To analyze (1) the sex-specific and age-bracket defined all-cause and coronary mortality in the 23-years' follow-up of the Turkish Adult Risk Factor Study, and (2) to determine the nation-wide prevalence of Type-2 diabetes and its recent trend. Information on the mode of death was obtained from first-degree relatives and/or health personnel of local heath office. Information collected in survivors was based on history, physical examination of the cardiovascular system and Minnesota coding of resting electrocardiograms. Diabetes was defined by criteria of the American Diabetes Association without the use of glycated hemoglobin. Of the 1370 participants to be surveyed, 768 were examined, in 452 subjects information was gathered, and 29 men, 18 women were ascertained to have died. Cumulative assessment of the entire cohort in the age bracket 45-74 years disclosed coronary mortality to be 7.5/1000 person-years in men and 3.74 in women, persisting to be high among the European countries. The recent decline observed in overall mortality seemed to halt as well. Of greatest concern was the finding in the past 12 years that the rate of rise in the age-controlled prevalence of Type-2 diabetes was as high as 5% annually. Overall and coronary mortality in Turkish adults continue to be high, while an elicited annual increase of 5% in the age-controlled prevalence of diabetes is virtually alarming and requires new public health policies.

This study aimed to examine the overall and coronary mortality in the 2014 Turkish Adult Risk Factor Study survey, and the distribution of cumulative mortality and incident coronary heart disease (CHD) across 7 geographic regions. Information on mode of death was appropriately obtained. Information collected from survivors was based on history, examination of the cardiovascular system and the Minnesota coding of electrocardiograms. Cox regression analyses were performed. Of the 1.323 participants to be surveyed, 87 were lost to follow-up, 753 examined, and 35 ascertained as deceased. In 448 subjects, verbal information alone was obtained regarding health status. Nineteen deaths were of coronary and cerebrovascular origin. Cumulative 24-year assessment of the entire cohort in the age bracket 45-74 years disclosed high coronary mortality, at 7.3 per 1000 person-years in men and 3.8 in women, and recorded a limited decline of 18% since the year 2000. Age-adjusted Cox regression analysis, comprising 614 deaths and 482 incident CHD over a follow-up of 9.6 years, revealed higher mortality rates in the Mediterranean region and in men in the Black Sea and Marmara regions. The age-adjusted CHD incidence was significantly higher in males of the Mediterranean and females of the Southeast regions. An estimated 400-420.000 incident CHD cases develop currently each year in Turkey. The generally high age-adjusted overall mortality in Turkey displays significant differences across geographic regions. Age-adjusted CHD incidence is not regressing sufficiently, and is especially high among men of the Mediterranean and women of the Southeast regions.

Sleep is an important modulator of cardiovascular function and is recognized to play an important role in the pathogenesis and progression of cardiovascular disease. However, results of the studies investigating the relationship between sleep complaints and cardiovascular outcomes are still controversial. This study aimed to investigate the associations of sleep duration and sleep quality with Framingham 10-year hard coronary heart disease (CHD) risk score in Turkish adults. We included a total of 362 participants (mean age: 48.5 ± 9.0 years, 50.6% males) and measured sleep quality and sleep duration using Pittsburgh Sleep Quality Index (PSQI). Framingham risk scoring system was utilized to calculate the 10-year hard CHD risk of participants. Binary logistic regression analysis was performed to determine the association between sleep quality, sleep duration, and CHD risk. Both short sleep duration (<6 hours) (OR = 3.858, 95% CI: 1.245–11.956) and long sleep duration (≥8 hours) (OR = 2.944, 95% CI: 1.087–7.967) were identified as the predictors of 10-year hard CHD risk. However, sleep quality was not associated with 10-year CHD risk even as a categorical or continuous variable (OR = 0.864, 95% CI: 0.418–1.787 and OR = 0.985, 95% CI: 0.868–1.117, respectively). Our findings highlighted previous studies demonstrating the U-shaped relationship, with both short and long sleep durations to be associated with a higher CHD risk. Evaluation of habitual sleeping patterns may provide additional information in clinical cardiovascular risk assessment. Future research should investigate whether interventions to optimize sleep duration may help to prevent coronary events in large population-based cohorts.