Document Type : Original Article
Authors
- Shirin Mahmoudi Kohi 1
- Noushin Mohammadifard 2
- razieh hassannejad 3
- Fatemeh Nouri, MSc 4
- Marjan Mansourian 5
- Nizal Sarrafzadegan 6
1 Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
2 Noushin Mohammadifard, PhD, Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
3 Razieh Hassannejad, PhD, Interventional Cardiology Research Center, Cardiovascular Research Institute. Isfahan University of Medical Sciences, Isfahan, Iran
4 PhD Candidate, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
5 Marjan Mansourian, PhD, Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
6 Nizal Sarrafzadegan, MD , Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Coronary heart disease (CHD) has an enormous contributes to mortality and morbidity in Iran. We fitted a model in this study to determine changes in risk factors and treatment uptake to CHD mortality rate reduction in Isfahan between 2007 and 2016.
We fitted the IMPACT model to determine how much the decrease in CHD death can be explained by treatment uptake and significant risk factors included in the analyses for adults 35 to 84 years old. Diabetes, BMI, and smoking were considered as the CHD risk factors. Medical and interventional treatments were studied in four different groups of patients. The primary data sources were obtained from the Persian registry of cardiovascular disease (PROVE), The Isfahan healthy heart program (IHHP), and the impact of self-care management and adopted Iranian guidelines for hypertension treatment on improving the control rate of hypertension (IMPROVE CARE ) study, death registration system and the Isfahan province Cemetery.
CHD mortality rate decreased by 14% between 2007 and 2016 in Iran for adults 35 to 84 years old and caused 212 CHD death prevented or delayed in 2016. Treatment uptakes caused 99% prevented death. Risk factors caused about 15% of excess death. It seems that the prevalence of CHD is increasing while the death rate is decreasing because of these observed changes.
Risk factors got worse in 2016 and, without treatment, it could lead to an increase in CHD mortality in Iran. Preventive policies should control the risk factor and add to the decrease in CHD death.
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