Risk Factors of Ischemic Heart Disease and Risk-Related Awareness in University Students

Yıl 2024, Cilt: 33 Sayı: 1, 57 - 72, 16.07.2024

Semanur Kızılaslan , Çiğdem Samancı Tekin

https://doi.org/10.17942/sted.1430834

Öz

Objective: Ischemic heart disease (IHD) is the most fatal disease in Turkey. The present study attempted to explore IHD risk factors and risk-related awareness among university students.
Materials and Methods: We took the height, weight, waist circumference, and blood pressure measurements of 786 university students and tried to identify their IHD risk factors and risk-related awareness through a survey. The study was carried out on a public university campus over three weekends in October 2022.
Results: The findings showed that the most common modifiable IHD risk factors were poor physical activity (48.9%), smoking (30.5%), and overweight/obesity (21.5%) in our sample aged 18-35 years. Yet, the most prevalent non-modifiable risk factor was found to be familial chronic diseases (29.9%). Besides, the participants were found to have poor knowledge of IHD risk factors (8.9±2.5). Our other remarkable finding demonstrated that the male students’ knowledge of CVD was poorer than their female counterparts, although the male gender is a non-modifiable CVD risk factor.
Conclusion: Participants with a relatively high level of education, interestingly, had poor knowledge and risk awareness of IHD despite bearing a higher rate of IHD risk factors.

Anahtar Kelimeler

heart disease risk factors, myocardial ischemia, cardiovascular diseases, university, student, healthy lifestyle

Proje Numarası

TÜBİTAK 2209-A 1919B012107777

Üniversite Öğrencilerinde İskemik Kalp Hastalığı Risk Faktörleri ve Farkındalık Düzeyi

Öz

Amaç: Türkiye’de iskemik kalp hastalığı en çok ölüme yol açan hastalıktır. Bu çalışmada üniversite öğrencilerinin İskemik Kalp Hastalığı (İKH) risk faktörleri ve farkındalık düzeylerinin saptanması amaçlanmıştır.
Gereç ve Yöntem: Çalışma 786 üniversite öğrencisi ile yürütülmüş, öğrencilerin boy, ağırlık, bel çevresi ve kan basıncı ölçümleri yapılmış ardından riskleri ve risk farkındalığını saptamaya yönelik anket formu uygulanmıştır.
Bulgular: Yaşları 18-35 (20,8±2,4) arasında değişen 786 üniversite öğrencisinden oluşan bu örneklemde, en sık görülen düzeltilebilir risk faktörleri yetersiz fiziksel aktivite (%48,9), sigara kullanımı (%30,5) ve aşırı kilolu/obez olma (%21,5) idi. Değiştirilemez faktörler açısından da ailede kronik hastalık varlığı %29,9 idi. Ayrıca katılımcıların iskemik kalp hastalığı risk faktörleri bilgi düzeyleri düşüktü (8,9±2,5). Dikkat çeken bir başka sonuç da erkek cinsiyet kalp hastalıkları açısından değiştirilemez bir risk faktörü olmasına karşın, erkek öğrencilerin kalp hastalıkları ile ilgili bilgi düzeyleri kız öğrencilerden daha düşüktü.
Sonuç: Nispeten yüksek eğitim düzeyine sahip üniversite öğrencileri, yüksek oranda risk faktörü taşımalarına rağmen, düşük bilgi seviyesi ve risk farkındalığına sahipti.

Anahtar Kelimeler

Kalp hastalığı risk faktörleri, miyokard iskemisi, kardiyovasküler hastalıklar, sağlıklı yaşam tarzı, üniversite, öğrenci

Etik Beyan

Etik kurul onayımız mevcuttur.

Destekleyen Kurum

TÜBİTAK

Proje Numarası

TÜBİTAK 2209-A 1919B012107777

Teşekkür

Çalışmamızdaki desteklerinden dolayı TÜBİTAK'a ve anket doldurulması ve antropometrik ölçümlerin yapılmasında yer alan tüm öğrencilere teşekkür ederiz.

