Investigation of Framingham Risk Factors in Turkish adults

Year 2011, Volume: 2 Issue: 1, 42 - 49, 01.03.2011

Nilgün Tekkeşin Cumhur Kılınç

https://doi.org/10.5799/ahinjs.01.2011.01.0208

Abstract

Objectives: The aim of this study was to determine 10-year risk for development of cardiovascular diseases using Framingham risk scoring as a tool for the estimation of coronary risk and renew the blood lipid levels. Materials and methods: Samples from fasting 3169 healthy donors declaring as having no cardiovascular disease and diabetes (1800 women, mean age 46.8±9.2 years) and 1369 men, mean age 46.03±8.4 years) were tested and scored according to risk factors in both genders. Results: When average values were considered, total cholesterol level was higher (204±42 mg/dL) according to reactive insert reference values. High total kolesterol and low HDL-C levels were seen in 20% and 19.5% of men and 32.6% and 1.1% of women, respectively. The number of participants having systolic blood pressure ≥130 mmHg and diastolic blood pressure ≥ 85 mmHg were 775 (24.5%) and the distribution of those values was 10.6 % in men and 13.9% in women. The mean 10-year cardiovascular disease risks were 9.4 % in men and 4.6% in women among 3169 participants. Conclusion: A 10-year risk of coronary disease, in Turkish males was 2-fold higher than in Turkish females. Use of Framingham study in clinical assessments maintains to be a valid method in preventive approaches for development of cardiovascular diseases.

Keywords

Framingham risk score, coronary heart disease, HDL-cholesterol, LDL-cholesterol, total cholesterol

Türk erişkinlerde Framingham Risk Faktörlerinin araştırılması

Abstract

Amaç: Çalışmanın amacı, Framingham Risk Skorlamasını kullanarak belli bir grupta 10 yıllık koroner kalp hastalığı gelişim riskini belirlemek ve kan lipid değerlerini tekrar gözden geçirmektir. Gereç ve yöntemler: Örnekler kardiyovasküler bir hastalığı ve diyabeti olmadığını beyan eden 3169 katılımcıdan toplandıktan sonra (1800 kadın; yaş ortalaması 46.8±9.2 yıl ve 1369 erkek; yaş ortalaması 46.03±8.4 yıl) bir dizi risk faktörleri [yaş, total kolesterol (kolesterol-T), cinsiyet, HDL-kolesterol (HDL-K), sistolik kan basıncı, diyabet varlığı ve sigara kullanımı] yönünden skorlandırılmıştır. Bulgular: Ortalama değerler göz önüne alındığında, kolesterol-T düzeyi, reaktif içeriğinde belirlenen üst sınırın (200 mg/dL) üzerinde tespit edilmiştir (204±42 mg/dL). Yüksek kolesterol-T ve düşük HDL-K düzeyi, erkeklerde sırasıyla % 20 ve % 19.5 ve kadınlarda % 32.6 ve % 1.1 olarak bulundu. Sistolik kan basıncı ≥130 mmHg ve diyastolik kan basıncı ≥85 mmHg olan katılımcıların sayısı 775 (% 24.5) adet olup bu değerlerin cinsiyete göre dağılımı erkeklerde % 10.6, kadınlarda % 13.9 olarak bulunmuştur. On yıllık koroner kalp hastalığı riski, 3169 katılımcı arasından erkeklerde % 9.4 ve kadınlarda % 4.6 bulunmuştur (p

Keywords

Framingham risk skorlaması, koroner kalp hastalığı, HDL-kolesterol, LDL-kolesterol, total kolesterol

