Skip to main content
Top
Published in: BMC Public Health 1/2013

Open Access 01-12-2013 | Research article

Decreasing trends in cardiovascular mortality in Turkey between 1988 and 2008

Authors: Gönül Dinç, Kaan Sözmen, Gül Gerçeklioğlu, Hale Arık, Julia Critchley, Belgin Ünal

Published in: BMC Public Health | Issue 1/2013

Login to get access

Abstract

Background

Cardiovascular disease (CVD) mortality increased in developed countries until the 1970s then started to decline. Turkey is about to complete its demographic transition, which may also influence mortality trends. This study evaluated trends in coronary heart disease (CHD) and stroke mortality between 1988 and 2008.

Methods

The number of deaths by cause (ICD-8), age and sex were obtained from the Turkish Statistical Institute (TurkStat) annually between 1988 and 2008. Population statistics were based on census data (1990 and 2000) and Turkstat projections. European population standardised mortality rates for CHD and stroke were calculated for men and women over 35 years old. Joinpoint Regression was used to identify the points at which a statistically significant (p < 0.05) change of the trend occurred.

Results

The CHD mortality rate increased by 2.9% in men and 2.0% in women annually from 1988 to 1994, then started to decline. The annual rate of decline for men was 1.7% between 1994–2008, whilst in women it was 2.8% between 1994–2000 and 6.7% between 2005–2008 (p < 0.05 for all periods).
Stroke mortality declined between 1990–1994 (annual fall of 3.8% in both sexes), followed by a slight increase between 1994–2004 (0.6% in men, 1.1% in women), then a further decline until 2008 (annual reduction of 4.4% in men, 7.9% in women) (p < 0.05 for all periods).

