Trends in cardiovascular risk factors in Poland – what has a decade of prevention changed?
Cardiovascular diseases remain the most common cause of death, including in Poland. But have we really made progress in preventing them in recent years? A team of researchers analyzing the nationwide CVD prevention program (CHUK) checked this on a massive sample of over 705,000 people aged 35–55. The result is a mixture of good news and warning signs: we smoke less and have better lipids, but we still don’t exercise enough, and our body weight and glucose levels are going up.
What is the CHUK program?
A cardiovascular disease prevention program whose primary goal was to reduce morbidity and mortality from cardiovascular disease by increasing the detection and identification of risk factors in the Polish population. During the study period, the participants were adults aged 35–55 without a diagnosed history of heart disease or diabetes. During a visit to their primary care physician, patients completed a standardized interview (smoking, physical activity, family history), had their blood pressure, body weight, and waist circumference measured, and had their TC, LDL-C, HDL-C, TG, and fasting glucose levels determined. During the follow-up visit, a SCORE assessment – 10-year risk of cardiovascular death – was performed, and recommendations were made.
What did the data from 2012–2021 show?
- Cigarette smoking is declining – from 36% to 27.29% in men and from 24% to 17.98% in women (both p < 0.001).
- Hypertension is more common in men (17.45–19.62%) than in women (6.84–8.58%); changes over time are curvilinear (p < 0.01).
- The lipid profile is improving – mean TC and LDL-C are clearly down (by approx. 3.29 and 3.11 mg/dL; both p < 0.001).
- Physical activity remains the Achilles heel – >75% of respondents report too little exercise throughout the decade.
- Overweight and obesity are much more common in men (overweight ~49.45%, obesity ~24.69%) than in women (~31.67% and ~17.12%, respectively).
- Glucose – a small but significant increase in average values (p = 0.045); the percentage of values in the prediabetes/hyperglycemia range is higher in men.
- Overall risk decreases – average SCORE steadily declines (p < 0.001); the percentage of SCORE ≥5% decreases in women from 0.49% to 0.26% and in men from 18.72% to 13.08%.
Expert opinion
Which of the CHUK program analysis results is most important from a public health perspective?
“It is imperative to note the decrease in smoking prevalence and the improvement in lipid parameters. Every reduction in the percentage of smokers and every improvement in the lipid profile translates directly into a reduction in the number of heart attacks, strokes, and premature deaths. This is proof that systemic preventive measures can have a real impact on public health,” emphasizes Dr. Kubielas.
What surprised the researchers the most?
“The biggest surprise was the very high level of physical inactivity – over three-quarters of people of working age remain physically inactive. No drug therapy or dietary intervention can replace regular exercise,” notes Dr. Czapla, professor at the Wroclaw Medical University. “On the positive side, there has been a systematic decline in the percentage of smokers, which shows the effectiveness of consistent anti-smoking measures.”
How should the differences between women and men be interpreted?
“Men in Poland smoke more, are more likely to have hypertension, a poorer lipid profile, and a higher BMI. Women fare better, but not perfectly. This shows that prevention must be tailored – a campaign for a 40-year-old man should look different than one for a 40-year-old woman,” notes Dr. Kubielas.
Which intervention is most important for Poland?
“The priority should be to fight hypertension decisively. It is the most common and most cost-effective risk factor to control. That is why we have launched the ‘Keep Your Blood Pressure Under Control’ campaign, which shows how education, regular measurements, and appropriate therapy can easily reduce the consequences of cardiovascular disease,” says Prof. Izabella Uchmanowicz.
What does this mean for public health?
There has been progress: we smoke less, we control cholesterol better, and the 10-year risk of CVD mortality according to SCORE is falling. This is the result of years of education, drug reimbursement, and the work of primary care physicians and nurses.
There are challenges: the epidemic of sedentary lifestyles, increasing body weight, and hyperglycemia. This trio drives hypertension, atherosclerosis, and diabetes—and will not improve on its own. The data also show apparent gender differences: men smoke more often, have worse lipids, higher blood pressure, are more often overweight/obese, and have worse glycemia. Prevention should be gender-specific.
In 2020–2021, there was a decline in participation in the program, attributed to the pandemic and limited access to services. This is a lesson that the prevention system must be crisis-resistant (telemedicine, e-education, home blood sampling, mobile testing points).
Good news for patients: if you quit smoking and lower your LDL-C, your risk really goes down – you can see it in the population data. Just 30 minutes of moderate exercise 5 times a week, plus 2 muscle-strengthening sessions, is the “cheapest medicine” for your heart, sugar, and blood pressure.
This material is based on the article:
Trends in cardiovascular risk factors in Poland: results from the comprehensive cardiovascular risk prevention program (CHUK)
Grzegorz Kubielas, CHRISTOPHER S. LEE, MD, MBA, INC., Marta Wleklik, Dr Michał Czapla, PhD, RD, EMT-P, FESC , Stanisław Surma, Grzegorz K. Jakubiak, Andrzej Mysiak, Magdalena Lisiak, Izabella Uchmanowicz, RN. PhD, MBA,FESC, FHFA
BMC Public Health, 2025, 25:2962
DOI:10.1186/s12889-025-24385-6