References

• McDermott MM. The international pandemic of chronic cardiovascular disease. JAMA 2007;297:1253-1258.
• Petersen S, Peto V, Rayner M, Leal J, Luengo-Fernandez R, Gray A. European cardiovascular disease statistics. London: British Heart Foundation, 2005.
• Rosamond W, Flegal K, Friday G, et al. Heart disease and stroke statistics—2007 update: a report from the American Heart Association statistics committee and stroke statistics subcommittee. Circulation 2007,115:69-171.
• Kannel W, McGee D, Gordon T. A general cardiovascular risk profile: the Framingham Study. Am J Cardiol 1976; 38:46-51.
• Anderson KM, Wilson PWF, Odell PM, et al: An updated coronary risk profile: a statement for health professionals. Circulation 1991; 83:356-362.
• Wilson PWF, D’Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation 1998; 97:1837–1847.
• Kannel WB, Dawber TR, Kagan A, Revotskie N, Stokes J III. Factors of risk in the development of coronary heart disease—six year follow-up experience. The Framingham Study. Ann Intern Med1961;55:33-50.
• Kagan A, Dawber TR, Kannel WB, Revotskie N. The Framingham study: a prospective study of coronary heart disease. Fed Proc1962;21:52-59.
• Kannel WB. Coronary heart disease risk factors in the elderly. Am J Geriatr Cardiol 2002;11:101-108.
• Folsom AR, Chambless LE, Ballantyne CM, et al. An assessment of incremental coronary risk prediction using creactive protein and other novel risk markers: the atherosclerosis risk in communities study. Arch Intern Med 2006;166:1368-1373.
• Wang TJ, Gona P, Larson MG, et al. Multiple biomarkers for the prediction of first major cardiovascular events and death. N Engl J Med 2006;355:2631-2640.
• National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation 2002;106:3143-4217.
• Levy D, Wilson PWF, Anderson KM, Castelli WP. Stratifying the patient at risk from coronary disease: New insights from the Framingham Heart Study. Am Heart J 1990;119:712-719.
• Stamler J, Wentworth D, Neaton JD: Is relationship between serum cholesterol and risk of premature death from coronary heart disease continuous and graded? Findings in 356222 primary screenees of the Multiple Risk Factor Intervention Trial (MRFIT). JAMA 1986;256:2823-2831.
• Onat A, Surdum-Avcı G, Senocak M, Örnek E, Gözükara Y. Serum lipids and their interrelation in Turkish adults. J Epidemiol Comm Hlth 1992; 46: 470-476.
• Mahley RW, Palaoğlu KE, Atak Z, et al: Turkish Heart Study: Lipids, lipoproteins, and apolipoproteins. J Lipid Res 1995; 36: 839-859.
• Gülec S. Kalp damar hastalıklarında global risk ve hedefler. Türk Kardiyol Dern Ars 2009; 37:1-10.
• Tokgözoğlu L. Türklerde kolesterol ve trigliseridler. TEKHARF: Türk eriskinlerinde kalp sağlığının dünü ve bugünü. Ed. Onat A, Avcı GS, Soydan Đ, Koylan N, Sansoy V, Tokgözoğlu L. Đstanbul, 1996;45-62.
• Goldstein JL, Kita T, Brown MS: Defective lipoprotein receptors and atherosclerosis: Lessons from an animal counterpart of familial hypercholesterolemia. N Engl J Med 1983; 309:288-296.
• The Lipid Research Clinics Coronary Primary Prevention Trial results. 1. Reduction in incidence of coronary heart disease. JAMA 215:351, 1984.
• Onat A, Yıldırım B, Uslu N, ve ark. Türk eriskinlerinde plazma lipoprotein ve apolipoproteinleri: Genel düzeyler, risk faktörleriyle iliskileri ve kadınlarda HDL’nin koroner riski belirleyiciliği. Türk Kardiyol Dern Ars 1999; 27:7281.
• Mahley RW, Mahley LL, Bersot TP, Pépin GM, Palaoğlu KE. The Turkish lipid problem: low levels of high density lipoproteins. Turk J Endocr Metab 2002;1:1-12.
• Onat A. Risk factors and cardiovascular disease in Turkey. Atherosclerosis 2001; 156:1-10.
• Onat A, Hergenç G, Uzunlar B, ve ark. Türk toplumunda koroner risk faktörü olarak HDL-kolesterol: öngördürücülüğü, belirleyicileri ve iliskileri. Türk Kardiyol Dern Ars 2003; 31:9-16.
• Hergenc G, Ozsullu T, Uzun A, Cetinalp P, Bayrak A, Maral H. Kocaeli Lipid Study. Low HDL in cardiovascular diseases. Atherosclerosis 1999;146:S25.
• Onat A, Adalet K. Smoking tendency in Turkish adults. In: Onat A (ed.). TEKHARF: Coronary health, risk profile and heart disease in Turkish adults. Istanbul, Oran, 2000:57-59.
• Onat A, Uysal Ö, Hergenç G. TEKHARF çalısması orijinal kohortunun Framingham risk fonksiyonuna göre değerlendirilmesi: Halkımızın mutlak koroner riskinin yüksekliğine iliskin bir ek kanıt. Türk Kardiyol Dern Ars 2001;29:208-209.
• Onat A. Türk Yetiskinleri için Kullanılmaya Uygun Bir Koroner Risk Puanlaması.Türk Kardiyol Dern Ars 2002; 30:604-611.
• Güleç S.Kalp damar hastalıklarında global risk ve hedefler. Türk Kardiyol Dern Ars 2009; 37:1-10.
• Atamer Y, Atamer A. Lipoprotein (a) ve serum lipidlerinin aterosklerotik olgulardaki değisikliklerinin incelenmesi. Dicle Tıp Derg 2002; 29:31-36.
• Dalar Y, Bahçeci M. Diyarbakır’da sağlık kuruluslarına basvuran kisilerin obezite ve lipid parametreleri açısından değerlendirilmesi. Dicle Tıp Derg 2000;27:13-20.
• Erden S. Poliklinik hastalarında obezite sıklığı ve klinik özellikleri. Đstanbul Ünv. Đstanbul Tıp Fak. Mec 2001; 64: 249-254.