INTRODUCTION: Cardiovascular events are still the most common cause of death in the Czech Republic. The increasing prevalence of risk factors such as dyslipidaemia, hypertension, obesity, and diabetes individually and collectively contribute to cardiovascular events. The aim of this study was to determine their prevalence and interrelationships. METHOD: The data for this epidemiological study were obtained from the Czech cross-sectional study EHES 2019 (European Health Examination Survey) with stratified random sampling. Firstly, individual risk factors (dyslipidaemia, hypertension, obesity, diabetes, and smoking) in population aged 25-64 years of age were monitored using questionnaires and physical and laboratory measurements; additionally, the cumulative effect of these risk factors in subjects was examined. Finally, cardiovascular risk in the age group of 40-64 years (767 out of 1057 participants) was estimated using the SCORE EU chart (for countries with high cardiovascular risk). Individual parameters were assessed according to standard criteria: dyslipidaemia = total cholesterol ≥5.0 mmol/l, and/or HDL-C < 1.0 mmol/l in men, or <1.2 mmol/l in women, and/or LDL-C ≥ 3.0 mmol/l and/or fasting TAG ≥ 1.7 mmol/l (or ≥2 mmol/l without fasting) and/or medication with lipid-lowering drugs; obesity = BMI > 30 kg/m2; hypertension = systolic blood pressure ≥ 140 mmHg, and/or diastolic blood pressure ≥ 90 mmHg, and/or antihypertensive treatment; diabetes mellitus = HbA1c ≥ 48 mmol/mol and/or on treatment. Data were analysed by descriptive statistics. RESULTS: Of the total number of 1057 study participants (426 men and 631 women) aged 25-64 years, roughly 84% presented with ≥1 cardiovascular disease risk factor. The most common risk factor was dyslipidaemia, which occurred in 71.7% of the subjects. The prevalence of hypertension was 36.3% (men 46.0%, women 26.3%). 29.7% of subjects were obese, diabetes mellitus occurred in 5.7% (men 7.6%, women 3.7%). 17.7% were regular smokers; another 6.6% reported occasional smoking. A combination of risk factors was common, e.g., 77.3% had dyslipidaemia and/or hypertension. There were 16.1% of subjects without monitored cardiovascular risk factors. After stratification of cardiovascular risk prediction according to SCORE chart, 49.7% of individuals fall into low risk, 28.6% into medium risk, and up to 11.3% into high and 10.4% into very high risk. CONCLUSION: The most common risk factor is lipid spectrum disorders (71.7%). Combination of risk factors is common, which increases the risk of cardiovascular events in these individuals. In the 40-64 age group, 21.7% of the population is at >5% risk of a fatal cardiovascular event over the next 10 years.

• MeSH
• diabetes mellitus epidemiologie   MeSH
• dospělí MeSH
• dyslipidemie epidemiologie   MeSH
• hypertenze epidemiologie   MeSH
• kardiovaskulární nemoci * epidemiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• obezita epidemiologie   MeSH
• prevalence MeSH
• průřezové studie MeSH
• rizikové faktory kardiovaskulárních chorob * MeSH
• rizikové faktory MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

OBJECTIVE: This study analysed the prevalence of hypertension and its associated risk factors in Czech adults aged 25-64 using data from the 2019 European Health Examination Survey (EHES). Given the limited number of large-scale studies in Central Europe, this study provides crucial evidence to inform public health strategies. Examining gender differences and applying updated control thresholds, it provides valuable insights into hypertension management in Czechia. SUBJECT AND METHODS: We conducted a cross-sectional analysis using EHES 2019 data. Participants underwent a medical examination assessing cardiovascular health, including blood pressure and blood tests. A total of 1,056 participants were included, aged 25-64 years (mean age of 44.4 ± 0.73) years and with a mean BMI of 27.6 ± 0.35 kg/m2. Hypertension was defined as systolic blood pressure and/or diastolic blood pressure (mean of the second and the third measurements, 1 min apart) ≥140/90 mm Hg and/or current antihypertensive treatment. Awareness was determined by self-reporting prior diagnosis. Control was assessed as blood pressure <130/80 mm Hg (control 1) or <140/90 mm Hg (control 2). RESULTS: Hypertension prevalence was 36.3%, with higher rates in males (46.0%) than in females (26.3%, p < 0.001). Awareness was 64.8% greater in females (72.0% vs. 60.9%, p = 0.027). Treatment was received by 47.6% of hypertensives, more by women (57.7% vs. 42.0%, p < 0.001). Control rates were 10.4% (control 1) and 49.4% (control 2). CONCLUSION: Hypertension is common in Czech adults, with gender differences in prevalence, awareness, and treatment. Despite high awareness, treatment and control remain suboptimal, indicating the need for targeted interventions.

