Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Oct 11;9(1):55.
doi: 10.1186/1478-7954-9-55.

National and subnational mortality effects of metabolic risk factors and smoking in Iran: a comparative risk assessment

Farshad Farzadfar  1 , Goodarz Danaei, Hengameh Namdaritabar, Julie Knoll Rajaratnam, Jacob R Marcus, Ardeshir Khosravi, Siamak Alikhani, Christopher Jl Murray, Majid Ezzati
Affiliations

National and subnational mortality effects of metabolic risk factors and smoking in Iran: a comparative risk assessment

Farshad Farzadfar et al. Popul Health Metr. .

Abstract

Background: Mortality from cardiovascular and other chronic diseases has increased in Iran. Our aim was to estimate the effects of smoking and high systolic blood pressure (SBP), fasting plasma glucose (FPG), total cholesterol (TC), and high body mass index (BMI) on mortality and life expectancy, nationally and subnationally, using representative data and comparable methods.

Methods: We used data from the Non-Communicable Disease Surveillance Survey to estimate means and standard deviations for the metabolic risk factors, nationally and by region. Lung cancer mortality was used to measure cumulative exposure to smoking. We used data from the death registration system to estimate age-, sex-, and disease-specific numbers of deaths in 2005, adjusted for incompleteness using demographic methods. We used systematic reviews and meta-analyses of epidemiologic studies to obtain the effect of risk factors on disease-specific mortality. We estimated deaths and life expectancy loss attributable to risk factors using the comparative risk assessment framework.

Results: In 2005, high SBP was responsible for 41,000 (95% uncertainty interval: 38,000, 44,000) deaths in men and 39,000 (36,000, 42,000) deaths in women in Iran. High FPG, BMI, and TC were responsible for about one-third to one-half of deaths attributable to SBP in men and/or women. Smoking was responsible for 9,000 deaths among men and 2,000 among women. If SBP were reduced to optimal levels, life expectancy at birth would increase by 3.2 years (2.6, 3.9) and 4.1 years (3.2, 4.9) in men and women, respectively; the life expectancy gains ranged from 1.1 to 1.8 years for TC, BMI, and FPG. SBP was also responsible for the largest number of deaths in every region, with age-standardized attributable mortality ranging from 257 to 333 deaths per 100,000 adults in different regions.

Discussion: Management of blood pressure through diet, lifestyle, and pharmacological interventions should be a priority in Iran. Interventions for other metabolic risk factors and smoking can also improve population health.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Geographic regions used in the analysis.
Figure 2
Figure 2
Prevalence of smoking and mean levels of other risk factors in 2005, by region and sex. All figures are age-standardized to the 2005 national population.
Figure 3
Figure 3
Effects of each risk factor on life expectancy at birth in 2005, by region and sex.
Figure 4
Figure 4
Age-standardized mortality rates attributable to each risk factor in 2005, by region and sex.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Sarraf-Zadegan N, Boshtam M, Malekafzali H, Bashardoost N, Sayed-Tabatabaei FA, Rafiei M. et al.Secular trends in cardiovascular mortality in Iran, with special reference to Isfahan. Acta Cardiol. 1999;54(6):327–33. - PubMed
    1. Naghavi M, Abolhassani F, Moradi Lakeh M, Jafari N, Vaseghi S, Kazemeini H, National burden of dieases, injuries, and risk factors and disability adjusted life expectancy in Islamic Republic of Iran in 2003. 1. Tehran: Ministry of Health; 2003.
    1. Lewington S, Clarke R, Qizilbash N, Peto R, Collins R. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002;360(9349):1903–13. - PubMed
    1. Lewington S, Whitlock G, Clarke R, Sherliker P, Emberson J, Halsey J. et al.Blood cholesterol and vascular mortality by age, sex, and blood pressure: a meta-analysis of individual data from 61 prospective studies with 55,000 vascular deaths. Lancet. 2007;370(9602):1829–39. - PubMed
    1. Whitlock G, Lewington S, Sherliker P, Clarke R, Emberson J, Halsey J. et al.Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet. 2009;373(9669):1083–96. doi: 10.1016/S0140-6736(09)60318-4. - DOI - PMC - PubMed

LinkOut - more resources