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Estimation of burden of ischemic heart diseases in Isfahan, Iran, 2014: using incompleteness and misclassification

Mehran Shams-Beyranvand^1,2, Farshad Farzadfar¹, Shohreh Naderimagham¹

¹Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Journal of Diabetes and Metabolic Disorders

|March 24, 2017

Insights

Ischemic heart diseases (IHDs) caused significant years of life lost (YLLs) and years lived with disability (YLDs) in Isfahan, particularly affecting the elderly. Public health initiatives are recommended to reduce the burden of IHDs from an early age.

Area of Science:

Epidemiology
Public Health
Cardiology

Background:

Cardiovascular diseases (CVDs) are the leading global cause of death.
Ischemic heart diseases (IHDs) represent the primary form of CVDs and a major cause of mortality worldwide.
This study quantifies the burden of IHDs in Isfahan using disability-adjusted life years (DALYs).

Purpose of the Study:

To estimate the disease burden of Ischemic Heart Diseases (IHDs) in Isfahan.
To calculate Disability-Adjusted Life Years (DALYs) for IHDs in the study population.
To identify age-sex specific rates and contributing factors to IHDs burden.

Main Methods:

A population-based study conducted in Isfahan in 2014.
Years of Life Lost (YLLs) calculated using death registration data and life expectancy from GBD 2013.
Years Lived with Disability (YLDs) calculated using STEPS data and disability weights from GBD 2013.

Main Results:

The total DALYs for IHDs in Isfahan was 43,517.71 years in 2014.
YLLs accounted for 31,891.79 years and YLDs for 11,625.92 years.
The highest rates of DALYs, YLLs, and YLDs were observed in individuals aged 80 years and older for both sexes.

Conclusions:

Years of Life Lost (YLLs) constituted the largest proportion of the IHD burden, particularly in the elderly population.
Public health authorities are urged to implement educational and cultural programs targeting IHD risk factors and prevention.
Early-onset prevention strategies are recommended to mitigate the long-term impact of IHDs, considering Isfahan's predominantly younger population.

Read full analysis

Abstract

Background:

Over the past decade, cardiovascular diseases (CVDs) have been the leading cause of death in the world. Ischemic heart diseases (IHDs) are the main form of CVDs and are the most important single cause of death around the world. This study aimed to estimate the burden of IHDs in the city of Isfahan by calculating disability-adjusted life years (DALYs).

Methods:

This population-based study was conducted on the population living in the city of Isfahan in 2014. Years of life lost due to premature mortality (YLLs) were calculated by multiplying the number of deaths due to IHDs (that was collected from death registration system (DRS) and was adjusted for incompleteness and misclassification) with life expectancy (that was extracted from the Global Burden of Diseases, Injuries, and Risk Factors study (GBD) 2013). Years lived with disability (YLDs) were calculated by multiplying the prevalent cases of IHDs in each age-sex group (that was calculated using the stepwise approach to non-communicable disease risk factor surveillance (STEPS)) with total disability weight of IHDs (that was calculated using the GBD 2013). DALYs were calculated as the sum of YLDs and YLLs.

Results:

In 2014, the number of DALYs due to IHDs was 43517.71 years which was formed of 31891.79 years of YLLs and 11625.92 years of YLDs. The rate of DALYs due to IHDs was 4412.33 (95% uncertainty interval (UI): 3636.70-5162.72) person-years per 100,000 persons in males and 3476.66 (95% UI: 2948.95-4010.51) person-years per 100,000 persons in females. The highest rates of YLLs, YLDs, and DALYs due to IHDs in both sexes were occurred in 80 years and older.

Conclusions:

The highest proportion of the burden of IHDs in the city of Isfahan was attributed to YLLs in the elderly people. Since the majority of the population of Isfahan is <60 years old and IHDs are long-lasting, the health authorities are recommended to design and implement educational and cultural programs to inform people about the risk factors and the methods to prevent these diseases. These programs can be used as a strategy to reduce the incidence of IHDs from an early age.

Keywords:

Burden of disease Disability-adjusted life years (DALYs)Ischemic heart diseases (IHDs)Years lived with disability (YLDs)Years of life lost due to premature mortality (YLLs)

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