ISSN 1016-5169 | E-ISSN 1308-4488
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Female and urban participants demonstrate an adverse trend in overall mortality in Turkey – and a report on the TARF survey 2016 [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2017; 45(5): 391-397 | DOI: 10.5543/tkda.2017.76746

Female and urban participants demonstrate an adverse trend in overall mortality in Turkey – and a report on the TARF survey 2016

Altan Onat1, Mehmet Özbek2, Süleyman Karakoyun3, Okan Uzun4, Muhammed Keskin4, Yusuf Karadeniz5, Mert I. Hayıroğlu4, Volkan Çamkıran6, Adnan Kaya7, Günay Can8
1Department of Cardiology, İstanbul University Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
2Department of Cardiology, Yüzüncü Yıl University Faculty of Medicine, Van, Turkey
3Department of Cardiology, Kafkas University Faculty of Medicine, Kars, Turkey
4Siyami Ersek Center For Cardiovascular Surgery, İstanbul, Turkey
5Department of Endocrinology, Atatürk University Faculty of Medicine, Erzurum, Turkey
6Department of Cardiology, Koç University Faculty of Medicine, İstanbul, Turkey
7Department of Cardiology, Düzce University Faculty of Medicine, Düzce, Turkey
8Department of Public Health, İstanbul University University Faculty of Medicine, İstanbul, Turkey


OBJECTIVE
This study is an examination of 1) overall mortality trend in the Turkish Adult Risk Factor (TARF) study stratified by sex and place of residence, and 2) brief report on main aspects of the 2016 survey.

METHODS
The period of last 18 years was divided into 2 for trend analysis of data. Required information on deaths was obtained. Baseline age ≥40 years at the beginning of each period was the inclusion criterion. Cox regression analyses were performed.

RESULTS
Among over 2500 participants in each, deaths were recorded in 281 and 334 individuals in Periods 1 and 2, respectively, and baseline mean age was 54.6 years and 56.4 years, respectively, in each period. Age-adjusted hazard ratio for mortality in Period 2 remained virtually the same for rural males, rose to borderline significance for urban males and rural females (p=0.06, p=0.09), and increased 1.72-fold for urban females (p=0.006), as compared to Period 1. Whereas males gained an average of 3.8 years of survival in the later period compared with the earlier period, females gained only 1.8 years. This narrowed the difference in mean age at death in favor of women from 2.5 years to 0.5 year. Of 1144 participants to be surveyed in the TARF 2016, 48 were lost to follow-up, 695 were examined, and 39 participants were ascertained to be deceased. In 362 cases, verbal information was obtained regarding health status.

CONCLUSION
Gain in survival in Turkish women has distinctly stagnated compared with men, and hazard of death has risen significantly for women and urban residents in the past decade, suggesting interaction between female sex and urban residence. Both phenomena require recognition and adoption of appropriate measures.

Keywords: Sex, mortality/trend, Turkey/epidemiology

Corresponding Author: Altan Onat, Türkiye
Manuscript Language: English
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