Trends in Mortality, Coronary Morbidity and Mortality in the Inhabitants of the Marmara Region

In the third survey of a cohort of the Marmara region of Turkey in J un e 1997, a total of 531 subjects of the original cohort were followed up and 212 new Iy enrolled persons were subjected to physical examination and an ECG recording at rest. Rates of death, coronary heart disease (CHD) death, and new nonfatal coronary events (NCE) were studied in the original cohort whose median age at time of survery was 46 years both in men and women. NCE were defined to ineJude nonfatal myocardial infarction, acute myocardial ischemia, and newly developed stable angina with or without associated myocardial ischemia. During a mean of 7 years since the initial survey, the follow-up amounted to 5200 personyears, anda total of 35 deaths, 21 CHD deaths and 26 NCE were registered. Overall annual death rate was 6.7 per 1000 adults which w as slightly higher in women (7 .4 vs. 6.1 per 1000). A similar slight preponderance of females (4.5 vs. 3.6 per 1000) was noted in CHD death as well. NCE were observed at a rate of 6.5 per 1000 adults (7.1 in women vs. 6 per 1000 in men). Coronary death and event rates in the Marmara region appeared to be similar to those of the entire Turkish cohort studied in 1995 though female preponderance was confined to this region . Though most (13/1 7) of new coronary events in women consisted of new angina and/or new myocardial ischemia, most (8/15) of new events in men manifested as myocardial infarction.