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Several studies reported statistically significant associations of blood pressure (BP) with short-term air temperature variability (TV), but the effect of TV on BP was found to differ in different areas. This study aimed to detect the association between BP and TV in Kaunas, Lithuania. Data from the international Health, Alcohol, and Psychosocial Factors in Eastern Europe study was used to gather information on the participants’ BP during 2006–2008. The TV variables were the diurnal temperature range (DTR), the standard deviation (SD) of hourly temperature during the 24 h (TSD) and the first 12 h of the day (TSDF), and the SD of daily minimum and maximum temperatures during the exposure days (DTV). Multiple linear regression was used after controlling for potential confounders. Among the participants, 45.5% were men, 30.9% were aged > 65 years, and 9.8% were normotensive. A positive association of systolic BP with TSD on the same day (TSD0), DTR with lags of 0–2 days, and DTV with lags of 0–1 day and of diastolic BP with TSD0 and TSDF was found, a stronger impact being observed in males and in physically active participants. The impact of TV was stronger at lower temperatures, and a statistically significant negative interaction between air temperature and TV variables was found. In May–June, a negative association of DTV with diastolic BP was observed. We found a positive association of BP with TV. Sex, the level of physical activity, and air temperature may modify the relationship between TV and BP.

Background The aims of this study were to explore associations of the distance and use of urban green spaces with the prevalence of cardiovascular diseases (CVD) and its risk factors, and to evaluate the impact of the accessibility and use of green spaces on the incidence of CVD among the population of Kaunas city (Lithuania). Methods We present the results from a Kaunas cohort study on the access to and use of green spaces, the association with cardiovascular risk factors and other health-related variables, and the risk of cardiovascular mortality and morbidity. A random sample of 5,112 individuals aged 45-72 years was screened in 2006-2008. During the mean 4.41 years follow-up, there were 83 deaths from CVD and 364 non-fatal cases of CVD among persons free from CHD and stroke at the baseline survey. Multivariate Cox proportional hazards regression models were used for data analysis. Results We found that the distance from people’s residence to green spaces was not related to the prevalence of health-related variables. However, the prevalence of cardiovascular risk factors and the prevalence of diabetes mellitus were significantly lower among park users than among non-users. During the follow up, an increased risk of non-fatal and fatal CVD combined was observed for those who lived ≥629.61 m from green spaces (3rd tertile of distance to green space) (hazard ratio (HR) = 1.36), and the risk for non-fatal CVD–for those who lived ≥347.81 m (2nd and 3rd tertile) and were not park users (HR = 1.66) as compared to men and women who lived 347.8 m or less (1st tertile) from green space. Men living further away from parks (3rd tertile) had a higher risk of non-fatal and fatal CVD combined, compared to those living nearby (1st tertile) (HR = 1.51). Compared to park users living nearby (1st tertile), a statistically significantly increased risk of non-fatal CVD was observed for women who were not park users and living farther away from parks (2nd and 3rd tertile) (HR = 2.78). Conclusion Our analysis suggests public health policies aimed at promoting healthy lifestyles in urban settings could produce cardiovascular benefits.

Background Ageing populations experience greater risks associated with health and survival. It increases the relevance of identifying variables associated with mortality. Grip strength (GS) has been identified as an important biomarker for all cause and cardiovascular mortality, however, its prognostic value has not been studied in Lithuania. The aim of the present study is to evaluate the relationship of GS to vital status in a representative sample of the Lithuanian 45–72-year-old urban population during the period of 12 years of follow-up and to explore associations of GS with all-cause mortality and mortality from cardiovascular diseases (CVD). Methods Within the framework of the international study Health, Alcohol and Psychosocial Factors in Eastern Europe (HAPIEE) 7,115 men and women 45–72 years of age were examined in the baseline survey (2006 to 2008). Data from the Official Lithuanian Mortality Register were used to evaluate CVD and all-cause mortality from follow-up till 2020. Cox proportional hazards regression was used, and four models for all-cause and CVD mortality were assessed. Results The mean GS was significantly higher among survivors’ men and women as compared to individuals deceased from CVD and other causes of death. In survivor men and women groups, minimal values of GS in all terciles were higher as compared to all three deceased groups. In both men and women groups, the lowest GS (1st tercile) was associated with a significantly higher risk of all-cause and CVD mortality as compared to the highest levels of GS (3rd tercile) in three Cox regression models. In both men and women were found to have a 1.34- and 1.35-fold higher risk of all-cause mortality, respectively, at lower GS, but no significant difference in the risk of CVD mortality. When GS was treated in all models as decrement per 1 kg and decrement per 1 SD, in both men and women, the risk of all-cause mortality significantly increased with decreasing of GS. Conclusions The mean GS was significantly higher among survivors’ men and women as compared to deceased from CVD and other causes of death. Risk of all-cause mortality significantly increased with decreasing of GS.

