Estimation of 10-Year Risk of Cardiovascular Diseases Using WHO Risk Prediction Charts: A Population-Based Study in Southern Iran
Abstract
Background: An effective strategy for primary prevention of Cardiovascular Disease (CVD) is accurate diagnosis and the subsequent evidence-based treatment for high-risk people. This study aimed to estimate the 10-year risk of CVD and its related factors.
Methods: The baseline data of 8138 participants of the Pars cohort study (PCS) in southern Iran were used. Risk scores were calculated using the updated 2019 WHO CVD risk prediction charts. The scores were determined based on age, gender, current smoking status, systolic blood pressure (SBP), diabetes status, and total serum cholesterol. Demographic and socioeconomic variables, physical activity, and anthropometric indices were measured and analyzed. Multivariable logistic regression was applied to estimate the adjusted odds ratio (aOR) and 95% confidence intervals (CI).
Results: The mean (SD) age of the participants was 51.65 (9.06) years, and 53.44% were female. The 10-year CVD risk for 23.89% of participants was ≥10%. The prevalence of hypertension, diabetes, hypercholesterolemia, and smoking was 12.79%, 8.38%, 12.80%, and 14.41%, respectively. Having abdominal obesity, having low or moderate physical activity, being illiterate or having diplomas or lower degrees, and being in the third quartile of the wealth score group were associated with a higher 10-year risk of CVD.
Conclusion: About one-fourth of the participants had moderate risk and higher. Due to the relatively high prevalence of CVD risk factors in the middle-aged population, the modifiable risk factors are recommended to be adjusted. Additionally, individual- and community-based educational policies are essential to create a healthy lifestyle.
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25. Rezaei F, Nedjat S, Golestan B, Majdzadeh R (2011). Comparison of onset age and pattern of male adolescent smoking in two different socioeconomic districts of Tehran, Iran. Int J Prev Med, 2:224-28.
26. Rezaei F, Nedjat S, Golestan B, Majdzadeh R (2011). Reasons for smoking among male teenagers in Tehran, Iran: Two case-control studies using snowball sampling. Int J Prev Med, 2:216-23.
27. Rezaei F, Noroozi M, Mansourian M, Safari O, Jahangiry L (2017). The role of social and familial factors as predicting factors related to hookah and cigarette smoking among adolescents in Jahrom, south of Iran. Int J Pediatr, 5:4929-4937.
28. Azadbakht L, Esmaillzadeh A (2008). Dietary and non-dietary determinants of central adiposity among Tehrani women. Public Health Nutr, 11:528-534.
29. Ekelund U, Ward HA, Norat T, et al (2015). Physical activity and all-cause mortality across levels of overall and abdominal adiposity in European men and women: the European Prospective Investigation into Cancer and Nutrition Study (EPIC). Am J Clin Nutr, 101:613-621.
30. Peer N, Lombard C, Steyn K, Levitt N (2016). Differential associations of cardiovascular disease risk factors with relative wealth in urban-dwelling South Africans. J Public Health (Oxf), 38:e232-e239.
31. Lear SA, Hu W, Rangarajan S, et al (2017). The effect of physical activity on mortality and cardiovascular disease in 130 000 people from 17 high-income, middle-income, and low-income countries: the PURE study. Lancet, 390:2643-2654.
32. Pollitt RA, Rose KM, Kaufman JS (2005). Evaluating the evidence for models of life course socioeconomic factors and cardiovascular outcomes: a systematic review. BMC Public Health, 5:7.
33. World Health Organization (2007). Prevention of cardiovascular disease: Guideline for assessment and management of cardiovascular risk. Geneva: World Health Organization.
34. Esteghamati A, Gouya MM, Abbasi M, et al (2008). Prevalence of diabetes and impaired fasting glucose in the adult population of Iran: National Survey of Risk Factors for Non-Communicable Diseases of Iran. Diabetes Care, 31:96-98.
