Turk Kardiyol Dern Ars. Ahead of Print: TKDA-40330 | DOI: 10.5543/tkda.2019.40330
The impact of addressing modifiable risk factors to reduce the burden of cardiovascular disease in Turkey
, Isabelle Gagnon-Arpin2
, Simten Malhan3
, Mehmet Ergun Öksüz3
, Greg Sutherland2
, Alexandru Dobrescu2
, Guillermo Villa4
, Gülnihal Ertuğul5
, Mohdhar Habib61
University of Health Sciences, Ankara Yüksek Ihtisas Training and Research Hospital, Ankara, Turkey2
The Conference Board of Canada, Ottawa, Ontario, Canada3
Sağlık Yönetimi Programı, Baskent University, Ankara, Turkey4
Economic Modeling Center, Global Health Economics, Amgen Economic Modeling Center of Excellence, Zug, Switzerland5
Health Policy and Reimbursement, Amgen, Istanbul, Turkey6
Value, Access and Policy, Amgen, Inc, Thousand Oaks, California, United States of America
OBJECTIVE Our study aimed to estimate the impact of addressing modifiable risk factors on the future burden of cardiovascular diseases (CVD) in the general population and in two high-risk populations (heterozygous familial hypercholesterolemia and secondary prevention) for Turkey.
METHODS One model investigated the impact of reaching World Health Organization (WHO) voluntary targets for tobacco use, hypertension, type 2 diabetes, obesity and physical inactivity in the general population. Another model estimated the impact of reducing LDL-cholesterol in two high-risk populations through increased access to effective treatment. Inputs for the models include disease and risk factor prevalence rates, a population forecast, baseline CVD event rates, and treatment effectiveness, primarily derived from the published literature. Direct costs to the public health care system and indirect costs from lost production are included, although the cost of programs and pharmacological interventions to reduce risk factors was not considered.
RESULTS The value of reaching WHO risk factor reduction targets is estimated at US$9.3 billion over the next 20 years, while the value of reducing LDL-cholesterol is estimated at up to US$8.1 billion for high-risk secondary prevention patients and US$691 million for heterozygous familial hypercholesterolemia patients.
CONCLUSION Efforts to achieve WHO risk factor targets and further lower LDL-cholesterol through increased access to treatment for high-risk patients are projected to greatly reduce the growing clinical and economic burden of CVD in Turkey.
Cardiovascular Diseases, Heart Diseases, Risk Factors, Hyperlipidemias, Public Health
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Corresponding Author: Yücel Balbay, Türkiye