Cardiovascular Mortality Risk Factors in The Northeast of Iran: A Four-Year Cohort Study

Document Type : Research Paper

Authors

1 Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Department of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

3 International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Department of General Surgery, Mashhad University of Medical Sciences, Mashhad, Iran.

10.22038/jnfh.2023.69911.1426

Abstract

Introduction: Cardiovascular diseases (CVD) have been recognized as the leading causes of death worldwide and in Iran. Deaths from CVD diseases accounted for approximately 39.42% of Razavi Khorasan Province (RKP). In this study, the risk factors associated with CVD mortality in the residents of RKP were evaluated. Method: This retrospective cohort study was done based on recorded information from the Vic Chancellery of Health Questionnaires of KRP (2016–2019). Results: Overall, 2,304,156 participants entered the study. CVD deaths made up about 50% of total deaths. The opium use, history of heart attack, BMI ≥ 40 kg/m2, homemade alcohol, FBS mg/dL>126, diabetes, BMI ≥ 30 kg/m2, and always using salt, Systolic blood pressure, Framingham risk score, and age were CVD risk factors, respectively (OR 6.59, 4.91, 3.25, 2.64, 2.00, 1.99, 1.89, 1.80, 1.09, 1.04, and 1.03, P = 0.001). Also, higher educational level, female gender, BMI 25-27 kg/m, healthier eating habits (higher consumption of dairy, fruits, and vegetables), moderate exercise, and aspirin use were identified as protective factors. Conclusion:  In this study, behavioural risk factors, opium use, BMI ≥ 40 and≥ 30 kg/m2, homemade alcohol, salt, medical history, heart attacks, and diabetes were identified as important CVD risk factors. Also, a higher educational level, female gender, BMI 25-27 kg/m2, healthier eating habits (higher consumption of dairy products, fruits, and vegetables), exercise, and aspirin were protective factors in KRP, especially in Dargaz, and they may be the cause of increasing sudden deaths, especially heart attacks.

Keywords


  1. Roth GA, Mensah GA, Johnson CO, Addolorato G, Ammirati E, Baddour LM, et al. Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update From the GBD 2019 Study. Journal of the American College of Cardiology. 2020;76(25):2982-3021.
  2. Thomas H, Diamond J, Vieco A, Chaudhuri S, Shinnar E, Cromer S, et al. Global Atlas of Cardiovascular Disease 2000-2016: The Path to Prevention and Control. Global heart. 2018;13(3):143-63.
  3. Association AH. Cardiovascular disease: A costly burden for America projections through 2035. 2017.
  4. . (http://ghcearegistry.org/orchard/the-daly HYPERLINK "http://ghcearegistry.org/orchard/the-daly2021"2021).
  5. Sadeghi M, Talaei M, Oveisgharan S, Rabiei K, Dianatkhah M, Bahonar A, et al. The cumulative incidence of conventional risk factors of cardiovascular disease and their population attributable risk in an Iranian population: The Isfahan Cohort Study. Advanced biomedical research. 2014;3.
  6. Pakdaman M, Gravandi S, Askari R, Shafii M, Khaleghi Muri M, Bahariniya S. Estimation of the Economic Burden of Cardiovascular Diseases in Selected Hospitals of Yazd in 2018. Qom University of Medical Sciences Journal. 2020;14(7):58-68.
  7. دکتر طاهره سموات و همکاران ، برنامه جامع کشوری پیشگیری و کنترل بیماری قلبی عروقی 1391. 1391.
  8. Andersson C, Vasan RS. Epidemiology of cardiovascular disease in young individuals. Nature reviews Cardiology. 2018;15(4):230-40.
  9. https://www.who.int/chp/chronic_disease_report/media/Factsheet HYPERLINK "https://www.who.int/chp/chronic_disease_report/media/Factsheet1.pdf2021"1 HYPERLINK "https://www.who.int/chp/chronic_disease_report/media/Factsheet1.pdf2021".pdf HYPERLINK "https://www.who.int/chp/chronic_disease_report/media/Factsheet1.pdf2021"2021.
  10. Gaziano TA. Lifestyle and Cardiovascular Disease: More Work to Do. Journal of the American College of Cardiology. 2017;69(9):1126-8.
  11. Sadeghi M, Talaei M, Oveisgharan S, Rabiei K, Dianatkhah M, Bahonar A, et al. The cumulative incidence of conventional risk factors of cardiovascular disease and their population attributable risk in an Iranian population: The Isfahan Cohort Study. Adv Biomed Res. 2014;3:242.
  12. Moraes-Silva IC, Mostarda CT, Silva-Filho AC, Irigoyen MC. Hypertension and Exercise Training: Evidence from Clinical Studies. Advances in experimental medicine and biology. 2017;1000:65-84.
  13. Fujiwara T, Takeda N. Glucose Fluctuation and Cardiovascular Diseases. International heart journal. 2020;61(4):633-5.
  14. Colagiuri S. Definition and Classification of Diabetes and Prediabetes and Emerging Data on Phenotypes. Endocrinology and metabolism clinics of North America. 2021;50(3):319-36.
  15. Almourani R, Chinnakotla B, Patel R, Kurukulasuriya LR, Sowers J. Diabetes and Cardiovascular Disease: an Update. Current diabetes reports. 2019;19(12):161.
  16. Mohammadi H, Ohm J, Discacciati A, Sundstrom J, Hambraeus K, Jernberg T, et al. Abdominal obesity and the risk of recurrent atherosclerotic cardiovascular disease after myocardial infarction. European journal of preventive cardiology. 2020;27(18):1944-52.
  17. World Health Organization. Obesity and overweight. Geneva:

