Browsing by Author "Dobrescu, Alexandru"
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Item The impact of addressing modifiable risk factors to reduce the burden of cardiovascular disease in Turkey(2019) Balbay, Yucel; Gagnon-Arpin, Isabelle; Malhan, Simten; Oksuz, Mehmet Ergun; Sutherland, Greg; Dobrescu, Alexandru; Villa, Guillermo; Ertugul, Gulnihal; Habib, Modhar; 0000-0002-5723-5965; 31483303; K-8238-2012Objective: 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 the 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 were 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.Item Modeling the burden of cardiovascular disease in Turkey(2018) Malhan, Simten; Oksuz, Mehmet Ergun; Balbay, Yucel; Gagnon-Arpin, Isabelle; Sutherland, Greg; Dobrescu, Alexandru; Villa, Guillermo; Ertugrul, Gulnihal; Habib, Mohdhar; 0000-0002-5723-5965; 30297582; K-8238-2012Objective: This study aims to estimate the current and future burden of cardiovascular diseases (CVD) in Turkey. Methods: A burden-of-disease model was developed that included inputs on population growth, prevalence, and incidence of ischemic disease (IHD) and cerebrovascular disease (CeVD), prevalence of modifiable risk factors, mortality rates, and relationship between risk factors and IHD/ CeVD. Direct costs to the public health-care system and indirect costs from lost production due to premature mortality, hospitalizations, disability, and absenteeism were considered. Results: We estimated that in 2016, 3.4 million Turkish adults were living with CVD, including 2.5 million affected by IHD, and 0.9 million by CeVD. This prevalence is projected to increase to 5.4 million by 2035. The economic burden of CVD was estimated at US$10.2 billion in 2016, projected to increase twofold to US$19.4 billion by 2035. Conclusion: Our study confirms that the current burden of CVD is significant, and that it is projected to increase at a steep rate over the next two decades. This growing burden of disease will likely create significant pressure on the public health-care system in the form of direct health-care costs, as well as on society in the form of lost productivity. (Anatol J Cardiol 2018; 20: 235-40)