[Epidemiology and prevention of cardiovascular diseases after 1989]

During the past 30 years the geographical distribution of cardiovascular diseases in Europe has substantially changed. The highest rates that were reported in the mid sixties in Finland occurred in 1990/91 occurred in central and eastern Europe. The reasons for such different development of cardiovascular mortality have not been explained yet. The epidemy of cardiovascular diseases in post-socialist countries may be only partially associated with high prevalence of the three classical risk factors (hypercholesterolemia, smoking, hypertension). Presumably other, yet unrecognized risk factors have potentiated the classical ones (psychosocial stress, specific nutritional deficiencies). A decrease in mortality from cardiovascular diseases can be attributed to improvements in care of patients with cardiovascular diseases, mainly with coronary heart disease including AMI, with favourable effects on survival and to a decline in risk factors prevalence or to a combination of both. Similar detailed information for Slovakia is lacking. Therefore it is difficult to predict the future incidence of cardiovascular diseases and AMI in Slovakia. The authors in the review article focused on some epidemiological and preventive aspects of cardiovascular diseases and their implementation at present. In order to achieve a reversal of the unfavourable trend of cardiovascular mortality it is insufficient only to answer the basic questions, as e.g., what was the reason for such differing trends in disease rates and mortality from cardiovascular diseases in our country (and in post-socialist countries of central and eastern Europe) and e.g. in Finland or in the U.S.A., where cardiovascular mortality decreased almost by half. For the appropriate formulation of prevention measures with a focus on cardiovascular diseases, detailed analysis of the current specific situation in our country is also necessary.