Background and Objectives: Over the past decades, various epidemiological analyses have reported a significant decrease in the number of deaths related to cardiovascular diseases (CVDs). Trends in acute myocardial infarction (AMI) morbidity and mortality from ischemic heart disease (IHD) were less studied in Eastern and Central Europe. This study aimed to determine and evaluate changes in AMI morbidity and mortality from IHD among the middle-aged urban Lithuanian population during 2000–2023. Materials and Methods: The data source was the Kaunas ischemic heart disease registry for residents aged 25–64. The diagnosis of AMI was based on the proposed epidemiological criteria used in the WHO MONICA project protocol. Age-standardized morbidity and mortality rates were calculated per 100,000 population. The changes in morbidity and mortality rates were calculated using the Joinpoint regression analysis method, and changes presented as a percentage estimate per year. Results: During 2000–2023, it was observed that age-standardized AMI morbidity significantly changed in the 25–64-year-old male and female population (−1.3%/yr., p = 0.006 and −2.3%/yr., p < 0.001, respectively). In males aged 25–54, a significant decrease in AMI morbidity rates by an average of 2.2%/yr. (p < 0.001) was found, contrary to the males aged 55–64, where morbidity was without substantial changes. We found a significant decrease in AMI morbidity in both age groups (the younger and older) of females, by 2.1%/yr. (p = 0.002) and 2.4%/yr. (p < 0.001), respectively. In the 25–64-year-old male population mortality from IHD significantly decreased (−2.0%/yr., p < 0.001), whereas in females it did not significantly change. Mortality from IHD in males aged 25–54 and 55–64 years significantly decreased by an average of 3.3%/yr. (p = 0.002) and 1.2%/yr., (p = 0.004), respectively. No significant trends in mortality from IHD in both age groups of females over the past 24 years were observed. Conclusions: During the study period, the age-standardized AMI morbidity among Kaunas middle-aged males and females significantly decreased. The age-standardized mortality from IHD decreased significantly among Kaunas middle-aged males, but there were no significant changes among females.

Background: The purpose of the study is to evaluate the association between cognitive function and risk of all-cause and cardiovascular disease mortality during 10 years of the follow-up. Methods: 7087 participants were assessed in the baseline survey of the Health Alcohol Psychosocial Factors in Eastern Europe (HAPIEE) study in 2006–2008. During 10 years of follow-up, all-cause and CVD mortality risk were evaluated. Results: During 10 years of follow-up, 768 (23%) men and 403 (11%) women died (239 and 107 from CVD). After adjustment for sociodemographic, biological, lifestyle factors, and illnesses, a decrease per 1 standard deviation in different cognitive function scores increased risk for all-cause mortality (by 13%–24% in men, and 17%–33% in women) and CVD mortality (by 19%–32% in men, and 69%–91% in women). Kaplan-Meier survival curves for all-cause and CVD mortality, according to tertiles of cognitive function, revealed that the lowest cognitive function (1st tertile) predicts shorter survival compared to second and third tertiles (p < 0.001). Conclusions: The findings of this follow-up study suggest that older participants with lower cognitive functions have an increased risk for all-cause and CVD mortality compared to older participants with a higher level of cognitive function.

