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Explaining the decline in coronary heart disease mortality in Turkey between 1995 and 2008.

Unal, B; Sözmen, K; Arık, H; Gerçeklioğlu, G; Altun, DU; Şimşek, H; Doganay, S; Demiral, Y; Aslan, Ö; Bennett, K; et al. Unal, B; Sözmen, K; Arık, H; Gerçeklioğlu, G; Altun, DU; Şimşek, H; Doganay, S; Demiral, Y; Aslan, Ö; Bennett, K; O'Flaherty, M; Capewell, S; Critchley, J (2013) Explaining the decline in coronary heart disease mortality in Turkey between 1995 and 2008. BMC Public Health, 13 (1135). ISSN 1471-2458 https://doi.org/10.1186/1471-2458-13-1135
SGUL Authors: Critchley, Julia

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Abstract

BACKGROUND: Coronary heart disease (CHD) mortality rates have been decreasing in Turkey since the early 1990s. Our study aimed to determine how much of the CHD mortality decrease in Turkey between 1995 and 2008 could be attributed to temporal trends in major risk factors and how much to advances in medical and surgical treatments. METHODS: The validated IMPACT CHD mortality model was used to combine and analyse data on uptake and effectiveness of CHD treatments and risk factor trends in Turkey in adults aged 35-84 years between 1995 and 2008.Data sources were identified, searched and appraised on population, mortality and major CHD risk factors for adults those aged 35-84 years. Official statistics, electronic databases, national registers, surveys and published trials were screened from 1995 onwards. RESULTS: Between 1995 and 2008, coronary heart disease mortality rates in Turkey decreased by 34% in men and 28% in women 35 years and over. This resulted in 35,720 fewer deaths in 2008.Approximately 47% of this mortality decrease was attributed to treatments in individuals (including approximately 16% to secondary prevention, 3% angina treatments, 9% to heart failure treatments, 5% to initial treatments of acute myocardial infarction, and 5% to hypertension treatments) and approximately 42% was attributable to population risk factor reductions (notably blood pressure 29%; smoking 27%; and cholesterol 1%). Adverse trends were seen for obesity and diabetes (potentially increasing mortality by approximately 11% and 14% respectively). The model explained almost 90% of the mortality fall. CONCLUSION: Reduction in major cardiovascular risk factors explained approximately 42% and improvements in medical and surgical treatments explained some 47% of the CHD mortality fall. These findings emphasize the complimentary value of primary prevention and evidence-based medical treatments in controlling coronary heart disease.

Item Type: Article
Additional Information: © 2013 Unal et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Adult, Aged, Aged, 80 and over, Coronary Disease, Female, Humans, Male, Middle Aged, Models, Theoretical, Mortality, Risk Factors, Treatment Outcome, Turkey, Public Health, 1117 Public Health And Health Services
SGUL Research Institute / Research Centre: Academic Structure > Population Health Research Institute (INPH)
Journal or Publication Title: BMC Public Health
ISSN: 1471-2458
Language: eng
Dates:
DateEvent
5 December 2013Published
PubMed ID: 24308515
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/107240
Publisher's version: https://doi.org/10.1186/1471-2458-13-1135

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