35. Esteghamati A, Abbasi M, Alikhani S, et al (2008). Prevalence, awareness, treatment, and risk factors associated with hypertension in the Iranian population: the national survey of risk factors for noncommunicable diseases of Iran. Am J Hypertens, 21:620-626.
2. Heidenreich PA, Trogdon JG, Khavjou OA, et al (2011). Forecasting the future of cardiovascular disease in the United States: a policy statement from the American Heart Association. Circulation, 123:933-944.
3. Mathers CD, Loncar D (2006). Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med, 3:e442.
4. Roth GA, Johnson C, Abajobir A, et al (2017). Global, regional, and national burden of cardiovascular diseases for 10 causes, 1990 to 2015. J Am Coll Cardiol, 70:1-25.
5. Mokdad A, Tehrani-Banihashemi A, Moradi-Lakeh M, et al (2018). Burden of cardiovascular diseases in the Eastern Mediterranean Region, 1990-2015: findings from the Global Burden of Disease 2015 study. Int J Public Health, 63(Suppl 1):137-149.
6. Fakhrzadeh H, Bandarian F, Adibi H, et al (2008). Coronary heart disease and associated risk factors in Qazvin: a population-based study. East Mediterr Health J, 14:33-41.
7. Hatmi Z, Tahvildari S, Motlag AG, Kashani AS (2007). Prevalence of coronary artery disease risk factors in Iran: a population based survey. BMC Cardiovasc Disord, 7:32.
8. Karami M, Mobasheri F, Khosravi Shadmani F (2013). Potential Impact Fraction of modifying selected risk factors on burden of cardiovascular disease in Iran: comparative risk assessment. Razi J Med Sci, 20:62-71.
9. Kaptoge S, Pennells L, De Bacquer D, et al (2019). World Health Organization cardiovascular disease risk charts: revised models to estimate risk in 21 global regions. Lancet Glob Health, 7:e1332-e1345.
10. World Health Organization (2020).Hearts: technical package for cardiovascular disease management in primary health care. https://apps.who.int/iris/bitstream/handle/10665/333221/9789240001367-eng.pdf
11. Lloyd-Jones DM (2010). Cardiovascular risk prediction: basic concepts, current status, and future directions. Circulation, 121:1768-1777.
12. Jahangiry L, Farhangi MA, Rezaei F (2017). Framingham risk score for estimation of 10-years of cardiovascular diseases risk in patients with metabolic syndrome. J Health Popul Nutr, 36:36.
13. Rezaei F, Seif M, Gandomkar A, Fattahi MR, Hasanzadeh J (2021). Agreement between laboratory-based and non-laboratory-based Framingham risk score in Southern Iran. Sci Rep, 11: 10767.
14. Rezaei F, Seif M, Gandomkar A, et al (2022). Comparison of laboratory-based and non-laboratory-based WHO cardiovascular disease risk charts: a population-based study. J Transl Med, 20:133.
15. Sarrafzadegan N, Hassannejad R, Marateb HR, et al (2017). PARS risk charts: A 10-year study of risk assessment for cardiovascular diseases in Eastern Mediterranean Region. PLoS One, 12:e0189389.
16. Gandomkar A, Poustchi H, Moini M, et al (2017). Pars cohort study of non-communicable diseases in Iran: protocol and preliminary results. Int J Public Health, 62:397-406.
17. Akbarzadeh A, Salehi A, Vardanjani HM, et al (2019). Epidemiology of Adult Diabetes Mellitus and its Correlates in Pars Cohort Study in Southern Iran. Arch Iran Med, 22:633-639.
18. National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) (2002). Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation, 106(25):3143-3421.
19. James PA, Oparil S, Carter BL, et al (2014). Evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA, 311:507-520.
20. Islami F, Kamangar F, Nasrollahzadeh D, et al (2009). Socio-economic status and oesophageal cancer: results from a population-based case–control study in a high-risk area. Int J Epidemiol, 38:978-988.
