On the Pathophysiology of Excess Coronary Morbidity and Mortality Among Turks: Implications for Detection and Prevention [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2001; 29(10): 602-609

On the Pathophysiology of Excess Coronary Morbidity and Mortality Among Turks: Implications for Detection and Prevention

Altan ONAT1

Based on the data of the Turkish Adult Risk Factor study accumulated over ll years, this paper attempts to clıa rac teri ze the disparity between the risk profiles of Turks and Western populations and to ascribe these to plausible pathogenetic mechanisms. Findings of the majority of patients w ith coronary heart disease (CHD) anel differences of data from the adult populations of Turks and Danes (of the Copenhagen City study) clearly show that - rather than LDL-cholesterol elevation - Turks exhibit str.iking features involving HDL-cholesterol , triglycerides, apolipoprotein (apo) B, (central) obesity , hyperinsulinemia and bloaci pressure. Turkish women, in particular, elisplay a profile of ri sk higher than men in regard to obesity, blood pressure and apo B. Triglyceride and apo B features indicare that excess number of smail dense LDL partides is widespread among Turkish adults. Underly ing th is ri sk profile - to be designated as atherogenic dyslipidemia - are visceral obesity and insulin resistance. lmpaired "fatty acid trapping" by ad ipose tissue, increased seeretian of VLDL by the liver, excess depositian of triglycerides in skeletal muscle and d iminished insulin sens itiv ity presumably account for these features of coronary risk. Our data d ispute the hypothesis that genetic factors are the main determinant of low HDL-C levels and support that the frequ ently encountered fas ring hypertriglyceridemia - asi de central obesity, cigare tte smoking and sedentary lifesry le - is the primary factor. l mplications of the proposecl hypothesis include a more accurate risk assessment in individuals having total cholesterol levels 180-200 mg/di and the potential improvement of cardiovascular health in millions of Turks by adapting appropriate li fesryle in primary and secondary prevention.

Keywords: Atherogenic clys lipidemia, coronary heart disease , risk profile, risk factors, Turkish adults

How to cite this article
Altan ONAT. On the Pathophysiology of Excess Coronary Morbidity and Mortality Among Turks: Implications for Detection and Prevention. Turk Kardiyol Dern Ars. 2001; 29(10): 602-609
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