The prevalence of coronary artery disease in an urban population in Isfahan, Iran

Abstract

Objective: Cardiovascular diseases, especially coronary artery disease (CAD), are responsible for the highest mortality rate in Iran. This study was conducted to determine the prevalence of CAD in an urban sample in Isfahan by the Minnesota code of a 12-lead resting electrocardiogram (ECG), the Rose questionnaire on chest pain and a self-reported previous medical history.

Methods and results: Among the target sample of 6,470 men and women aged 35-79 years who were randomly selected from 80 random clusters in Isfahan, 5,773 subjects (about 90%) have participated. The WHO (Rose) questionnaires (Q) on chest pain were completed for all participants and 12-lead ECGs were taken. The overall prevalence of CAD based on the Rose Q and/or ECG was 19.4% (95% CI 18.4% to 20.4%) which was significantly higher among women 21.9% (95% CI 20.5% to 23.3%) than men 16.0% (95% CI 14.5% to 17.5%) (p < 0.05). The prevalence of CAD increased with age in both sexes. The prevalence of definite and possible angina based on the questionnaire was higher among women compared to men (p < 0.05), also a greater prevalence of ECG-based possible ischaemia was observed among woman than men (12.3% vs. 7.5%) (p < 0.05). However, definite and possible MI and definite ischaemia based on ECG abnormalities were higher among men than women (p < 0.05). The total prevalence of symptomatic CAD was 9.3% and about 22% of those with symptoms of CAD on Q have some evidence on ECG. The findings also showed that CAD is more common among people with less education, lower income and the unemployed (p < 0.05).

Conclusion: These findings indicate that there is a high prevalence of CAD among the Iranian population which need more programmes of health promotion and lifestyle changes and further studies to assess the used epidemiological methods for estimating CAD prevalence, especially among women.