High-risk profile in a region with extremely elevated cardiovascular mortality

Although mortality rates from cardiovascular diseases have shown a remarkable decline in many western countries, cardiovascular mortality in Lithuania has remained high. It is widely accepted that half of the decline in cardiovascular mortality can be attributed to favourable changes in modifiable risk factors.

In 2006, the Lithuanian High Cardiovascular Risk Programme was started. A two-level approach--primary health care institutions and specialised cardiovascular prevention units--was applied. The cardiovascular risk profile was evaluated for a group of 17,031 middle-aged subjects enrolled into the programme at a primary level and 2908 at a specialised level.

Among the persons examined, 61.8% (10,519) were female. Arterial hypertension was present in 60.2% of the subjects. Dyslipidaemia was present in 88.8%. Total cholesterol was 6.02 ± 1.23 mmol/L, LDL cholesterol 3.74 ± 1.09 mmol/L, HDL cholesterol 1.53 ± 0.52 mmol/L, and triglycerides 1.61 ± 1.27 mmol/L. Diabetes mellitus was found in 10.3%, abdominal obesity in 45.4%, and metabolic syndrome in 43.8% of cases. These values were even greater in high-risk subjects.

In middle-aged subjects the prevalence of dyslipidaemia, arterial hypertension, diabetes, and metabolic syndrome was found to be high. We can roughly state that almost nine out of ten middle-aged subjects in Lithuania have established dyslipidaemia, every second one has established arterial hypertension, and four out of ten are obese. Hence, these are the main risk factors that should be considered first of all in daily clinical practice.