Top

BMC Public Health

Published in:

Open Access 01-12-2020 | Obesity | Research article

Prevalence of modifiable cardiovascular risk factors in Yazd inner-city municipalities

Authors: Mohsen Mirzaei, Masoud Mirzaei, Ali Reza Sarsangi, Nasser Bagheri

Published in: BMC Public Health | Issue 1/2020

Abstract

Background

Cardiovascular disease (CVD) is the leading cause of death in the world. With effective intervention and control of cardiovascular risk factors, mortality rates may be reduced. The aim of this study was to investigate the prevalence of modifiable risk factors across five municipalities in Yazd city.

Methods

Ten thousand residents of the Yazd greater area aged 20–69 years were selected using cluster random sampling method. Overall, 200 clusters were randomly selected based on the postcodes of residents who lived in the five municipalities of Yazd. Those who lived in Yazd annexed cities and rural areas were excluded. A valid questionnaire was completed and physical examination performed as done (94.9% response rate). Instances of self-reported diabetes mellitus, high blood cholesterol, tobacco smoking, and unhealthy diet were recorded. Blood pressure, height, and weight were measured and physical activity was classified by International Physical Activity Questionnaire (IPAQ). A chi-square test was used to analyze the differences in variables across municipalities. Statistical analyses were performed using SPSS V. 16.

Results

We analyzed 8749 participants’ data from Yazd city. The prevalence of diabetes mellitus, hypercholesterolemia, and hypertension were 14.1, 16.7 and 18.6%, respectively. One in every four people consumed the recommended five servings of vegetables per day. Fish consumption was less than 5% at least once a week among participants. An unhealthy diet (85.7%); low physical activity (52.2%), hypertension (36.7%) and obesity (26.3%) were the most common cardiovascular risk factors. Only 2.1% of adults had no risk factors for CVD, and almost 75% of people had more than one risk factor. The prevalence of risk factors (excluding hypertension) was significantly different across the municipalities. Residents of region three had the highest prevalence of all risk factors aside from inactivity and unhealthy diet.

Conclusion

unhealthy dietary habits and inactivity are the most common modifiable risk factors of CVD in Yazd. Spatial variations of cardiovascular risk factors observed. This geographic health inequality requires more attention from policymakers to control CVD risk factors across different municipalities accordingly. Promoting healthy lifestyle is the top priority of health intervention programs. It is recommended to increase access to sport arenas and restrict access to tobacconist in high-risk areas.

Truthmann J, Busch M, Scheidt-Nave C, Mensink GB, Gößwald A, Endres M, et al. Modifiable cardiovascular risk factors in adults aged 40–79 years in Germany with and without prior coronary heart disease or stroke. BMC Public Health. 2015;15(1):701. https://doi.org/10.1186/s12889-015-1929-5.CrossRefPubMedPubMedCentral

Sardarinia M, Akbarpour S, Lotfaliany M, Bagherzadeh-Khiabani F, Bozorgmanesh M, Sheikholeslami F, et al. Risk factors for incidence of cardiovascular diseases and all-cause mortality in a middle eastern population over a decade follow-up: Tehran lipid and glucose study. PLoS One. 2016;11(12):e0167623. https://doi.org/10.1371/journal.pone.0167623.CrossRefPubMedPubMedCentral

Organization WH. Global action plan for the prevention and control of noncommunicable diseases 2013–2020. 2013.

Peykari N, Hashemi H, Dinarvand R, Haji-Aghajani M, Malekzadeh R, Sadrolsadat A, et al. National action plan for non-communicable diseases prevention and control in Iran; a response to emerging epidemic. J Diabetes Metab Disord. 2017;16(1):3. https://doi.org/10.1186/s40200-017-0288-4.CrossRefPubMedPubMedCentral

Sadeghi M, Haghdoost A, Bahrampour A, Dehghani M. Modeling the burden of cardiovascular diseases in Iran from 2005 to 2025: the impact of demographic changes. Iran J Public Health. 2017;46(4):506.PubMedPubMedCentral

Aghamohammadi S, Kazemi E, Khosravi A, Kazemeini H. The trend of ten leading causes of death in the Islamic Republic of Iran, 2006-2011. Iran J Epidemiol. 2017;12(4):1–11.

