Showing papers by "Renata Cifkova published in 2016"

A century of trends in adult human height

Abstract: Being taller is associated with enhanced longevity, and higher education and earnings. We reanalysed 1472 population-based studies, with measurement of height on more than 18.6 million participants to estimate mean height for people born between 1896 and 1996 in 200 countries. The largest gain in adult height over the past century has occurred in South Korean women and Iranian men, who became 20.2 cm (95% credible interval 17.5–22.7) and 16.5 cm (13.3–19.7) taller, respectively. In contrast, there was little change in adult height in some sub-Saharan African countries and in South Asia over the century of analysis. The tallest people over these 100 years are men born in the Netherlands in the last quarter of 20th century, whose average heights surpassed 182.5 cm, and the shortest were women born in Guatemala in 1896 (140.3 cm; 135.8–144.8). The height differential between the tallest and shortest populations was 19-20 cm a century ago, and has remained the same for women and increased for men a century later despite substantial changes in the ranking of countries.

EUROASPIRE IV: A European Society of Cardiology survey on the lifestyle, risk factor and therapeutic management of coronary patients from 24 European countries:

Abstract: AimsTo determine whether the Joint European Societies guidelines on cardiovascular prevention are being followed in everyday clinical practice of secondary prevention and to describe the lifestyle,...

ESHRE Guideline: management of women with premature ovarian insufficiency

Abstract: study question: What is the optimal management of women with premature ovarian insufficiency (POI) based on the best available evidence in the literature? summary answer: The guideline development group (GDG) formulated 99 recommendations answering 31 key questions on the diagnosis and treatment of women with POI. what is known already: NA. study design, size, duration: This guideline was produced by a multidisciplinary group of experts in the field using the methodology of the Manual for ESHRE Guideline Development, including a thorough systematic search of the literature, quality assessment of the included papers up to September 2014 and consensus within the guideline group on all recommendations. The GDG included a patient representative to ensure input from women with POI. After finalization of the draft, the European Society for Human Reproduction and Embryology (ESHRE) members and professional organizations were asked to review the guideline. participants/materials, setting, methods: NA. main results and the role of chance: The guideline provides 17 recommendations on diagnosis and assessment of POI and 46 recommendations on the different sequelae of POI and their consequences for monitoring and treatment. Furthermore, 24 recommendations were formulated on hormone replacement therapy in women with POI, and two on alternative and complementary treatment. A chapter on puberty induction resulted in five recommendations. limitations, reasons for caution: The main limitation of the guideline is that, due to the lack of data, many of the recommendations are based on expert opinion or indirect evidence from studies on post-menopausal women or women with Turner Syndrome. wider implications of the findings: Despite the limitations, the guideline group is confident that this document will be able to guide health care professionals in providing the best practice for managing women with POI given current evidence. Furthermore, the guideline grouphas formulated research recommendations on the gaps in knowledge identified in the literature searches, in an attempt to stimulate research on the key issues in POI.

Desphospho-uncarboxylated matrix Gla protein is associated with increased aortic stiffness in a general population.

Abstract: Matrix Gla protein (MGP), a natural inhibitor of calcification, strongly correlates with the extent of coronary calcification. Vitamin K is the essential cofactor for the activation of MGP. The nonphosphorylated-uncarboxylated isoform of MGP (dp-ucMGP) reflects the status of this vitamin. We investigated whether there is an association between dp-ucMGP and stiffness of elastic and muscular-type large arteries in a random sample from the general population. In a cross-sectional design, we analyzed 1087 subjects from the Czech post-MONICA study. Aortic and femoro-popliteal pulse wave velocities (PWVs) were measured using a Sphygmocor device. Dp-ucMGP concentrations were assessed in freshly frozen samples by enzyme-linked immunosorbent assay methods using the InaKtif MGP iSYS pre-commercial kit developed by IDS and VitaK. Aortic PWV significantly (P<0.0001) increased across the dp-ucMGP quartiles. After adjustment for all potential confounders, aortic PWV independently correlated with dp-ucMGP (with beta coefficient (s.d.) 11.61 (5.38) and P-value=0.031). In a categorized manner, subjects in the top quartile of dp-ucMGP (⩾ 671 pmol l−1) had a higher risk of elevated aortic PWV, with corresponding adjusted odds ratio (95% confidence interval) 1.73 (1.17–2.5). In contrast, no relation between dp-ucMGP and femoro-popliteal PWV was found. In conclusion, increased dp-ucMGP, which is a circulating biomarker of vitamin K status and vascular calcification, is independently associated with aortic stiffness, but not with stiffness of distal muscular-type arteries.

