Epidemiology of coronary heart disease risk factors in central Iran: a 10-year cohort study

Abstract

Background As a result of its unique lifestyle, culture, and genetic characteristics, central Iran exhibits differences in coronary heart disease (CHD) risk factor prevalence and impact. Therefore, investigating the epidemiology of CHD risk factors and their effects on CHD events in this region is of particular significance. Methods Two-thousand participants of a community-based Iranian population, aged 20–74 years, were investigated with a mean follow-up of 9.9 years (range: 7.6 to 12.2). An analysis of Cox regression was conducted to determine the association between CHD development and classic risk factors like age, gender, smoking, socioeconomic status, physical activity, education, obesity, dyslipidemia, hypertension, and diabetes. For risk factors and protective factors, attributed risk percentages and absolute risk reductions were calculated. Results After a follow-up period of nearly 10 years, a total of 225 CHD events were reported, accounting for 14.5% of the participants. Most participants had more than one risk factor. Age was the most critical risk factor. In comparison to females, male gender had a HR of 1.45 (CI: 1.11–1.90, p-value = 0.006) for developing CHD. Socioeconomic status and BMI were not significantly associated with CHD. Nearly 80% of the patients had dyslipidemia with a hazard ratio of 2.19 (CI: 1.40–3.44, p = 0.01). Hypertension with prevalence of 28.9% and pre-hypertension with prevalence of 52% were significant risk factors. Diabetes with a prevalence of 19.76% had a HR of 2.70 (CI: 2.07–3.53), but pre-diabetes was not significantly associated with CHD. Awareness of diabetes, dyslipidemia, and hypertension were 81%, 27.9%, and 48.1%, respectively. Regarding medication usage, the corresponding percentages were 51% for diabetes, 13.2% for dyslipidemia, and 41% for hypertension. Conclusions Compared to neighboring countries and other parts of the world, classical CHD risk factors are highly prevalent in Iran. This can prompt Iranian healthcare policy makers to change their strategies.