Piotr Bandosz

A century of trends in adult human height

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. DOI: http://dx.doi.org/10.7554/eLife.13410.001

Knowledge and use of hormone replacement therapy among Polish women: estimates from a nationally representative study—HORTPOL 2002

OBJECTIVES To evaluate the knowledge about hormone replacement therapy (HRT) and the prevalence of its current use in Polish female population. METHODS Cross-sectional survey on a representative sample of 1544 women between 18 and 87 years of age. RESULTS Almost half of the Polish women have heard of HRT. Depending on the education level, 26-38% of women knew that HRT alleviates the physical and psychological symptoms of menopause and 18-32% knew that HRT reduces the risk of developing osteoporosis. Forty-three percent of all the women with a higher level of education were aware that HRT increases the risk of breast and uterine cancer. The prevalence of current HRT use among women aged 45-64 was 12%. Women who had only basic education were less likely to use HRT than those with a medium and higher education level. Lack of information about HRT was the main cause of not using it. Forty-four percent of the perimenopausal women (age range 45-54 years) have never heard of HRT and 36% were never told by their healthcare providers that they could use it. Nineteen percent of perimenopausal women were not using HRT because they were afraid of the HRT related risks. Sixty-four percent of women who were using HRT were prescribed oral HRT preparations. CONCLUSIONS A fairly small proportion of Polish women currently uses HRT, largely because most remain poorly informed about the therapy.

Prevalence of chronic kidney disease in a representative sample of the Polish population: results of the NATPOL 2011 survey

BACKGROUND Chronic kidney disease (CKD) has been proven to be a major risk factor of cardiovascular disease (CVD). Until now, data on the prevalence of CKD among adults in Poland were limited. The NATPOL 2011 survey is a cross-sectional observational study designed to assess the prevalence and control of CVD risk factors in Poland, and the first study capable of evaluating CKD prevalence in adult Polish citizens. METHODS Serum creatinine concentration and the urine albumin-to-creatinine ratio (ACR) were measured in 2413 randomly selected participants (ages 18-79 years) from a national survey study. CKD was diagnosed if the estimated glomerular filtration rate (eGFR) was <60 mL/min/1.73 m(2) or ≥60 mL/min/1.73 m(2) with coexisting albuminuria (ACR ≥ 30 mg/g). Additionally, comorbidities and anthropometric and social factors related to the prevalence of CKD were analysed. RESULTS The prevalence of CKD was estimated at 5.8% [95% confidence interval (95% CI) 4.6-7.2] using Chronic Kidney Disease Epidemiology Collaboration formula. The general prevalence was higher when the MDRD was applied [6.2% (95% CI 4.0-7.6)]. An eGFR <60 mL/min/1.73 m(2) was found in 1.9% (95% CI 1.5-2.5) of the studied population. This was accompanied by low awareness of this condition (14.9%). The frequency of albuminuria was estimated at 4.5% (95% CI 3.4-5.9). Diabetes mellitus (DM) and arterial hypertension (AH) were more frequent among respondents with diagnosed CKD compared with those without CKD [18.5 versus 4.5% (P < 0.001) and 67.8 versus 29.0% (P < 0.001) respectively]. DM and AH were, apart from increasing age, the two greatest risk factors of CKD. CONCLUSION The estimated prevalence of CKD among adults in Poland is 5.8% (∼1 724 960 patients). Its prevalence was lower than expected. CKD is more frequent in older subjects, smokers and people with comorbidities such as AH and DM.

Distribution of C‐reactive protein and its relation to arterial hypertension in a country representing a high‐risk region for cardiovascular diseases

Aims. The high‐sensitivity C‐reactive protein (hs‐CRP) measurement is recommended by ESC/ESH Guidelines 2003 in patients with arterial hypertension. The aim of this study was to assess distribution of hs‐CRP in Poland, a country representing a high‐risk region for CVD. Methods and results. In 2002, the cross‐sectional survey NATPOL PLUS was performed in a representative sample of adults in Poland aged 18–94 years. The questionnaire, anthropometrical and blood pressure measurements, glycaemia, lipidogram and hs‐CRP were performed in 2333 respondents. The results of hs‐CRP>10 mg/l were excluded from analysis. Mean hs‐CRP was 2.03±2.14 mg/l (2.13±2.12 mg/l in women vs 1.91±2.16 mg/l in men; p<0.05). Hs‐CRP⩾1 mg/l was observed in 58% of women and in 52% of men (p<0.05). In hypertensives (⩾140/90 mmHg or treatment: women 30% vs men 29%, ns.), hs‐CRP⩾1 mg/l was found in 74% of women, and in 63% of men. The transformed values of hs‐CRP [−1/[hs–CRP]½] were higher in hypertensive patients than in normotensives (−0.94 vs −1.05; p<0.01). Conclusion. (i) The increased level of hs‐CRP was found in more than half of adults in Poland. (ii) The hs‐CRP is higher in hypertensive patients than in normotensives. (iii) In view of the given results, routine measurements of hs‐CRP in hypertensive patients in a country like Poland should be reconsidered.

