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czynniki ryzyka
palenie tytoniu
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Abstrakt
Background: Smoking is one of the most common cardiovascular risk factors. It is responsible for 7 million deaths annually in the world. Another 1.2 million people die from passive smoking. Nicotinism causes a chronic inflammatory process, oxidative stress, and it also works by increasing adrenergic arousal. The Cardiovascular Diseases Prevention Program implemented by Primary Healthcare Clinics is designed to assess the risk factors for cardiovascular events in patients. This provides an opportunity for an early response and appropriate action.
Methods: A retrospective analysis of data obtained by the National Health Fund as part of the implementation of 86,485 preventive cards of the Cardiovascular Diseases Prevention Program in the Lubelskie Voivodeship in 2008-2018 was carried out. The analyzes were performed using the IBM SPSS Statistics for Windows, version 25 program. The chi-square test and the Pearson linear correlation between the quantitative features were used to test the relationship between the two qualitative features. Significant predictors of a risk factor for cardiovascular disease were determined using multivariate logistic regression. The significance level was assumed to be α = 0.05 for two-tailed tests.
Results: Tobacco smoking was declared by 26.5% of all respondents. It was significantly more often declared by men. The percentage of smokers increased with age - the highest was obtained for the group of 55-year-olds. Smoking cigarettes was significantly more often reported by people with primary education (44%), manual workers (33%) and retirees / pensioners (35%). Smoking tobacco escalated the risk of being diagnosed with arterial hypertension by 16.5%. It significantly influenced the risk of diabetes - even by 33.9%. It raised the risk of hypercholesterolaemia by 17.1% compared to never-smokers as well.
Conclusions: The prevalence of nicotinism is alarmingly high. The effective implementation of the Cardiovascular Diseases Prevention Program provides an opportunity to educate on a large scale and identify patients at high risk of a cardiovascular event. Assessing the risk of death on the SCORE scale can motivate patients to change their lifestyle and make them aware of the impact of smoking on increasing this risk.
Bibliografia
Amano, T., Matsubara, T., Uetani, T., Kato, M., Kato, B., Yoshida, T., Harada, K., Kumagai, S., Kunimura, A., Shinbo, Y., Kitagawa, K., Ishii, H., Murohara, T. (2011). Impact of omega-3 polyunsaturated fatty acids on coronary plaque instability: an integrated backscatter intravascular ultrasound study. Atherosclerosis, 218(1), 110–116. https://doi.org/10.1016/j.atherosclerosis.2011.05.030
Benowitz, N., L., Burbank, A., D. (2016). Cardiovascular toxicity of nicotine: Implications for electronic cigarette use. Trends in Cardiovascular Medicine, 26:515–23. https://doi.org/10.1016/j.tcm.2016.03.001
Carreras, G., Lugo, A., Stival, C., Amerio, A., Odone, A., Pacifici, R., Gallus, S., Gorini, G. (2021). Impact of COVID-19 lockdown on smoking consumption in a large representative sample of Italian adults. Tobacco control, tobaccocontrol-2020-056440. Advance online publication. https://doi.org/10.1136/tobaccocontrol-2020-056440
Chang, C. M., Corey, C. G., Rostron, B. L., Apelberg, B. J. (2015). Systematic review of cigar smoking and all cause and smoking related mortality. BMC public health, 15, 390. https://doi.org/10.1186/s12889-015-1617-5
Conroy, R. M., Pyörälä, K., Fitzgerald, A. P., Sans, S., Menotti, A., De Backer, G., De Bacquer, D., Ducimetière, P., Jousilahti, P., Keil, U., Njølstad, I., Oganov, R. G., Thomsen, T., Tunstall-Pedoe, H., Tverdal, A., Wedel, H., Whincup, P., Wilhelmsen, L., Graham, I. M., SCORE project group (2003). Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. European Heart Journal, 24(11), 987–1003. https://doi.org/10.1016/s0195-668x(03)00114-3
Di Renzo, L., Gualtieri, P., Pivari, F., Soldati, L., Attinà, A., Cinelli, G., Leggeri, C., Caparello, G., Barrea, L., Scerbo, F., Esposito, E., De Lorenzo, A. (2020). Eating habits and lifestyle changes during COVID-19 lockdown: an Italian survey. Journal of Translational Medicine, 18(1), 229. https://doi.org/10.1186/s12967-020-02399-5
European Commission (2017). Special Eurobarometer 458—Attitudes of Europeans towards Tobacco and Electronic Cigarettes. (in:) https://ec.europa.eu/commfrontoffice/publicopinion/index.cfm/ResultDoc/download/DocumentKy/79002 (access: 04.07.2022).