Kaynakça

• Sidney S, Rosamond WD, Howard VJ, Luepker R V. The heart disease and stroke statistics-2013 update and the need for a national cardiovascular surveillance system. Circulation. 2013 Jan 1;127(1):21–3.
• Roth GA, Johnson C, Abajobir A, Abd-Allah F, Ferede Abera S, Abyu G, et al. Global, Regional, and National Burden of Cardiovascular Diseases for 10 Causes, 1990 to 2015. J Am Coll Cardiol [Internet]. 2017 Jul 4 [cited 2023 Jul 25];70(1):1–25. Available from: http://repositorio.insp.mx:8080/jspui/handle/20.500.12096/7883
• Prabhakaran D, Jeemon P. The changing patterns of cardiovascular diseases and their risk factors in the states of India: The Global Burden of Disease Study 1990–2016. Lancet Glob Heal [Internet]. 2018 [cited 2023 Oct 10];6(12):e1339–51. Available from: https://www.thelancet.com/journals/langlo/article/PIIS2214-109X1830407-8/fulltext
• Turkish Statistical Institute. Death and Cause of Death Statistics, 2022 [Internet]. 49679. 2023 [cited 2023 Oct 24]. Available from: https://data.tuik.gov.tr/Bulten/Index?p=Olum-ve-Olum-Nedeni-Istatistikleri-2022-49679#:~:text=Ölümler nedenlerine göre incelendiğinde%2C 2022,ile solunum sistemi hastalıkları izledi.&text=Grafikteki rakamlar%2C yuvarlamadan dolayı toplamı vermeyebilir.
• Roth GA, Mensah GA, Johnson CO, Addolorato G, Ammirati E, Baddour LM, et al. Global burden of cardiovascular diseases and risk factors, 1990-2019: Update from the GBD 2019 Study. J Am Coll Cardiol. 2020 Dec 22;76(25):2982–3021.
• Khan MA, Hashim MJ, Mustafa H, Baniyas MY, Al Suwaidi SKBM, AlKatheeri R, et al. Global epidemiology of ıschemic heart disease: Results from the Global Burden of Disease Study. Cureus [Internet]. 2020 [cited 2023 Oct 10]; Available from: https://www.cureus.com/articles/36728-global-epidemiology-of-ischemic-heart-disease-results-from-the-global-burden-of-disease-study.pdf
• Batty GD, Leon DA. Socio-economic position and coronary heart disease risk factors in children and young people: Evidence from UK epidemiological studies. Eur J Public Health [Internet]. 2002 [cited 2023 Oct 20];12(4):263–72. Available from: https://academic.oup.com/eurpub/article-abstract/12/4/263/487819
• Leeder S, Raymond S, Greenberg H, Liu H, Esson K. A race against time: the challenge of cardiovascular disease in developping countries. Trustees of Columbia University [Internet]. 2004 [cited 2023 Oct 10];(May). Available from: https://scholar.google.com.tr/scholar?hl=tr&as_sdt=0%2C5&q=Leeder%2C+S%2C+Raymond%2C+S%2C+Greenberg%2C+H%2C+Liu%2C+H+and+Esson%2C+K+%282004%29+A+race+against+time%3A+the+challenge+of+cardiovascular+disease+in+developing+countries.+New+York%3A+Trustees+of+
• Katzmarzyk PT, Pérusse L, Malina RM, Bergeron J, Després JP, Bouchard C. Stability of indicators of the metabolic syndrome from childhood and adolescence to young adulthood: The Quebec Family Study. J Clin Epidemiol [Internet]. 2001 [cited 2023 Oct 20];54(2):190–5. Available from: https://www.sciencedirect.com/science/article/pii/S0895435600003152
