Prevention of Chronic Non-Communicable Diseases: Quo Vadis? A New Example from Zagreb

Središnji događaj obilježavanja Svjetskog dana srca 2015. godine u Republici Hrvatskoj bila je otvorena javnozdravstvena akcija probira vodećih čimbenika kardiovaskularnog rizika u Zagrebu. Osobe s izrazito visokom učestalosti čimbenika rizika uključene su u javnozdravstveni program „Čuvari srca“ u kojemu se procjenjivao kardiovaskularni rizik i izdavane su preporuke za očuvanje zdravlja. Cilj je ovog rada izvijestiti o rezultatima te utvrditi važnost detekcije pojedinih čimbenika rizika u osoba s visokim kardiovaskularnim rizikom. Sudionici su samonicijativno, nakon najava u medijima, pristupili besplatnoj detekciji čimbenika kardiovaskularnog rizika pri javnom okupljanja. Prema nahođenju zainteresiranih osoba zdravstveni su djelatnici određivali indeks tjelesne mase (ITM), mjerili vrijednosti arterijskoga tlaka (AT) te određivali glukozu i ukupni kolesterol iz kapilarne krvi. Prvih 100 sudionika akcije s izrazito visokom učestalosti pojedinih čimbenika rizika dobilo je pozivnicu za detaljnu evaluaciju i procjenu kardiovaskularnog rizika u Poliklinici za prevenciju kardiovaskularnih bolesti i rehabilitaciju u Zagrebu. Zasebno su prikazani rezultati obiju akcija. Otvorenoj javnozdravstvenoj akciji probira čimbenika kardiovaskularnog rizika odazvalo se 308 sudionika, i to 59,7 % žena i 40,3 % muškaraca. Prosječna dob sudionika iznosila je 68,8 ± 13,2 godine. Povišen AT (92,5 %) i povišen ITM (46,5 % prekomjerna tjelesna težina; 25,7 % pretilost) najčešći su čimbenici rizika. Izrazito povišena vrijednost ukupnog kolesterola registrirana je u 11,8 %, a izrazito povišena vrijednost glukoze u kapilarnoj krvi u 4,1 % sudionika. Od 100 pozvanih sudionika za akciju procjene kardiovaskularnog rizika odazvalo se njih 77 %, i to 75,3 % žena i 24,7 % muškaraca. Povišene vrijednosti AT-a imalo je njih 90,9 %, dislipidemiju 85,7 %, povećan opseg struka registriran je u 84,4 % sudionika, a njih 78,9 % imalo je povišen ITM. Dodatno smo analizirali rezultate 30 sudionika s otprije poznatom arterijskom hipertenzijom i dislipidemijom i utvrdili su kod njih prisutni čimbenici rizika povišen ITM (80,0 %), povišen opseg struka (76,7 %), povišene vrijednosti urata (23,3 %), C-reaktivnog proteina (16,7 %), kreatinina (10,0 %) i glukoze u krvi (10,0 %). Zaključno, kod sudionika javnozdravstvene akcije najčešći su čimbenici rizika arterijska hipertenzija i povišen ITM. U sudionika s otprije poznatom arterijskom hipertenzijom i dislipidemijom uočili smo blag pristup kako glede neliječenja tih bolesti, tako i što se tiče korekcije nezdravih životnog navika i suboptimalnog medikamentnog liječenja.The central event of the World Heart Day 2015 in Croatia was an open public-health initiative screening for leading cardiovascular risk factors in the city of Zagreb. Individuals with very high risk factor prevalence were accepted into the “Guardians of the Heart” program that assessed cardiovascular risk and offered advice on health. The goal of this article is to report on these results and demonstrate the significance of detecting specific risk factors in individuals with high cardiovascular risk. After an announcement in the media, participants voluntarily applied for free assessment of cardiovascular risk factors during the public event. For interested citizens, health professionals determined the body-mass index (BMI), measured blood pressure (BP), and determined glucose levels and total cholesterol from capillary blood. The first 100 participants with extremely high prevalence of individual risk factors were invited to further detailed evaluation and cardiovascular risk assessment at the Institute for Cardiovascular Prevention and Rehabilitation in Zagreb. The results of both actions are presented here. The open public-health action was attended by 308 participants, of whom 59.7% were women and 40.3% men. The average age was 68.8±13.2 years of age. Elevated BP (92.5%) and BMI (46.5% overweight, 25.7% obese) were the most common risk factors. Highly elevated total cholesterol levels were registered in 11.8% participants, and highly elevated glucose levels in the capillary blood in 4.1%. Of the 100participants invited to detailed cardiovascular risk assessment, 77% responded, of whom 75.2% were women and 24.7% men. Increased BP levels were found in 90.9% of these respondents; dyslipidemia in 85.7%, increased waist size in 84.4%, and 78.9% had elevated BMI. We performed an additional analysis on the results of 30 participants with existing hypertension and dyslipidemia and found elevated risk factors, including elevated BMI (80.0%), waist size (76.7%), urate levels (23.3%), C-reactive protein (16.7%), creatinine (10.0%), and blood glucose levels (10.0%). The most common risk factors in the participants of this public-health action were arterial hypertension and increased BMI. In participants with existing hypertension and dyslipidemia we noted a dismissive approach to these risk factors, both in the sense of non-treatment