To the editor

I have read with great interest the new paper by Niklas et al.1 Indeed, the authors should be congratulated for another important analysis of data from the WOBASZ II (Multicenter National Population Health Examination Survey; Polish, Wieloośrodkowe Ogólnopolskie Badanie Stanu Zdrowia Ludności). As hypertension and hypercholesterolemia are considered the major factors influencing population health in developed countries, results of Niklas et al1 (only 5% of the participants had both blood pressure and cholesterol well controlled) should be seen as alarming.2

Niklas et al3 analyzed the potential reasons that could have been responsible for low control rate of the 2 analyzed diseases. According to the previously published data, 41% of the WOBASZ II surveyed participants with hypertension were not aware of the disease. The corresponding proportion for hypercholesterolemia was 61%.4 Is it possible to present the proportion of the study participants with hypertension and hypercholesterolemia who were aware of the diseases? The proportion of the study participants not aware among those with uncontrolled hypertension and hypercholesterolemia would be of special interest. Indeed, if this proportion occurred to be high, it could be seen as another reason for more intensive screening programs in Poland. However, if the proportion was rather low, it would mean more emphasis should probably be given to counteract low adherence and persistence of patients as well as inertia of physicians.

Niklas et al1 showed that patients with cardiovascular disease have a 2-fold higher probability of well controlled hypertension and hypercholesterolemia. Although this Figure agrees with the previously published data from secondary prevention surveys, it should be highlighted that even among patients with the highest cardiovascular risk, that is, those with established coronary artery disease, the control of risk factors is insufficient.5 Considering all the available data, there is a considerable potential for reduction of cardiovascular risk in Poland, and the preventive cardiology should become an important priority for the policymakers.