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The aim of the study was to estimate trends and differences in cardiovascular disease (CVD) risk factor prevalence among middle-aged men and women based on the data from the Lithuanian High Cardiovascular Risk (LitHiR) primary prevention program between 2009 and 2018.A community-based cross-sectional study included men aged 40-54 years and women aged 50-64 years without overt CVD. Nationally representative data comprised 110,370 Lithuanian adults (42.4% men and 57.6% women) examined in the period 2009-2018. Prevalences of major CVD risk factors, such as dyslipidaemia, arterial hypertension, diabetes mellitus, obesity, metabolic syndrome and smoking, were assessed.The study showed a significant drop in the prevalence of dyslipidaemia and TC levels among men (p = 0.030 and p0.001) and no significant change among women (p = 0.594 and p = 0.799). The prevalence of AH significantly decreased in both gender groups (p0.001 in women and p0.001 in men). Obesity rates declined among women while it remained constant among men (p0.001 and p = 0.100 respectively). There was a significant decline among women and a significant increase among men in the prevalence of metabolic syndrome (p0.001 and p = 0.016 respectively). The prevalence of diabetes increased until 2013, after which it started decreasing in the whole group (p = 0.005). The study showed a significant increase in the percentage of smoking women (p0.001), although the number of smoking men remained much higher (about 40%) (p0.001).In our observational study, we have documented a high prevalence of all CVD risk factors in 2009 with a slight decrease during the period in most prevalence rates, except in dyslipidaemia and smoking levels.

Summary Objectives: There is increasing evidence that metabolic syndrome (MetS) may be associated with increased uric acid levels. Previous studies indicate that hyperuricaemia is an independent risk factor for cardiovascular disorders. We sought to determine the association of serum uric acid (SUA) with MetS components and other cardiovascular risk factors among middle aged Lithuanians with MetS. Design and methods: A cross-sectional study was conducted in 2018. A total of 705 subjects aged 40 to 65 years with MetS diagnosed using NCEP ATP III criteria were included. None of the participants had previously diagnosed cardiovascular, cerebrovascular, peripheral artery or end-stage oncological disease. Blood tests and all anthropometric measurements were obtained using standard methods. Subjects were divided into 2 groups: with hyperuricaemia and without hyperuricaemia. Results: Hyperuricaemia was found in 33.3% of subjects. Mean serum uric acid level increased as the number of metabolic factors increased. Participants with hyperuricaemia had abnormal waist circumference (p < 0.001), higher systolic (p = 0.001) and diastolic blood pressure (p = 0.003), higher levels of triglycerides and, lower levels of high-density lipoprotein cholesterol (p < 0.001). Subjects in hyperuricaemia group were more likely to be alcohol users (p = 0.034), to have diabetes (p = 0.02) and higher body mass index (p < 0.001). Their creatinine levels were statistically significantly higher (p < 0.001). Conclusions: Our analysis showed that serum uric acid is associated with MetS and other cardiovascular risk factors. The study found a statistically significant association with the four out of five components of the MetS (excluding plasma glucose) as well as with alcohol consumption, and renal function indicators (creatinine, eGFR).

Summary Objectives: Circulating levels of inflammatory markers such as high sensitivity C-reactive protein (hs-CRP) have been reported to be associated with increased risk of cardiovascular disease (CVD), as well as with metabolic syndrome (MetS). Therefore, our objectives were to investigate the associations between hs-CRP levels and individual MetS components as well as to analyse if hs-CRP levels are linked with the number of MetS components present in middle-aged subjects. Design and methods: A cross-sectional study included 4628 middle-aged MetS subjects from the Lithuanian High Cardiovascular Risk primary prevention programme (LitHiR) from 2011 to 2020. MetS was diagnosed according to the National Cholesterol Education Program ATP III modified criteria. CRP was measured by a validated high-sensitivity assay. A hs-CRP cutpoint of 5 mg/l was used to differentiate high and low hs-CRP groups. Results: The mean value of hs-CRP was 3.23 ± 4.04 mg/l, and significantly increased as the number of components of MetS increased (p < 0.001). The concentration of serum hs-CRP was significantly associated with waist circumference, systolic and diastolic blood pressure, and fasting blood glucose (all p < 0.001). However, no statistically significant associations were found between hs-CRP and serum triglycerides (p = 0.340) or serum high-density lipoprotein cholesterol (p = 0.148). Conclusions: Serum hs-CRP increased progressively with increased waist circumference, blood pressure, fasting blood glucose in middle-aged subjects with MetS. The higher values of hs-CRP were more often present in obese subjects and women. The incremental rise in mean serum hs-CRP level was found with an increasing number of MetS components.

