzing mobility, self-care, usual activities, pain, anxiety/depression (five questions, each with three levels) and subjective health state (visual analogue score, VAS). RESULTS: Persons without any of the analyzed risk factors scored significantly higher within all studied dimensions of QL and VAS. The lowest level of satisfaction was noticed in patient with CHD, especially after myocardial infarction. Patients with untreated hypertension, smoking, hypercholesterolemia, obesity and sedentary lifestyle reported significantly higher degree of disability than persons with well controlled hypertension, free of smoking habit, with no lipid disorders, slim and with at least moderate physical activity level. Among all analyzed risk factors the strongest correlation was found for untreated hypertension and sedentary lifestyle. In healthy subjects demographic variables, as age, sex, marital status, education and employment were the most important determinants of quality of life. The rates of reported problems increased significantly with age, women tended to score lower than men. Pain or discomfort was the most frequent disorder in healthy persons while anxiety or depression and pain in patients with risk factors and coronary heart disease. CONCLUSION: Patients with risk factors of coronary heart disease, as hypertension, smoking, hypercholesterolemia, obesity and sedentary lifestyle clearly reported high degree of disability and poor subjective health state. Prevention and treatment should focus especially on effective control of hypertension and promoting physical activity as the strongest determinants of quality of life.
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[Physical activity volume as a key factor influencing obesity and metabolic syndrome prevalence in middle-aged men. Long-term prospective study]
Przegla̧d lekarski. 01/2005; 62 Suppl 3:8-13.
There are only few studies analyzing longitudinal effects of regular physical activity on the prevalence of obesity and other characteristics of metabolic syndrome. The aim of the study was to assess the effect of various training programs on the prevalence of obesity and metabolic syndrome in middl... [more] There are only few studies analyzing longitudinal effects of regular physical activity on the prevalence of obesity and other characteristics of metabolic syndrome. The aim of the study was to assess the effect of various training programs on the prevalence of obesity and metabolic syndrome in middle-aged men. Long-term effects of training (mean 17.5 years) have been compared in 305 men aged 30-59 years (mean 41.8) divided into three groups: sedentary (S) individuals (LTPA <1000 kcal/week), group with moderate (M) LTPA (LTPA between 1000-2000 kcal/week) and highly (H) active group (LTPA > 2000 kcal/week). We analyzed also aerobic capacity influence on anthropometric and metabolic data. Mean values of body weight, BMI and body fat increased in all groups, however the values in H group are much more favorable as compared with sedentary and moderately active individuals. At final examination we diagnosed obesity (BMI > or = 30.0 kg/m2) in 23.3% sedentary men, 20.0% of moderate activity and 12% of highly active group. Frequency of obesity increased above twofold in sedentary individuals (10.8 vs 23.3%). Consequently only H group was able to maintain BMI value about 25.0 and to increase significantly HDL (51.7 vs. 56.6 mg/dl) in the follow-up. Metabolic syndrome as defined by ATP III has been diagnosed in 26.6% of sedentary, 23.1% of moderate and only 8.4% of highly active middle-aged men. CONCLUSIONS: the prevalence of obesity and metabolic syndrome development in middle-aged men depends on leisure time physical activity volume and aerobic capacity. Training with exercise expenditure > 2000 kcal/week which results in maintenance of good aerobic capacity level is a strong protective factor in development of obesity and metabolic syndrome in middle-aged men.
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[Body weight change and health outcomes in middle-aged men--a prospective study results]
Przegla̧d lekarski. 01/2005; 62 Suppl 3:18-22.
In recent years more attention is paid to the role of body weight change and cardiovascular disease risk. The aim of the study was to evaluate correlation between body weight change and risk of ischaemic heart disease (IHD) and selected cardiovascular disease risk in middle-aged male during long-ter... [more] In recent years more attention is paid to the role of body weight change and cardiovascular disease risk. The aim of the study was to evaluate correlation between body weight change and risk of ischaemic heart disease (IHD) and selected cardiovascular disease risk in middle-aged male during long-term surveillance. The study was conducted among group of healthy male volunteers (n=189) aged 30-49 years at baseline. Prevalence of disease due to cardiovascular causes was ascertained in study participants during an average follow-up of 17.7 +/- 4.4 years. Changes in weight were classified in three categories: stable weight (+/- 5 kg), weight gain (>5 kg) or weight loss (>5 kg). Logistic regression analysis was performed to study the correlation between weight change and Relative Risk (RR) of cardiovascular disease in the examined subjects. All analyses were adjusted for age, smoking and level of leisure-time physical activity. In this study 48.4% men maintained weight, 5.9% lowered weight and 45.7% gained weight. Ischaemic heart disease was diagnosed in 12.2% of men, including non fatal myocardial infarction in 5.3%, hypertension in 40.7%, and hyperchoesterolaemia in 62.4%, respectively. Among participants with weight gain of more than 5 kg total cardiovascular disease risk was 4 times higher (adjusted RR=4.07, 95% CI, 1.33-12.44), ischaemic heart disease 3 times higher (adjusted RR=3.27, 95% CI, 1.17-9.17), and hypercholesterolaemia 2 times higher (adjusted RR=2.15, 95% CI, 1.09-4.24) in comparison with those with stable weight. This study results suggests that maintaining stable weight during adulthood can be effective strategy for lowering cardiovascular disease risk.