• Klíčová slova
• Awareness, Control, Hypertension, Prevalence, Treatment,
• Publikační typ
• časopisecké články MeSH

IntroductionStudy aimed to determine the occurrence of 5 thrombosis-related single-nucleotide polymorphisms (SNPs) in patients with venous thromboembolism (VTE) (n = 2630) and a control group (n = 2637) in the Czech population.MethodsThe following gene SNPs were detected in both groups: F5 Leiden (rs6025), F2 (rs1799963), FGG, fibrinogen gamma' (rs2066865), F11 (rs2289252) and ABO (rs8176719). Statistical analysis was performed using SAS statistical software with population genetics tools.ResultsHeterozygotes for F5 Leiden were associated with a 5.58-fold and homozygotes F5 Leiden with a 33.46-fold increased risk of VTE. At SNP rs1799963 (F2, prothrombin), only heterozygotes had a significant 3.9-fold increased risk of VTE. The findings at SNP rs2066865 (fibrinogen gamma', FGG) showed a 1.37-fold increased risk of VTE for FGG heterozygotes and a 1.77-fold increased risk of VTE for FGG homozygotes. There is also a significant 1.42-fold increase risk of VTE in the heterozygotes and a 1.80-fold increase risk of VTE in the homozygotes of the SNP rs 2289252 (F11). Further higher increases in the risk of VTE in both variants were found in patients with VTE at rs8176719 (ABO, non-O). It corresponds to a 2.2-fold increase in the risk of VTE in heterozygotes and a 3.5-fold increase in the risk of VTE in homozygotes.ConclusionBesides F5 Leiden and prothrombin mutation, the study suggests that the gene polymorphisms of FGG (rs2066865), F11 (rs2289252) and ABO (rs8176719) play a role as an independent heritable risk factor for VTE in the Czech population.

• Klíčová slova
• rs1799963, rs2066865, rs2289252, rs6025, rs8176719, venous thromboembolism,
• MeSH
• dospělí MeSH
• fibrinogen genetika   MeSH
• jednonukleotidový polymorfismus * MeSH
• lidé středního věku MeSH
• lidé MeSH
• prevalence MeSH
• senioři MeSH
• žilní tromboembolie * genetika   epidemiologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH
• Názvy látek
• fibrinogen MeSH

INTRODUCTION: Chronic thromboembolic pulmonary hypertension (CTEPH) and venous thromboembolism (VTE) are thought to share many common risk factors. Our study aimed to determine the frequencies of 5 thrombosis-related gene single nucleotide polymorphisms (SNPs) associated with VTE in patients with CTEPH (n 129) compared with a control group of healthy individuals without a history of VTE (n 2637). METHODS: The SNPs of the following genes were investigated: F5 (F V Leiden, rs6025), F2 prothrombin (rs1799963), fibrinogen gamma (FGG, rs2066865), F11 (rs2289252) and ABO (non-O, rs8176719) in both groups. RESULTS: The study found that the rs1799963 variant was more common in patients with chronic thromboembolic pulmonary hypertension (CTEPH) compared to the control group (p < .0001). The GA heterozygous variant showed a significant increase with an odds ratio (OR) of 4.480 (95% CI: 2.344-8.562) or a finding by maximum likelihood analysis (MLA) with p < .0001. Additionally, there was a notable increase in the rs8176719 variant with p < .0001 in CTEPH patients. Both the homozygous G/G variant and the heterozygous -/G variant also showed an increase, with OR of 4.2317 (95% CI: 2.45571-7.2919) and 2.4324 (95% CI: 1.46435-4.0403) respectively, or MLA (p < .0001 and p .0006). The study also revealed a higher prevalence of the heterozygous C/T variant of rs2289252 in CTEPH patients, with an OR of 1.5543 (95% CI: 1.02503-2.3568) or MLA (p .0379). CONCLUSION: The study suggests that the observed gene polymorphisms F2 (rs1799963), ABO (rs8176719), and F11 (rs2289252) may play a role as independent heritable risk factors in the development of CTEPH.

