Turkish assessment of SURF (SUrvey of Risk Factor Management) study: Control rates of cardiovascular risk factors derived from databases of 15 different levels of health centers in Turkey.

OBJECTIVE: The aim of this study was to evaluate the adherence to recommendations for secondary prevention and the achievement of treatment targets for the control of risk factors in patients with established coronary heart disease (CHD) who were followed-up at various healthcare facilities in Turkey. METHODS: According to the protocol of the international Survey of Risk Factor Management study, questionnaire forms were completed and demographic, anthropometric, and laboratory data of CHD patients who were followed-up at a total of 15 selected primary, secondary, and tertiary healthcare centers were recorded. RESULTS: Among a total of 724 CHD patients (69.8% male; mean age: 63.3±10.7 years) included in the study, 18.4% were current smokers, only 19.1% had normal body mass index, and 22.1% had waist circumference below the limit of abdominal obesity. Physical activity was insufficient in 53% of the patients, 47.3% had low high-density lipoprotein cholesterol value, 46% had triglyceride level above 150 mg/dL, and 67% had glycated hemoglobin value of 6.5% or above. Of all the patients, 88.1% were using antiplatelet drugs, 71.4% were using beta-blockers, 55.7% were using statins, and 41.9% were using angiotensin-converting enzyme inhibitors/angiotensin receptor blockers. Blood pressure was under control in 56.7% of the hypertensive patients using antihypertensive drugs, and the proportion of diabetic patients who reached glycemic control targets using antidiabetic drugs was 35.9%. Low-density lipoprotein cholesterol was below 70 mg/dL in 12.2% of the patients using statins. CONCLUSION: According to the data obtained, among Turkish CHD patients, the control rate of cardiovascular risk factors is low, and implementation of the recommendations regarding lifestyle modification and medication use for secondary prevention in the current guidelines are insufficient.

Effect of vitamin D status on lipid profile in premenopausal women: a cross-sectional study.

High lipid levels play important roles in the pathogenesis of atherosclerosis and some authors suggest vitamin D deficiency as a risk factor for atherosclerosis. The aim of this study was to evaluate the effect of vitamin D status on lipid profile in premenopausal women. PATIENTS AND METHODS: A total of 315 nonsmoking premenopausal female volunteers without diabetes mellitus were included in the study. Patients were divided into four subgroups. The groups were as follows: patients with less than or equal to 12 ng/ml (group 1, n=126) vitamin D levels, between 20 and 12 ng/ml (group 2, n=48), between 30 and 20 ng/ml (group 3, n=21), and at least 30 ng/ml (group 4, n=120) vitamin D levels. Total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), and non-HDL-C levels of the four groups were compared. RESULTS: HDL-C levels of group 4 were the highest (P=0.03), and TG and non-HDL-C levels of group 1 were the highest (P=0.04, 0.016, respectively) in all groups. There was no significant difference between serum parathormone, calcium, and phosphorus levels of the four groups (P=0.778, 0.121, 0.184, respectively). In unadjusted analysis, 25-hydroxy vitamin D levels were found to be correlated negatively with BMI (P=0.0005), LDL-C (P=0.01), and non-HDL-C (P=0.003) and correlated positively with HDL-C levels (P=0.006). After adjustments for age, sex, BMI, and log parathormone levels were made, no correlation was found between 25-hydroxy vitamin D and lipid (TC, LDL-C, HDL-C, and TG) levels (P=0.91, 0.06, 0.95, 0.79, respectively). CONCLUSION: There may be an association between vitamin D insufficiency and dyslipidemia. However, this association may depend on obesity.