World Health Organization; 2018 http://www.who.int/media

centre/factsheets/fs311/en/.

  1. Jeong SW, Kim SH, Kang SH, Kim HJ, Yoon CH, Youn TJ, et al. Mortality reduction with physical activity in patients with and without cardiovascular disease. European heart journal. 2019;40(43):3547-55.
  2. Kramer A. An Overview of the Beneficial Effects of Exercise on Health and Performance. Advances in experimental medicine and biology. 2020;1228:3-22.
  3. Sheehy S, Palmer JR, Rosenberg L. Leisure Time Physical Activity in Relation to Mortality Among African American Women. American journal of preventive medicine. 2020;59(5):704-13.
  4. Koohsari MJ, Nakaya T, Hanibuchi T, Shibata A, Ishii K, Sugiyama T, et al. Local-Area Walkability and Socioeconomic Disparities of Cardiovascular Disease Mortality in Japan. Journal of the American Heart Association. 2020;9(12):e016152.
  5. Nalini M, Shakeri R, Poustchi H, Pourshams A, Etemadi A, Islami F, et al. Long-term opiate use and risk of cardiovascular mortality: results from the Golestan Cohort Study. European journal of preventive cardiology. 2021;28(1):98-106.
  6. Xi B, Veeranki SP, Zhao M, Ma C, Yan Y, Mi J. Relationship of Alcohol Consumption to All-Cause, Cardiovascular, and Cancer-Related Mortality in U.S. Adults. Journal of the American College of Cardiology. 2017;70(8):913-22.
  7. Samadi S, Baneshi MR, Haghdoost AA. Pattern of alcohol consumption among men consumers in Kerman, Iran. Addiction & health. 2017;9(3):139.
  8. Kunutsor SK, Seidu S, Khunti K. Aspirin for primary prevention of cardiovascular and all-cause mortality events in diabetes: updated meta-analysis of randomized controlled trials. Diabetic medicine : a journal of the British Diabetic Association. 2017;34(3):316-27.
  9. Yusuf S, Joseph P, Rangarajan S, Islam S, Mente A, Hystad P, et al. Modifiable risk factors, cardiovascular disease, and mortality in 155 722 individuals from 21 high-income, middle-income, and low-income countries (PURE): a prospective cohort study. Lancet (London, England). 2020;395(10226):795-808.
  10. Che B, Shen S, Zhu Z, Wang A, Xu T, Peng Y, et al. Education Level and Long‐term Mortality, Recurrent Stroke, and Cardiovascular Events in Patients With Ischemic Stroke. Journal of the American Heart Association. 2020;9(16):e016671.
  11. Noale M, Limongi F, Maggi S. Epidemiology of Cardiovascular Diseases in the Elderly. Advances in experimental medicine and biology. 2020;1216:29-38.
  • Receive Date: 24 January 2023
  • Revise Date: 18 March 2023
  • Accept Date: 28 March 2023
  • First Publish Date: 28 March 2023