Cardiovascular Health in the European Union and Türkiye

(A Comparative Assessment in Light of OECD Findings)

Cardiovascular diseases (CVDs) are among the leading causes of death both in European Union (EU) countries and in Türkiye. OECD data show that, across the EU, approximately one third of all deaths are attributable to CVDs, while in Türkiye, diseases of the circulatory system have consistently ranked first among causes of mortality for many years. This situation demonstrates that cardiovascular health is not only a clinical issue but also a major public health and health policy concern.

Within the European Union, cardiovascular diseases are associated with particularly high mortality rates in Central and Eastern European countries. In contrast, more favorable outcomes have been achieved in Western and Southern Europe through long-standing preventive policies, although regional inequalities remain a significant and persistent challenge.

In Türkiye, the burden of CVDs is closely linked to rapid urbanization, changes in dietary habits, physical inactivity, and tobacco use. Although Türkiye has a younger population compared to EU countries, the early onset of hypertension, obesity, and diabetes increases cardiovascular risk. This indicates that, despite its “demographic advantage,” Türkiye faces a substantial cardiovascular disease burden.

According to OECD findings, a large proportion of cardiovascular diseases in the European Union are associated with preventable risk factors. These include hypertension, obesity, diabetes, tobacco use, and physical inactivity.

From Türkiye’s perspective, the overall picture is largely similar:

• Tobacco use remains high, particularly among men.
  
• Obesity is widespread, especially among women and lower socioeconomic groups.
  
• Physical inactivity constitutes a major public health problem among both children and adults.
  

While EU countries widely employ policy tools such as taxation, food labeling, advertising restrictions, and environmental regulations to address these risks, such policies are only partially implemented in Türkiye and remain limited in terms of continuity and impact.

The OECD report highlights that early diagnosis and regular screening rates across the European Union are insufficient. In many countries, screenings for hypertension, diabetes, and hyperlipidemia are not conducted in a systematic manner.

In Türkiye, the Family Medicine system offers significant potential in this area. Regular population follow-up, chronic disease monitoring, and free screening services theoretically place Türkiye in an advantageous position. However, in practice:

• Screening results often fail to translate into effective follow-up and treatment,
  
• Patient adherence is low,
  
• Integration problems between primary care and secondary–tertiary care levels hinder the full utilization of this potential.
  

Although substantial progress has been made in acute cardiovascular care in EU countries, OECD data indicate that post-discharge follow-up and rehabilitation services remain weak. High readmission rates among patients with stroke and heart failure clearly illustrate this issue.

A similar situation exists in Türkiye. While acute treatment services are relatively strong, particularly in large cities:

• Regular post-discharge follow-up,
  
• Access to cardiac rehabilitation services,
  
• Multidisciplinary care models
  

are not sufficiently widespread. This not only reduces patients’ quality of life but also places an additional burden on the health system.

The OECD emphasizes that digital health solutions hold great potential in the management of cardiovascular diseases. Although electronic health records and telehealth applications are becoming more widespread in the European Union, significant differences persist among countries.

Türkiye has made a strong initial investment in digital infrastructure through systems such as e-Nabız and centralized health data platforms. However, these systems have yet to reach the desired level in terms of:

• Integration with clinical decision support mechanisms,
  
• Active use in chronic disease management,
  
• Expansion of remote monitoring and telemedicine applications.
  

The key policy gap identified by the OECD for the European Union is also largely applicable to Türkiye:
A treatment-oriented approach continues to overshadow prevention and long-term management.

For Türkiye, the following policy needs stand out:

• Strengthening preventive public health policies,
  
• More effective use of primary care in cardiovascular risk management,
  
• Standardization of post-discharge care and rehabilitation,
  
• Reduction of socioeconomic and regional inequalities,
  
• Active and rational use of digital health solutions.
  

Cardiovascular diseases represent a preventable public health crisis for both the European Union and Türkiye. The policy recommendations proposed by the OECD for the EU also provide a strong roadmap for Türkiye.

An integrated approach that combines prevention, early diagnosis, coordinated care, and digital innovation is critical for reducing the burden of cardiovascular diseases in Türkiye and for strengthening the sustainability of the health system.

Kemal KAHYALAR