Assessment and Analysis of the Data from the Program “Basic Interventions of Non‑Communicable Diseases in Iran’s Primary Health Care System in Urmia City, Iran, 2023
Abstract
Abstract
Background: Cardiovascular diseases are among the leading causes of death and disability worldwide, including in Iran. Identifying their risk factors is essential for implementing cost‑effective preventive interventions. This study aimed to determine the prevalence of behavioral risk factors for non‑communicable diseases and their relationship with of cardiovascular diseases risk level in Urmia City, Iran. Materials and Methods: This cross‑sectional study involved 10,000 individuals aged 30 years and older who underwent risk assessment in 2023. Participants were selected through multi‑stage cluster sampling. Data were collected using a researcher‑designed checklist within the Integrated Health System and analyzed using, employing independent t‑tests and Chi‑square tests. Results: The prevalence of risk factors was: history of diabetes (12.22%), hypertension (17.24%), high cholesterol (14.93%), family history of diabetes (4.25%), pre‑diabetes (7.19%), and pre‑hypertension (29.33%). The distribution of risk levels was as follows: 91.15% of participants was classified as having a risk level below 10%, 8.24% between 10 and 20%, 0.33% between 20 and 30%, and 0.28% above 30%. There was a significant positive correlation between risk level and fasting blood sugar, cholesterol, systolic and diastolic blood pressure, age, body mass index (BMI), and waist circumference. Conclusions: The implementation of the risk assessment program and the identification of risk factors at early stages will help in the regular follow‑up of high‑risk individuals, provide them with necessary health care, and lead to the prevention or early diagnosis of disease.
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Darabi F, Ezatti F, Mohammadhossrini T. Assessing the risk of cardiovascular diseases in women and men in the primary health care: A case study in Ardabil, Iran. Payesh (Health Monitor) 2023;22:699‑708.
Rabbani B, Khosravi A, Azimi M, Tabrizi JS, Atefi A, Ataey A, et al. Provincial differential in premature deaths due to non‑communicable diseases in Iran, 2016‑2019. Iran. J. Epidemiol 2023;18:292‑304.
Tabatabaei S. The effect of lifestyle education on the quality of life of patients with ischemic heart disease. Tolooebehdasht 2023;22:87‑99.
Raghfar H, Sargazi N, Mehraban S, Akbarzadeh MA, Vaez Mahdavi MR, Vahdati Manesh Z. The economic burden of coronary heart disease in Iran: A bottom‑up approach in 2014. J Ardabil Univ Med Sci 2018;18:341‑56.
Derakhshan S, Khalili D, Etemad K, Nazari SSH, Kavousi A, Hadavand F, et al. Prevalence of cardiovascular risk factors in men and women referred to health centers in the four cities of the Ira‑PEN pilot program, 2016‑2017. Iran. J. Endocrinol. Metab. 2021;23:9‑20.
Abzaliyev K, Suleimenova M, Chen S, Mansurova M, Abzaliyeva S, Manapova A, et al. Predicting Cardiovascular Aging Risk Based on Clinical Data Through the Integration of Mathematical Modeling and Machine Learning. Appl Sci. 2025;15:5077.
Pettee KK, Kriska AM, Conroy MB, Johnson BD, Orchard TJ, Goodpaster BH, et al. Discontinuing hormone replacement therapy: Attenuating the effect on CVD risk with lifestyle changes. Am J Prev Med 2007;32:483‑9.
Rezaei F, Seif M, Fattahi MR, Gandomkar A, Hasanzadeh J. Estimation of 10‑year risk of cardiovascular diseases using WHO risk prediction charts: A population‑based study in southern Iran. Iran J Public Health 2022;51:1667.
Azmin M, Mohebi F, Yoosefi M, Ahmadi N, Shirazi S, Modirian M, et al. The incremental cost of implementing the world health organization Package of essential non‑communicable (PEN) diseases interventions in Iran. PLoS Global Public Health 2023;3:e0000449.
Laffond A, Rivera‑Picón C, Rodríguez‑Muñoz PM, Juárez‑Vela R, Ruiz de Viñaspre‑Hernández R, Navas‑Echazarreta N, et al. Mediterranean diet for primary and secondary prevention of cardiovascular disease and mortality: An updated systematic review. Nutrients 2023;15:3356.
