ObjectiveCardiovascular health (CVH) is a relatively new concept defined by the American Heart Association (AHA). The aim of the present study was to assess whether the indices of CVH were discriminators of socioeconomic status (SES) in the adult population of the Republic of Srpska (RS).DesignPopulation-based cross-sectional study.SettingRS, Bosnia and Herzegovina.ParticipantsThe study involved 4165 adults aged ≥18 years (mean age 50.2; 54% women) who participated in the National Health Survey performed from September to November 2010 in the RS.Study variablesParticipant's education was a proxy for SES. Potential discriminators of SES were indices of CVH presented according to AHA as: ideal health behaviours index (non-smoking, body mass index <25 kg/m2, physical activity at goal level and healthy diet); ideal health factors index (untreated total cholesterol <200 mg/dL, untreated blood pressure <120/<80 mm Hg, untreated fasting glucose <100 mg/dL and non-smoking); and ideal CVH status (defined as all seven ideal health metrics present) versus intermediate and poor CVH status.ResultsParticipants with high educational levels had a significantly greater number of ideal CVH metrics, and ideal health factor metrics compared with those with low or medium educational level (OR 0.88 95% CI 0.77 to 0.99 and OR 0.88 95% CI 0.80 to 0.96; OR 0.81 95% CI 0.69 to 0.96 and OR 0.77 95% CI 0.68 to 0.87; respectively). The number of ideal behaviour metrics was not a discriminator of educational groups. Concerning the categories of CVH status the poor CVH was a discriminator for low and medium education compared with those with high education (OR 1.93 95% CI 1.24 to 3.01 and OR 1.54 95% CI 1.08 to 2.19, respectively).ConclusionsOur findings emphasise the large potential for preventing cardiovascular disease, showing a low proportion with a favourable CVH profile, especially among low-educated people. It is necessary to consider prevention strategies aimed at improving CVH in RS, targeting primarily low educational groups.

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Our study indicates extremely low prevalence of ideal and high prevalence of poor CVH in the adult RS population. Such alarming results require urgent action. Comprehensive public health strategies and interventions must be developed to assist individuals and population in improving their CVH.

BackgroundA relatively consistent body of literature, mainly from high-income countries, supports an inverse association between socio-economic status (SES) and risk of cardiovascular disease (CVD). Data from low- and middle-income countries are scarce. This study explores SES differences in cardiovascular health (CVH) in the Republic of Srpska (RS), Bosnia and Herzegovina, a middle-income country.MethodsWe collected information on SES (education, employment status and household’s relative economic status, i.e. household wealth) and the 7 ideal CVH components (smoking status, body mass index, physical activity, diet, blood pressure, total cholesterol, and fasting blood glucose) among 3601 participants 25 years of age and older, from the 2010 National Health Survey in the RS. Based on the sum of all 7 CVH components an overall CVH score (CVHS) was calculated ranging from 0 (all CVH components at poor levels) to 14 (all CVH components at ideal levels). To assess the differences between groups the chi-square test, t-test and ANOVA were used where appropriate. The association between SES and CVHS was analysed with multivariate linear regression analyses. The dependent variable was CVHS, while independent variables were educational level, employment status and wealth index.ResultsAccording to multiple linear regression analysis CVHS was independently associated with education attainment and employment status. Participants with higher educational attainment and those economically active had higher CVHS (b = 0.57; CI = 0.29–0.85 and b = 0.27; CI = 0.10–0.44 respectively) after adjustment for sex, age group, type of settlement, and marital status. We failed to find any statistically significant difference between the wealth index and CVHS.ConclusionThis study presents the novel information, since CVHS generated from the individual CVH components was not compared by socio-economic status till now. Our finding that the higher overall CVHS was independently associated with a higher education attainment and those economically active supports the importance of reducing socio-economic inequalities in CVH in RS.

The main objective of the presented paper was to evaluate the integrated design strategies applied in refurbishment of the prefabricated residential housing, erected in'70 in the New Belgrade, Serbia, in order to achieve energy savings accompanied with reduction of CO2 emissions and improvement of households' health and comfort. Conducted study led to the preliminary design of energy refurbishment of the existing building, and its conversion to energy efficient building with minimized loads. Building's dynamic behavior and energy efficiency have been optimized implementing BPS-Building Performance Simulation. Very significant reduction of thermal and cooling loads with the reference to the building's existing status is obtained. Refurbishment encompassed comprehensive optimization of building's envelope structure, natural and mixed ventilation. The implementation of a series of EEI (energy efficiency improvement) measures resulted in significant reduction of buildings energy loads. The investment in energy efficiency retrofitting can improve macroeconomic stability and contribute to the sustainable economic growth. Furthermore, economic analyses were performed for each model, considering present economic situation in Serbia and availability of funds for refurbishment. Presented methodology and results of the performed analyses offer an opportunity to extend their application to other neighborhoods, exploring refurbishment potential results if applied on a greater urban scale. Economically feasible Energy Refurbishment of Prefabricated Building inBelgrade, Serbia The main objective of the presented paper was to evaluate the integrated design strategies applied in refurbishment of the prefabricated residential housing and their economic feasibility, considering current economic situation in Serbia. The aim of the study is architectural re-design using "passive" and "active" measures to improve and optimize the energy efficiency of residential buildings.Design strategies were applied in order to achieve energy savings accompanied with reduction of CO 2 emissions and improvement of households' health and comfort. By BPS -Building Performance Simulation were analyzed effects of the implementation of a series of EEI (energy efficiency improvement) measures and they resulted in significant reduction of buildings energy loads. Considering present economic situation in Serbia and availability of funds for refurbishment, by analyzing these six different energy efficiency retrofitting models, valuable inputs were obtained for further development of economic models. The results clearly prove that every retrofit scenario is economically feasible.

The present study confirmed demographic, socio-economic and health status inequalities in the UHCS in RS. These findings have significant implications for health policy makers that seek to provide equal care for all people living in RS.

Significant differences in the prevalence of CVH metrics between men and women in the Republic of Srpska should be considered in cardiovascular disease prevention.

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