• McGill HC, McMahan CA, Zieske AW, Malcom GT, Tracy RE, Strong JP. Effects of nonlipid risk factors on atherosclerosis in youth with a favorable lipoprotein profile. Circulation. 2001 Mar 20;103(11):1546–50.
• Napoli C, Glass CK, Witztum JL, Deutsch R, D’Armiento FP, Palinski W. Influence of maternal hypercholesterolaemia during pregnancy on progression of early atherosclerotic lesions in childhood: Fate of Early Lesions in Children (FELIC) study. Lancet [Internet]. 1999 [cited 2023 Oct 20];354(9186):1234–41. Available from: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(99)02131-5/fulltext
• Ather M, Khan AH, Bandeshah AA, Wajid H, Adnan S, Abbasi AS. Hypertension among general population visiting at South East Hospital and Research Center, Islamabad, Pakistan. Int J Curr Res Rev [Internet]. 2022 [cited 2023 Oct 24];14(10):09–14. Available from: https://www.researchgate.net/profile/Attiya-Hameed-Khan/publication/360725300_Hypertension_Among_General_Popultaion_Visiting/links/628730276e41e5002d33455f/Hypertension-Among-General-Popultaion-Visiting.pdf
• T.C. Sağlık Bakanlığı. Türkiye Kalp ve Damar Hastalıklarını Önleme ve Kontrol Programı Birincil , İkincil ve Üçüncül Korumaya Yönelik Stratejik Plan ve Eylem Planı [Internet]. Temel Sağlık Hizmetleri Genel Müdürlüğü. 2010 [cited 2023 Jul 25]. 812 p. Available from: https://scholar.google.com/scholar?hl=tr&as_sdt=0%2C5&q=Türkiye+Kalp+Ve+Damar+Hastalıklarını+Önleme+Ve+Kontrol+Programı%2C+Sağlık+Bakanlığı&btnG=
• TKD. Türk Kardiyoloji Derneği Koroner Kalp Hastalığı Korunma ve Tedavi Kılavuzu [Internet]. 2002 [cited 2023 Oct 10]. Available from: https://scholar.google.com.tr/scholar?hl=tr&as_sdt=0%2C5&q=8.%09Onat%2C+A.%2C+Büyüköztürk%2C+K.%2C+Sansoy%2C+V.%2C+Avcı%2C+Ş.+G.%2C+Akgün%2C+G.%2C+Tokgözoğlu%2C+L.%2C+...+%26+Ergene%2C+O.+%282002%29.+Türk+kardiyoloji+derneği+koroner+kalp+hastalığı+korunma
• Barbaresko J, Rienks J, Nöthlings U. Lifestyle indices and cardiovascular disease risk: A meta-analysis [Internet]. Vol. 55, American Journal of Preventive Medicine. 2018 [cited 2023 Oct 24]. p. 555–64. Available from: https://www.sciencedirect.com/science/article/pii/S0749379718318877
• World Health Organization. Cardiovascular death and disability can be reduced more than 50 percent. Indian J Med Sci [Internet]. 2003 [cited 2023 Oct 24];57(3):117–21. Available from: https://www.who.int/news/item/17-10-2002-cardiovascular-death-and-disability-can-be-reduced-more-than-50-percent
• Onat A, Karakoyun S, Akbaş T, Karadeniz FÖ, Karadeniz Y, Çakir H, et al. Turkish Adult Risk Factor survey 2014: Overall mortality and coronary disease incidence in Turkey’s geographic regions. Turk Kardiyol Dern Ars [Internet]. 2015 [cited 2023 Oct 10];43(4):326–32. Available from: https://jag.journalagent.com/tkd/pdfs/TKDA_43_4_326_332.pdf
• Kozan O, Oguz A, Abaci A, Erol C, Ongen Z, Temizhan A, et al. Prevalence of the metabolic syndrome among Turkish adults. Eur J Clin Nutr [Internet]. 2007 [cited 2023 Oct 10];61(4):548–53. Available from: https://www.nature.com/articles/1602554
• T.C. Sağlık Bakanlığı. Türkiye Beslenme ve Sağlık Araştırması, 2010 [Internet]. 2014. [cited 2023 Oct 10]. Available from: https://scholar.google.com.tr/scholar?hl=tr&as_sdt=0%2C5&q=türkiye+beslenme+ve+sağlık+araştırması&btnG=
