The Isfahan cohort study: rationale, methods and main findings

Area of Science:

• Cardiology
• Epidemiology
• Public Health

Background:

• Cardiovascular diseases (CVDs) represent a major global health challenge.
• Understanding the impact of risk factors in diverse populations is crucial for effective prevention strategies.

Purpose of the Study:

• To investigate the incidence of cardiovascular events (ischemic heart disease and stroke) in a 10-year longitudinal population-based study in central Iran.
• To determine the individual and combined impact of major risk factors on cardiovascular event incidence within this cohort.

Main Methods:

• The Isfahan Cohort Study (ICS) recruited 35+ year olds from urban and rural areas in central Iran.
• Follow-up data over 24,379 person-years identified incident cases of ischemic heart disease (IHD) and stroke.
• Statistical analysis assessed the risk associated with hypertension, diabetes mellitus, and hypercholesterolemia.

Main Results:

• The study documented 219 incident cases of IHD and 57 incident cases of stroke.
• Absolute risk of IHD was 8.9 per 1000 person-years, with higher rates in men.
• Hypertension showed a 3.5-fold increased risk for IHD, followed by diabetes (2.5-fold) and hypercholesterolemia (2-fold).

Conclusions:

• This cohort study confirms significant associations between hypertension, diabetes, hypercholesterolemia, and cardiovascular events in the Iranian population.
• Observed ethnic differences in risk factor impact underscore the limitations of applying Western risk equations universally.
• Findings emphasize the need for localized risk assessment and targeted public health interventions for cardiovascular disease prevention in Iran.