Threshold for diagnosing hypertension by automated office blood pressure using random sample population data.

Abstract: Objective:Manual office blood pressure (BP) is still recommended for diagnosing hypertension. However, its predictive value is decreased by errors in measurement technique and the white-coat effect. The errors can be eliminated by automated office BP (AOBP) measurement taking multiple readings with

Changes in Hypertension Prevalence, Awareness, Treatment, and Control in High-, Middle-, and Low-Income Countries: An Update.

Abstract: The aim of this paper was to critically evaluate recent publications on hypertension treatment and control in regions by income. Prevalence of hypertension is increasing worldwide, most prominently in low-income countries. Awareness, treatment, and control are most successful in North America while remaining a challenge in middle- and low-income countries. Easy access to medical care and aggressive use of pharmacotherapy are the key strategies which have proved to be successful in reducing the burden of hypertension on the population level.

Educational level and risk profile and risk control in patients with coronary heart disease

Abstract: BackgroundThe purpose of this study was to ascertain way in which conventional risk factors, readiness to modify behaviour and to comply with recommended medication, and the effect of this medication were associated with education in patients with established coronary heart disease (CHD).MethodsThe EUROASPIRE IV (EUROpean Action on Secondary Prevention by Intervention to Reduce Events) study was a cross-sectional survey undertaken in 24 European countries to ascertain how recommendations on secondary CHD prevention are being followed in clinical practice. Consecutive patients, men and women ≤80 years of age who had been hospitalized for an acute coronary syndrome or revascularization procedure, were identified retrospectively. Data were collected through an interview with examinations at least six months and no later than three years after hospitalization.ResultsA total of 7937 patients (1934 (24.37%) women) were evaluated. Patients with primary education were older, with a larger proportion of women. Con...

Continuation of the ESH-CHL-SHOT trial after publication of the SPRINT: rationale for further study on blood pressure targets of antihypertensive treatment after stroke

Abstract: Alberto Zanchetti, Lisheng Liu, Giuseppe Mancia, Gianfranco Parati, Guido Grassi, Marco Stramba-Badiale, Vincenzo Silani, Grzegorz Bilo, Giovanni Corrao, Antonella Zambon, Lorenza Scotti, Xinhua Zhang, Ting Rui Guan, Yuqing Zhang, Xuezhong Zhang, Eivind Berge, Josep Redon, Krzysztof Narkiewicz, Anna Dominiczak, Peter Nilsson, Margus Viigimaa, Stéphane Laurent, Enrico Agabiti-Rosei, Zhaosu Wu, Dingliang Zhu, José Luis Rodicio, Luis Miguel Ruilope, Nieves Martell-Claros, Fernando Pinto Roland E. Schmieder, Michel Burnier, Maciej Banach, Renata Cifkova, Csaba Farsang, Alexandra Konradi, Irina Lazareva, Yuriy Sirenko, Maria Dorobantu, Arman Postadzhiyan, Rok Accetto, Bojan Jelakovic, Dragan Lovic, Athanasios J. Manolis, Philippos Stylianou, Dror Dicker, Gangzhi Wei, Chengbin Xu, Hengge Xie, Antonio Coca, John O’Brien, Gary Ford, on behalf of the ESH-CHL-SHOT trial investigators

Soluble receptor for advanced glycation end products and increased aortic stiffness in the general population.