Aye LL, Tripathy JP, Maung Maung T, Oo MM, Nwe ML, Thu HMM, et al. Experiences from the pilot implementation of the package of essential non‑communicable disease interventions (PEN) in Myanmar, 2017‑18: A mixed methods study. PLoS One 2020;15:e0229081.
Vaidya A, Simkhada P, Lee A, Jones S, Mukumbang FC. Implementing a package of essential non‑communicable diseases interventions in low‑and middle‑income countries: A realist review protocol. BMJ Open 2023;13:e074336.
Fasero M, Coronado PJ. Cardiovascular disease risk in women with menopause. J Clin Med 2025;14:3663.
Jamshidi A, Daroudi R, Aas E, Khalili D. A cost‑effectiveness analysis of risk‑based intervention for prevention of cardiovascular diseases in IraPEN program: A modeling study. Front Public Health 2023;11:1075277.
Jahani M, Barzegar M, Abbasi M, Charati JY, Mahmoodi G. Analysis of the results of cardiovascular disease risk assessment program. J Babol Univ Med Sci 2021;23:236‑43.
Koosha A, Motlagh A, Maleki A, Najmi M, Dini M, Arjmandpour M. Collection of basic interventions for non‑communicable diseases in the primary health care system of Iran (IraPEN): Executive Instruction and Educational Content of Midwives. Ministry of Health and Medical Education, Iran; 2017.
Sadeghi V, Jannati A, Sadeghi‑Bazargani H, Imani A. Which interventions should be included in national health system assessment framework? Selecting essential interventions based on effective coverage approach. Ann Med Health Sci Res 2019;9:542‑9.
Soltani S, Saraf‑Bank S, Basirat R, Salehi‑Abargouei A, Mohammadifard N, Sadeghi M, et al. Community‑based cardiovascular disease prevention programmes and cardiovascular risk factors: A systematic review and meta‑analysis. Public Health 2021;200:59‑70.
Annesley TM. The paintsville heart study. Clin Chem 2021;67:331‑2.
Zangeneh A, Najafi F, Khosravi A, Ziapour A, Molavi H, Moradi Z, et al. Epidemiological patterns and spatiotemporal analysis of cardiovascular disease mortality in Iran: Development of public health strategies and policies. Curr. Probl. Cardiol. 2024;49:102675.
Shariatpanahi SP, Habibi D, Rafiei M, Ghandi Y, Anvari M. Determination of relations between systolic blood pressure and heart attack in patients with type 2 diabetes with association rules. J Arak Uni Medicla Sci 2018;20:44‑50.
Loscalzo J, Fauci AS, Kasper DL, Hauser SL, Longo DL, Jameson JL, editors. Harrisons Principles of Internal Medicine. 21st ed. New York: McGraw-Hill; 2022.
Albeladi F, Salem IW, Zahrani M, Alarbedi L, Abukhudair A, Alnafei H, et al. Incidence of coronary artery disease in King Abdulaziz University Hospital, Jeddah, Saudi Arabia, 2019–2020: A retrospective cohort study. Cureus 2022;14:e28770.
Al‑Ghamdi S, Aldosari KH, Hussain ABO. Predictors of cardiovascular morbidity among adult hypertensive patients: A cross‑sectional study from the Kingdom of Saudi Arabia. Patient Prefer Adherence 2023;17:1361‑9.
Vasan RS, Larson MG, Leip EP, Evans JC, O’Donnell CJ, Kannel WB, et al. Impact of high‑normal blood pressure on the risk of cardiovascular disease. N Engl J Med 2001;345:1291‑7.
Beigi M, Hadaegh F, Azizi F. Prediction of cardiovascular disease in individuals aged over 40 years according to fasting and post-challenge glycemia: Tehran Lipid and Glucose Study. Diabetes Care 2007;30:1447-52.
Kamiab Z, Mirzaei M, Dabiran S. The pattern of age changes of first acute myocardial infarction in Rafsanjan during 2003 to 2012: Has age decreased? J Rafsanjan Univ Med Sci 2017;15:1015‑26.
Alnefaie SA, Bajaber AS, Alzahrani AS, Alotaibi RS, Alotaibi AJ, Alnefaie SA, et al. Applicability and risk stratification of QRISK®, Framingham risk score, systematic coronary risk evaluation (SCORE), and American College of Cardiology/American Heart Association (ACC/AHA) risk assessment tools among patients in Taif, Saudi Arabia. Cureus 2025;17:e86910.
