Kardiyovasküler risk faktörü olarak kent çevresi

AMAÇ: Dünya kardiyovasküler mortalite ve morbiditede özel bir yükselme yaşamaktadır. Bu yükseklik kentsel alanda kırsaldan fazla olduğu gibi gelişmiş ülkelerdede gelişmekte olan ülkelerden fazladır. Bu görünümde kentsel çevrenin birden çok nedenle ilişkili olduğu görülmektedir. Epidemiyolojik dönüşüm, koruyucu önlemler alınacaksa dikkatlerin toksik çevreye yönelmesi aşamasına gelmiştir. Bu derleme, kentsel çevrenin kardiyovasküler hastalıkların gelişimine etkisini değerlendirmeyi amaçlamaktadır. Bu şekilde kardiyovasküler hastalık morbidite ve mortalitesindeki artışın kökenine ışık tutulabilir. YÖNTEM: Çevresel ve kardiyovasküler hastalıklar hakkındaki literatürün, indeksli ve online dergiler Pubmed, Google ve Google Scholar kullanılarak, sistematik derlemesi yapıldı. Yerleşim ve kentsel çevre hakkındaki uygun yerel bilgiler de değerlendirildi. BULGULAR: Kentsel çevrenin toksik olma ve kardiyovaskuler hastalık oluşturma veya mevcut olanı kötüleştirmesine yönelik çeşitli özellikleri gösterildi. SONUÇ: Kentsel alanların düzenli gelişimi, sosyal, politik ve ekonomik mühendislik ile kırsaldan kentsele göçten vazgeçirme ve kentsel altyapının güçlendirilmesi zorunlu hale gelmiştir. Bunlar, kardiyovaskülar hastalık artışı olgusuna olumlu etkide bulunur.

The urban enviroment as a cardiovascular disease risk factor

AIM: The world is experiencing a phenomenal rise in cardiovascular disease morbidity and mortality. These are higher in developed than developing countries as well as urban more than rural areas. The place of the urban environment in this picture is seen more as an association than a cause. With the epidemiological transition coming on, the need to draw attention to the role of a “toxic” environment becomes necessary if preventive measures are to be put in place. This review article sought to evaluate the role of the urban environment in the development of cardiovascular disease. This would therefore highlight the areas where preventive measures can be instituted to stem the tide of rising cardiovascular disease morbidity and mortality METHOD: A systematic review of literature on environmental and cardiovascular diseases from indexed and on-line journals using Pubmed, Google and Google scholar were performed. Relevant local materials on housing and urban environment were also consulted. RESULTS: The various ways by which the urban environment would become toxic and precipitate incident cardiovascular disease or worsen pre-existing ones are highlighted. CONCLUSION: The need to ensure orderly development of urban areas, discourage rural to urban migration by deliberate social, political and economic engineering and improve urban infrastructure become compelling. These would impact positively on the phenomenon of increase of cardiovascular diseases.

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