10 years coronary heart disease risk among 20-79 years old adults in the rural region of köşk town and an intervention sample at the high risk group, Aydin, 2015

Aim and hypothesis: Study has two stages. The aim of the first stage, the prevalence study, is to calculate the 10 years risk of coronary heart disease among 20-79 years old adults by individual Framingham Risk Score evaluation. The aim of the second stage which is the intervention study is to evaluate the efficacy of the intervention by calculating the change at the risk after 6 months- by separating the group determines as at risk into two groups, sending SMSs consisting of information about the personal risks to the intervention group twice a month, totally 12 SMSs. Methods: The first stage of the study was conducted in the neighborhood of Koçak, Güzelköy, İlyasdere and Kuyucular. The second stage of the study Kuyucular composed intervention group, Güzelköy and İlyasdere composed control group. At the beginning of the study, data was collected with the survey revealing general socio-demographic information and health status of the study group and blood pressure, height, weight, HDL and total cholesterol measurements were performed. Framingham 10-years risk of coronary disease has been separately arranged for both sexes. According to these tables; the points appropriate for the age groups at the sections related to total cholesterol, smoking, HDL, systolic blood pressure were gathered and "10-year probability corresponding to an individual's risk" was determined. A one hour education on Framingham risk score and coronary heart disease were given to all individuals participating to the study. The SMSs containing spot and remaindering information about training topics necessary for the individual counseling were sent to the participants at the intervention group. Framingham risk score was calculated after intervention by performing survey and measurements again and the change of risk was determined. Findings: In study area, 655 from 896 individuals aged 20-79 were assigned accordance with the study criteria, of those 530 (80,9%) subject could be reached. No statistical difference between the classifications of the study participant neighborhoods' Framingham risk scores was found. Among the participants (n:530); 10 years coronary heart disease risk of more than 20% were 6.4% for men, 0,4% for women and between 10-20% were 40,6% for men and 0,9% for women. After the intervention, appropriate salt consumption, assessment of their physical activity, appropriate fruit, vegetables and fish consumption were significantly higher in the intervention group. Weight and BMI mean values in intervention group were decreased significantly but an increase in control group was determined. The average systolic blood pressure decreased significantly in the intervention group. In the intervention group, at the initial stage 40 (87.0%) of 46 participants were at medium risk group and 6 (13.0%) were in the high-risk group, after the intervention 11 of the participants (24.0%) passed into the low-risk group, all of this transition has been from the moderate-risk group. 4 (8.7%) of 6 participants who were in the high-risk group before the intervention was transferred to the modarete-risk group. Thus, a total of 15 (32.7%) participants that one of every three participants were settled into a lower risk group after the intervention. In the control group, initially 42 (95.5%) of the 44 participants were in the modarete-risk group and 2 (4.5%) were in the high risk group, after 6-month follow-up 5 (11.4%) of the participants were in the modarete-risk group was transferred the high-risk group. There was no response after the intervention as transfer to low-risk group. Therefore, a total of five participants (11.4%), one out of every nine people had settled into a high risk group after the intervention. Results: At the end of the study, it has been found that individualized SMS interventions based on individual risk factors provided behavior changes, lowered Framingham risk levels and it was an effective method for lowering risk factors of coronary heart disease. This method may be recommended for increasing the effectiveness of primary health care services. Key words: Framingham risk score, coronary heart disease, intervention.