Predictors of major adverse cardiovascular events; results of population based MELEN study with prospective follow-up.

OBJECTIVE: In healthy persons, cardiovascular risk is the result of multiple interacting risk associates including demographic, clinical, genetic and environmental factors. Several non-invasive tools such as echocardiography, ultrasonography and electrocardiography as well as new biochemical markers were shown to be applicable to predict cardiovascular events. However, implementation of all of these tools has not been tested before. The aim of the study was to evaluate the independent predictors of major adverse cardiovascular events in a prospective population based study, with the use of bioempedance analysis, echocardiography, ultrasonography and ECG. PATIENTS AND METHODS: The baseline measurements were conducted on 2230 participants (1427 women, 803 men with a mean age of 49 ± 15). The follow-up was done 36 months after the baseline admission via telephone call. Major adverse event was defined as mortality or myocardial infarction or stroke. RESULTS: Follow-up data was possible in 1495 participants (65%). During the follow-up of 36 months (4485 patient years), 42 major adverse events occurred (0.03%). Among them, 16 were death (1 stroke, 2 cancer, 13 cardiac related), 12 were stroke and 14 were myocardial infarction. Age, body mass index and atrial fibrillation were independent predictors of major adverse events; AF being the most powerful (Odds ratio 10.46; 95% confidence interval [1.73-63.14]; p = 0.010). CONCLUSIONS: Age, lower body mass index and atrial fibrillation were independent predictors of major cardiovascular events in our cohort.

The impact of metabolic syndrome on carotid intima media thickness.

OBJECTIVES: Metabolic syndrome (MetS) is a cluster of metabolic abnormalities involving several cardiovascular risk factors. Carotid intima media thickness (CIMT) is an important early screening tool to assess subclinical manifestation of cardiovascular and metabolic diseases. We aimed to investigate the impact of MetS on CIMT in a large scaled community based study. METHODS: The study was conducted on 2102 participants. Carotid intima media thickness was measured in all of the participants. The study sample was divided into 4 groups; Group 1 subjects with a body mass index (BMI) < 25.0 kg/m2 [n = 499 (MetS- = 488, MetS+ = 11)], Group 2 BMI between 25.0 and 29.9 kg/m2 [n = 693 (MetS- = 559, MetS+ = 134)], Group 3 BMI between ≥ 30 kg/m2 and 39.9 kg/m2 [n = 822 (MetS- = 375, MetS+ = 477)], and Group 4 BMI ≥ 40 kg/m2 [n = 88 (MetS- = 27, MetS+ = 61)]. RESULTS: Carotid intima media thickness was higher in the individuals with MetS compared to their normal counterparts. Furthermore, the subgroup analysis showed that CIMT values in Group 1 (0.55±0.18 vs 0.82±0.70; p < 0.001), Group 2 (0.59±0.20 vs 0.68±0.18; p < 0.001) and Group 3 (0.61±0.15 vs 0.65±0.18; p < 0.001) were significantly higher in subjects with MetS compared to their normal counterparts, whereas the values were similar in Group 4 (0.62±0.13 vs 0.65±0.17; p = 0.363). CONCLUSIONS: Carotid intima media thickness of overweight, obese and normal weight individuals without MetS were lower than their counterparts with MetS. MetS had no impact on CIMT in morbid obese individuals possibly due to established insulin resistance earlier than MetS.

Predictors of hypertension control in Turkey: the MELEN study.

BACKGROUND: Hypertension is one of the most common causes of atherosclerosis, morbidity and mortality in adults. A total of 11 million hypertensive patients were estimated in Turkey. AIM: The aim of this study was to investigate the prevalence, awareness and control of hypertension in Duzce and compare the current data with the literature. MATERIALS AND METHODS: The visits were carried out in May and June, 2010 in Yigilca town health centre on 2298 participants (1471 female, 827 male with a mean age of 50). Data were obtained by a simple form, physical examination and sampling of blood. Hypertension was defined as a blood pressure 140 mmHg and/or 90 mmHg, and/or use of antihypertensive medication. The data of patients under control were compared with the patients who were not under control. RESULTS: Hypertension was detected in 964 participants. General prevalence was 42%. Hypertension awareness ratio was 70%, use of antihypertensive medication was 39% and the ratio of patients under control was 28%. Antihypertensive drug use, age and awareness were lower in the uncontrolled group. Logistic regression analysis revealed that only antihypertensive drug use and BMI < 30 were the independent predictors of hypertension under control [Odd's ratio (OR) = 3.43; 95% confidence interval (CI) = 2.54-4.64, p < 0.001 and OR = 1.69; 95% CI = 1.23- 2.32, p = 0.01; respectively]. CONCLUSIONS: Hypertension is one of the most important public health problems in Turkey. According to the literature data the awareness of hypertension was increased significantly in the last five years. On the other hand, control ratio was increased very little compared with the previous studies.

Effect of combined oral contraceptive use on platelet volume in women at reproductive age.

INVESTIGATION: Combined oral contraceptives use is associated with an increased risk of developing venous and arterial thromboembolic events. Platelet size, measured as mean platelet volume (MPV), is associated with platelet reactivity. METHODS: Ninety-five women using oral contraceptives for contraception were investigated retrospectively. The patients' blood pressure, pulse and hematological values at application and at the sixth month were evaluated retrospectively. RESULTS: There was no difference between the values of blood pressure (systolic and diastolic), pulse, hematological values (which contain leukocytes, platelets and mean platelet volume) at application and at the sixth month. CONCLUSION: We determined that using oral contraceptives for contraception did not change MPV values in young women.