[Myocardial infarction--threats and medical care. Longitudinal observations in a population of 280,000 women and men--Project POL-MONICA Krakow. II. Risk factors and mortality due to ischemic heart disease in men ages 35-64].

The objective of paper was to assess to which extent hypertension, hypercholesterolemia, obesity and smoking are related to the risk of dying due to ischaemic heart disease (IHD) and to which extent changes in IHD risk factors could explain changes in IHD mortality in Polish men. The study was done in population of men at age 35-64 years, inhabitants of one Polish province (Tarnobrzeg Voivodship), which was subjected to POL-MONICA Kraków Project. The risk of IHD death and predicted changes in IHD mortality were assessed by logistic regression model using the risk factors measurements obtained at 3 screening surveys of independent random samples of studied population. Surveys were carried out in 1983-84, 1987-88 i 1992-93 and 2502 men were examined in total. 97% were followed for 12 years and 69 died of IHD. Higher risk of IHD death was found in men who had hypercholesterolemia, hypertension and who were smokers. Odds ratio adjusted to age and other risk factors was 1.87 for hypercholesterolemia, 2.38 for hypertension and 1.73 for smoking. There was no significant relation between obesity and risk of IHD death. In the studied population there was an increase in the prevalence of hypercholesterolemia and decrease in the prevalence of hypertension. There was no significant changes in the prevalance of obesity and smoking. Compared to 1983-84, predicted increase in IHD mortality calculated from changes in risk factors was 7.7% in 1987-88 and 0.2% in 1992-93. Predicted changes were smaller than observed, which were 40.1% and 39.3% increase respectively. In conclusion, despite of confirmed strong relationship between risk factors studied and risk of IHD death, combined effect of spontaneous changes in the risk factors was to small to explain observed changes in IHD mortality in the studied population.