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0.57Impact points
Effects of social intervention on detection and efficacy of treatment for arterial hypertension. Main results of the Polish Four Cities Programme.
Kardiologia polska. 01/2005; 61(12):546-58; discussion 559-60.
BACKGROUND: Cardiovascular diseases are the main cause of death in the adult Polish population. Beside lipid disorders and cigarette smoking, hypertension represents the most important risk factor leading to cardiovascular complications. Representative studies conducted in Poland in 1994-2002 showed... [more] BACKGROUND: Cardiovascular diseases are the main cause of death in the adult Polish population. Beside lipid disorders and cigarette smoking, hypertension represents the most important risk factor leading to cardiovascular complications. Representative studies conducted in Poland in 1994-2002 showed that in 2002 the number of respondents in the survey who stated they knew their own blood pressure values dropped by 3.5 million, compared with 1994. This decrease was predominantly seen in small towns and in the countryside. Preventive programmes should therefore be addressed mainly to the most vulnerable communities. Modern methods of social marketing may play a substantial role in the creation of a healthy lifestyle. AIM: The aim of the Polish Four Cities Programme (PP4M), conducted in 2000-2001, was to develop the most effective methods of detection of and improvement in treatment for hypertension among the residents of small towns and rural areas. One of the programme tasks was to compare the effectiveness of a standard medical screening intervention with a similar approach combined with the use of social marketing methods.Methods. The programme was conducted by an interdisciplinary team in three small Polish towns -- Kartuzy, Oborniki Wlkp. and Braniewo, as well as in one of the districts of a large city Łódź -- Olechów. Medical intervention combined with social marketing (community intervention) took place in Oborniki Wlkp. whereas the residents of Kartuzy and Łódź were subjected only to the traditional medical intervention. Braniewo served as a control location -- neither medical nor community intervention was implemented. Community intervention with elements of social marketing consisted of a three-month, intensive education and information campaign, initiated four weeks prior to the start of medical intervention. Epidemiological situation was assessed in all the four cities before and after the completion of the preventive interventions (screening), using representative surveys, with the objective to assess the changes in the awareness of one's own blood pressure values, detection of hypertension and knowledge concerning cardiovascular risk factors.Results. In two survey locations -- Kartuzy and Łódź - awareness of one's own blood pressure values after the medical intervention did not significantly change (61% and 67.6% at baseline versus 62.1% and 71.6% after the intervention, respectively). In contrast, social marketing activities conducted in Oborniki significantly increased this parameter from 61.5% to 79.8% (p<0.01). While medical intervention did not change the proportion of non-diagnosed hypertension in a small town (a non-significant decrease from 49% to 45% in Kartuzy), its effect in a large city was clearly visible (a decrease from 46% to 28% in Łódź). In Oborniki Wlkp. (medical intervention combined with social marketing) the effects were the most noticeable -- a reduction from 50% to 27% was achieved. The efficacy of hypertension treatment at baseline was low (4.7% in Kartuzy, 6.6% in Oborniki, and 6.5% in Łódź), but it then improved significantly (a twofold increase in Kartuzy and Oborniki, and more than twofold increase in Łódź). When the target value of blood pressure was set at 160/95 mmHg, the highest efficacy of hypotensive therapy was observed directly after the completion of medical and community intervention in Oborniki (an almost twofold increase in treatment efficacy). CONCLUSIONS: 1. Medical intervention combined with a community intervention and marketing campaign leads to a statistically significant improvement in self-awareness of blood pressure values among residents of small towns. 2. Medical intervention combined with community intervention brings the detection rate of hypertension in small towns up to the level observed in large cities. 3. Medical intervention, especially when combined with community intervention, improves the efficacy of the treatment of hypertension, regardless of the size of agglomeration.
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0.57Impact points
[Prevalence of hypertension and effectiveness of its treatment in adult residents of our country. Results of the WOBASZ program].
Kardiologia polska. 01/2005; 63(6 Suppl 4):S614-9.
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0.57Impact points
[Evaluation of physical activity levels in the adult population of Poland. Results of the WOBASZ program].
Kardiologia polska. 01/2005; 63(6 Suppl 4):S636-40.
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0.57Impact points
[The value of a nutritious and energetic diet for adult inhabitants of Poland. Results of the WOBASZ program].
Kardiologia polska. 01/2005; 63(6 Suppl 4):S663-9.
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0.57Impact points
[Intake of consumed products by adults in the Polish population. Results of the WOBASZ program].
Kardiologia polska. 01/2005; 63(6 Suppl 4):S670-6.
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[Life style modification in lung cancer prevention]
Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 01/2004; 15(90):559-62.
According to the recent data tobacco use increases the mortality rates due to cancers by about 30-40%. Active smoking is responsible for approximately 80% incidents of lung cancer while passive smoking attributes to 20-60% increase in lung cancer morbidity. However, in Poland as well as in other Eur... [more] According to the recent data tobacco use increases the mortality rates due to cancers by about 30-40%. Active smoking is responsible for approximately 80% incidents of lung cancer while passive smoking attributes to 20-60% increase in lung cancer morbidity. However, in Poland as well as in other European countries a certain decline in the number of new incidents and death rates due to lung cancer has been observed. These positive changes seem to reflect a decrease in prevalence of tobacco use in the industrialized world. It is also well documented that lung cancer can be avoidable by the means of appropriate diet and physical activity level.
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