Cardiovascular diseases are one of the leading causes of death in the world. When we look at the distribution prevalence of cardiovascular diseases, hypertension, atherosclerosis, arrhythmia and heart failure constitute a significant part of these diseases. Risk factors of cardiovascular diseases are divided into two: modifiable and unmodifiable factors. While modifiable risk factors include smoking, hypertension, hypercholesterolemia, low HDL-cholesterol (good cholesterol) value, Diabetes Mellitus and obesity, non-modifiable risk factors include risks such as age and family history. The research, which was conducted to reveal the effect of nutrition on cardiovascular diseases, was conducted on individuals with cardiovascular disease hospitalized at Afyon Kocatepe University Ahmet Necdet Sezer Research and Application Hospital in Afyonkarahisar between January and March 2017. The sample of the study consisted of 200 people (102 men, 98 women) randomly selected on a voluntary basis. The data of the research was collected with a survey form. As a result of the research, when the BMIs of the patients are examined by gender, it is seen that 81.6% of women and 76.3% of men are slightly overweight, 1st degree overweight, 2nd degree overweight and 3rd degree overweight. When the answers to the questions about eating habits were examined, it was determined that the patients generally had insufficient knowledge about nutrition and 69% of them did not have a suitable diet. Key words: cardiovascular diseases, nutrition, risk v ABSTRACT Cardiovascular diseases are one of the leading causes of death worldwide. When we look at the distribution, prevalence of cardiovascular diseases, hypertension, atherosclerosis, arrhythmia and heart failure constitute a significant part of these disorders. The risk factors of cardiovascular diseases are divided into two as modifiable and non-modifiable factors. There are risk factors such as smoking, hypertension, hypercholesterolemia, low HDL-cholesterol (good cholesterol) value, Diabetes Mellitus and obesity, but there are also risks such as age and family history in unchangeable risk factors. The study was conducted on individuals with cardiovascular disease in Afyon Kocatepe University Ahmet Necdet Sezer Research and Practice e Hospital located in Afyonkarahisar between January-March 2017 to determine the effect of feeding on cardiovascular diseases. The survey sample consisted of 200 people (102 males, 98 females) selected randomly on the basis of voluntarism. Survey data were collected by questionnaire. When the BMI's of the patients were examined according to gender, 81.6% of the women and 76.3% of the men were; slightly obese, first degree obese, second degree obese and third degree obese. When the answers to the questions about eating habits are examined, it is determined that the patients generally have insufficient knowledge about nutrition and 69% do not have a proper diet. Key words: cardiovascular diseases, nutrition, risk 1 1. INTRODUCTION Cardiovascular diseases are one of the leading causes of death in the world. According to Turkish Statistical Institute's statistics on causes of death in 2015, circulatory system diseases rank first with a rate of 40.3%. Ischemic heart diseases accounted for 40.5% of circulatory system diseases, followed by cerebro-vascular heart disease, which accounted for 24.3%. (1) When we look at the distribution prevalence of cardiovascular diseases, hypertension, atherosclerosis, arrhythmia, and heart failure constitute a significant part of these diseases. Today's accepted important risk factors for cardiovascular diseases are listed as follows: 1. Age (≥45 in men, ≥55 in women or early menopause) 2. Family history of heart disease (a first-degree relative with a history of coronary artery disease before the age of 55 in men and before the age of 65 in women). 3. Smoking 4. Hypertension (140/90 mmHg or more or being treated for hypertension) 5. Hypercholesterolemia (total cholesterol over 200 mg/dl, LDL-cholesterol (bad cholesterol) over 130 mg/dl) 6. Low HDL-cholesterol (good cholesterol) value (<40 mg/dl) 7. Diabetes Mellitus 8. Obesity 9. Inability to cope with stress 10. Excessive alcohol consumption 11. Low physical activity (lack of exercise) 12. Birth control pill use (if smoking) 13. Menopause (2) Age When the incidence and prevalence of cardiovascular diseases are examined, it is seen that cardiovascular diseases increase with age. Therefore, age is considered one of the most important risk factors. (3) According to the data of the Turkish statistical institution, While the elderly population (65 and over) was 5 million 682 thousand 3 people in 2012, it increased by 17.1% in the last five years and reached 6 million 651 thousand 503 people in 2016. While the proportion of the elderly population in the total population was 7.5% in 2012, it increased to 8.3% in 2016. 43.9% of the elderly population is male and 56.1% is female. (4) Family History of Heart Disease Family history of disease is among the risk factors that cannot be changed. The development of early coronary artery disease in the father or other first-degree male relative before the age of 55, and in the mother or other first-degree female relative before the age of 65, increases the person's risk of cardiovascular disease by 1.3-1.6 times. (3) (5) Even if other risks are corrected, a family history of the disease maintains the person's risk. Smoking Smoking is one of the major CVD risks. Smoking is considered one of the most important preventable causes of mortality. Smoking 20 or more cigarettes per day increases the risk of CVD by 2 times. The risk of myocardial infarction and cardiac death in smokers was found to be 2.7 times higher in men and 4.7 times higher in women than in non-smokers. (6) It also reduces HDL level and increases platelet aggregation. It has been shown that the fibrinogen level and blood viscosity in the blood also increase. (7) Smoking habit tends to decrease in men and increase in women in our country. Considering that coronary heart disease mortality in women is at the highest level among European countries, the seriousness of this increase in smoking tendency in our women becomes even more important. 