• Klíčová slova
• CTEPH, rs1799963, rs2066865, rs2289252, rs6025, rs8176719, thrombophilia,
• MeSH
• ABO systém krevních skupin genetika   MeSH
• chronická nemoc MeSH
• dospělí MeSH
• faktor V genetika   MeSH
• fibrinogen genetika   MeSH
• incidence MeSH
• jednonukleotidový polymorfismus * MeSH
• lidé středního věku MeSH
• lidé MeSH
• plicní embolie genetika   MeSH
• plicní hypertenze * genetika   MeSH
• protrombin genetika   MeSH
• senioři MeSH
• trombofilie genetika   MeSH
• žilní tromboembolie genetika   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• ABO systém krevních skupin MeSH
• faktor V MeSH
• fibrinogen MeSH
• protrombin MeSH

Exposures to social and environmental stressors arise individual behavioural response and thus indirectly affect cardiometabolic health. The aim of this study was to investigate several social and environmental stressors and the paths of their influence on cardiometabolic health. The data of 2154 participants (aged 25-64 years) from the cross-sectional population-based study were analysed. The composite score of metabolic disorders (MS score) was calculated based on 5 biomarkers: waist circumference, blood pressure, fasting blood glucose, HDL-cholesterol, triglycerides. The effects of social stressors (education level, income), environmental stressors (NO2, noise) and behavioural factors (unhealthy diet, smoking, alcohol consumption, sedentary behaviours) on MS score were assessed using a structural model. We observed a direct effect of education on MS score, as well as an indirect effect mediated via an unhealthy diet, smoking, and sedentary behaviours. We also observed a significant indirect effect of income via sedentary behaviours. The only environmental stressor predicting MS was noise, which also mediated the effect of education. In summary, the effect of social stressors on the development of cardiometabolic risk had a higher magnitude than the effect of the assessed environmental factors. Social stressors lead to an individual's unhealthy behaviour and might predispose individuals to higher levels of environmental stressors exposures.

• MeSH
• biologické markery krev   MeSH
• dospělí MeSH
• HDL-cholesterol krev   MeSH
• kardiovaskulární nemoci etiologie   epidemiologie   MeSH
• kouření škodlivé účinky   MeSH
• krevní glukóza metabolismus   MeSH
• krevní tlak MeSH
• lidé středního věku MeSH
• lidé MeSH
• metabolické nemoci etiologie   epidemiologie   MeSH
• obvod pasu MeSH
• průřezové studie MeSH
• psychický stres MeSH
• rizikové faktory MeSH
• sedavý životní styl * MeSH
• triglyceridy krev   MeSH
• vystavení vlivu životního prostředí škodlivé účinky   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• biologické markery MeSH
• HDL-cholesterol MeSH
• krevní glukóza MeSH
• triglyceridy MeSH

BACKGROUND: The inverse association between education and obesity was previously found in numerous studies. This study aims to assess several possible mediators in the educational disparities in adiposity. We hypothesize the potential mediating role of lifestyle, socioeconomic, and mental health factors in the association between education and adiposity. METHODS: Cross-sectional population-based sample from Czechia included 2,154 25-64 years old subjects (54.6% women). Education was classified as high, middle, and low. Adiposity was assessed as a latent variable based on body fat percentage, BMI, waist circumference, and visceral fat. The mediation potential of unhealthy dietary behavior, alcohol intake, smoking, sedentary behaviors, income, stress, depression, and quality of life was assessed in age-adjusted sex-specific multiple mediation models. RESULTS: The negative direct effect of education on adiposity was statistically significant at 5% level of significance in both sexes. For men, the indirect effect was statistically significant via sedentary behavior (β = 0.041; 95% CI [0.025-0.062]) with a mediation ratio of 23.7%. In women, the indirect effect was statistically significant via dietary risk (β = -0.023, 95% CI [-0.037, -0.013]), alcohol intake (β = -0.006; 95% CI [-0.014, -0.001]), sedentary behavior (β = 0.012, 95% CI [0.004,0.023]), income (β = -0.022; 95% CI [-0.041, -0.004]), and mental health (β = -0.007; 95% CI [-0.019, -0.001]). The total mediation ratio in women was 30.5%. CONCLUSIONS: Sedentary behaviors had mediating role in the association between education and adiposity in both sexes, with more important role in men. In addition, unhealthy diet and lower income partially mediated the educational gradient in adiposity in women.