21. Momeni M, Danaei M, Ebrahimi S (2020). Estimating the Frequency of Risk Factors and the 10-Year Risk of Developing Cardiovascular Diseases in Middle-aged Population in Kerman, Iran. Shiraz E-Med J, 21:e90551.
22. Islam JY, Zaman MM, Moniruzzaman M, Shakoor SA, Hossain AE (2020). Estimation of total cardiovascular risk using the 2019 WHO CVD prediction charts and comparison of population-level costs based on alternative drug therapy guidelines: a population-based study of adults in Bangladesh. BMJ Open, 10:e035842.
23. Rajati F, Hamzeh B, Pasdar Y, et al (2019). Prevalence, awareness, treatment, and control of hypertension and their determinants: Results from the first cohort of non-communicable diseases in a Kurdish settlement. Sci Rep, 9: 12409.
24. Moosazadeh M (2013). Meta-analysis of prevalence of smoking in 15-64-year-old population of west of Iran. Int J Prev Med, 4:1108-14.
25. Rezaei F, Nedjat S, Golestan B, Majdzadeh R (2011). Comparison of onset age and pattern of male adolescent smoking in two different socioeconomic districts of Tehran, Iran. Int J Prev Med, 2:224-28.
26. Rezaei F, Nedjat S, Golestan B, Majdzadeh R (2011). Reasons for smoking among male teenagers in Tehran, Iran: Two case-control studies using snowball sampling. Int J Prev Med, 2:216-23.
27. Rezaei F, Noroozi M, Mansourian M, Safari O, Jahangiry L (2017). The role of social and familial factors as predicting factors related to hookah and cigarette smoking among adolescents in Jahrom, south of Iran. Int J Pediatr, 5:4929-4937.
28. Azadbakht L, Esmaillzadeh A (2008). Dietary and non-dietary determinants of central adiposity among Tehrani women. Public Health Nutr, 11:528-534.
29. Ekelund U, Ward HA, Norat T, et al (2015). Physical activity and all-cause mortality across levels of overall and abdominal adiposity in European men and women: the European Prospective Investigation into Cancer and Nutrition Study (EPIC). Am J Clin Nutr, 101:613-621.
30. Peer N, Lombard C, Steyn K, Levitt N (2016). Differential associations of cardiovascular disease risk factors with relative wealth in urban-dwelling South Africans. J Public Health (Oxf), 38:e232-e239.
31. Lear SA, Hu W, Rangarajan S, et al (2017). The effect of physical activity on mortality and cardiovascular disease in 130 000 people from 17 high-income, middle-income, and low-income countries: the PURE study. Lancet, 390:2643-2654.
32. Pollitt RA, Rose KM, Kaufman JS (2005). Evaluating the evidence for models of life course socioeconomic factors and cardiovascular outcomes: a systematic review. BMC Public Health, 5:7.
33. World Health Organization (2007). Prevention of cardiovascular disease: Guideline for assessment and management of cardiovascular risk. Geneva: World Health Organization.
34. Esteghamati A, Gouya MM, Abbasi M, et al (2008). Prevalence of diabetes and impaired fasting glucose in the adult population of Iran: National Survey of Risk Factors for Non-Communicable Diseases of Iran. Diabetes Care, 31:96-98.
35. Esteghamati A, Abbasi M, Alikhani S, et al (2008). Prevalence, awareness, treatment, and risk factors associated with hypertension in the Iranian population: the national survey of risk factors for noncommunicable diseases of Iran. Am J Hypertens, 21:620-626.
| Files | ||
| Issue | Vol 51 No 7 (2022) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v51i7.10101 | |
| Keywords | ||
| Cardiovascular diseases WHO Risk prediction Socioeconomic Life style Pars cohort | ||
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How to Cite
1.
Rezaei F, Seif M, Fattahi MR, Gandomkar A, Hasanzadeh J. Estimation of 10-Year Risk of Cardiovascular Diseases Using WHO Risk Prediction Charts: A Population-Based Study in Southern Iran. Iran J Public Health. 2022;51(7):1667-1676.