Background Several lifestyle behaviours, including physical activity, smoking, alcohol consumption, nutrition habits, and social activity have been associated with psychological well-being (PWB). However, their effect on PWB prospectively has been less studied. The aim of the present study was to evaluate the influence of lifestyle factors on higher future PWB during the 10-year follow-up of middle-aged and elderly urban population. Methods In the baseline survey (2006 to 2008), 7115 men and women 45–72 years of age were examined within the framework of the international study Health, Alcohol and Psychosocial Factors in the Eastern Europe (HAPIEE). In the follow-up survey (in 2016), which was performed among all 6210 participants who survived till that year, 4266 individuals participated responding to postal questionnaires. PWB was assessed by a CASP-12 questionnaire. The lifestyle behaviours, including smoking and nutrition habits, alcohol consumption, social and physical activity, were evaluated by the questionnaire. Multivariable logistic regression models were applied for statistical data analysis. Results After accounting for several potential confounders, healthy levels of lifestyle behaviours were associated with higher PWB after 10-year follow-up. Never-smokers in men and former smokers in women had higher PWB by 43 and 67% odds respectively in comparison with smokers. Physical activity in women and high social activity both in men in women was positively related to higher PWB. More frequent fresh vegetable and fruit consumption was associated with higher odds of higher PWB (odds ratio 1.57 in men and 1.36 in women, p  < 0.05) compared to less frequent consumption of such food groups. Dose-response relationship between increasing number of healthy lifestyle factors and higher PWB was determined both in men and women. Conclusions Lifestyle factors such as never smoking and former smoking, high social activity, and more frequent fresh vegetable and fruit consumption increased the odds of higher PWB over 10 years of follow-up in men and women groups. The increase of the protective health behaviour score was directly associated with the odds of higher PWB.

Background The study aimed to examine whether after confounding by possible socio-demographic and other risk factors, psychological well-being is independently associated with reduced all-cause and cardiovascular mortality. Methods Initial data were collected within the framework of the international project HAPIEE in 2006–2008. A random sample of 7115 individuals aged 45–72 years was screened. Deaths were evaluated by death register of Kaunas city (Lithuania) in a follow-up study till 2016. Psychological well-being was evaluated by a CASP-12 questionnaire. Socio-demographic, lifestyle, biologic factors and depressive symptoms were evaluated. Results Age-adjusted survival curves revealed that psychological well-being predicts longevity in men and women ( p  < 0.001). After adjustment for many possible confounders psychological well-being was independently associated with all-cause mortality in men (HR 0.77; 95% CI 0.62–0.94) and women (HR 0.73; 95% CI 0.56–0.96). However, psychological well-being association with cardiovascular mortality attained statistical significance only in the women’s group (HR 0.53; 95% CI 0.33–0.87), but not in men (HR 0.98; 95% CI 0.72–1.33). Conclusions Psychological well-being is an important predictor of longevity, controlling well-recognized risk factors such as age, education, cardiovascular diseases, social status, marital status, lifestyle and biological factors and depressive symptoms. Positive psychological well-being should be taken into account when screening older people to prevent negative health outcomes.

Background and Objectives: Helicobacter pylori, classified as a Group I carcinogen, is the main risk factor for gastric cancer, one of the leading causes of cancer mortality globally. Lithuania reports one of the highest gastric cancer rates in Europe, yet recent large-scale epidemiological data on H. pylori prevalence are lacking. This study aimed to assess the current seroprevalence of H. pylori in Lithuanian adults and its associations with sociodemographic, environmental factors, and dyspeptic symptoms. Materials and Methods: A cross-sectional study was conducted between 2020 and 2023 at the Lithuanian University of Health Sciences in Kaunas city. Randomly selected adults aged 25–69 years underwent venous blood sampling for H. pylori IgG antibody testing (Serion ELISA) and completed a questionnaire on demographic–environmental factors and dyspeptic symptoms in the past 30 days. Subjects previously treated for H. pylori were excluded from seroprevalence analysis. Seroprevalence was compared across age groups using χ2 and Z-tests with Bonferroni correction. Multivariable logistic regression identified factors associated with H. pylori seropositivity. The selected level of statistical significance was p < 0.05. Results: A total of 1046 adults (mean age 47.2 years, SD = 11.5; 50% males) participated in the study. The overall age-standardized H. pylori seroprevalence was 63.1% (95% CI 60.4–66.7). Seropositivity increased with age, peaking at 80.3% in males aged 55–69. Higher seroprevalence was observed among those with basic education and those lacking access to municipal or heated water during childhood. Regression analysis revealed that male sex, aging, and lower education were significantly associated with H. pylori seropositivity. No significant link was found between H. pylori seroprevalence and gastrointestinal complaints. Conclusions: H. pylori seroprevalence remains high in Lithuanian adults, highlighting the need for ongoing surveillance and consideration of screening strategies. H. pylori infection was linked to sociodemographic and environmental factors but not dyspeptic complaints.

