Joint effect of modifying selected risk factors on attributable burden of cardiovascular diseases

Area of Science:

• Public Health
• Epidemiology
• Cardiovascular Disease Research

Background:

• Limited research exists on the combined impact of multiple risk factors on the avoidable burden of cardiovascular diseases (CVDs).
• Understanding these joint effects is crucial for effective public health interventions and disease prevention strategies.

Purpose of the Study:

• To estimate the joint effect of multiple avoidable risk factors on the burden of cardiovascular diseases (CVDs).
• To quantify the potential reduction in disability-adjusted life years (DALYs) attributable to CVDs by addressing key risk factors.

Main Methods:

• Utilized the Potential Impact Fraction (PIF) method to estimate avoidable disease burden.
• Employed data from Iran's 3rd National Surveillance of Risk Factors of Non-Communicable Diseases-2007 for risk factor prevalence (diabetes, hypertension, central obesity, hypercholesterolemia).
• Incorporated measures of effect (multivariate adjusted hazard ratios) from a cohort study to calculate PIF and joint risk factor effects.

Main Results:

• In theoretical minimum risk scenarios, 37% of CVD-attributable DALYs in males and 59.4% in females are avoidable.
• Addressing current risk factor prevalence to plausible minimum levels could avert 17.8% of CVD-attributable DALYs in males and 34% in females.

Conclusions:

• The Potential Impact Fraction (PIF) is a valuable tool for quantifying avoidable disease burden.
• Applying PIF to updated burden of disease estimates can improve priority setting for CVD prevention efforts.
• Reporting the magnitude of avoidable DALYs, rather than just percentages, provides a clearer picture of public health impact.