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Premature coronary heart disease and traditional risk factors-can we do better?
Roxana Sadeghi1, Nadia Adnani2, Azam Erfanifar2
1Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
Insights
Premature Coronary Heart Disease (CHD) affects many, with 96% of patients having traditional risk factors like dyslipidemia and hypertension. Effective management and prevention strategies for these factors are lacking in Iran, highlighting a significant public health concern.
Area of Science:
- Cardiology
- Public Health
- Preventive Medicine
Background:
- Traditional cardiovascular risk factors are key predictors of premature Coronary Heart Disease (CHD).
- Effective management of these risk factors is crucial for preventing adverse cardiovascular events.
- Identifying and treating established risk factors is prioritized over investigating less common ones.
Purpose of the Study:
- To determine the prevalence of traditional risk factors in patients with premature CHD in Iran.
- To assess demographic and historical characteristics of these patients.
- To investigate the hypothesis of insufficient risk assessment and preventive interventions in the asymptomatic adult population.
Main Methods:
- A study involving 125 patients under 50 years old admitted with acute coronary syndromes.
- Patients were confirmed to have Coronary Heart Disease (CHD) via myocardial infarction or coronary angiography.
- Data collected included demographic information and the presence of traditional risk factors.
Main Results:
- The study population had a mean age of 42.50±5.65 years, with 73.6% being male.
- High prevalence of risk factors was observed: 77.6% had dyslipidemia, 46.4% were smokers, 35.2% had hypertension, and 26.4% had diabetes mellitus.
- Critically, 96% of patients had at least one traditional risk factor, yet control rates for dyslipidemia, diabetes (HbA1c<7%), and hypertension were very low (34% of hypertensives had normal BP). Only 2.4% engaged in regular physical activity.
Conclusions:
- Premature Coronary Heart Disease (CHD) represents a significant public health issue in Iran.
- There is a notable deficiency in the effective treatment and intensive management of established traditional risk factors in patients with premature CHD.
- Substantial improvements are needed in risk management strategies and preventive interventions for individuals at risk of or experiencing premature CHD in Iran.
Background:
Traditional cardiovascular risk factors are strong predictors of an increased likelihood for premature CHD. Considering the benefits of risk factors᾿ management, it is imperative to find and treat them before looking for more unknown and weak risk factors.
Objectives:
Limited information is available about the demographic and historical characteristics of the patients with premature Coronary Heart Disease (CHD) in IR Iran. The main objective of this study was to determine the prevalence of the traditional risk factors in these patients. Also, the researchers hypothesized that there are insufficient risk assessment and preventive intervention methods for the asymptomatic adult population.
Methods:
This study was conducted on 125 patients with premature CHD (age<50 years) who were admitted in two academic hospitals with acute coronary syndromes. The patients were accepted since they had a definite CHD on the basis of acute myocardial infarction (elevated cardiac enzymes) or documented CAD in coronary angiography.
Results:
The mean age of the study population was 42.50±5.65 (26 to 49 years). Among the patients,92 (73.6%) were male, 113 (90.4%) were married, 58 (46.4%) were smokers,19 (15.2%) were opium users, 97 (77.6%) had dyslipidemia, 44 (35.2%) had hypertension, and 33 (26.4%) had diabetes mellitus. In addition, family history was presented in 54 patients (43.2%). Among the study population, 120 patients (96%) had at least one of the traditional risk factors, including dyslipidemia, hypertension, diabetes mellitus, cigarette smoking, and family history of CHD. However, none of the dyslipidemic patients had controlled total cholesterol, LDL, HDL, and triglyceride. Also, none of the diabetic patients had hemoglobin A1C<7%. Among the 44 hypertensive patients, blood pressure of 15 ones (34%) was within the normal range. Besides, only 3 patients (2.4%) had regular physical activity (at least 30 minutes, three times a week).
Conclusions:
Premature Coronary Heart Disease is a public health problem. However, there is lack of effective and intensive treatments of well-defined traditional risk factors and prevention methods for the majority of the patients experiencing premature CHD. In sum, there is still plenty of room for improvement of risk management in IR Iran.
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