Conclusions

A decrease in CVD mortality was observed from 1995 onwards in Turkey. The causes need to be explored in detail to inform future policy priorities in noncommunicable disease control.
Appendix
Available only for authorised users
Literature
3.
go back to reference Committee on Preventing the Global Epidemic of Cardiovascular Disease: Meeting the challenges in developing countries, board on global health: promoting cardiovascular health in the developing world a critical challenge to achieve global health. 2010, Washington DC: The National Academies Press Committee on Preventing the Global Epidemic of Cardiovascular Disease: Meeting the challenges in developing countries, board on global health: promoting cardiovascular health in the developing world a critical challenge to achieve global health. 2010, Washington DC: The National Academies Press
6.
go back to reference Onat A: Risk factors and cardiovascular disease in Turkey. Atherosclerosis. 2001, 156: 1-10. 10.1016/S0021-9150(01)00500-7.CrossRefPubMed Onat A: Risk factors and cardiovascular disease in Turkey. Atherosclerosis. 2001, 156: 1-10. 10.1016/S0021-9150(01)00500-7.CrossRefPubMed
7.
go back to reference Akgun S, Rao C, Yardim N, Basara BB, Aydin O, Mollahaliloglu S, et al: Estimating mortality and causes of death in Turkey: methods, results and policy implications. Eur J Public Health. 2007, 17: 593-599. 10.1093/eurpub/ckm022.CrossRefPubMed Akgun S, Rao C, Yardim N, Basara BB, Aydin O, Mollahaliloglu S, et al: Estimating mortality and causes of death in Turkey: methods, results and policy implications. Eur J Public Health. 2007, 17: 593-599. 10.1093/eurpub/ckm022.CrossRefPubMed
10.
go back to reference Ford ES, Capewell S: Coronary heart disease mortality among young adults in the U. S. from 1980 through 2002: concealed leveling of mortality rates. J Am Coll Cardiol. 2007, 50: 2128-2132. 10.1016/j.jacc.2007.05.056.CrossRefPubMed Ford ES, Capewell S: Coronary heart disease mortality among young adults in the U. S. from 1980 through 2002: concealed leveling of mortality rates. J Am Coll Cardiol. 2007, 50: 2128-2132. 10.1016/j.jacc.2007.05.056.CrossRefPubMed
11.
go back to reference O’Flaherty M, Ford E, Allender S, Scarborough P, Capewell S: Coronary heart disease trends in England and Wales from 1984 to 2004: concealed levelling of mortality rates among young adults. Heart. 2008, 94: 178-181. 10.1136/hrt.2007.118323.CrossRefPubMed O’Flaherty M, Ford E, Allender S, Scarborough P, Capewell S: Coronary heart disease trends in England and Wales from 1984 to 2004: concealed levelling of mortality rates among young adults. Heart. 2008, 94: 178-181. 10.1136/hrt.2007.118323.CrossRefPubMed
12.
go back to reference Wilson A, Siskind V: Coronary heart disease mortality in Australia: is mortality starting to increase among young men?. Int J Epidemiol. 1995, 24: 678e84-CrossRef Wilson A, Siskind V: Coronary heart disease mortality in Australia: is mortality starting to increase among young men?. Int J Epidemiol. 1995, 24: 678e84-CrossRef
13.
go back to reference Vaartjes I, O’Flaherty M, Grobbee DE, Bots ML, Capewell S: Coronary heart disease mortality trends in the Netherlands 1972–2007. Heart. 2011, 97: 569-573. 10.1136/hrt.2010.206565.CrossRefPubMed Vaartjes I, O’Flaherty M, Grobbee DE, Bots ML, Capewell S: Coronary heart disease mortality trends in the Netherlands 1972–2007. Heart. 2011, 97: 569-573. 10.1136/hrt.2010.206565.CrossRefPubMed
16.
go back to reference Razum O, Akgun S, Tezcan S: Cardiovascular mortality patterns in Turkey: what is the evidence?. Soz Praventivmed. 2000, 45 (1): 46-51. 10.1007/BF01358998.CrossRefPubMed Razum O, Akgun S, Tezcan S: Cardiovascular mortality patterns in Turkey: what is the evidence?. Soz Praventivmed. 2000, 45 (1): 46-51. 10.1007/BF01358998.CrossRefPubMed
18.
go back to reference Cancer incidence in five continents, volume 6. Edited by: Waterhouse J, Correa P, Muir C, Powell J. 1976, Lyon: International Agency for Research on Cancer, 456-3 Cancer incidence in five continents, volume 6. Edited by: Waterhouse J, Correa P, Muir C, Powell J. 1976, Lyon: International Agency for Research on Cancer, 456-3
20.
go back to reference Ozdemir R: The evaluation of the death reporting system. 2012, Turkey: Izmir data. PhD thesis. Ege University, Public Health Department Ozdemir R: The evaluation of the death reporting system. 2012, Turkey: Izmir data. PhD thesis. Ege University, Public Health Department
22.
go back to reference Müller-Nordhorn J, Binting S, Roll S, Willich SN: An update on regional variation in cardiovascular mortality within Europe. Eur Heart J. 2008, 29 (10): 1316-1326.CrossRefPubMed Müller-Nordhorn J, Binting S, Roll S, Willich SN: An update on regional variation in cardiovascular mortality within Europe. Eur Heart J. 2008, 29 (10): 1316-1326.CrossRefPubMed
23.
go back to reference Global Adult Tobacco Survey Turkey Report: 2010, Ankara: The Ministry of Health of Turkey Global Adult Tobacco Survey Turkey Report: 2010, Ankara: The Ministry of Health of Turkey
24.
