Rates of Death and of Coronary Events in the Turkish Adult Survey: 5-year Follow-up of the Cohort

Two-thirds of the original cohort residing in various geographic regions of Turkey who had been studied 5 years previously was followed up by physical examination and an ECG recording at rest. Rates of death, coronary heart disease (CHD) death, and new coronary events were studied in these 1644 adults (comprising 844 women) initially aged 20 years or over. New coronary events were defined to inelude fatal and nonfatal myocardial infarction, acute myocardial ischemia and newly developed stable angina with or without associated myocardial ischemia. Overall annual death rate was 8.9 per 1000 adults reflecting the observed 96 deaths which was in agreement with other estimates. CHD deaths numbered 41 (of which 19 in women) representing 3.8 per 1000 adults per annum and were found high in women. Nonfatal coronary events were registered in 53 adults (including 19 in women) and, when added to fatal events, resulted in 28 overall new coronary events in women and 49 in men. (corresponding annual rates per 1000 adults being 5.2 and 9, respectively). Rates in women appeared high. Coronary deaths observed in the Aegean, Mediterranean and Southeast Anatolian regions were low whereas those in the East Anatolia and Black Sea regions were high. Among subjects dying from CHD and having had new coronary events, hypertension was the major associated risk factor. Smoking was the most commonly accompanying risk factor in men, obesity in women, each exhibiting a reverse trend in the other gendre. Based on this study and on the data obtained from the Marmara region surveyed a year ago, it may be concluded that 160.000 adult men and 120.000 women die each year in Turkey. These comprise 66.000 coronary deaths in men and 6 1.000 in women annually. Among these deaths 70.000 were considered to be fatal coronary e:vents which, when included to 160.000 nonfatal ones, lead to an estimated annual 230.000 new coronary events among Turks.