Prevalence of diabetes and impaired fasting glucose in Poland—the NATPOL 2011 Study

The aim of the analysis was to assess the prevalence of diabetes and impaired fasting glucose in Poland.

Population Effect of Differences in Cholesterol Guidelines in Eastern Europe and the United States

IMPORTANCE The American College of Cardiology/American Heart Association (ACC/AHA) guidelines for the management of blood cholesterol and the current European Society of Cardiology/European Atherosclerosis Society (ESC/EAS) guidelines differ in how they identify adults in need of statin therapy; furthermore, it is unclear how this difference translates into numbers and characteristics of patients recommended for treatment. OBJECTIVE To determine the effect of the ACC/AHA and ESC/EAS cholesterol guidelines when applied to a population-based sample. DESIGN, SETTING, AND PARTICIPANTS We used nationally representative data for 3055 adults aged 40 to 65 years from the 2007-2012 National Health and Nutrition Examination Surveys (NHANES) for the United States and for 1060 adults aged 40 to 65 years from the 2011 Nadciśnięnie Tętnicze w Polsce survey for Poland. Data analysis was conducted from May 1, 2014, to December 31, 2015. MAIN OUTCOMES AND MEASURES The number and characteristics of adults recommended for statin therapy according to the ACC/AHA and ESC/EAS guidelines were evaluated, and characteristics were compared between adults with discordant recommendations. RESULTS The 3136 US adults in NHANES (2007-2012) aged 40 to 65 years represented 100.1 million adults; after excluding the 81 patients with missing data, these population estimates translate to 97.9 million adults. Similarly, the 1060 Polish adults in NATPOL (2011) aged 40 to 65 years represent 13.5 million adults. Using weighted data, in the United States, 43.8% (95% CI, 40.9%-46.7%) of adults would be recommended for statin therapy according to ACC/AHA guidelines and 39.1% (95% CI, 36.4%-41.8%) according to ESC/EAS guidelines. In Poland, 49.9% (95% CI, 46.9%-52.9%) of adults would be recommended for statin therapy under ACC/AHA guidelines compared with 47.6% (95% CI, 44.6%-50.7%) under ESC/EAS guidelines. Among individuals without cardiovascular disease and not currently taking statins, 11.0% of US and 10.5% of Polish adults had discordant guideline recommendations. Compared with individuals recommended for statin therapy by the ESC/EAS guidelines but not the ACC/AHA guidelines, those recommended for statin therapy under the ACC/AHA guidelines only had less chronic kidney disease; however, these individuals were also more likely to smoke, have lower high-density lipoprotein cholesterol levels, and have higher predicted 10-year risk of cardiovascular disease. CONCLUSIONS AND RELEVANCE Despite differences in the ACC/AHA and EAS/ESC guidelines, the numbers of adults aged 40 to 65 years recommended for cholesterol-lowering therapy under each guideline were similar when applied to nationwide representative samples from both the United States and Poland. Discordant recommendations were driven by differences in the risk equations used in the 2 guidelines and different recommendations for adults with chronic kidney disease.

Prevalence and distribution of left ventricular diastolic dysfunction in treated patients with long-lasting hypertension

Abstract Background: Although the presence of sub-clinical left ventricular diastolic dysfunction (LVDD) increases cardiovascular risk, the current ESH/ESC guidelines do not include the presence of this condition in the list of target organ damage or cardiovascular risk charts dedicated to the hypertensive population. Several conditions may predict the LVDD occurrence, however, clustering of these factors with hypertension makes the relationship less clear. Therefore, the aim of this study was to evaluate both the occurrence and the severity of diastolic dysfunction in a large cohort of treated hypertensives. Methods: We retrospectively analyzed records of 610 hypertensive participants of the CARE NORTH Study who consented to echocardiography and were free of overt cardiovascular disease. Mean age was 54.0 ± 13.9 years (mean ± SD), BMI 29.7 ± 4.8 kg/m2. The exclusion criteria were: established heart failure, LVEF <45%, coronary revascularization, valvular defect, atrial fibrillation, or stroke. The staging of LVDD was based on comprehensive transthoracic echocardiographic measurements. Results: 49.7% percent of the patients had normal diastolic function (38.8% vs. 59.0%, females (F) vs. males (M), respectively; p < .001). Grade 1 LVDD was documented in 24.4% (27.8% and 21.6%; F and M; p = .08) and grade 2 LVDD in 19.3% (24.9% and 14.6%; F and M; p = .001) of the patients. None were diagnosed with grade 3 LVDD. In the logistic regression model, female sex, advancing age, obesity status, established diabetes mellitus, higher 24-hour SBP, and increasing LVMI were identified as the independent variables increasing the odds for the presence of LVDD, whereas blood-lowering therapy attenuated the risk. Conclusions: There is an unexpectedly high prevalence of different forms of diastolic dysfunction in treated hypertensive patients who are free of overt cardiovascular disease.