Institute for Health Metrics and Evaluation (IHME). Iran profile. Seattle, WA: IHME, University of Washington, 2018. Available from http://www.healthdata.org/Iran.

Stewart J, Manmathan G, Wilkinson P. Primary prevention of cardiovascular disease: a review of contemporary guidance and literature. JRSM Cardiovasc Dis. 2017;6:2048004016687211. https://doi.org/10.1177/2048004016687211.CrossRefPubMedPubMedCentral

Perel P, Avezum A, Huffman M, Pais P, Rodgers A, Vedanthan R, et al. Reducing premature cardiovascular morbidity and mortality in people with atherosclerotic vascular disease. Glob Heart. 2015;10(2):99–110. https://doi.org/10.1016/j.gheart.2015.04.003.CrossRefPubMed

10.

Leong D, Joseph P, McKee M, Anand S, Teo K, Schwalm J, et al. Reducing the global burden of cardiovascular disease, part 2: prevention and treatment of cardiovascular disease. Circ Res. 2017;121(6):695–710. https://doi.org/10.1161/CIRCRESAHA.117.308903.CrossRefPubMed

11.

Jousilahti P, Laatikainen T, Peltonen M, Borodulin K, Männistö S, Jula A, et al. Primary prevention and risk factor reduction in coronary heart disease mortality among working aged men and women in eastern Finland over 40 years: population based observational study. Bmj. 2016;352:i721.CrossRef

12.

Psaltopoulou T, Hatzis G, Papageorgiou N, Androulakis E, Briasoulis A, Tousoulis D. Socioeconomic status and risk factors for cardiovascular disease: impact of dietary mediators. Hell J Cardiol. 2017;58(1):32–42. https://doi.org/10.1016/j.hjc.2017.01.022.CrossRef

13.

Tousoulis D. Socioeconomic status and cardiac disease in Europe: A modern-day problem in the era of economic crisis. Hellenic J Cardiol. 2017;58(1):1–3. https://doi.org/10.1016/j.hjc.2017.03.014.CrossRefPubMed

14.

Najafipour H, Afshari M, Rostamzadeh F. Prevalence of multiple coronary artery disease risk factors in Kerman: a population-based study in Southeast Iran. Iran J Med Sci. 2018;43(2):140–9.PubMedPubMedCentral

15.

Foster H, Celis-Morales C, Nicholl B, Petermann-Rocha F, Pell J, Gill J, et al. The effect of socioeconomic deprivation on the association between an extended measurement of unhealthy lifestyle factors and health outcomes: a prospective analysis of the UK biobank cohort. Lancet Public Health. 2018;3(12):e576–e85. https://doi.org/10.1016/S2468-2667(18)30200-7.CrossRefPubMed

16.

Kishi T, Okada E, Sato A, Ishikawa M, Ukawa S, Nakamura K, et al. Regional differences in mortality and food and nutrient intake and their associations among secondary healthcare service areas in Hokkaido. [Nihon koshu eisei zasshi] Jpn J Public Health. 2018;65(5):210–22. https://doi.org/10.11236/jph.65.5_210.CrossRef

17.

Walker J, Colhoun H, Livingstone S, McCrimmon R, Petrie J, Sattar N, et al. Type 2 diabetes, socioeconomic status and life expectancy in Scotland (2012–2014): a population-based observational study. Diabetologia. 2018;61(1):108–16. https://doi.org/10.1007/s00125-017-4478-x.CrossRefPubMed

18.

Fujiyoshi N, Arima H, Satoh A, Ojima T, Nishi N, Okuda N, et al. Associations between socioeconomic status and the prevalence and treatment of hypercholesterolemia in a general Japanese population: NIPPON DATA2010. J Atheroscler Thromb. 2018;25(7):606–20.CrossRef

19.

Young D, Fischer H, Arterburn D, Bessesen D, Cromwell L, Daley M, et al. Associations of overweight/obesity and socioeconomic status with hypertension prevalence across racial and ethnic groups. J Clin Hypertens. 2018;20(3):532–40. https://doi.org/10.1111/jch.13217.CrossRef

20.