• Abrignani MG, Lucà F, Favilli S, Benvenuto M, Rao CM, Di Fusco SA, et al. Lifestyles and Cardiovascular Prevention in Childhood and Adolescence. Vol. 40, Pediatric Cardiology. Springer New York LLC; 2019. p. 1113–25.
• Türkiye Fiziksel Aktivite Rehberi 2014. Türkiye Fiziksel Aktivite Rehberi [Internet]. Vols. 978-975–59, TC. Sağlık Bakanlığı. 2014 [cited 2023 Oct 10]. 1–120 p. Available from: https://www.google.com/search?q=Türkiye+Fiziksel+Aktivite+Rehberi&rlz=1C1SQJL_trTR782TR782&oq=Türkiye+Fiziksel+Aktivite+Rehberi&gs_lcrp=EgZjaHJvbWUyBggAEEUYOTIGCAEQRRg70gEIMTIwNWowajmoAgCwAgA&sourceid=chrome&ie=UTF-8
• Can G, Ozdilli K, Erol O, Unsar S, Tulek Z, Savaser S, et al. Comparison of the health‐promoting lifestyles of nursing and non‐nursing students in Istanbul, Turkey. Wiley Online Libr Nursing Heal Sci 2008•Wiley Online Libr [Internet]. 2008 [cited 2023 Oct 10];10(4):273–80. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1442-2018.2008.00405.x
• Güneş FE, Bekiroglu N, Imeryuz N, Agirbasli M. Awareness of cardiovascular risk factors among university students in Turkey. Prim Health Care Res Dev [Internet]. 2019 [cited 2023 Oct 10];20:e127. Available from: https://www.cambridge.org/core/journals/primary-health-care-research-and-development/article/awareness-of-cardiovascular-risk-factors-among-university-students-in-turkey/05338BD1BBA9291045E46FE9637A4677
• Status WHOP. The use and interpretation of anthropometry World Health Organization. WHO Expert Comm Geneva, Switz [Internet]. 1995 [cited 2023 Oct 12];1–186. Available from: https://scholar.google.com.tr/scholar?hl=tr&as_sdt=0%252C5&q=WHO.+Physical+status%253A+the+use+and+interpretation+of++anthropometry.+Report+of+a+WHO+Expert+Commit%2502tee%252C+Technical+Report+Series+No.+854%252C+World+Health++Organization%252C+Geneva%252C+Switzerland%25
• Tabachnick BG, Fidell LS. Using multivariate statistics. Harlow. Essex Pearson Educ Ltd [Internet]. 2014 [cited 2023 Oct 19]; Available from: https://www.pearsonhighered.com/assets/preface/0/1/3/4/0134790545.pdf
• Barker AR, Gracia-Marco L, Ruiz JR, Castillo MJ, Aparicio-Ugarriza R, González-Gross M, et al. Physical activity, sedentary time, TV viewing, physical fitness and cardiovascular disease risk in adolescents: The HELENA study. Int J Cardiol [Internet]. 2018 [cited 2023 Oct 23];254:303–9. Available from: https://www.sciencedirect.com/science/article/pii/S0167527317335039
• Gilani SI, Afridi S. Frequency of risk factors and awareness regarding ischemic heart diseases among medical students of a private medical college, Peshawar, Pakistan. Khyber Med Univ J [Internet]. 2017 [cited 2023 Oct 23];9(4). Available from: https://search.ebscohost.com/login.aspx?direct=true&profile=ehost&scope=site&authtype=crawler&jrnl=23052643&AN=127935985&h=T7akkSGFoC5T%2BQI%2FovUl4nu7XIp7Suc%2FojcFwta5PPAfiHmyQxFabW1t%2BDU7PMegK7jqWwrl0vMxY%2Bjzr5ZFHg%3D%3D&crl=c