Giovino, G. A., Mirza, S. A., Samet, J. M., Gupta, P. C., Jarvis, M. J., Bhala, N., Peto, R., Zatonski, W., Hsia, J., Morton, J., Palipudi, K. M., Asma, S., GATS Collaborative Group (2012). Tobacco use in 3 billion individuals from 16 countries: an analysis of nationally representative cross-sectional household surveys. Lancet (London, England), 380(9842), 668–679. https://doi.org/10.1016/S0140-6736(12)61085-X
Jackson, S. E., Garnett, C., Shahab, L., Oldham, M., Brown, J. (2021). Association of the COVID-19 lockdown with smoking, drinking and attempts to quit in England: an analysis of 2019-20 data. Addiction (Abingdon, England), 116(5), 1233–1244. https://doi.org/10.1111/add.15295
Kayhan Tetik, B., Gedik Tekinemre, I., Taş, S. (2021) The Effect of the COVID-19 Pandemic on Smoking Cessation Success. Journal of Community Health, 46(3), 471–475. https://doi.org/10.1007/s10900-020-00880-2
Kumagai, S., Amano, T., Takashima, H., Waseda, K., Kurita, A., Ando, H., Maeda, K., Ito, Y., Ishii, H., Hayashi, M., Yoshikawa, D., Suzuki, S., Tanaka, A., Matsubara, T., Murohara, T. (2015). Impact of cigarette smoking on coronary plaque composition. Coronary Artery Disease, 26(1), 60–65. https://doi.org/10.1097/MCA.0000000000000168
Obwieszczenie Ministra Zdrowia (2019). Obwieszczenie Ministra Zdrowia z dnia 21 marca 2019r. w sprawie ogłoszenia jednolitego tekstu rozporządzenia Ministra Zdrowia w sprawie świadczeń gwarantowanych z zakresu podstawowej opieki zdrowotnej. Dziennik Ustaw Rzeczypospolitej Polskiej http://prawo.sejm.gov.pl/isap.nsf/download.xsp/WDU20190000736/O/D20190736.pdf (access: 15.06.2022).
Piepoli, M. F., Hoes, A. W., Agewall, S., Albus, C., Brotons, C., Catapano, A. L., Cooney, M. T., Corrà, U., Cosyns, B., Deaton, C., Graham, I., Hall, M. S., Hobbs, F., Løchen, M. L., Löllgen, H., Marques-Vidal, P., Perk, J., Prescott, E., Redon, J., Richter, D. J., ESC Scientific Document Group (2016). 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). European Heart Journal, 37(29), 2315–2381. https://doi.org/10.1093/eurheartj/ehw106
Pinkas, J., Kaleta, D., Zgliczyński, W. S., Lusawa, A., Wrześniewska-Wal, I., Wierzba, W., Gujski, M., Jankowski, M. (2019). The Prevalence of Tobacco and E-Cigarette Use in Poland: A 2019 Nationwide Cross-Sectional Survey. International Journal of Environmental Research and Public Health, 16(23), 4820. https://doi.org/10.3390/ijerph16234820
Pisinger, C., Døssing, M. (2014). A systematic review of health effects of electronic cigarettes. Preventive Medicine, 69, 248–260. https://doi.org/10.1016/j.ypmed.2014.10.009
Podolec, P., Kopeć G. (2006). The prevalence of tobacco smoking among adult Poles–results of the POLSCREEN study. In: A. Cieśliński, A. Pająk, P. Podolec, A. Rynkiewicz (eds.), Nationwide Program of the Coronary Artery Disease Prevention POLSCREEN, 69–79, Poznań: Termedia
Polakowska, M., Kaleta, D., Piotrowski, W., Topór-Mądry, R., Puch-Walczak, A., Niklas, A., Bielecki, W., Kozakiewicz, K., Pająk, A., Tykarski, A., Zdrojewski, T., Drygas, W., On Behalf Of Wobasz Investigators (2017). Tobacco smoking in Poland in the years from 2003 to 2014. Multi‑centre National Population Health Examination Survey (WOBASZ). Polish archives of internal medicine, 127(2), 91–99. https://doi.org/10.20452/pamw.3896
Polakowska, M., Piotrowski, W., Tykarski, A., Drygas, W., Wyrzykowski, B., Pajak, A., Kozakiewicz, K., Rywik, S. (2005). Nałóg palenia tytoniu w populacji polskiej. Wyniki programu WOBASZ. Kardiologia Polska, 63(6 Suppl 4), S626–S631.