go back to reference Satman I: Population-based study of diabetes and risk characteristics in Turkey: results of the Turkish diabetes epidemiology study (TURDEP-I). Diabetes Care. 2002, 25: 1551-1556. 10.2337/diacare.25.9.1551.CrossRefPubMed Satman I: Population-based study of diabetes and risk characteristics in Turkey: results of the Turkish diabetes epidemiology study (TURDEP-I). Diabetes Care. 2002, 25: 1551-1556. 10.2337/diacare.25.9.1551.CrossRefPubMed
25.
go back to reference Sanisoglu SY, Oktenli C, Hasimi A, Yokusoglu M, Ugurlu M: Prevalence of metabolic syndrome-related disorders in a large adult population in Turkey. BMC Public Health. 2006, 6: 92-10.1186/1471-2458-6-92.CrossRefPubMedPubMedCentral Sanisoglu SY, Oktenli C, Hasimi A, Yokusoglu M, Ugurlu M: Prevalence of metabolic syndrome-related disorders in a large adult population in Turkey. BMC Public Health. 2006, 6: 92-10.1186/1471-2458-6-92.CrossRefPubMedPubMedCentral
26.
go back to reference Pająk A, Kozela M: Cardiovascular disease in Central and East Europe. Public Health Rev. 2011, 33 (2): 416-435. Pająk A, Kozela M: Cardiovascular disease in Central and East Europe. Public Health Rev. 2011, 33 (2): 416-435.
27.
go back to reference Unal B, Critchley JA, Capewell S: Circulation: explaining the decline in coronary heart disease mortality in England and Wales between 1981 and 2000. Circulation. 2004, 109 (9): 1101-1107. 10.1161/01.CIR.0000118498.35499.B2.CrossRefPubMed Unal B, Critchley JA, Capewell S: Circulation: explaining the decline in coronary heart disease mortality in England and Wales between 1981 and 2000. Circulation. 2004, 109 (9): 1101-1107. 10.1161/01.CIR.0000118498.35499.B2.CrossRefPubMed
28.
go back to reference Ford ES, Ajani UA, Croft JB, Critchley JA, Labarthe DR, Kottke TE, Giles WH, Capewell S: Explaining the decrease in U.S. deaths from coronary disease, 1980–2000. N Engl J Med. 2007, 356 (23): 2388-2398. 10.1056/NEJMsa053935.CrossRefPubMed Ford ES, Ajani UA, Croft JB, Critchley JA, Labarthe DR, Kottke TE, Giles WH, Capewell S: Explaining the decrease in U.S. deaths from coronary disease, 1980–2000. N Engl J Med. 2007, 356 (23): 2388-2398. 10.1056/NEJMsa053935.CrossRefPubMed
29.
go back to reference Kesteloot H, Sans S, Kromhout D: Dynamics of cardiovascular and all-cause mortality in Western and Eastern Europe between 1970 and 2000. Eur Heart J. 2006, 27 (1): 107-113.CrossRefPubMed Kesteloot H, Sans S, Kromhout D: Dynamics of cardiovascular and all-cause mortality in Western and Eastern Europe between 1970 and 2000. Eur Heart J. 2006, 27 (1): 107-113.CrossRefPubMed
30.
go back to reference Goldman L, Cook EF: The decline in ischemic heart disease mortality rates: an analysis of the comparative effects of medical interventions and changes in lifestyle. Ann Intern Med. 1984, 101 (6): 825-836. 10.7326/0003-4819-101-6-825.CrossRefPubMed Goldman L, Cook EF: The decline in ischemic heart disease mortality rates: an analysis of the comparative effects of medical interventions and changes in lifestyle. Ann Intern Med. 1984, 101 (6): 825-836. 10.7326/0003-4819-101-6-825.CrossRefPubMed
31.
go back to reference Hunink MG, Goldman L, Tosteson AN, Mittelman MA, Goldman PA, Williams LW, Tsevat J, Weinstein MC: The recent decline in mortality from coronary heart disease 1980–1990: the effect of secular trends in risk factors and treatment. JAMA. 1997, 277: 535-542. 10.1001/jama.1997.03540310033031.CrossRefPubMed Hunink MG, Goldman L, Tosteson AN, Mittelman MA, Goldman PA, Williams LW, Tsevat J, Weinstein MC: The recent decline in mortality from coronary heart disease 1980–1990: the effect of secular trends in risk factors and treatment. JAMA. 1997, 277: 535-542. 10.1001/jama.1997.03540310033031.CrossRefPubMed
32.
go back to reference Bandosz P, Sobien B, Podolec M, Dziedzic H, Zarzecka J, Loster B, et al: Decline in mortality from coronary heart disease in Poland after socioeconomic transformation: modelling study. BMJ. 2012, 344: d8136-10.1136/bmj.d8136.CrossRefPubMedPubMedCentral Bandosz P, Sobien B, Podolec M, Dziedzic H, Zarzecka J, Loster B, et al: Decline in mortality from coronary heart disease in Poland after socioeconomic transformation: modelling study. BMJ. 2012, 344: d8136-10.1136/bmj.d8136.CrossRefPubMedPubMedCentral
33.
go back to reference Unal B, Sözmen K, Arık H, Gerçeklioğlu G, Altun DU, Simşek H, Doganay S, Demiral Y, Aslan O, Bennett K, O’Flaherty M, Capewell S: Explaining the decline in coronary heart disease mortality in Turkey between 1995 and 2008. 2011, Trabzon, Turkey: 14th National Public Health Congress, 65-Abstract book Unal B, Sözmen K, Arık H, Gerçeklioğlu G, Altun DU, Simşek H, Doganay S, Demiral Y, Aslan O, Bennett K, O’Flaherty M, Capewell S: Explaining the decline in coronary heart disease mortality in Turkey between 1995 and 2008. 2011, Trabzon, Turkey: 14th National Public Health Congress, 65-Abstract book
Metadata
Title
Decreasing trends in cardiovascular mortality in Turkey between 1988 and 2008
Authors
Gönül Dinç
Kaan Sözmen
Gül Gerçeklioğlu
Hale Arık
Julia Critchley
Belgin Ünal
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2013
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-13-896

Other articles of this Issue 1/2013

BMC Public Health 1/2013 Go to the issue