Abstract: It has been suggested that accumulation of advanced glycation end products (AGEs) is involved in several pathophysiological processes in the vessel wall. We hypothesized that low levels of the soluble receptor for AGEs (sRAGE) might be associated with increased arterial stiffness, a manifestation of vascular ageing in the general population. Using a cross-sectional design, we analyzed 1077 subjects from the Czech post-MONICA study. The aortic pulse wave velocity (aPWV) was measured using a Sphygmocor device. sRAGE concentrations were assessed in frozen samples using enzyme-linked immunosorbent assay methods (RD P-value=0.018). In a categorized manner, subjects in the bottom sRAGE quartile had an odds ratio of an increased aPWV (⩾9.3 m s(-1)), adjusted for all potential confounders of 2.05 (95% confidence interval: 1.26-3.32; P=0.004), but this was only the case for non-diabetic hypertensive patients. In contrast, a low sRAGE was rejected as an independent predictor of an increased aPWV in normotensive or diabetic subjects using similar regression models. In conclusion, low circulating sRAGE was independently associated with increased arterial stiffness in a general population-based sample, but this was only observed in hypertensive non-diabetic patients.

Current and past smoking patterns in a Central European urban population: a cross-sectional study in a high-burden country.

Abstract: Many studies have examined the socioeconomic variations in smoking and quitting rates across the European region; however, data from Central and East European countries, where the tobacco burden is especially high, are sparse. This study aimed to assess the patterns in current and past smoking prevalence based on cross-sectional data from a Central European urban population sample. Data from 2160 respondents aged 25–64 years in Brno, Czech Republic were collected in 2013–2014 using the Czech post-MONICA survey questionnaire to assess the prevalence of cardiovascular risk factors, including smoking status. The age- and sex-stratified randomized sample was drawn using health insurance registries. Descriptive statistics and quit ratios were calculated, and chi-square and multivariate logistic analyses conducted to examine relationships between current and past smoking and demographic (age, gender, marital status) and socioeconomic variables (education, income, occupation). The prevalence of current and past smoking was 23.6 and 31.3 % among men and 20.5 and 23.2 % among women, respectively. Education reliably predicted smoking and quitting rates in both genders. Among men, being unemployed was associated with greater odds of smoking (OR 3.6; 1.6–8.1) and lower likelihood of quitting (OR 0.2: 0.1–0.6); the likelihood of quitting also increased with age (OR 1.8; 1.2–2.8). Among women, marital status (being married) decreased the odds of current smoking (OR 0.6; 0.4–0.9) and increased the odds of quitting (OR 2.2; 1.2–3.9). Quit ratios were the lowest in the youngest age group (25–34 years) where quitting was more strongly associated with middle income (OR 2.7; 95 % CI 1.2–5.9) than with higher education (OR 2.9; 95 % CI 0.9–8.2). Interventions to increase cessation rates and reduce smoking prevalence need to be gender-specific and carefully tailored to the needs of the disadvantaged groups of the population, especially the less well-off young adults. Future studies should examine the equity impact of the tobacco control policies and be inclusive of the Central and East European countries.

ESHRE Guideline: management of women with premature ovarian

Abstract: Изучаемый вопрос. Оптимальная тактика ведения женщин с преждевременной недостаточностью яичников (ПНЯ) на основе имеющихся наилучших доступных доказательств по данным литературы. Дизайн, размер, продолжительность исследования. Представленное руководство разработано мультидисциплинарной группой экспертов в данной области с использованием методологии разработки руководств Европейского общества по репродукции и эмбриологии человека (ESHRE), в том числе тщательного систематического поиска литературы, оценки качества включенных работ до сентября 2014 года и консенсуса Группы по разработке руководства по всем рекомендациям. В оценку были включены пациентки с типичными признаками ПНЯ. После завершения работы с руководством ознакомились члены ESHRE и профессиональных организаций. Основные результаты. Группа разработчиков сформулировала 99 рекомендаций в ответ на 31 ключевой вопрос по диагностике и лечению женщин с ПНЯ. В частности, руководство содержит 17 рекомендаций по диагностике и оценке ПНЯ и 46 рекомендаций по различным осложнениям ПНЯ и их последствиям для мониторинга и лечения. Кроме того, были сформулированы 24 рекомендации относительно заместительной гормональной терапии женщин с ПНЯ и 2 рекомендации по альтернативной и комплементарной терапии. В главе, посвященной началу пубертата, имеется 5 рекомендаций. Ограничения, причины для осторожности. Основное ограничение руководства – в недостаточном количестве необходимых данных, в связи с чем многие рекомендации основаны на мнении экспертов или косвенных результатах исследований постменопаузальных женщин либо женщин с синдромом Тернера. Несмотря на это, Группа по разработке руководства уверена, что документ позволит координировать (направлять) специалистов в области здравоохранения в обеспечении наилучшей тактики ведения женщин с ПНЯ благодаря имеющимся на сегодня доказательным данным. Кроме того, Группа по разработке руководства сформулировала научные рекомендации в условиях недостаточной информации, полученной по результатам литературного поиска, с целью стимулирования исследований в ключевых вопросах ПНЯ.

