ARYA Atherosclerosis Journal

Incidence and risk factors for cardiovascular mortality in Iranian adults: Findings from a 10‑year Yazd Healthy Heart Project Study

Document Type : Original Article

Authors

Mohammadtaghi Sarebanhassanabadi 1
Samira Qaderi 2
Mahdi Karimi 2
Lida Hosseini 1
Pedro Marques-Vidal 3
Ahmad Shajari 4
Hamideh Mihanpour 5
Sima Mozafari 1

1 Yazd Cardiovascular Research Center, Non-communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

2 Islamic Azad University, Tehran Medical Branch, Tehran, Iran

3 Department of Internal Medicine, BH10-642, Rue du Bugnon 46, CH-1011 Lausanne, Switzerland

4 Department of Medicine, YMS. C., Islamic Azad University, Yazd, Iran

5 Department of Occupational Health Engineering, Genetic and Environmental Adventures Research Center, School of Abarkouh Paramedicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

10.48305/arya.2026.45970.3132
Abstract
BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death worldwide, with a growing burden in low- and middle-income countries. Given the increasing CVD mortality in Iran and the limited evidence on long-term lifestyle determinants, a cohort study is needed to examine the effects of related factors.
METHODS: A total of 2,000 adults, including 1,000 men and women aged 20 to 74 years, were enrolled in a population-based cohort study in Yazd, Iran, from 2005 to 2006, with a mean follow-up of 10 years. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for CVD mortality in relation to demographic, economic status, educational, and lifestyle factors.
RESULTS: During follow-up, 83 CVD deaths occurred (5.4%). The mortality rate was 6.8% in men and 3.8% in women. After adjustment for hypertension, diabetes, and hypercholesterolemia, significant predictors of CVD mortality included age ≥65 years (HR = 3.63, 95% CI: 2.28-5.77), male sex (HR = 2.29, 95% CI: 1.31-3.34), and smoking (HR = 1.95, 95% CI: 1.21-3.13). In contrast, moderate physical activity was associated with a lower risk of mortality (HR = 0.38, 95% CI: 0.17-0.84), and high school education was also protective (HR = 0.49, 95% CI: 0.25-0.98). In subgroup analyses among men, age ≥65 years, moderate physical activity, and high school education remained significant predictors of CVD mortality (P < 0.05).
CONCLUSION: Age 65 years or older, smoking, and male sex increased the risk of CVD mortality in this Iranian cohort. Physical activity and higher educational attainment were associated with a reduced risk of CVD mortality.

Keywords

Cardiovascular Disease, Mortality
Risk Factors
Incidence
Cohort Studies
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ARYA Atherosclerosis Journal
Volume 22, Issue 3
May and June 2026
Pages 36-45

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