The Incidence of Coronary Heart Disease and the Population Attributable Fraction of Its Risk Factors in Tehran: A 10-Year Population-Based Cohort Study

Abstract

BackgroundData on incidence of coronary heart disease (CHD) is scarce in the Middle East and little is known about the contribution of known risk factors in this area.MethodsThe incidence of CHD and the effect of modifiable risk factors were explored in 2889 men and 3803 women aged 30–74 years in the population based cohort of the Tehran Lipid and Glucose Study, during 1999–2010. Average population attributable fraction (aPAF) was calculated for any risk factor using direct method based on regression model.ResultsThe crude incidence rate in men was about twice that in women (11.9 vs. 6.5 per 1000 person-years). The aPAF of hypertension, diabetes, high total cholesterol and low-HDL cholesterol was 9.4%, 6.7%, 7.3% and 6.1% in men and 17%, 16.6%, 12% and 4.6% in women respectively. This index was 7.0% for smoking in men. High risk age contributed to 42% and 22% of risk in men and women respectively.ConclusionsThe incidence in this population of Iran was comparable to those in the US in the seventies. Well known modifiable risk factors explained about 40% and 50% of CHD burden in men and women respectively. Aging, as a reflection of unmeasured or unknown risk factors, bears the most burden of CHD, especially in men; indicating more age-related health care is required.

Population Attributable fraction Estimation of the Cardiovascular Diseases–related factors: An Evidence from western part of Iran

“…In the present study, high-risk age in men (15.0%), in comparison with women (6.3%) had a higher PAF, which was consistent with the results of two population based cohort studies conducted in Iran (36.1% in men vs. 16.6% in women and 42% in men vs. 22% in women) [26,27] and a study from…”

“…The association between classic risk factors and CVD has been proven, but even for those risk factors with the same effect size, they can produce a completely different effect on the occurrence of disease due to the difference in the prevalence, so the calculation of PAF must be performed, using the population of the target community. In the present study, PAF of hypertension for CVDs has a higher value in women (42.8%) than in men (35.7%), and this difference has been reported from two population based cohort studies conducted in Iran (19.3% in women vs. 11.7% in men) and (17% in women vs. 9.4% in men) [26,27]. Also, it is consistent with the results of study in Sweden from "the Malmö preventive project" (23% in women vs. 12% in men) [28].…”

“…The findings of this study showed no significant statistical relationships between the CVD and substance abuse, occupation, place of residence, taking contraceptive pills, the use of hormone replacement therapy and menopause. None of the previous studies looked at these variables [26][27][28][29][30][31][32][33].…”

A new approach to test validity and clinical usefulness of the 2013 ACC/AHA guideline on statin therapy: A population-based study

“…The low performance of the ACC/AHA guideline for high dose statin therapy in women should not be translated to the low importance of hypercholesterolemia in them. Recently we revealed that hypercholesterolemia (total cholesterol ≥240 mg/dl) increases the risk of CVD up to 60% in both genders but with more population attributable risk in women than in men (12% vs. 7.3%) [25].…”

Different Weight Histories and Risk of Incident Coronary Heart Disease and Stroke: Tehran Lipid and Glucose Study

“…Considering the high prevalence and incidence of obesity and CVD among Middle Eastern populations,13, 14 this study was conducted to investigate the effect of different weight histories—including current and maximum BMI, current and maximum WC, duration of general and central adiposity, and cumulative excess BMI and WC, considering both duration and degree of overweight status or obesity—on CHD and stroke events among Iranian adults in the population‐based cohort of the TLGS (Tehran Lipid and Glucose Study).…”