Hypertension and hypercholesterolemia in the Czech population

Abstract: Introduction Hypertension and hypercholesterolemia are inter-related ad mutually potentiating cardiovascular risk factors, which, when occurring together, strongly accelerate atherosclerosis and significantly increase cardiovascular risk.The aim of our study was to assess the prevalence and control of both risk factors in the Czech population. Methods A 1 % population random sample aged 40-64 years was examined within the Czech post-MONICA in 2006-2009. Hypertension was defined as systolic blood pressure 140 mm Hg and/or diastolic BP 90 mm Hg or use of antihypertensive medication. Hypercholesterolemia was defined according to cardiovascular risk and LDL-cholesterol levels or use of lipid-lowering drugs. Results In a group of 2 508 persons (51 % of females), hypertension was found in 52 % and hypercholesterolemia in 40 % of examined individuals. Both risk factors occurred together in 30 % of subjects. While lipid-lowering drugs were used by 39 % of individuals with hypertension and hypercholesterolemia, target LDL-cholesterol were achieved by only 42 % of treated individuals. Only a total of 10 % individuals with both hypertension and hypercholesterolemia achieved target levels for both risk factors. Conclusion Treatment and control of hypercholesterolemia in patients with hypertension remains unsatisfactory in the Czech Republic. Taking into account the high prevalence of hypercholesterolemia and the substantial increase in cardiovascular risk, lipid-lowering drugs should be considered in each patient with hypertension.Key words: antihypertensive drugs - Czech post-MONICA - lipid-lowering drugs - SCORE - target values - total cardiovascular risk.

The changes of secondary prevention practice in Czech post-stroke patients between 2007 and 2012/13

Abstract: Lze považovat za prokazane, že i pacienti po ischemicke cevni mozkove přihodě (iCMP) maji prospěch z naležitě provaděne sekundarni prevence. Cilem studie bylo zhodnotit změny v adherenci k lecebným cilům sekundarni prevence (definovaným soucasnými doporucenimi) po roce 2007 u ceských pacientů po iCMP.Porovnany byly dvě nezavisle deskriptivni studie, realizovane v letech 2007 a 2012. Konsekutivni pacienti mladsi 81 let po potvrzene prvni iCMP byli identifikovani a vysetřeni minimalně sest měsiců po teto přihodě. Studijni populace zahrnovala dva soubory, 341 a 424 pacientů o průměrnem věku 69,0 (± SD 9,1) a 66,8 (± SD 10,4) roku. Vedeni lecby cevni mozkove přihody v akutnim stadiu se mezi lety 2007 a 2012/2013 zlepsilo. Podil pacientů hospitalizovaných na iktove jednotce se signifikantně zvýsil ze 6,5 na 41,8 %, zatimco indikace inicialni trombolýzy stoupla z 2,4 % na 22,2 %. V sekundarni prevenci se rovněž zvýsila preskripce statinů z 52,2 % na 62,0 % a clopidogrelu z 0 % na 18,4 %.V prvni studii (2007) bylo asi 39 % pacientů obeznich, 61 % mělo zvýsený krevni tlak, 68 % bylo hypercholesterolemických a 33 % vykazovalo suboptimalni kontrolu glykemie. Ze zakladnich parametrů sekundarni prevence se pouze kontrola hypercholesterolemie mirně zlepsila do roku 2012/2013 (podil pacientů s LDL cholesterolem ≥ 2,5 mmol/l klesl z 67,9 % na 58,3 %).Pacienti vysetřeni v roce 2007 take vykazovali obzvlastě vysoke riziko mortality, pětileta celkova mortalita a mortalita z kardiovaskularnich přicin cinily 25,8 % a 19,9 %.Souhrnně přes jednoznacne zlepseni lecby v akutnim stadiu skutecna klinicka praxe v sekundarni prevenci iCMP zdaleka neni optimalni.