Mirzaei M, Salehi-Abargouei A, Mirzaei M, Mohsenpour M. Cohort Profile: The Yazd Health Study (YaHS): a population-based study of adults aged 20–70 years (study design and baseline population data). Int J Epidemiol. 2017;47(3):697–8h. https://doi.org/10.1093/ije/dyx231.CrossRef

21.

Chobanian A, Bakris G, Black H, Cushman W, Green L, Izzo J Jr, et al. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. Jama. 2003;289(19):2560–71. https://doi.org/10.1001/jama.289.19.2560.CrossRefPubMed

22.

Who EC. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet (London, England). 2004;363(9403):157–63. https://doi.org/10.1016/S0140-6736(03)15268-3.CrossRef

23.

Gil Á, Martinez de Victoria E, Olza J. Indicators for the evaluation of diet quality. Nutr Hosp. 2015;31(3):128–44. https://doi.org/10.3305/nh.2015.31.CrossRefPubMed

24.

Baghiani Moghaddam M, Bakhtari Aghdam F, Asghari Jafarabadi M, Allahverdipour H, Nikookheslat S, Safarpour S. The Iranian version of international physical activity questionnaire (IPAQ) in Iran: content and construct validity, factor structure, internal consistency and stability. World Appl Sci J. 2012;18(8):1073–80.

25.

Committee IR. Guidelines for data processing and analysis of the International Physical Activity Questionnaire (IPAQ)-short and long forms. 2005. http://www.sdp.univ.fvg.it/sites/default/files/IPAQ_English_self-admin_short.pdf.

26.

Kriaucioniene V, Klumbiene J, Petkeviciene J, Sakyte E. Time trends in social differences in nutrition habits of a Lithuanian population: 1994-2010. BMC Public Health. 2012;12(1):218. https://doi.org/10.1186/1471-2458-12-218.CrossRefPubMedPubMedCentral

27.

Tabatabaei-Malazy O, Qorbani M, Samavat T, Sharifi F, Larijani B, Fakhrzadeh H. Prevalence of dyslipidemia in Iran: a systematic review and meta-analysis study. Int J Prev Med. 2014;5(4):373–93.PubMedPubMedCentral

28.

Namayandeh S, Sadr S, Ansari Z, Rafiei M. A cross-sectional study of the prevalence of coronary artery disease traditional risk factors in Yazd urban population, Yazd healthy heart project. Int Cardiovasc Res J. 2011;5(1):7–13.

29.

Jafari-Adli S, Jouyandeh Z, Qorbani M, Soroush A, Larijani B, Hasani-Ranjbar S. Prevalence of obesity and overweight in adults and children in Iran; a systematic review. J Diabetes Metabol Disord. 2014;13(1):121. https://doi.org/10.1186/s40200-014-0121-2.CrossRef

30.

Najafipour H, Yousefzadeh G, Forood A, Karamouzian M, Shadkam M, Mirzazadeh A. Overweight and obesity prevalence and its predictors in a general population: a community-based study in Kerman, Iran (Kerman coronary artery diseases risk factors studies). ARYA Atheroscler. 2016;12(1):18–27.PubMedPubMedCentral

31.

Kolahi A, Moghisi A, Ekhtiari Y. Socio-demographic determinants of obesity indexes in Iran: findings from a nationwide STEPS survey. Health Promot Perspect. 2018;8(3):187–94. https://doi.org/10.15171/hpp.2018.25.CrossRefPubMedPubMedCentral

32.

Fakhrzadeh H, Djalalinia S, Mirarefin M, Arefirad T, Asayesh H, Safiri S, et al. Prevalence of physical inactivity in Iran: a systematic review. J Cardiovasc Thorac Res. 2016;8(3):9297. https://doi.org/10.15171/jcvtr.2016.20.CrossRef

33.

Najafipour H, Moazenzadeh M, Afshari M, Nasri H, Khaksari M, Forood A, et al. The prevalence of low physical activity in an urban population and its relationship with other cardiovascular risk factors: findings of a community-based study (KERCADRS) in southeast of Iran. ARYA Atheroscler. 2016;12(5):212–9.PubMedPubMedCentral

34.

