The Isfahan cohort study: Rationale, methods and main findings

Sarrafzadegan, Nizal; Talaei, Mohammad; Sadeghi, Masoumeh; Kelishadi, Roya; Oveisgharan, Shahram; Mohammadifard, N.; Sajjadieh, Amir; Kabiri, Payam; Marshall, Tom; Thomas, G. Neil; Tavasoli, Ali Akbar

doi:10.1038/jhh.2010.99

Cited by 114 publications

(155 citation statements)

References 29 publications

(24 reference statements)

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“…However, according to our findings, hypertension has a strong association with the risk of IHD as well (RR = 1.90; 95% CI, 1.59-2.26). These findings are similar to those of our previous study (18) and those of other studies such the Honolulu Heart Program that showed that systolic blood pressure and smoking were the most important risk factors of IHD, rather than other risk factors, including high cholesterol level (23). In Iran, the prevalence of hypertension is high, with an increasing trend in recent years (24).…”

Section: Discussionsupporting

confidence: 82%

Do cardiometabolic risk factors relative risks differ for the occurrence of ischemic heart disease and stroke?

et al. 2016

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Background:The effects of the risk factors of ischemic heart disease (IHD) and stroke on the occurrence of these diseases differ between different populations. Objectives: To study the difference in the effects of different cardiovascular (CVD) risk factors on the incidence of IHD and stroke in an Iranian adult population. Patients and Methods:The Isfahan Cohort Study (ICS) is a longitudinal study that followed up 6323 subjects older than 35 years with no history of CVD since 2001. Of the original sample, only 5431 participants were contacted and followed up until 2011. The end points were the occurrence of IHD (defined as fatal and non-fatal myocardial infarction, unstable angina, and sudden cardiac death) and stroke. After 10 years of follow-up, 564 new cases of IHD and 141 new cases of stroke were detected. The relative risks (RRs) of cardiometabolic risk factors such as hypertension, diabetes, hypercholesterolemia, hypertriglyceridemia, high low-density lipoprotein cholesterol (LDL-C) level, low high-density lipoprotein cholesterol (HDL-C) level, current smoking, obesity, high waist-to-hip ratio, family history of CVD, and metabolic syndrome were compared between IHD and stroke patients. The ratio of relative risks (RRR) was calculated for comparing two RRs and estimated adjusted RRR was calculated by using generalized linear regression with a log link and binomial distribution. Results: The RRs of the occurrence of IHD and stroke in diabetic patients were 1.94 and 3.26, respectively, and the difference was statistically different (P = 0.016). The RR of high LDL-C was significantly higher for IHD than for stroke (P = 0.045), while all the other risk factors showed similar RRs for IHD and stroke, with no significant difference in their RRR, including hypertension. Diabetes and hypertension had the highest RRs for IHD, followed by diabetes, metabolic syndrome, and hypertension for stroke. Conclusions:The effect of diabetes mellitus on stroke was more significant than on IHD, and the effect of high LDL-C level was more significant on IHD than on stroke, other risk factors, including hypertension, have similar RRs for IHD and stroke. Health care professionals need more training regarding the RRs of these risk factors in the Iranian society, and health decision makers should consider it in their future policies.

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Section: Discussionsupporting

confidence: 82%

Do cardiometabolic risk factors relative risks differ for the occurrence of ischemic heart disease and stroke?

et al. 2016

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“…Although the in-hospital diagnoses of clinicians were taken into account, the final decisions of the outcome adjudication panel were made independently. A detailed explanation regarding the follow-up is available else- where (14).…”

Section: Follow-up Surveysmentioning

confidence: 99%

“…Measurement of blood pressure and anthropometric parameters were carried out following standard protocols and using calibrated instruments as described previously (14). The waist circumference was taken as the smallest circumference at or below the costal margin.…”

Section: Baseline Surveymentioning

confidence: 99%

Appropriate Cut-off Values of Waist Circumference to Predict Cardiovascular Outcomes: 7-year Follow-up in an Iranian Population

et al. 2012

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Objective Due to the lack of compelling evidence for waist circumference (WC) as a cardiovascular disease (CVD) risk factor in many ethnic groups, the need for local research has been expressed by international authorities. This study was undertaken to determine the optimal cut-off points of WC for predicting incident CVD and metabolic syndrome in an Iranian population. Materials and Methods A total of 6,504 participants from three areas in central Iran were followed over 7 years. Receiver operating characteristics (ROC) and area under the curve (AUC) were used to identify the maximum value of sensitivity and specificity combinations corresponding to the appropriate cut-off points of WC for the detection of the metabolic syndrome and CVD events. The optimal cut-off values were defined as the point at which the value of "sensitivity+specificity-1" reached the maximum value. Finally, Cox proportional hazard modeling was used to determine which cut-off point was better fit in the CVD risk prediction model. Results After 394,418 person-years of follow-up, 427 incident primary CVD events (233 men) were identified. Considering CVD, the optimum cut-off points were 99/103.5 cm (men/women) but these had a low sensitivity (AUC: 0.59, 95%CI 0.55-0.63 in both men and women). The second highest values for discriminating CVD were 93/97 cm that resulted in acceptable sensitivity. Regarding the metabolic syndrome, 92.6/97.8 cm were identified as optimum (AUC: 0.67, 95%CI 0.65-0.69 in men and 0.65, 95%CI 0.63-0.67 in women). The best cut-off values that fit in the Cox regression model were 90/97 cm. Conclusion International recommended WC cut-off values for the Middle East are not appropriate compared to the locally defined cut-off values in Iran.