Myopatie asociovaná se statiny: klinické doporučení Slovenskej asociácie aterosklerózy a České společnosti pro aterosklerózu

Abstract: Nežadouci ucinky hypolipidemik a předevsim slatinu se dostaly v posledni době do popředi pozornosti. Obecne definujeme statinovou intoleranci jako přitomnost svalových obtiži nebo dalsich nežadoucich přiznaků (nebo laboratornich abnormalit) spojených s terapii statiny, ktere vede k jejimu vysazeni, nebo znemožňuji titraci lecby k davce dostatecne k dosaženi cilove hodnoty LDL-cholesterolu. Frekvence statinove intolerance se pohybuje v rozpěti od l % do 20 % v různých popsaných souborech. Nejdůležitějsi jsou se statiny spojene svalove obtiže, tzv. se statiny asociovana myopatie (SAM). Protože neexistuje dostatecne specifický a senzitivni laboratorni marker SAM, je vhodne použivani skorovacich systemů urcujicich pravděpodobnost SAM na zakladě charakteru symptomů. Existuje řada rizikových faktorů rozvoje SAM (vcetně lekových interakci), ktere musime zhodnotit, a pokud možno, eliminovat, již před zahajenim lecby. Z hlediska terapie je vhodne připomenout, že větsina pacientů se SAM je schopna tolerovat jiný slatin a/nebo jine davkovani statinu. V připade uplne intolerance (po vyzkouseni nejmeně 2 až 3 různých typů statinu) volime terapii založenou na jiných hypolipidemicich. V tomto směru jsou jiste naději nove lecebne možnosti (předevsim inhibitory PCSK9).

Indikace PCSK9 inhibitorů v nové léčbě hypercholesterolémie vzorném poli ČSAT

Abstract: Lekem volby pro lecbu hypercholesterolemie jsou statiny, ktere snižuji LDL-cholesterol až o 50 %, což u větsiny pacientů staci k dosaženi jeho cilových hodnot. Výjimkou jsou nemocni s familiarni hypercholesterolemii a pacienti s intoleranci statinů. Dosaženi cilových hodnot LDL cholesterolu u těchto dvou skupin nemocných by měly umožnit nove leky - PCSK9 inhibitory, ktere snižuji LDL-cholesterol o dalsich 50-60 %. Prvni dva PCSK9 inhibitory (alirocumab a evolocumab) již byly schvaleny pro klinicke použiti evropskými regulacnimi autoritami. Primarni indikaci ke kombinaci statin + PCSK9 inhibitor budou nemocni s potvrzenou diagnozou familiarni hypercholesterolemie, kteři jsou dispenzarizovani v CR převažně ve specializovaných centrech projektu MedPed. Dale by tato lecba měla být dostupna i pro ostatni nemocne ve velmi vyso kem riziku kardiovaskularnich komplikaci, u kterých nelze dosahnout cilových hodnot LDL-cholesterolu ani maximalni davkou statinů, nebo pro nemocne s prokazanou intoleranci statinů.

Epidemiology of Hypertension and Brain Disease

Abstract: Hypertension is the most prevalent cardiovascular disorder affecting 20–50 % of the adult population in developed countries. There are considerable differences in the prevalence, awareness, treatment, and control of hypertension worldwide. Elevated BP is the strongest modifiable risk factor for stroke, both ischemic and hemorrhagic. About 54 % of strokes all over the world are attributed to high BP (systolic BP > 115 mmHg). The prevalence and incidence of stroke in the general population increases with age and is directly related to BP levels. The prevalence of dementia shows a strong increase with age from 5 % at the age of 65 years to 20 % at the age of 80 years and 40 % at the age of 90 years. However, the link between BP and cognitive function is complex. Hypertension predisposes to cognitive decline and dementia, although BP commonly decreases when dementia develops.