Sahebkar M, Heidarian Miri H, Noormohammadpour P, Akrami R, Mansournia N, Tavana B, et al. Prevalence and correlates of low physical activity in the Iranian population: national survey on non-communicable diseases in 2011. Scand J Med Sci Sports. 2018;28(8):1916–24. https://doi.org/10.1111/sms.13082.CrossRefPubMed

35.

Khavaninzadeh A, Sarbaz M, Ahmadian S. Investigating the changing process of green spaces during the past three decades using remote evaluation (case study: Yazd). J Geogr Urban Space Dev. 2018;4(2):99–115.

36.

Jafari M, Heidari Noshahr M, Parsa E. Role of providing Urban Services in creating marginal neighborhoods of Yazd City based on citizenship rights. Bioethics J. 2018;8:83–94. https://doi.org/10.22037/bj.v8i0.23226.CrossRef

37.

Nemati S, Rafei A, Freedman N, Fotouhi A, Asgary F, Zendehdel K. Cigarette and water-pipe use in Iran: geographical distribution and time trends among the adult population; a pooled analysis of national STEPS surveys, 2006–2009. Arch Iran Med. 2017;20(5):295.PubMed

38.

Moosazadeh M, Ziaaddini H, Mirzazadeh A, Ashrafi-Asgarabad A, Haghdoost A. Meta-analysis of smoking prevalence in Iran. Addict Health. 2013;5(3–4):140.PubMedPubMedCentral

39.

Yang W, Lu J, Weng J, Jia W, Ji L, Xiao J, et al. Prevalence of diabetes among men and women in China. N Engl J Med. 2010;362(12):1090–101. https://doi.org/10.1056/NEJMoa0908292.CrossRefPubMed

40.

Zhou M, Astell-Burt T, Bi Y, Feng X, Jiang Y, Li Y, et al. Geographical variation in diabetes prevalence and detection in China: multilevel spatial analysis of 98,058 adults. Diabetes Care. 2015;38(1):72–81. https://doi.org/10.2337/dc14-1100.CrossRefPubMed

41.

Maier W, Holle R, Hunger M, Peters A, Meisinger C, Greiser K, et al. The impact of regional deprivation and individual socio-economic status on the prevalence of type 2 diabetes in Germany. A pooled analysis of five population-based studies. Diabet Med. 2013;30(3):e78–86. https://doi.org/10.1111/dme.12062.CrossRefPubMed

42.

Abebe S, Berhane Y, Worku A, Getachew A. Prevalence and associated factors of hypertension: a crossectional community based study in Northwest Ethiopia. PLoS One. 2015;10(4):e0125210. https://doi.org/10.1371/journal.pone.0125210.CrossRefPubMedPubMedCentral

43.

Laohasiriwong W, Puttanapong N, Singsalasang A. Prevalence of hypertension in Thailand: hotspot clustering detected by spatial analysis. Geospat Health. 2018;13(1). https://doi.org/10.4081/gh.2018.608.

Title: Prevalence of modifiable cardiovascular risk factors in Yazd inner-city municipalities
Authors: Mohsen Mirzaei
Masoud Mirzaei
Ali Reza Sarsangi
Nasser Bagheri
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Obesity
Obesity
Hypercholesterolemia
Published in: BMC Public Health / Issue 1/2020
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-020-8217-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Prevalence of modifiable cardiovascular risk factors in Yazd inner-city municipalities

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2020

A tool to assess alignment between knowledge and action for health equity

Making hospital shops healthier: evaluating the implementation of a mandatory standard for limiting food products and promotions in hospital retail outlets

Exercise/physical activity and health outcomes: an overview of Cochrane systematic reviews

The development of a questionnaire to assess leisure time screen-based media use and its proximal correlates in children (SCREENS-Q)

Prevalence and determinants of anaemia in women of reproductive age in Sudan: analysis of a cross-sectional household survey

“Like a ticking time bomb”: the persistence of trauma in the HIV diagnosis experience among black men who have sex with men in New York City