Awareness, treatment, control of hypertension, and associated factors: Results from a Turkish national study.

OBJECTIVE: Despite the fact that hypertension (HT) can be diagnosed and easily treated, it is frequently not handled well throughout the world, and as a developing country in Turkey. The objective of this study was to assess the factors associated with the awareness, treatment, and control of HT in Turkey. METHODS: Data came from Chronic Diseases and Risk Factors Survey, comprising a nationally representative sample of 12,971 individuals, conducted by the Turkish Ministry of Health in 2011. HT was defined as having systolic/diastolic blood pressure (BP) at least 140/90 mmHg, usage of HT medicines, or having a previous diagnosis. Awareness, treated, and controlled HT were determined by questionnaires/BP measurements. Stepwise multiple logistic regression analysis was used to estimate associated factors. RESULTS: The prevalence of HT was found to be 24.8%. Awareness, treatment, and control rates were 65%, 59%, and 30%, respectively. The risk factors for lack of awareness or treatment of HT were male gender, young age, rural residency, lower education, being employed, sedentary lifestyle, and less physical activity for women, unhealthy dietary habits for men, and modifiable risk factors, including smoking and drinking for men. Increasing age, low education for women, marital status subgroups within gender (being single for men and being married for women), smoking and alcohol use for men, and diseases such as diabetes and obesity were also correlated with poor control of HT. CONCLUSION: This study recognized associated risk factors that may guide policies and interventions to enhance awareness, treatment, and control of HT in Turkey.

Association of Dilated Perivascular Spaces With Lipid Indices in Ischemic Stroke Patients.

Background Dilated perivascular spaces (dPVS) in the basal ganglia are associated with aging, vascular risk factors, and other magnetic resonance imaging (MRI) markers of cerebral small vessel disease (cSVD). While high blood lipids are a well-demonstrated risk factor for large artery atherosclerosis, their role in cSVD remains largely elusive. Methods We evaluated lipid profiles, cardiovascular risk factors, and brain MRI findings in patients with ischemic stroke or transient ischemic attack. We analyzed the extent of dPVS, cerebral microbleed (CMB), and cerebral white matter hyperintensities (WMHs) as MRI indices of cSVD and investigated associations of dPVS with lipid parameters and other cSVD indices. Results Our study enrolled 173 patients with ischemic stroke or transient ischemic attack. The mean age was 68.38±14.31 (range 35-99) years, and 57.8% (n=100) of patients were male. dPVSwere detected in 97% (n=168) of the patients. Among the whole population, half of the patients (n=87) had moderate to severe dPVS. According to the univariate analysis, age, hypertension, previous antiaggregant and/or anticoagulant use, and the high-density lipoprotein to low-density lipoprotein (HDL/LDL) ratio but not other lipid profiles, cerebral microbleed load, and cerebral white matter hyperintensities severity were found to be positively associated with dPVS number in the basal ganglia. After multivariate logistic regression analysis, only age and WMH severity remained statistically significant. Conclusions dPVS are closely associated with other cSVD subtypes and aging. The studied lipid indices were not independently associated with moderate to severe dPVS in basal ganglia in ischemic stroke patients. The association of each lipid and HDL/LDL ratio needs to be further studied with a larger number of participants.

Urban and rural differences in hypertension risk factors in Turkey.

OBJECTIVE: Existing literature shows considerable regional differences in terms of hypertension (HT) prevalence in Turkey. The purpose of this study was to analyze some of the known HT risk factors contributing to the variations between urban and rural areas of Turkey in HT development. METHODS: We used data from the 2011 Chronic Diseases and Risk Factors Survey that was conducted by the Turkish Ministry of Health on a representative sample of the Turkish adult population aged 20 years or more (n=16.227). HT was defined as having at least one of the following: a mean systolic/diastolic blood pressure of at least 140/90 mm Hg, a previously diagnosed disease, or use of antihypertensive medication. Stepwise multiple logistic regression analysis was used to estimate HT risk factors in urban and rural settings. RESULTS: Although the HT prevalence was higher in rural areas (28.4%) than in urban areas (23.9%), in this study, urbanization was found to be a contributing factor in multivariate regression analysis. Furthermore, separate regressions for urban and rural settings revealed that age, obesity, diabetes, hyperlipidemia, and smoking were independently and positively associated (p<0.05) with HT in both settings, while marital status, employment type, mental health, and lifestyle patterns; nutritional habits; and amount of physical activity and sedentary time (p<0.05) were risk indicators in urban areas only. CONCLUSION: The findings of our study demonstrate that contributory factors show some variations between urban and rural settings, and on gender within each setting. Taking into account the variations between urban and rural areas in HT development may provide greater insight into the design of prevention strategies.