Qureshi M, Ishaq K, Daniyal M, Iftikhar H, Rehman MZ, Salar SA. Forecasting cardiovascular disease mortality using artificial neural networks in Sindh, Pakistan. BMC Public Health 2025;25:34.
Sezavar SH, Valizadeh M, Moradi M, Rahbar MH. Trend of changes in age and gender of patients admitted in Rasul‑e‑Akram hospital with first acute myocardial infarction from 1998 to 2007. J Ardabil Univ Med Sci 2010;10:29‑37.
Ahmadi A, Etemad K, Ahmadi S, Khaledifard A. Current status of myocardial infarction and risk factors for associated mortality in Iran: A review. J Epidemiol Public Health Rev 2016;1:1‑5.
Tarı Selçuk K, Mercan Y, Aydın T. Uncontrolled blood pressure in patients with hypertension and associated factors: the role of low health literacy. J Clin Pract Res 2018;40:222227.
Ali MK, Bhaskarapillai B, Shivashankar R, Mohan D, Fatmi ZA, Pradeepa R, et al. Socioeconomic status and cardiovascular risk in urban South Asia: The CARRS study. Eur J Prev Cardiol 2016;23:408‑19.
Kernizan D, Connolly S, Turpin D, Zaidi A, Baker‑Smith CM. Is family history for the management of cardiovascular health in youth still relevant in clinical practice? Curr Atheroscler Rep 2024;26:629‑37.
Hajar R. Risk factors for coronary artery disease: Historical perspectives. Heart Views 2017;18:109‑14.
Emamian MH, Hashemi H, Fotouhi A. Predicted 10‑year risk of cardiovascular disease in the Islamic Republic of Iran and the body mass index paradox. East Mediterr Health J 2020;26:1465‑72.
Khani S, Rafiei S, Ghashghaee A, Masoumi M, Rezaee S, Kheradkhah G, et al. Cardiovascular risk factors among nurses: A global systematic review and meta‑analysis. PLoS One 2024;19:e0286245.
Olubiyi OA, Rotimi BF, Afolayan MA, Alatishe‑Muhammad BW, Olubiyi OM, Balami AD. The ten‑year risk of developing cardiovascular disease among public health workers in North‑Central Nigeria using Framingham and atherogenic index of plasma risk scores. BMC Public Health 2022;22:847.
Sadeghi M, Heidari R, Dehghan‑naseiri S, Ghaheri R, Cheraghi M, Sarrafzadegan N. A comparison of cardiovascular risk factors and healthy lifestyle of housewives and working women in Iran central regions‑Isfahan Healthy Heart Program. Yafteh 2012;13:55‑64.
WHO. WHO Package of Essential Noncommunicable (PEN) Disease Interventions for Primary Health Care. Geneva, Switzerland: World Health Organisation; 2020.
Bastos ML, Menzies D, Hone T, Dehghani K, Trajman A. The impact of the Brazilian family health on selected primary care sensitive conditions: A systematic review. PLoS One 2017;12:e0182336.
Cicero AFG, Fogacci F. Pericardial fat as a new independent biomarker of vascular aging. Int J Cardiol 2018;260:211‑2.
Yusuf S, Hawken S, Ôunpuu S, Dans T, Avezum A, Lanas F, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): Case‑control study. Lancet 2004;364:937‑52.
Abrahams‑Gessel S, Denman CA, Montano CM, Gaziano TA, Levitt NS, et al. An assessment of community health workers ability to screen for cardiovascular disease risk with a simple, non‑invasive risk assessment instrument in Bangladesh, Guatemala, Mexico, and South Africa: an observational study. Lancet Glob Health 2015;3:e556e563.
ARIC I. The Atherosclerosis Risk in Communities (ARIC) study: Design and objectives. Am J Epidemiol 1989;129:687‑702.
Xia W, Khalil RA. Hormone replacement therapy and cardiovascular health in postmenopausal women. Int J Mol Sci 2025;26:5078.
Wieben AM, Walden RL, Alreshidi BG, Brown SF, Cato K, Coviak CP, et al. Data science implementation trends in nursing practice: A review of the 2021 literature. Appl Clin Inform 2023;14:585‑93.
Black AD, Car J, Pagliari C, Anandan C, Cresswell K, Bokun T, et al. The impact of eHealth on the quality and safety of health care: A systematic overview. PLoS Med 2011;8:e1000387.
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