Summary Cardiovascular diseases are the main cause of premature death worldwide. More than half of deaths were caused by cardiovascular diseases in 2017 in Lithuania. Primary prevention programmes encourage both medical staff and general population to pay attention to potential health issues as well as attempt to eradicate risk factors causing cardiovascular diseases. “A Funding Programme for the Screening and Preventive Management of the High Cardiovascular Risk Individuals” published in Lithuania has been implemented as of 2006. Analysis of the results of the programme shows that the prevalent cases of arterial hypertension are gradually declining. However, the prevalence of dyslipidaemia is still not decreasing. The prevalence of other modifiable cardiovascular disease risk factors has erratic trends with a slight overall decline. Consequently, mortality rate of cardiovascular diseases has decreased by more than one third among middle-age population over the past 10 years. Having higher availability of the anti-hypertensive and anti-lipid medications already achieved, the future plans include the aim of further reducing elevated blood pressure and effectively treating dyslipidaemia. In order to implement a strategy that focuses on smoking prevention, promotion of healthy nutrition and physical activity, a significant contribution is required from the state authorities.

Absorptive capacity is considered a main precondition for regional innovativeness. However, each region is unique, and analyzing its innovativeness requires an appropriate methodology. Within scientific discussion on the concept of the “region”, most of the scientific research analyzing absorptive capacity tends to be conducted for large or highly developed regions. Small countries (such as Lithuania) are considered indivisible regional units; therefore, there is still a lack of research to provide specific tools that could be adapted to assess regional absorptive capacity in a small country. Taking this into consideration, this chapter’s objective is to present a methodology for assessing RIS absorptive capacity that has been adapted to the context of regions in a small country (Lithuania). Its goals are as follows: (1) to explain the concept of absorptive capacity in the context of a RIS; (2) to provide the theoretical background for assessing absorptive capacity; (3) to present a methodology for assessing absorptive capacity in a small country (Lithuania); and (4) to explain the main results of the research, which was conducted for RIS in Lithuania using the methodology presented here. The scientific research methods used were an analysis of scientific literature, statistical analysis, and the SAW multiple criteria method. The research revealed that regions in a small country differ in their various indicators of absorptive capacity. Using the appropriate tool for assessment can also be a tool for identifying a region’s strong and weak points as well as for promoting or interfering with the absorption of external knowledge.

Vitality of a smart region depends on the network of closely interconnected actors (individuals and institutions) seeking common goals of development and their capacities to ensure effective knowledge creation and exploitation. This network (a regional innovation system (RIS)) empowers processes of absorptive capacity—knowledge access, anchoring and diffusion, contributing to regional innovativeness and competitiveness. Absorptive capacity is considered an important object of scientific research. However, there is still a lack of research providing specific tools that are adaptable for assessing the regional absorptive capacity in a small country. Existing differences among countries and even regions inside a small country require adjusted and modified methods and instruments. Consequently, the goal of this research is to present and substantiate the methodological approach of assessing the RIS's absorptive capacity giving evidence from a smart region (Kaunas County) of a small country (Lithuania). The mixed-method approach of the research (combining qualitative and quantitative research strategies) was used to substantiate the presented methodological approach. A smart region of a small country can be characterized by a denser institutional infrastructure and higher results (outcomes) of innovative activities. Smartness of the region can be understood as a consequence of the higher level of absorptive capacity.