To determine the association of housing items and amenities with psychological wellbeing (PWB) and their relationship with all-cause and cardiovascular disease (CVD) mortality. This study was based on the framework of the HAPIEE study. Data from the Lithuanian Mortality Register were used to evaluate CVD and all-cause mortality from baseline survey (2006-2008) till 2023. The logistic regression model and multivariate Cox regression model were applied for data analysis. The multivariable regression models showed that the material aspects of people's lives influenced their PWB status: increasing the number of housing items per 1 unit significantly increased the odds ratio (OR) of higher PWB status for males [OR = 1.14 (95% CI 1.11-1.18)] and females [OR = 1.13 (95% CI 1.11-1.17)] and decreased the risk of all-cause and CVD mortality in females [respectively HR = 0.93 (95% CI 0.91-0.96) and HR = 0.91 (95% CI 0.87-0.95)] and in males [respectively HR = 0.92 (95% CI 0.90-0.94) and HR = 0.90 (95% CI 0.87-0.93)]. These data suggest that the household items and amenities influenced PWB and may be used as risk factors in assessing the risk of all-cause and CVD mortality.

There is a lack of reliable epidemiological data on long-term survival trends of first-ever stroke patients in Lithuanian population. To evaluate trends in long-term survival after stroke and to determine the influence of some sociodemographic and lifestyle factors, time and subtype of stroke, and stroke care on survival. All stroke events included in Kaunas stroke register database were ascertained and validated according to the standardized criteria outlined by the WHO MONICA Project. The study included all patients in Kaunas (Lithuania) city aged 25 to 64 years who experienced a stroke between 1986 and 2011. Death time was confirmed by the Office for National Death Statistics. Estimates of stroke long-term survival data and factors influencing survival changes were made by applying the Kaplan-Meier and Cox regression analysis. During the study period, 4,129 persons aged 25-64 years suffered from a first-ever stroke: 2,215 (53.6%) of them were men and 1,914 (46.4%)-women. Ischemic stroke was significantly more frequent in males than in females (80.6% and 78.6%, respectively, p<0.05) and subarachnoid hemorrhage was more common in women than in men (9.0% and 7.0% respectively, p <0.05). Of all first-ever stroke patients, 3,272 (79.2%) survived 1 year and 2,905 (70.4%) survived 5 years after stroke onset. The 1- and 5-years survival rate after a first-ever stroke in women was significantly higher as compared with that in men (Log-rank test p = 0.0001). The older (55-64 year) persons had poorer 1-year and 5-years survival rate as compared with persons in the younger (25-54 years) age group (Log-rank test p = 0.0001). Among persons with a first-ever stroke who had their stroke in 2007-2011, 1- and 5-year survival rate was higher compared with that in persons who had had a stroke in 1986-1990 and in 1997-2001 (Log-rank test p = 0.0001). The persons with a first-ever ischemic stroke had a better chance to survive first 1- and 5-years after stroke compared with persons who had intracerebral or subarachnoid haemorrhage. Only female gender was associated with higher 1- and 5-year survival rate after first-ever stroke. The older age, previous myocardial infarction and diabetes mellitus were associated with lower 1- and 5-year survival rate after first-ever stroke. This population-based study of patients with first-ever stroke demonstrated that the long-term survival was better in women than men, and improved significantly in both men and women during the past decade. Long-term survival was better of those with first-ever ischemic stroke and of younger age- 25 to 54 years.