Control of hypertension in Turkey--is it improving? The Kocaeli 2 study.

OBJECTIVES: In a previous study conducted in Kocaeli, Turkey, ten years before, a very low rate of hypertension control (6.2%) was reported. This hypertension survey was conducted to determine whether the treatment and control rates of hypertension improved in the same region. STUDY DESIGN: Using a stratified sampling method, 1222 subjects (559 males, 663 females, mean age 44.8+/-13.6 years) living in Kocaeli, aged 25 or over, were included. After administration of a standardized questionnaire, blood pressure was measured in the sitting position from both arms after at least five minutes of resting. The measurement was repeated after 10 minutes on the arm with the higher initial reading. Hypertension was defined as the presence of a mean systolic blood pressure = or >140 mmHg and/or a mean diastolic blood pressure = or >90 mmHg, or a previous diagnosis of hypertension and/or use of antihypertensive drugs. RESULTS: The prevalence of hypertension was 33.6% (37.1% in women, and 29.5% in men, p<0.001). Of the hypertensive subjects, 59.3% were aware of their condition. Hypertension was controlled in 8.7% of the subjects (systolic blood pressure <140 mmHg and diastolic blood pressure <90 mmHg). CONCLUSION: Our results showed that about one-third of the adult population in Kocaeli had hypertension, with low rates of control and awareness. Since the previous survey, there has been a small improvement in hypertension control rate, but uncontrolled hypertension is still remarkably high in this geographical region. These findings are consistent with the recent Turkish Hypertension Prevalence study (PatenT) reporting a control rate of 8.1%.

Frequency of abdominal obesity and metabolic syndrome in healthcare workers and their awareness levels about these entities.

OBJECTIVES: We investigated the frequency of metabolic syndrome (MetS) and abdominal obesity and evaluated the level of awareness about these two conditions in healthcare workers. STUDY DESIGN: A total of 723 healthcare workers (372 physicians, 247 nurses, 104 other healthcare staff; mean age 32.8+/-8.2 years) from four centers were included. Demographic, anthropometric, and biochemical data were recorded, lifestyle features were inquired, and the levels of awareness about abdominal obesity and MetS were surveyed. The criteria recommended by the Adult Treatment Panel (ATP) III were used for the diagnosis of abdominal obesity and MetS. The presence of MetS was evaluated in 178 subjects. Univariate and multivariate analyses were performed to evaluate the association between lifestyle features and abdominal obesity. RESULTS: The frequency of abdominal obesity was 13.8% and it was significantly higher in males than in females (19.1% vs 10.6%; p=0.002). Metabolic syndrome was diagnosed in 14 participants (7.9%), and there was no significant difference between men and women in this respect (p>0.05). The cut-off values for abdominal obesity and at least three criteria of MetS were correctly listed by 47 participants (6.5%) and 240 participants (33.2%), respectively, with physicians showing significantly higher awareness levels (p=0.001). In multivariate analysis, age =or>40 years and male gender were significantly associated with abdominal obesity. CONCLUSION: Our results demonstrate that only a minority of healthcare workers are cognizant of MetS as a clinical syndrome and the definition of abdominal obesity.