Several Risk Factors Associated with Cardiovascular Disease Event: Results from The Population-based MASHAD Cohort Study

Document Type : Original Article


1 International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Department of Nutrition Sciences, Varastegan Institute for Medical Sciences, Mashhad, Iran.

4 Norwegian Center for e-health Research, University hospital of North Norway, Tromsø, Norway.

5 Cardiovascular Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

6 Brighton & Sussex Medical School, Division of Medical Education, Falmer, Brighton, Sussex BN1 9PH, UK.

7 ocial Determinants of Health Research, Center, Mashhad University of Medical Sciences, Mashhad, Iran.


Introduction: Cardiovascular disease (CVD) is the leading cause of mortality and one of the main challenges for health systems worldwide. In this study, we aimed to evaluate the association of socio-demographic, lifestyle, psychological and anthropometric factors and underlying diseases such as hypertension (HTN), diabetes mellitus (DM) and metabolic syndrome (MS) with CVD risk among a subpopulation of Iranian adults.
Methods: In this prospective study, a total of 235 CVD patients along with 8405 healthy and non-symptomatic individuals who participated in MASHAD cohort study were enrolled. CVD diagnosis was performed by taking electrocardiogram (ECG) and medical history and performing physical examination for each participant. Health and lifestyle questionnaires, the Beck’s anxiety inventory (BAI), Beck’s depression inventory (BDI) and the James and Schofield human energy requirements equations were completed for all participants. Anthropometric measurements were also recorded for all subjects. All statistical analyses including chi-square and student independent T-test were performed using SPSS 16.0 software (SPSS Inc., Chicago, IL, USA) at a significant level of 0.05.
Results: We found that there were significant associations between CVD risk and age, body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), diabetes mellitus (DM) and family history (FH) of CVD in both genders; though, there was a significant negative correlation between physical activity level (PAL) and risk of CVD among men and women. Also hypertension (HTN), metabolic syndrome (MS), depression and anxiety were positively and higher education level was negatively associated with CVD events only in females. While, waist-to-hip ratio (WHR) was an independent predictor of CVD among males (P-value< 0.05).
Conclusion: There are several modifiable and non-modifiable risk factors that are independently considered as CVD predictors among the MASHAD study population. It is recommended to prioritize the lifestyle modification, development of local risk calculators and gender-related stratified strategies in order to prevent and manage CVD among the Iranian population.


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