Sex-specific Prevalence of coronary heart disease among Tehranian adult population across different glycemic status: Tehran Lipid and Glucose Study, 2008-2011

Abstract

Background: Coronary heart disease (CHD) is one of the main causes of deaths. Alarmingly Iranian populations had a high rank of CHD worldwide. The current study aimed to assess the prevalence of CHD across different glycemic categories. Methods: This study was conducted on 7,718 Tehranian participants (Men=3427) aged ≥ 30 years from 2008 to 2011. They were categorized based on glycemic status. The prevalence of CHD was calculated in each group, separately. CHD was defined as hospital records adjudicated by an outcome committee. The association of different glycemic categories with CHD was calculated using multivariate logistic regression, compared with normal fasting glucose /normal glucose tolerance (NFG/NGT) group as reference. Results: The age-standardized prevalence of isolated impaired fasting glucose (iIFG), isolated impaired glucose tolerance (iIGT), both impaired fasting glucose and impaired glucose tolerance (IFG/IGT), newly diagnosed diabetes mellitus (NDM), and known diabetes mellitus (KDM) were 14.30% [95% confidence interval (CI): 13.50-15.09], 4.81% [4.32-5.29], 5.19% [4.71-5.67], 5.79% [5.29-6.28] and 7.72% [7.17-8.27], respectively. Among a total of 750 individuals diagnosed as cases of CHD (398 in men), 117 (15.6%), 453 (60.4%), and 317 (42.3%) had history of myocardial infarction (MI), cardiac procedure, and unstable angina, respectively. The age-standardized prevalence of CHD for Tehranian population was 7.71% [7.18-8.24] in total population, 8.62 [7.81-9.44] in men and 7.19 [6.46-7.93] in women. Moreover, among diabetic participants, the age-standardized prevalence of CHD were 13.10 [9.83-16.38] in men 10.67 [8.90-12.44] in women, respectively, which were significantly higher than corresponding values for NFG/NGT and prediabetic groups. Across 6 levels of glycemic status, CHD was associated with IFG/IGT [ odds ratio (OR) and 95% CI: 1.38 (1.01-1.89)], NDM [1.83 (1.40-2.41)], and KDM [2.83 (2.26-3.55)] groups, in the age and sex adjusted model. Furthermore, in the full-adjusted model, only NDM and KDM status remained to be associated with the presence of CHD by ORs of 1.40 (1.06-1.85) for NDM and 1.90 (1.50-2.41) for KDM. Conclusion: The high prevalence of CHD, especially among diabetic populations, necessitates urgent implementation of behavioral interventions among Tehranian population, according to evidence-based guidelines for the clinical management of diabetic patients.

Letter to the Editor Regarding “Nationwide Prevalence of Diabetes and Prediabetes and Associated Risk Factors Among Iranian Adults: Analysis of Data from PERSIAN Cohort Study”

“…In their study, using fasting blood sugar criteria, they found that about 40.40% of the participants had dysglycemia (i.e., impaired fasting plasma glucose or diabetes). This finding is supported by our recent study performed in the metropolitan city of Tehran between 2008 and 2011, which showed that only 62.20% of Tehranian adults had normal glucose tolerance, based on strict criteria [2].…”

Number of parity/live birth(s) and cardiovascular disease among Iranian women and men: Results of over 15 years of follow-up.

“…More details of TLGS design and enrollment have been reported elsewhere [18]. 5,223 women and 4,330 men aged ≥ 30 years (4,459 women and 3,468 men from phase I and 764 new women and 862 new men from phase II) were enrolled. Participants were excluded if they were single (194 women and 179 men), with CVD at baseline (281 women and 318 men), and with no live births (21 women and 8 men), leading to a total of 4727 women and 3825 men.…”

Anthropometric indices and the risk of incident sudden cardiac death among adults with and without diabetes: over 15 years of follow-up in The Tehran Lipid and Glucose Study

“…Owing to notable incidence, unanticipated nature, and high rate of fatality, SCD is taking into account as a public health concern [4,5]. Coronary heart disease (CHD), with a prevalence of 7.7% among Tehranian adult residents [6], is the structural basis for approximately 70% of all SCD; however, the majority of CHD-related SCD occurs as the initial manifestation of CHD [7]; this is mainly because a great proportion of individuals experiencing SCD are not categorized into high-risk groups based on stratification of former studies [5,7,8]. This issue highlights the need for further investigations to identify the risk factors and high-risk groups for SCD well.…”