Distributions of ischemic heart disease risk factors in patients who were admitted for angioplasty in Iran

Ahmad Reza Assareh, Maria Cheraghi, Mohammad Nourizadeh, Farzad Daeenejad, Habib Haybar, Mohammad Reza Kiarsi

Cardiovasclar Disease Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Public Health Department, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

DOI: 10.4236/wjcd.2013.34A007                

Abstract

The aim of this study was to study the prevalence of different risk factors of coronary artery disease (CAD) in Patients who were admitted for angioplasty. Methods: A cross-sectional study was conducted on 333 patients who were admitted with diagnosis as a CAD and candidates for angioplasty in Imam Khomeini hospital, Ahvaz city, Iran 2011. The prevalence of different risk factors was determined using descriptive statistics. Results: The prevalence of CAD risk factors in overall subjects were: 1) 45.3% hypertension (considering >140/90 mmHg); 2) 34.5% high cholesterol (>240 mg/dl); 3) 27.6% diabetic mellitus (>126 mg/dL); 4) family history of heart disease: 20.7%; 5) smokers: 19.9%. Conclusion: This data have shown the prevalence of IHD (Ischemic Heart Disease) risk factors specially about hypertension in patients with IHD was high, so could require urgent decision making to national control program of non-communicable diseases in Iran.

Keywords

Prevalence; (Ischemic Heart Disease) Risk Factors; Ahvaz; Iran

1. INTRODUCTION

Cardiovascular diseases are a major public health problem worldwide [1]. CAD is the most common form of cardiovascular disease with an estimated prevalence of CAD in men is 6.9%, and 6% among women [2]. CAD is the major cause of morbidity and mortality and accounts for the most expensive costs in medical assistance in Iran [3]. It is responsible for approximately 30% of all deaths worldwide each year [4]. Almost 80% of these deaths occur in low and middle income countries, and half occur in women [5].^‍‍

CAD is a chronic process that begins during adolescence and slowly progresses throughout life. Independent risk factors include family history of premature CAD, cigarette smoking, diabetes mellitus, hypertension, dyslipidemia, a sedentary life style, advanced age, gender and obesity. The risk factors accelerate or modify a complex and chronic inflammatory process that ultimately manifests as fibrous atherosclerotic plaque [2]. The incidence of CAD is compatible with the pattern of the distribution of CAD risk factors, it occurs when the risk factors are present, so we need to know the prevalence of these risk factors, isolated or in combination, because it is through the reduction of these risk factors and using primary and secondary prevention programs that we will achieve effectiveness in any health program. The familial antecedents are un-modifiable and independent risk factors that, even though having already been studied [6], still require further investigation. Patients whose firstdegree relatives develop early CAD have higher risks of developing coronary artery disease than the general population.

Cigarette smoking may lead to double risk for coronary artery disease, 30% of which are attributed to the number of cigarettes smoked. In a study [7,8] with 106,745 males in Korea, tobacco was a major and modifiable risk factor for cardiovascular disease, according to serum cholesterol levels; low cholesterol levels did not provide a protective effect in those smokers. These findings are supported by those of the prospective study of the American Cancer Society, of the Nurses’ Health Study, and of some meta-analyses [9-12]. Coronary artery disease occurs more commonly in diabetic patients than in the general population, affecting more than 55% of patients [13].

Hypertension is a well-established risk factor for cardiovascular disease and for congestive heart failure [14]. The importance of this association was well defined in the findings of the Framingham Study and Multiple Risk Factor Intervention Trial-MRFIT [15].

The aim of this study was to investigate the prevalence of different CAD risk factors in Patient, who were admitted for angiography in Imam Khomeini Hospital, Ahvaz city.

2. METHODS

A cross-sectional study was conducted involving 333 patients who were admitted and diagnosed as CAD candidate for angiography in Imam Khomeini Hospital, Ahvaz city, 2011.

Inclusion criteria for angiography were patients with CAD risk factors that had high risk characteristics in non invasive test such as exercise treadmill test (ETT) or they had typical chest pain with elevated cardiac enzyme.

Patients with neurologic dysfunction or sever peripheral artery disease or sever renal function impairment were excluded from study.

This study was conducted to assess the prevalence of CAD risk factors utilizing the medical history, physical examination and laboratory tests to consider known risk factors.

We collected the data regarding risk factors for all 333 patients. After completing their informed consent, they were given an interview, physical examination and blood sample tests. Age was confirmed as per identify card. Preprotocol blood samples were obtained for FBS and total cholesterol. FBS was assayed at the enzymatic methodology by glucose oxidize Kit; total cholesterol was assayed at the enzymatic methodology.

Arterial blood pressure levels in the right arm (average of 3 measurements having the patient seated and rested), total cholesterol, lipoprotein profile and fasting glucose concentrations. The measurements were collected during the first 72 h of hospitalization. Individuals’ past medical histories and their reports assisted us in characterizing the subjects as having hypertension, hypercholesterolemia, or diabetes. In keeping with the long-standing classification criteria used in several population-based studies, patients whose blood pressure, according to their medical records, were greater or equal to 140/90 mmHg or were taking antihypertensive medication were classified as hypertensive [13].Hypercholesterolemia and hypertriglyceridemia were defined as serum total cholesterol (TC) and triglycerides (TG) levels greater than 200 and 150 mg/dl, respectively, or if hypo-lipidemic treatment was administered. Diabetics were those with fasting blood glucose equal or greater than 126 mg/dl for two times or those who were under diabetic diet or medications.

3. ETHICS

The study protocol was approved by ethics committee of Ahvaz Jundishapur University of Medical Sciences. All patients provided written informed consent.

4. STATISTICAL ANALYSIS

Prevalence of CAD risk factors was determined using descriptive statistics, and it was used to process the outcomes in tables and graphs. All analysis was performed using SPSS [16] statistical analysis software.

5. RESULTS

We assess 333 CAD patients those were admitted for angiography in Imam Khomeini Hospital in Ahvaz city, out of them 59.2% was male, and 40.8% was female. Table 1 shows the basic characteristics of patients.

Figure 1 demonstrated the prevalence of CAD risk factors under the study including, hypertension, hyperlipidemia, diabetic mellitus, family history of CAD in the

Conflicts of Interest

The authors declare no conflicts of interest.

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