• Kaya M, Ergün A. Sağlık Bilimleri öğrencilerinin sigara içme durumu, etkileyen faktörler ve ikincil sigara dumanı ile ilgili farkındalık düzeyleri. J Acad Res Nurs [Internet]. 2020 [cited 2024 May 28];6(3):416–41. Available from: https://jag.journalagent.com/z4/download_fulltext.asp?pdir=jaren&plng=eng&un=JAREN-04696
• Fyfe-Johnson AL, Ryder JR, Alonso A, Maclehose RF, Rudser KD, Fox CK, et al. Ideal cardiovascular health and adiposity: Implications in youth. J Am Heart Assoc. 2018 Apr 17;7(8).
• Janssen I, Katzmarzyk PT, Srinivasan SR, Chen W, Malina RM, Bouchard C, et al. Combined influence of body mass index and waist circumference on coronary artery disease risk factors among children and adolescents. Pediatrics [Internet]. 2005 [cited 2023 Oct 20];115(6):1623–30. Available from: https://publications.aap.org/pediatrics/article-abstract/115/6/1623/67498
• Guardamagna O, Abello F, Cagliero P, Lughetti L. Impact of nutrition since early life on cardiovascular prevention. Vol. 38, Italian Journal of Pediatrics. 2012.
• Özpulat F, Erdem Y. Üniversite öğrencilerinin riskli sağlık davranışları ve etkileyen faktörlerin incelenmesi. Ankara Sağlık Bilim Derg [Internet]. 2019 [cited 2024 May 28];(1):110–26. Available from: https://dergipark.org.tr/en/pub/ausbid/issue/46310/527570
• Theodore RF, Broadbent J, Nagin D, Ambler A, Hogan S, Ramrakha S, et al. Childhood to early-midlife systolic blood pressure trajectories: Early-life predictors, effect modifiers, and adult cardiovascular outcomes. Hypertension. 2015 Dec 1;66(6):1108–15.
• Mohamed Moussa MM, El-mowafy RI, El-Ezaby HH. Prevalence of hypertension and associated risk factors among university students: Comparative study. J Nurs Educ Pract [Internet]. 2016 [cited 2023 Oct 23];6(5). Available from: https://www.researchgate.net/profile/Maha-Moussa/publication/290995470_Prevalence_of_hypertension_and_associated_risk_factors_among_university_students_Comparative_study/links/605e1b4b458515e83472e095/Prevalence-of-hypertension-and-associated-risk-factors
• Campanozzi A, Avallone S, Barbato A, Iacone R, Russo O, De Filippo G, et al. High sodium and low potassium intake among Italian children: Relationship with age, body mass and blood pressure. PLoS One. 2015 Apr 8;10(4).
• Almalki MA, Al MNJ, Khayat MA, Bokhari HF, Subki AH, Alzahrani AM, et al. Population awareness of coronary artery disease risk factors in Jeddah, Saudi Arabia: A crosssectional study. Int J Gen Med [Internet]. 2019 [cited 2023 Oct 23];12:63–70. Available from: https://www.tandfonline.com/doi/abs/10.2147/IJGM.S184732
• Nowbar AN, Gitto M, Howard JP, Francis DP, Al-Lamee R. Mortality from ischemic heart disease: Analysis of data from the world health organization and coronary artery disease risk factors from NCD risk factor collaboration. Circ Cardiovasc Qual Outcomes. 2019 Jun 1;12(6).
• Demir Doğan M, Elik B. University students’ knowledge level about risk factors for cardiovascular diseases, their healthy life awareness, and the influencing factors. J Public Heal. 2023;
• Alruways AH, Alotaibi N, Rashikh M, Alnufeie A, Alshammari YD, Alharthy M, et al. Awareness and prevalence of coronary artery disease risk factors among Saudi adults in Dawadmi, Riyadh province: A cross-sectional study. J Fam Med Prim Care [Internet]. 2020 [cited 2023 Oct 23];9(11):5629. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7842469/
