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Turk Kardiyol Dern Ars. 2019 Sep;47(6):487-497. doi: 10.5543/tkda.2019.40330.

The impact of addressing modifiable risk factors to reduce the burden of cardiovascular disease in Turkey.

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Department of Cardiology University of Health Sciences, Türkiye Yüksek Ihtisas Training and Research Hospital, Ankara, Turke.
The Conference Board of Canada, Ottawa, Ontario, Canada.
Health Management Program, Baskent University, Ankara, Turkey.
Economic Modeling Center, Global Health Economics, Amgen Economic Modeling Center of Excellence, Zug, Switzerland.
Health Policy and Reimbursement, Amgen, Istanbul, Turkey.
Value, Access and Policy, Amgen, Inc, Thousand Oaks, California, United States of America.



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.


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.


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.


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.

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