[Longitudinal trends in major cardiovascular disease risk factors in the Czech population]

Cardiovascular disease (CVD) is the main cause of death in the Czech Republic. The decline in CVD mortality observed in our country since 1985 may be due to a decrease in its incidence or case fatality. Case fatality is mostly related to the standard of health care whereas the incidence of CVD is associated with the risk profile of the population. The aim of this study is to monitor longitudinal trends in major CVD risk factors in the Czech population. Assessment of longitudinal trends in the population risk profile may help in analyzing the trends in CVD morbidity and mortality.

In the years 1985, 1988, 1992, 1997/98 and 2000/01, five independent cross-sectional surveys of CVD risk factors were conducted in a 1% population random sample, aged 25-64 years, selected from six districts of the Czech Republic (with a total of 5,736 males and 6,027 females examined). Over the study period of 15/16 years, there is a significant increase in BMI in males (from 27.0 +/- 4.0 to 28.1 +/- 4.4 kg/m2, p < 0.001) while the changes in BMI in females are of borderline significance. The proportion of male smokers is decreasing (from 49.2% to 37.8%, p < 0.001) whereas there is no change in the prevalence of smoking in the female population. Mean systolic and diastolic blood pressure as well as the prevalence of hypertension are decreasing in both sexes since 1985 (from 51.9% to 45.6% in males, p < 0.001; from 42.5% to 33.0% in females, p < 0.001). There is an increase in awareness of hypertension (from 41.4% to 62.1% in males, p < 0.001; from 58.9% to 73.8% in females, p < 0.001). The proportion of individuals treated by antihypertensive drugs is increasing (from 21.1% to 41.8%, p < 0.001 in males; from 38.9% to 59.1% in females, p < 0.001). Hypertension control has improved in either sex (males: from 2.8% to 13.1%, p < 0.001; females: from 5.2% to 22.2%, p < 0.001). Over the study period, there is a clear significant downward trend in total cholesterol levels in both sexes (males: from 6.21 +/- 1.29 to 5.88 +/- 1.08 mmol/l, p < 0.001; females: from 6.18 +/- 1.26 to 5.82 +/- 1.13 mmol/l, p < 0.001).

In a representative Czech population sample, a favorable trend in most major CVD risk factors was observed in the 1985-2000/01 period. This plays most likely a role in the decrease in CVD mortality.