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Differences in risk factors for coronary heart disease in patients from continental and Mediterranean regions of Croatia

Unterschiede in den Risikofaktoren für koronare Herzkrankheit bei kroatischen Patienten von kontinentalen und mediterranen Regionen

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Zusammenfassung

HINTERGRUND: Bezüglich der Abhängigkeit der Prävalenz der koronaren Herzkrankheit (KHK) von geographisch vorgegebenen Risikofaktoren liegen bisher nur spärliche Daten vor. Ein möglicher Einfluss des mediterranen Klimas im Vergleich zum kontinentalen Klima wurde bisher nur wenig untersucht. Wir analysierten die Daten der Secondary Prevention of Ischemic Coronary Events in Croatia V (TASPIC-CRO V) Studie, um mögliche Einflüsse zu erkennen. Die Studie inkludierte kroatische KHK-Patienten aus zwei Regionen – einer mediterranen und einer kontinentalen Region. METHODEN: Die Studie wurde an 31 kroatischen Forschungs-Zentren durchgeführt. Wir erhoben aus 3054 medizinischen Krankengeschichten von KHK-Patienten die Personaldaten, die demographischen Charakteristika und die Exposition zu bekannten Risikofaktoren wie Zigarettenkonsum, Hypertonie, Hyperlipidämie (Gesamtcholesterin, Triglyzeride, HDL-Cholesterin, LDL-Cholesterin) und dem Vorliegen von Typ II Diabetes mellitus. ERGEBNISSE: Sowohl die univariate als auch die multivariate statistische Analyse zeigten, dass die Prävalenz einer Hypertonie bei den untersuchten KHK-Patienten in der kontinentalen Region signifikant höher als in der mediterranen Region war (univariate Analyse: P < 0,001; multivariate Analyse: P = 0,003). Die multivariate Analyse zeigte eine höhere Prävalenz eines erniedrigten HDL-Cholesterins im kontinentalen Teil Kroatiens (p = 0,006) und eine höhere Prävalenz von Rauchern bei den Patienten an der mediterranen Küste (P = 0,007). In zwei mediterranen Subregionen wurde im Bezug auf das Gesamtcholesterin von hospitalisierten KHK-Patienten ein signifikanter Unterschied (P < 0,001) erhoben. Die anderen untersuchten Parameter unterschieden sich nicht signifikant. SCHLUSSFOLGERUNGEN: Es wurde eine erhöhte Prävalenz sowohl der Hypertonie als auch eines erniedrigten HDL-Cholesterins in hospitalisierten KHK-Patienten in der Region im Landesinneren im Vergleich zur Küstenregion Kroatiens gefunden. An der mediterranen Küste war dafür die Prävalenz von Rauchern höher. Die von uns bei hospitalisierten KHK-Patienten gefundenen Unterschiede des Gesamtcholesterins, LDL-Cholesterins und der Triglyzeride zwischen der mediterranen und der kontinentalen Region Kroatiens entsprechen nicht dem erwarteten Kontinent-Mittelmeer-Schema.

Summary

BACKGROUND: There are few data on differences in exposure to risk factors for coronary heart disease (CHD) in relation to geographic areas, especially areas with large differences in terms of continental and Mediterranean climates. To study these differences in Croatia, we analyzed data from the Treatment and Secondary Prevention of Ischemic Coronary Events in Croatia V (TASPIC-CRO V) study, which recruited Croatian CHD patients in two principal regions (Mediterranean and continental) of the country. METHODS: A total of 31 Croatian research centers participated in the study. We collected information on personal details, demographic characteristics and risk factor exposure from the hospital medical records of 3054 CHD patients. Risk factors included history of cigarette smoking, hypertension, hyperlipidemia (total cholesterol, triglycerides, HDL-cholesterol and LDL-cholesterol) and diabetes type 2. RESULTS: Both univariate and multivariate analyses showed that the prevalence of hypertension in examined CHD patients was significantly higher in the continental part of Croatia than in the Mediterranean part (univariate analysis: P < 0.001; multivariate analysis: P = 0.003). Multivariate analysis revealed a higher prevalence of decreased HDL-cholesterol in continental Croatia (P = 0.006) and a higher prevalence of smokers in coastal Mediterranean Croatia (P = 0.007). A significant difference in total cholesterol levels was noted between hospitalized CHD patients in two Mediterranean subregions (P < 0.001). No significant differences between continental and coastal Mediterranean parts of Croatia were found for other CHD risk factors. CONCLUSIONS: Higher prevalences of both hypertension and decreased HDL-cholesterol were recorded in hospitalized CHD patients in the continental part of Croatia, but in coastal Mediterranean Croatia there was higher prevalence of smokers. Differences in total cholesterol, LDL-cholesterol and triglycerides between hospitalized CHD patients in continental and coastal Mediterranean Croatia did not follow the expected continental–Mediterranean pattern.

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Authors and Affiliations

  1. Cardiology Division, Department of Internal Medicine, University Hospital Dubrava, Zagreb, Croatia

    Mijo Bergovec & Hrvoje Vražić

  2. Department of Internal Medicine, University Hospital Center Zagreb, Zagreb, Croatia

    Željko Reiner

  3. Department of Cardiovascular Diseases, University Hospital Center Zagreb, Zagreb, Croatia

    Davor Miličić

Authors
  1. Mijo Bergovec
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  2. Željko Reiner
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  3. Davor Miličić
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  4. Hrvoje Vražić
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Correspondence to Mijo Bergovec.

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Bergovec, M., Reiner, Ž., Miličić, D. et al. Differences in risk factors for coronary heart disease in patients from continental and Mediterranean regions of Croatia. Wien Klin Wochenschr 120, 684–692 (2008). https://doi.org/10.1007/s00508-008-1065-7

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  • DOI: https://doi.org/10.1007/s00508-008-1065-7

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