Sadaf G Sepanlou1, Roger B Newson2, Hossein Poustchi3, Masoud M Malekzadeh3, Parisa Rezanejad Asl3, Arash Etemadi4, Hooman Khademi5, Farhad Islami6, Akram Pourshams3, Paul D Pharoah7, Christian C Abnet8, Paul Brennan9, Paolo Bofetta10, Sanford M Dawsey8, Farin Kamangar11, Reza Malekzadeh3. 1. Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. dr.reza.malekzadeh@gmail.com, malek@ams.ac.ir. 2. National Heart and Lung Institute, Imperial College London, UK. 3. Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. 4. Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA. 5. Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran, International Agency for Research on Cancer, Lyon, France. 6. Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran, Surveillance and Health Services Research, American Cancer Society, Atlanta, USA. 7. Departments of Oncology and Public Health and Primary Care, University of Cambridge, Cambridge, UK. 8. Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA. 9. International Agency for Research on Cancer, Lyon, France. 10. The Tisch Cancer Institute, and Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA. 11. Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran, Department of Public Health Analysis, School of Community Health and Policy, Morgan State University, Baltimore, USA.
Abstract
BACKGROUND: High blood pressure is the second most important risk factor of cardiovascular diseases (CVDs) in Iran. It is imperative to estimate the burden of CVDs that can be averted if high blood pressure is controlled at the population level. The aim of the current study was to estimate the avertable CVD mortality in the setting of Golestan Cohort Study (GCS). METHODS: Over 50,000 participants were recruited and followed for a median of 7 years. The exposures of interest in this study were non-optimal systolic blood pressure (SBP) and hypertension measured at baseline. Deaths by cause have been precisely recorded. The Population Attributable Fraction (PAF) of deaths and Years of Life Lost (YLLs) due to CVDs attributable to exposures of interest were calculated. RESULTS: Overall, 223 deaths due to ischemic heart disease (IHD), 207 deaths due to cerebrovascular accidents (CVA), and 460 deaths due to all CVDs could be averted if the SBP of all subjects in the study were optimal. Similarly, 5,560 YLLs due to IHD, 4,771 YLLs due to CVA, and 11,135 YLLs due to CVDs could be prevented if SBP were optimal. In all age groups, the avertable deaths and YLLs were higher due to IHD compared with CVA. Deaths and YLLs attributable to non-optimal SBP in women were less than men. CONCLUSIONS: A very large proportion of CVD deaths can be averted if blood pressure is controlled in Iran. Effective interventions in primary and secondary health care setting are mandatory to be implemented as early as possible.
BACKGROUND: High blood pressure is the second most important risk factor of cardiovascular diseases (CVDs) in Iran. It is imperative to estimate the burden of CVDs that can be averted if high blood pressure is controlled at the population level. The aim of the current study was to estimate the avertable CVD mortality in the setting of Golestan Cohort Study (GCS). METHODS: Over 50,000 participants were recruited and followed for a median of 7 years. The exposures of interest in this study were non-optimal systolic blood pressure (SBP) and hypertension measured at baseline. Deaths by cause have been precisely recorded. The Population Attributable Fraction (PAF) of deaths and Years of Life Lost (YLLs) due to CVDs attributable to exposures of interest were calculated. RESULTS: Overall, 223 deaths due to ischemic heart disease (IHD), 207 deaths due to cerebrovascular accidents (CVA), and 460 deaths due to all CVDs could be averted if the SBP of all subjects in the study were optimal. Similarly, 5,560 YLLs due to IHD, 4,771 YLLs due to CVA, and 11,135 YLLs due to CVDs could be prevented if SBP were optimal. In all age groups, the avertable deaths and YLLs were higher due to IHD compared with CVA. Deaths and YLLs attributable to non-optimal SBP in women were less than men. CONCLUSIONS: A very large proportion of CVD deaths can be averted if blood pressure is controlled in Iran. Effective interventions in primary and secondary health care setting are mandatory to be implemented as early as possible.
Authors: S Yusuf; P Pais; R Afzal; D Xavier; K Teo; J Eikelboom; A Sigamani; V Mohan; R Gupta; N Thomas Journal: Lancet Date: 2009-03-30 Impact factor: 79.321
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Authors: Ahmed M Sarki; Chidozie U Nduka; Saverio Stranges; Ngianga-Bakwin Kandala; Olalekan A Uthman Journal: Medicine (Baltimore) Date: 2015-12 Impact factor: 1.817