Table 1
The distribution of CVD risk factors in the Iranian general population aged 40–65 years, 2005–2016.
| 2007 | 2008 | 2009 | 2011 | 2016 | |
|---|---|---|---|---|---|
| Men | |||||
| Number | 7,519 | 7,486 | 7,269 | 1,802 | 6,340 |
| Age (year) | 50.5 (50.4–50.6) | 50.5 (50.3–50.6) | 50.7 (50.6–50.8) | 50.8 (50.6–51.0) | 50.2 (50.1–50.3) |
| BMI (kg/m2) | 25.9 (25.8–26.1) | 25.7 (25.6–25.8) | 25.7 (25.5–25.8) | 26.3 (26.0–26.6) | 26.5 (26.4–26.6) |
| SBP (mmHg) | 129.7 (129.1–130.3) | 128.1 (127.5–128.7) | 127.9 (127.3–128.4) | 128.9 (128.0–129.8) | 127.7 (127.3–128.1) |
| DBP (mmHg) | 82.3 (81.9–82.7) | 82.2 (81.7–82.6) | 82.1 (81.7–82.5) | 80.9 (80.3–81.5) | 80.2 (79.9–80.5) |
| Current smoking | 35.9 (34.2–37.7) | 34.7 (33.0–34.6) | 34.8 (33.1–36.6) | 33.2 (30.5–35.9) | 30.0 (28.8–31.1) |
| Total Cholesterol (mg/dl) | 189.9 (188.3–191.4) | – | – | 180.9 (178.5–183.2) | 164.5 (163.6–165.4) |
| HDL_Cholesterol (mg/dl) | 41.1 (40.6–41.6) | – | – | 42.2 (41.7–42.8) | 37.6 (37.4–37.9) |
| Fasting Plasma Glucose (mg/dl) | 98.0 (96.4–99.6) | – | – | 102.8 (100.7–105.0) | 101.1 (100.2–102.0) |
| Diabetes | 15.1 (13.7–16.5) | – | – | 20.9 (18.8–23.1) | 16.3 (15.4–17.2) |
| Women | |||||
| Number | 7,481 | 7,417 | 7,187 | 2,608 | 6,967 |
| Age (year) | 50.7 (50.6–50.8) | 50.6 (50.5–50.7) | 50.9 (50.7–51.0) | 50.9 (50.8–51.1) | 50.4 (50.4–50.5) |
| BMI (kg/m2) | 29.0 (28.8–29.1) | 28.4 (28.3–28.6) | 28.6 (28.4–28.7) | 26.7 (28.4–28.9) | 29.2 (29.1–29.3) |
| SBP (mmHg) | 129.4 (128.7–130.1) | 127.4 (126.7–128.1) | 127.3 (126.7–128.0) | 129.0 (128.2–129.8) | 129.5 (129.1–130.0) |
| DBP (mmHg) | 84.4 (84.0–84.8) | 83.5 (83.1–83.9) | 83.4 (82.9– 83.8) | 82.1 (81.5–82.6) | 79.5 (79.2–79.8) |
| Current smoking | 5.3 (4.7–6.1) | 4.6 (3.9–5.3) | 5.2 (4.4–6.0) | 4.3 (3.6–5.1) | 4.4 (3.9–4.9) |
| Total Cholesterol (mg/dl) | 203.2 (201.7–204.7) | – | – | 197.0 (195.2–198.8) | 173.1 (172.2–173.9) |
| HDL_Cholesterol (mg/dl) | 44.7 (44.3–45.1) | – | – | 47.4 (46.9–47.9) | 43.5 (43.2–43.8) |
| Fasting Plasma Glucose (mg/dl) | 98.9 (97.6–100.1) | – | – | 107.1 (105.3–109.0) | 104.2 (103.3–105.1) |
| Diabetes | 15.4 (14.2–16.7) | – | – | 24.2 (22.5–26.0) | 19.2 (18.3–20.1) |
[i] All p-for trends of CVD risk factors are <0.05.
Figure 1
The trend of mean CVD risk in men and women: 2007–2016.
A: WHO no-lab model.
B: WHO lab-based model.
