The Trend of Risk for Cardiovascular Diseases During the Past Decade in Iran, Applying No-Lab and Lab-Based Prediction Models

Glob Heart. 2023 Feb 10;18(1):3. doi: 10.5334/gh.1180. eCollection 2023.

Abstract

Background: As a surrogate for all relevant risk factors, it is preferable to show trends in the mean cardiovascular disease(CVD) risk rather than to examine each risk factor trend separately.

Objectives: Using national representative data, this study aimed to determine the changes in the World Health Organization (WHO) CVD risk during the last decade considering both laboratory and non-laboratory risk scoring.

Methods: We used data from five rounds of the WHO STEPwise approach to surveillance surveys (2007-2016). In all, 62,076 (31,660 women) participants aged 40-65 years were included and their absolute CVD risk were calculated. The generalized linear model was performed to assess the trend of CVD risk in men and women, and also in diabetic and non-diabetic individuals.

Results: We showed significant declining trends in the mean CVD risk in the laboratory (from 10.5% to 8.8%) and non-laboratory (10.1% to 9.4%) models in men. In women, a significant reduction was observed in the laboratory-based model (from 8.4% to 7.8%). The laboratory model showed a greater decrease in men than women (P-for interaction < 0.001) and in diabetic patients (from 16.1% to 13.6%) than non-diabetic individuals (from 8.2% to 7%) (p-for interaction = 0.002). The proportion of high-risk individuals (risk ≥ 10%) decreased from 40% in 2007 to 31.5% in 2016 in men and from 29.8% to 26.1% in women based on the laboratory-model.

Conclusions: During the last decade, CVD risk had a significant decrease in men and women. The reduction was more evident in men and diabetic population. However, still, one-third of our population is considered high-risk.

Keywords: Cardiovascular disease; Diabetes; prediction models; primary prevention; risk assessment.

MeSH terms

  • Cardiovascular Diseases* / epidemiology
  • Diabetes Mellitus* / epidemiology
  • Female
  • Humans
  • Iran / epidemiology
  • Male
  • Risk Factors
  • Surveys and Questionnaires

Grants and funding

We express our appreciation to the National Institute of Health Researches of Iran, the Non-Communicable Diseases Center of the Ministry of Health, and the research team members in the Non-Communicable Diseases Research Center at Tehran University of Medical Sciences for conducting the STEPS surveys in Iran. Research reported in this publication was supported by Elite Researcher Grant Committee under award number “971143” from the National Institutes for Medical Research Development (NIMAD), Tehran, Iran.