The incidence of coronary heart disease and the population attributable fraction of its risk factors in Tehran: A 10-year population-based cohort study

Abstract

Background: Data on incidence of coronary heart disease (CHD) is scarce in the Middle East and little is known about the contribution of known risk factors in this area. Methods: The incidence of CHD and the effect of modifiable risk factors were explored in 2889 men and 3803 women aged 30-74 years in the population based cohort of the Tehran Lipid and Glucose Study, during 1999-2010. Average population attributable fraction (aPAF) was calculated for any risk factor using direct method based on regression model. Results: The crude incidence rate in men was about twice that in women (11.9 vs. 6.5 per 1000 person-years). The aPAF of hypertension, diabetes, high total cholesterol and low-HDL cholesterol was 9.4%, 6.7%, 7.3% and 6.1% in men and 17%, 16.6%, 12% and 4.6% in women respectively. This index was 7.0% for smoking in men. High risk age contributed to 42% and 22% of risk in men and women respectively. Conclusions: The incidence in this population of Iran was comparable to those in the US in the seventies. Well known modifiable risk factors explained about 40% and 50% of CHD burden in men and women respectively. Aging, as a reflection of unmeasured or unknown risk factors, bears the most burden of CHD, especially in men; indicating more age-related health care is required. © 2014 Khalili et al.