3 Hypertension Although hypertension is a very important risk factor for CVD, it is responsible for 35% of all atherosclerotic cardiovascular events. (8) Coronary heart disease is 2-3 times more common in hypertensives than in normotensives. (7) In addition to being a major risk factor for coronary heart disease and cerebrovascular disease, high blood pressure causes heart failure, renal failure, peripheral vascular disease, deterioration of retinal blood vessels, and vision loss. Starting from 115/75 mmHg in the same age group, every 20/10 mmHg increase in blood pressure doubles the risk of cardiovascular diseases. (9) Hypercholesterolemia Risk assessment One of the factors that should be taken into consideration when testing is LDL and total cholesterol values. Factors such as heredity, eating habits/nutrients, obesity and stress increase total cholesterol and LDL cholesterol. Individuals with total cholesterol over 200 mg/dl and LDL-cholesterol over 130 mg/dl are at risk for CVD. According to the American "National Cholesterol Education Program Adult Treatment Panel III" report, individuals are divided into different risk groups according to the presence of other major risk groups other than LDL. These risk groups are as follows: High Risk group: Those with coronary heart disease or equivalent disease are in this group. Coronary heart disease equivalents; Other forms of atherosclerotic disease, diabetes, and individuals with 2+ risk factors have a >20 risk of developing coronary heart disease within 10 years. Moderately High Risk Group: This group consists of individuals with 2+ risk factors who have not yet developed coronary heart disease. The risk of developing coronary heart disease within 10 years is between 10-20%. 4 Moderate Risk Group: Individuals with 2+ risk factors and a <10 chance of having a disease within 10 years. Low risk group: Those with 0-1 risk factors. (7) Low HDL-Cholesterol Value It is emphasized in the guidelines that low (<40 mg/dl) HDL cholesterol levels are a risk factor for CVD, whereas high (> 60 mg/dl) HDL cholesterol levels are a protective factor. (10) An average decrease of 1 mg/dl HDL cholesterol increases the risk of coronary heart disease by 2-3%. (11) Diabetes Mellitus Diabetes affects the whole world as a disease whose incidence increases day by day as a result of extended life expectancy, changes in lifestyle with developing technology, changing nutrition patterns and decreasing physical activity. According to the results of TURDEP-I (Turkish Diabetes Study), the prevalence of diabetes in our country was found to be 6.2% in adult men aged 20 and over and 8% in women (overall average 7.2%) between 1997 and 1998. In the results of TURDEP-II, which was conducted as a continuation of TURDEP-I and completed in 2010, the prevalence of diabetes was found to be 13.7% (12.4% in men and 14.6% in women) and a 90% increase in the prevalence of diabetes occurred in 12 years. b has been mentioned. (12) Diabetes is an independent risk factor for CVD. It increases the risk in men and women by two to four times, respectively. In the National Cholesterol Education Program report, DM is considered a coronary artery disease equivalent and thus falls into the highest risk category. This conclusion was reached because the risk of MI in type 2 DM patients without a history of myocardial infarction was found to be 20% and the risk of mortality was 15%, and this risk rate was similar to patients with a history of MI without diabetes. When a patient with type 2 diabetes has a myocardial infarction, the survival prognosis of these patients is much worse than that of coronary heart disease patients without diabetes (13) 5 Obesity Obesity is the biggest problem of developed and developing countries. Changing eating habits and preferences lead people to consume more fast food, and obesity is frequently encountered as a result of excess calories consumed combined with lack of physical activity. In the Study of Heart Disease and Risk Factors in Adults in Turkey (TEKHARF), conducted by the Turkish Cardiology Association and covering 3681 people, obesity was detected in one quarter of Turkish men (25.2 percent) over the age of 30 and in nearly half of women (44.2 percent). When considered separately in the middle-aged (31-49 years) and elderly (50 years and above) groups, this prevalence did not change significantly in men (24.8 and 25.7 percent) and increased significantly in women (38 percent and 50 percent, respectively). 2) has been reported. (9) The reason for this significant difference in women is menopause. At the beginning of menopause, a woman's body weight reaches its maximum, mostly due to increased fat tissue. As a result of shorter height and increased body weight, the weight status determined by body mass index (BMI) (kg/m2) also increases. Accordingly, overweight and obesity are more common in postmenopausal women than in premenopausal women. Even women who have not had problems with their body weight throughout their lives encounter undesirable weight and body mass index (BMI) increases during this period, and significant changes occur in their body measurements. The risk of developing CVD and diabetes in those with central type obesity is gyneoid obesity (lower body obesity).
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