ArticleBMJ (Clinical research ed.)2012
Decline in mortality from coronary heart disease in Poland after socioeconomic transformation: modelling study.
Article in BMJ (Clinical research ed.), 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers, 1 of them a synthesis that pooled it.
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Who cites it
58 citing papers in PubMed, 1 synthesis or guideline pooled it, 175 citations in OpenAlex.
- The impact of clinical and population strategies on coronary heart disease mortality: an assessment of Rose's big idea.BMC public health · 2022Pooled it
- Prognostic Value of the Modified Atherogenic Index of Plasma during Body Mass Reduction in Polish Obese/Overweight People.International journal of environmental research and public health · 2018Trial
- Trends of changes in physical activity of older adults in Poland 2009-2019. The results of the representative population-based PolSenior2 study.BMC public health · 2026Article
- The burden of diseases, injuries, and risk factors by voivodship in Poland, 1990-2023: a systematic analysis for the Global Burden of Disease Study 2023.The Lancet regional health. Europe · 2025Article
- A Modeling Study for Hip Fracture Rates in Romania.Journal of clinical medicine · 2025Article
- Success in achieving LDL-C target values in a high-risk population in Slovakia: the SlovakLipid retrospective study.Archives of medical science : AMS · 2025Article
- Clinical characteristics and management of hyperlipoproteinemia in patients with chronic coronary heart disease in Slovakia.Archives of medical science : AMS · 2025Article
- Changes in the exposure to cardiovascular disease risk factors in an 18 year follow-up study of a cohort of middle age urban residents. The Polish arm of the HAPIEE study.Cardiology journal · 2024Article
- Advancing nutrition science to meet evolving global health needs.European journal of nutrition · 2023Article
- Clinical determinants of ischemic heart disease in Eastern Europe.The Lancet regional health. Europe · 2023Review
- Changes in the Level of Premature Mortality in the Polish Population Due to Selected Groups of Cardiovascular Diseases before and during the Pandemic of COVID-19.Journal of clinical medicine · 2023Article
- Is area-level socioeconomic deprivation associated with mortality due to circulatory system diseases in Poland?BMC public health · 2023Article
- Changes in mortality of Polish residents in the early and late old age due to main causes of death from 2000 to 2019.Frontiers in public health · 2023Article
- The Devil Is in the Data: Can Regional Variation in Amenable Mortality Help to Understand Changes in Health System Performance in Poland?International journal of environmental research and public health · 2022Article
- Trends in premature mortality rates among the Polish population due to cardiovascular diseases.International journal of occupational medicine and environmental health · 2022Article
- Article
- Excess mortality in Poland during the first and second wave of the COVID-19 pandemic in 2020.Frontiers in public health · 2022Article
- Management of dyslipidemia in Poland: Interdisciplinary Expert Position Statement endorsed by the Polish Cardiac Society Working Group on Cardiovascular Pharmacotherapy. The Fourth Declaration of Sopot.Cardiology journal · 2022Article
- Heart failure re-hospitalizations and subsequent fatal events in coronary artery disease: insights from COMMANDER-HF, EPHESUS, and EXAMINE.Clinical research in cardiology : official journal of the German Cardiac Society · 2021Article
- Cause-of-death distributions and mortality trends in Turkey between 2009 and 2017.Balkan medical journal · 2021Article
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Authors and funding
9 authors at 3 institutions in 3 countries.
Funding
Abstract
objectivesTo examine how much of the observed rapid decrease in mortality from coronary heart disease in Poland after the political, social, and economic transformation in the early 1990s could be explained by the use of medical and surgical treatments and how much by changes in cardiovascular risk factors.
designA modelling study.
settingSources of data included controlled trials and meta-analyses, national surveys, and official statistics.
participantsPopulation of adults aged 25-74 in Poland in 1991-2005.
main outcome measuresNumber of deaths prevented or postponed in 2005 attributable to specific treatments for coronary heart disease and changes in risk factors. A previously validated epidemiological model for coronary heart disease was used to combine and analyse data on the uptake and effectiveness of specific cardiac treatments and changes in risk factors. The observed fall in deaths from coronary heart disease from 1991 to 2005 was then partitioned among specific treatments and risk factor changes.
resultsFrom 1991 to 2005, the death rate from coronary heart disease in Poland halved, resulting in 26,200 fewer coronary deaths in 2005 in people aged 25-74. About 37% (minimum estimate 13%, maximum estimate 77%) of this decrease was attributable to treatments, including treatments for heart failure (12%), initial treatments for acute coronary syndrome (9%), secondary prevention treatments after myocardial infarction or revascularisation (7%), chronic angina treatments (3%), and other treatments (6%). About 54% of the fall was attributed to changes in risk factors (minimum estimate 41%, maximum estimate 65%), mainly reductions in total cholesterol concentration (39%) and an increase in leisuretime physical activity (10%); however, these were partially offset by increases in body mass index (-4%) and prevalence of diabetes (-2%). Blood pressure fell in women, explaining about 29% of their decrease in mortality, but rose in men generating a negative influence (-8%). About 15% of the observed decrease in mortality was attributable to reduced smoking in men but was negligible in women.
conclusionsOver half of the recent fall in mortality from coronary heart disease in Poland can be attributed to reductions in major risk factors and about one third to evidence based medical treatments.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.