• Almas A, Hameed A, Sultan FAT. Knowledge of coronary artery disease (CAD) risk factors and coronary intervention among university students. J Pak Med Assoc [Internet]. 2008 [cited 2023 Oct 23];58(10):553–7. Available from: https://ecommons.aku.edu/pakistan_fhs_mc_med_med/250/
• Oğuz S, Erguvan B, Ünal G, Bayrak B, Çamcı G. Üniversite öğrencilerinde kardiyovasküler hastalıklar risk faktörleri bilgi düzeyinin belirlenmesi [Internet]. Vol. 26, MN kardiyoloji. 2019 [cited 2023 Oct 23]. p. 184–91. Available from: https://www.researchgate.net/profile/Sidika-Oguz/publication/335883267_Klinik_Arastirma_Determination_of_Klowledge_of_Cardiovasculer_Disease_Risk_Factors_Among_University_Students/links/5d81fd9f299bf1996f74e6fb/Klinik-Arastirma-Determination-of-Klowledge-
• Al-khlaiwi T, Alshammari H, Habib SS, Alobaid R, Alrumaih L, Almojel A, et al. High prevalence of lack of knowledge and unhealthy lifestyle practices regarding premature coronary artery disease and its risk factors among the Saudi population. BMC Public Health. 2023 Dec 1;23(1).
• Tran DMT, Zimmerman LM, Kupzyk KA, Shurmur SW, Pullen CH, Yates BC. Cardiovascular risk factors among college students: Knowledge, perception, and risk assessment. J Am Coll Heal [Internet]. 2017 Apr 3 [cited 2023 Oct 17];65(3):158–67. Available from: https://www.tandfonline.com/doi/abs/10.1080/07448481.2016.1266638
• Khera AV, Emdin CA, Drake I, Natarajan P, Bick AG, Cook NR, et al. Genetic risk, adherence to a healthy lifestyle, and coronary disease. N Engl J Med. 2016 Dec 15;375(24):2349–58.
• Steinberger J, Daniels SR, Hagberg N, Isasi CR, Kelly AS, Lloyd-Jones D, et al. Cardiovascular health promotion in children: Challenges and opportunities for 2020 and beyond: A Scientific statement from the American Heart Association. Circulation. 2016 Sep 20;134(12):e236–55.
• Kırmızıtoprak E, Şimşek Z. Cinsel yolla bulaşan hastalıklar ve güvenli cinsel yaşam konusunda gençlerin bilgi ve davranışlarına akran eğitiminin etkisi. TAF Prev Med Bull [Internet]. 2011 [cited 2024 May 28];10(4):463–72. Available from: https://www.academia.edu/download/55138049/bulasici_hastaliklar_makale.pdf
• White S, Park Y, Israel T, Cordero E. Longitudinal evaluation of peer health education on a college campus: Impact on health behaviors. J Am Coll Heal [Internet]. 2009 Mar 1 [cited 2024 May 28];57(5):497–506. Available from: https://www.tandfonline.com/doi/abs/10.3200/JACH.57.5.497-506
• Gölbaşi Z, Doğaner G, Erbaş N. The effect of Menstrual Health education conducted with peer education method to adolescent girls in 6-8 classes on information and behaviors. TAF Prev Med Bull [Internet]. 2012 [cited 2024 May 28];11(2):189–96. Available from: https://www.researchgate.net/profile/Zehra-Golbasi/publication/288725052_The_Effect_of_Menstrual_Health_Education_Conducted_with_Peer_Education_Method_to_Adolescent_Girls_in_6-8_Classes_on_Information_and_Behaviors/links/593eb71aa6fdcc1b10947377/The-Effec