• MeSH
• adipozita * MeSH
• analýza mediace MeSH
• disparity zdravotního stavu MeSH
• dospělí MeSH
• duševní zdraví * MeSH
• lidé středního věku MeSH
• lidé MeSH
• obezita epidemiologie   psychologie   MeSH
• průřezové studie MeSH
• sedavý životní styl MeSH
• socioekonomické faktory * MeSH
• stupeň vzdělání * MeSH
• životní styl * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH

BACKGROUND: Despite accessible diagnostics and treatment of hypertension, a high proportion of patients worldwide remain unaware of their diagnosis, and even more remain untreated. Several studies suggest that absence of comorbidities is a predictive factor for unawareness and consequently non-treatment of hypertension. There are only a few studies that have assessed the hypertension prevalence and management among apparently healthy individuals. OBJECTIVE: The aim of the study was to assess and compare hypertension prevalence, awareness, treatment and control among apparently healthy individuals, patients with internal diseases, and patients with non-internal diseases. METHODS: Data from standardised blood pressure measurements conducted during the Czech European Health Examination Survey 2014 and information on health status and health care use collected during the Czech European Health Interview Survey 2014 were analyzed. We focused on participants aged 25-64. Data were weighted on sex and age to ensure an appropriate sex and age structure of the population. The χ2-test and binary logistic regression analyses were used to compare distribution of cascade of care for hypertension between the health-status groups of respondents. RESULTS: The final eligible sample consisted of 1121 participants. The prevalence of hypertension was 32.8% in the healthy group, 29.8% in the non-internal disease group and 52.4% in the internal disease group, (p < 0.001). Awareness was 54.1%, 59.1% and 85.2% respectively, (p < 0.001). Treatment was 44.2%, 52.6% and 86.4%, respectively, (p < 0.001). Among apparently healthy respondents 62.6% had their blood pressure measured by a medical professional in the last year, compared to 71.1% in the non-internal disease group and 91.7% in the internal disease group, (p < 0.001). Differences in hypertension control were not statistically significant. CONCLUSIONS: Generally, our data show a discordance in hypertension management within the Czech population. Apparently healthy individuals are the least aware of their diagnosis and the highest proportion of them remain untreated.

• MeSH
• dospělí MeSH
• hypertenze * epidemiologie   terapie   diagnóza   MeSH
• krevní tlak MeSH
• lidé středního věku MeSH
• lidé MeSH
• prevalence MeSH
• zdraví - znalosti, postoje, praxe MeSH
• zdravotnické přehledy MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

OBJECTIVES: Previous studies on sex differences in cognitive decline provide inconsistent findings, with many European countries being underrepresented. We determined the association between sex and cognitive decline in a sample of Europeans and explored differences across birth cohorts and regions. METHODS: Participants 50+ years old enrolled in the Survey of Health, Ageing and Retirement in Europe had their cognition measured by tests of immediate recall, delayed recall and verbal fluency biennially up to 17 years of follow-up (median 6, interquartile range 3-9 years). We used linear mixed-effects models to assess the relationship between sex and the rate of cognitive decline, adjusting for sociodemographic and health-related characteristics. RESULTS: Of 66,670 participants (mean baseline age 63.5 ± standard deviation 9.4), 55% were female. Males and females had similar rates of decline in the whole sample in immediate recall (beta for interaction sex × time B = 0.002, 95% CI -0.001 to 0.006), delayed recall (B = 0.000, 95% CI -0.004 to 0.004), and verbal fluency (B = 0.008, 95% CI -0.005 to 0.020). Females born before World War II had a faster rate of decline in immediate recall and delayed recall compared to males, while females born during or after World War II had a slower rate of decline in immediate recall. Females in Central and Eastern Europe had a slower rate of cognitive decline in delayed recall compared to males. DISCUSSION: Our study does not provide strong evidence of sex differences in cognitive decline among older Europeans. However, we identified heterogeneity across birth cohorts and regions.