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“…This study was completed as part of a population-based, longitudinal, ongoing study of healthy Iranian adults aged 35 y and older at the time of recruitment in 2001, known as the Isfahan Cohort Study (ICS) (21). Individuals were selected from three provinces in central Iran, using the multistage random sampling method.…”

Section: Methodsmentioning

confidence: 99%

“…ICS aimed to determine the impact of various risk factors, including individual and environmental risk factors, on the incidence of cardiovascular diseases. Detailed information regarding ICS, including sampling, rationale and results, was presented elsewhere (21,22). In the current study, vitamin D levels were assessed in subjects who were free of MetS in 2001 and if their frozen serum samples were available in 2001, 2007 and 2013.…”

Section: Methodsmentioning

confidence: 99%

Prevalence and Trends of Vitamin D Deficiency among Iranian Adults: A Longitudinal Study from 2001-2013

Khosravi-Boroujeni

Sarrafzadegan

Sadeghi³

et al. 2017

J Nutr Sci Vitaminol

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Summary Vitamin D deficiency/insufficiency is currently considered to be a re-emerging public health problem globally. This study was designed to determine the prevalence of vitamin D deficiency and insufficiency and to investigate its trend from 2001 to 2013 in a longitudinal study of Iranian adults. This study was part of a population-based, longitudinal ongoing study of Iranian healthy adults aged 35 y and older at baseline. Serum vitamin D level was assessed in a sub-sample of 370 subjects, who were apparently healthy at the time of recruitment in 2001 and were free from MetS, in three phases (2001, 2007 and 2013) during the 12-y study period. Adjusted prevalence and trend of vitamin D deficiency were calculated. Mean serum vitamin D levels increased over the time of the study (52.12, 54.27 and 62.28 nmol/L, respectively) and the prevalence of vitamin D deficiency decreased Vitamin D has long been recognized for its role in the regulation of calcium and phosphorus homeostasis and bone health (4). Moreover, there is also an increasing body of evidence that has found an association between vitamin D deficiency and other health problems (5). For example, the risk of all-cause and cardiovascular mortality was reported higher in people with a lower level of serum 25(OH)D (6-8). Although the optimal serum level of 25(OH)D in humans is not fully recognised, several expert groups have considered levels of less than 25 nmol/L to be a 'deficiency' and 25-50 nmol/L to be an 'insufficiency' (9, 10).Due to the potential health problems related to vitamin D deficiency and its increasing prevalence, vitamin D deficiency/insufficiency is currently recognized as a reemerging public health problem at the global level (11). It is estimated that more than one billion people are vitamin D deficient/insufficient (12). For example, the prevalence of vitamin D deficiency was 36% in young adults in the United States (13), while studies in Australia have also reported a high prevalence of vitamin D deficiency (33% and 40% in men and women respectively), despite the high levels of sunshine (14). However, the situation seems to be worse in Middle-Eastern countries, despite the sunny climate throughout the year (15). The prevalence of vitamin D deficiency/insufficiency in adults was reported as 61.4% and 87.8% in Kuwait and Saudi Arabia respectively (16,17). Although there is no national level data on vitamin D deficiency in Iran, several small scale studies reported a prevalence of 44.2% to 72.3% in adults (18,19). Further, there are few longitudinal studies which have investigated the trends in the prevalence of vitamin D deficiency (20). Given the importance of adequate 25(OH)D levels and chronic disease prevention, this study aimed to determine the current prevalence of vitamin D deficiency and insufficiency,

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The Isfahan cohort study: Rationale, methods and main findings

Cited by 114 publications

References 29 publications

Do cardiometabolic risk factors relative risks differ for the occurrence of ischemic heart disease and stroke?

Do cardiometabolic risk factors relative risks differ for the occurrence of ischemic heart disease and stroke?

Appropriate Cut-off Values of Waist Circumference to Predict Cardiovascular Outcomes: 7-year Follow-up in an Iranian Population

Prevalence and Trends of Vitamin D Deficiency among Iranian Adults: A Longitudinal Study from 2001-2013

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