Poznańska, A., Rabczenko, D., Wojtyniak, B. (2020). Wybrane czynniki ryzyka zdrowotnego związane ze stylem życia. In: Wojtyniak, B., Goryński, P. ed. Sytuacja zdrowotna ludności Polski i jej uwarunkowania 2020. Narodowy Instytut Zdrowia Publicznego – Państwowy Zakład Higieny, Warszawa 2020; 454-476 https://www.pzh.gov.pl/sytuacja-zdrowotna-ludnosci-polski-i-jej-uwarunkowania-raport-za-2020-rok/ (access: 27.06.2022).
Ross, R., (1999). Atherosclerosis—an inflammatory disease. The New England Journal of Medicine, 340(2), 115–126. https://doi.org/10.1056/NEJM199901143400207
Shah, P.K. (2014). Biomarkers of plaque instability. Current Cardiology Reports, 16(12), 547. https://doi.org/10.1007/s11886-014-0547-7
St Helen, G., Havel, C., Dempsey, D. A., Jacob, P., 3rd, Benowitz, N. L. (2016). Nicotine delivery, retention and pharmacokinetics from various electronic cigarettes. Addiction (Abingdon, England), 111(3), 535–544. https://doi.org/10.1111/add.13183
Sulicka, J., Fornal, M., Gryglewska, B., Wizner, B., Grodzicki, T. (2006). Wybrane czynniki ryzyka chorób sercowo–naczyniowego u pacjentów podstawowej opieki zdrowotnej. Nadciśnienie Tętnicze, 5, 370–376.
WHO Fact sheets (2022). https://www.who.int/news-room/fact-sheets/detail/tobacco (access: 04.07.2022).
WHO Global Report (2012). Mortality Attributable to Tobacco. https://apps.who.int/iris/bitstream/handle/10665/44815/9789241564434_eng.pdf;jsessionid=FC463B25A4569645E547277447C0ED33?sequence=1 (access: 13.06.2022).
Zdrojewski, T., Jankowski, P., Bandosz, P., Bartuś, S., Chwojnicki, K., Drygas, W., Gaciong, Z., Hoffman, P., Kalarus, Z., Kaźmierczak, J., Kopeć, G., Mamcarz, A., Opolski, G., Pająk, A., Piotrowicz, R., Podolec, P., Rutkowski, M., Rynkiewicz, A., Siwińska, A., Stępińska, J., Windak, A., Wojtyniak, B. (2015). Nowa wersja systemu oceny ryzyka sercowo-naczyniowego i tablic SCORE dla populacji Polski. Kardiologia Polska, 73(10), 958–961. https://doi.org/10.5603/KP.2015.0182
Zdrojewski, T., Rutkowski, M., Bandosz, P., Gaciong, Z., Solnica, B., Drygas, W., Wojtyniak, B., Stokwiszewski, J., Pencina, M., Wołkiewicz, E., Piwonski, J., Jędrzejczyk, T., Grodzicki, T., Wyrzykowski, B. (2015). Ocena rozpowszechnienia i kontroli czynników ryzyka chorób serca i naczyń w Polsce – badania NATPOL 1997, 2002, 2011. In: G. Kopeć, P. Jankowski, A. Pająk, W. Drygas, (eds.) Epidemiologia i prewencja chorób układu krążenia, 57–64, Kraków: Medycyna Praktyczna.