Table 2
The proportion of CVD risk levels in the Iranian general population aged 40–65 years during 2007–2016.
| 2007 | 2008 | 2009 | 2011 | 2016 | |
|---|---|---|---|---|---|
| Men | |||||
| WHO non-laboratory model | |||||
| Risk <10% | 60.7 (59.3–62.0) | 61.7 (60.2–63.1) | 61.9 (60.6–63.3) | 59.8 (57.8–61.8) | 63.8 (62.8–64.8) |
| 10 ≤ Risk <20 | 30.5 (29.1–31.2) | 31.1(29.8–32.7) | 31.5 (30.1–32.9) | 31.9 (30.0–33.9) | 29.7 (28.7–30.7) |
| 20 ≤ Risk <30 | 7.2 (6.5–8.1) | 6.0 (5.3–6.7) | 5.6 (4.9–6.3) | 6.7 (5.7–7.8) | 5.5 (5.0–6.1) |
| 30 ≤ Risk | 1.6 (1.2–2.1) | 1.1 (0.8–1.5) | 0.9 (0.6–1.4) | 1.6 (1.0–2.4) | 0.9 (0.7–1.2) |
| WHO laboratory model | |||||
| Risk <10% | 60.0 (58.6–61.4) | – | – | 59.8 (57.6–61.9) | 68.5 (67.5–69.4) |
| 10 ≤ Risk <20 | 29.6 (28.1–31.1) | – | – | 29.6 (27.6–31.8) | 25.0 (24.1–26.0) |
| 20 ≤ Risk <30 | 8.0 (7.2–8.9) | – | – | 8.0 (6.9–9.2) | 5.3 (4.8–5.8) |
| 30 ≤ Risk | 2.4 (1.9–2.9) | – | – | 2.5 (2.0–3.3) | 1.2 (0.1–1.4) |
| Women | |||||
| WHO non-laboratory model | |||||
| Risk <10% | 70.6 (69.4–71.7) | 73.6 (72.4–74.7) | 71.8 (70.6–73.0) | 70.4 (69.1–71.7) | 71.8 (71.0–72.6) |
| 10 ≤ Risk <20 | 25.9 (24.7–27.0) | 24.1 (23.0–25.3) | 25.9 (24.7–27.1) | 27.1 (25.8–28.5) | 26.0 (21.2–26.8) |
| 20 ≤ Risk <30 | 3.3 (2.8–3.9) | 2.2 (1.8–2.6) | 2.2 (1.7–2.8) | 2.4 (1.9–2.9) | 2.1 (1.8–2.5) |
| 30 ≤ Risk | 0.3 (0.1–0.5) | 0.1 (0.07–0.2) | 0.1 (0.05–0.2) | 0.1 (0.04–0.3) | 0.06 (0.03–0.1) |
| WHO laboratory model | |||||
| Risk <10% | 70.2 (69.0–71.4) | – | – | 68.3 (66.8–69.8) | 73.8 (72.9–74.7) |
| 10 ≤ Risk <20 | 24.5 (23.4–25.7) | – | – | 26.3 (24.8–27.8) | 22.1 (21.3–23.0) |
| 20 ≤ Risk <30 | 4.3 (3.8–5.0) | – | – | 4.7 (4.0–5.5) | 3.7 (3.3–4.1) |
| 30 ≤ Risk | 1.0 (0.7–1.2) | – | – | 0.7 (0.5–1.1) | 0.3 (0.2–0.5) |
[i] WHO: World Health Organization.
For each risk category, the proportion and 95% CI were reported.
Table 3
The clinical performance of the WHO non-laboratory model in the Iranian general population aged 40–65 years.
| MEN (N = 15,661) | WOMEN (N = 17,056) | |
|---|---|---|
| WHO non-laboratory model | ||
| Sensitivity, % (95%CI)a | 87.2 (86.4–88.0) | 82.7 (81.8–83.7) |
| Specificity, % (95%CI)a | 87.0 (86.3–87.7) | 89.9 (89.3–90.4) |
| PPV, % (95%CI)a | 83.8 (82.9–84.6) | 80.6 (79.5–81.6) |
| NPV, % (95%CI)a | 89.9 (89.2–90.5) | 91.1 (90.6–91.7) |
| Sensitivity, % (95%CI)b | 98.1 (97.4–98.7) | 99.4 (98.7–99.8) |
| Specificity, % (95%CI)b | 61.2 (60.4–62.0) | 69.4 (68.7–70.2) |
| PPV, % (95%CI)b | 23.5 (22.5–24.5) | 16.6 (15.7–17.6) |
| NPV, % (95%CI)b | 99.6 (99.5–99.7) | 99.9 (99.9–100.0) |
[i] PPV: positive predictive value; NPV: negative predictive value; WHO: world health organization.
a Model performance was estimated considering the cut-off point of 20% for defining high-risk individuals in both laboratory and non-laboratory models.
b Model performance was estimated considering the cut-off point of 20% and 10% for defining high-risk individuals in the laboratory and non-laboratory models, respectively.
Figure 2
The trend of mean CVD riskin those with and without diabetes between 2007 and 2016.