nazan yardım

Contrasting cardiovascular mortality trends in Eastern Mediterranean populations: Contributions from risk factor changes and treatments

BACKGROUND Middle income countries are facing an epidemic of non-communicable diseases, especially coronary heart disease (CHD). We used a validated CHD mortality model (IMPACT) to explain recent trends in Tunisia, Syria, the occupied Palestinian territory (oPt) and Turkey. METHODS Data on populations, mortality, patient numbers, treatments and risk factor trends from national and local surveys in each country were collated over two time points (1995-97; 2006-09); integrated and analysed using the IMPACT model. RESULTS Risk factor trends: Smoking prevalence was high in men, persisting in Syria but decreasing in Tunisia, oPt and Turkey. BMI rose by 1-2 kg/m(2) and diabetes prevalence increased by 40%-50%. Mean systolic blood pressure and cholesterol levels increased in Tunisia and Syria. Mortality trends: Age-standardised CHD mortality rates rose by 20% in Tunisia and 62% in Syria. Much of this increase (79% and 72% respectively) was attributed to adverse trends in major risk factors, occurring despite some improvements in treatment uptake. CHD mortality rates fell by 17% in oPt and by 25% in Turkey, with risk factor changes accounting for around 46% and 30% of this reduction respectively. Increased uptake of community treatments (drug treatments for chronic angina, heart failure, hypertension and secondary prevention after a cardiac event) accounted for most of the remainder. DISCUSSION CHD death rates are rising in Tunisia and Syria, whilst oPt and Turkey demonstrate clear falls, reflecting improvements in major risk factors with contributions from medical treatments. However, smoking prevalence remains very high in men; obesity and diabetes levels are rising dramatically.

Determinants of Breast and Cervical Cancer Screening Uptake Among Women in Turkey.

The aim of the study was to assess the influence of sociodemographic characteristics on breast and cervical cancer screening among women 30 years and older in Turkey. We used data from the National Chronic Diseases and Risk Factors Survey conducted by the Ministry of Health in 2011. Multivariate logistic regression analysis was used to assess the association of sociodemographic factors, lifestyle variables, and cancer screening. Overall, 22.0% of women ever had a Pap smear test for cervical cancer screening and 19.0% ever had a mammography for breast cancer screening(n = 6846). Individuals with a university degree, social security, doing moderate physical activity, and consuming 5 portions of fruit or vegetable/day were more likely to receive Pap smear test and mammography. Residing in the eastern region and living in rural area was associated with lower likelihood of receiving both types of screening.

Determinants of prevalence, awareness, treatment and control of high LDL-C in Turkey

Objective: High blood cholesterol is one of the main modifiable risk factors for cardiovascular diseases (CVDs). The aim of the study is to determine the factors associated with the prevalence, awareness, treatment, and control of high “low-density lipoprotein-cholesterol” (LDL-C) among adults aged ≥20 years in Turkey. Methods: We used data from Chronic Diseases and Risk Factors Survey conducted in 2011–2012. The presence of high LDL-C, lipid-lowering treatment eligibility, and achievement of target LDL-C were defined according to the third Adult Treatment Panel guidelines on treatment of high cholesterol. Multivariate logistic regression analyses were performed to determine the associations between participant characteristics and high LDL-C prevalence, awareness, treatment, and control. Results: Framingham risk score categorization was performed for 13121 individuals aged ≥20 years. Approximately, 28% of the participants presented with high LDL-C. Among those with high LDL-C, 55.8% were aware of their situation; among those aware of high LDL-C, 46.9% were receiving lipid-lowering medication, and 50.6% of individuals who were receiving treatment achieved target LDL-C levels on the basis of their coronary heart disease (CHD) risk. Control of high LDL-C was negatively associated with the presence of diabetes mellitus (odds ratio: 0.36, 95% CI: 0.27–0.49, p<0.001). Conclusion: Despite the high awareness rates, there was a high proportion of adults who did not receive treatment or achieve recommended levels of LDL-C during treatment. The low treatment and control levels among individuals based on their CHD risk levels call for a better application of recommendations regarding personal preventive measures and treatments in Turkey.

Owerweight and obesity among children in Turkey

Obesity in childhood is increasing and becoming a major public health problem in the last years in Turkey.The aim of the study was to find out the prevalance of childhood overweight and obesity among Turkish second grade of schoolchildren. The data was collected from 53 cities in 12 NUTS Area in May-June 2013. This study is a cross-sectional study, overweight and obesity prevalance were calculated by using WHO criteria. The numbers of the children in the sample were 5600. Out of 216 schools, 43 were from rural settlements and 163 from urban settlements. The target age group of the study was 7-8 years age children at second grade of the schools. Out of all children at the schools, 88.8% of the children had parent consent for antropometric measurements. The antropometric measurements were conducted by by trained health staff using standardized equipment. Out of all the children in the sample, 88.5% of them was analyzed. Out of the children, 49.9% were girls and 52.7% were seven years old. According to WHO Criteria, the prevalance of overweight were 14.5% (95% CI 13.1-15.9) and the prevalance of obesity was 8.6% (95% CI 7.52-9.67) among 7 years age children. These figures were respectively 13.9% (95% CI 12.5-15.3) and 8.0% (95 % CI 6.90-9.09) among 8 years age children. Prevalance for overweight and obesity were different by gender and residence. Boys and children living in urban settlements were more frequently overweight and obese. Overweight and obesity prevalance showed differences by NUTS Regions. Istanbul and East Blacksea NUTS Regions had the highest figures among all regions (15.9% CI 13.4-18.4; 18.3% CI 11.5-25.1, respectively). These findings shows that there is an urgent need to develop obesity prevention program for children in the country.