A Decade Trends in Total and Sex-specific Cerebrovascular Disease Mortality in Turkey: 2013-2022

Abstract

Objective: Cerebrovascular diseases (CVD) remain a significant global public health concern and a leading cause of mortality. This study aims to assess the current trends in cerebrovascular disease-related mortality in Turkey, with a particular focus on disparities in age and gender. To achieve this, we will utilize mortality data from the Turkish Statistical Institute (TUIK). Methods: Mortality data for ischemic heart disease from 2013 to 2022 were obtained from the TUIK mortality database. Analytical methods involved the use of Joinpoint analysis to calculate both the annual percentage change (APC) and the average annual percentage change (AAPC). This allowed for the identification of significant alterations in trends over the study period. Additionally, we conducted a detailed examination of sex-specific variations, and age-standardized rates (ASRs) were computed. Results: In 2013, the total CVD death rate was 25.2%, with male and female death rates of 22.9% and 27.5%, respectively. This year marked the highest recorded stroke death rate within the provided timeframe. By 2022, these rates had consistently decreased. The total stroke death rate was 19.2%, with males at 18.7% and females at 19.7%. The analysis indicated a decreasing trend in CVD mortality in Turkey from 2013 to 2022. However, this decrease was not statistically significant (APC=1.9, 95% CI: -0.8; 4.3, p=0.123). The decline was more pronounced in females (APC=2.4, 95% CI: -0.7; 4.9, p=0.121) compared to males (APC=1.2, 95% CI: -1.3; 3.8, p=0.2351). Comparatively, the latest available data underscore significant disparities in cerebrovascular disease mortality across European regions. Western Europe had the lowest percentage of total deaths attributed to stroke, with 5.9% in males and 8.2% in females. In contrast, Eastern Europe recorded the highest percentages, with 11.6% in males and 17.5% in females. These disparities were reflected in Age-Standardized Mortality Rates (ASMRs), with Western Europe having the lowest ASMRs for stroke and Eastern Europe having the highest. Conclusion: While there have been global reductions in CVD mortality, Turkey has mirrored these declining trends, albeit at a lower rate than many European countries. The presented results emphasize the need for continual research and improved interventions targeting the observed inequalities in cerebrovascular disease mortality outcomes in Turkey. The regional and sex disparities highlighted necessitate targeted health policies and resource allocation to effectively mitigate cerebrovascular disease-related mortalities.