• Klíčová slova
• cognition, cognitive decline, dementia, older people, sex differences,
• MeSH
• kognice MeSH
• kognitivní dysfunkce * diagnóza   epidemiologie   MeSH
• kohortové studie MeSH
• lidé středního věku MeSH
• lidé MeSH
• longitudinální studie MeSH
• pohlavní dimorfismus * MeSH
• senioři MeSH
• stárnutí psychologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH
• Geografické názvy
• Evropa epidemiologie   MeSH

UNLABELLED: Retinal microcirculation reflects retinal perfusion abnormalities and retinal arterial structural changes at relatively early stages of various cardiovascular diseases. Wall-to-lumen ratio (WLR) may represent the earliest step in hypertension-mediated organ damage.Our objective was to compare functional and structural parameters of retinal microcirculation in a randomly selected urban population sample, in hypertensive and normotensive individuals. DESIGN AND METHOD: A total of 398 randomly selected individuals from an urban population aged 25-65 years, residing in Pilsen, Czech Republic, were screened for major cardiovascular risk factors. Retinal microcirculation was assessed using scanning laser Doppler flowmetry, with data evaluable in 343 patients. Complete data were available for 342 individuals divided into four groups based on blood pressure and control status of hypertension: normotensive individuals ( n = 213), treated controlled hypertensive individuals ( n = 30), treated uncontrolled hypertensive individuals ( n = 26), and newly detected/untreated hypertensive individuals ( n = 73). RESULTS: There was a tendency to higher wall thickness in treated but uncontrolled hypertensive patients (compared to normotensive and treated controlled hypertensive individuals). WLR was significantly increased in treated but uncontrolled hypertensive patients as well as in individuals with newly detected thus untreated hypertension or in patients with known but untreated hypertension. There was no difference in WLR in treated, controlled hypertensive patients compared with normotensive individuals. CONCLUSION: Our results show that an increased WLR, reflecting early vascular damage, was found in newly detected individuals with hypertension and in untreated hypertensive patients, reflecting early hypertension-mediated vascular damage. Early initiation of hypertension treatment may be warranted.

• MeSH
• arterioly MeSH
• hypertenze * MeSH
• krevní tlak MeSH
• lidé MeSH
• mikrocirkulace MeSH
• retinální cévy diagnostické zobrazování   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

IMPORTANCE: Aspirin is an effective and low-cost option for reducing atherosclerotic cardiovascular disease (CVD) events and improving mortality rates among individuals with established CVD. To guide efforts to mitigate the global CVD burden, there is a need to understand current levels of aspirin use for secondary prevention of CVD. OBJECTIVE: To report and evaluate aspirin use for secondary prevention of CVD across low-, middle-, and high-income countries. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional analysis using pooled, individual participant data from nationally representative health surveys conducted between 2013 and 2020 in 51 low-, middle-, and high-income countries. Included surveys contained data on self-reported history of CVD and aspirin use. The sample of participants included nonpregnant adults aged 40 to 69 years. EXPOSURES: Countries' per capita income levels and world region; individuals' socioeconomic demographics. MAIN OUTCOMES AND MEASURES: Self-reported use of aspirin for secondary prevention of CVD. RESULTS: The overall pooled sample included 124 505 individuals. The median age was 52 (IQR, 45-59) years, and 50.5% (95% CI, 49.9%-51.1%) were women. A total of 10 589 individuals had a self-reported history of CVD (8.1% [95% CI, 7.6%-8.6%]). Among individuals with a history of CVD, aspirin use for secondary prevention in the overall pooled sample was 40.3% (95% CI, 37.6%-43.0%). By income group, estimates were 16.6% (95% CI, 12.4%-21.9%) in low-income countries, 24.5% (95% CI, 20.8%-28.6%) in lower-middle-income countries, 51.1% (95% CI, 48.2%-54.0%) in upper-middle-income countries, and 65.0% (95% CI, 59.1%-70.4%) in high-income countries. CONCLUSION AND RELEVANCE: Worldwide, aspirin is underused in secondary prevention, particularly in low-income countries. National health policies and health systems must develop, implement, and evaluate strategies to promote aspirin therapy.

• MeSH
• Aspirin * terapeutické užití   MeSH
• dospělí MeSH
• kardiovaskulární látky terapeutické užití   MeSH
• kardiovaskulární nemoci * epidemiologie   mortalita   prevence a kontrola   MeSH
• lidé středního věku MeSH
• lidé MeSH
• průřezové studie MeSH
• rozvojové země ekonomika   statistika a číselné údaje   MeSH
• sekundární prevence * ekonomika   metody   statistika a číselné údaje   MeSH
• senioři MeSH
• vyspělé země ekonomika   statistika a číselné údaje   MeSH
• zpráva o sobě ekonomika   statistika a číselné údaje   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• Research Support, N.I.H., Extramural MeSH
• Názvy látek
• Aspirin * MeSH
• kardiovaskulární látky MeSH