Global Heart最新文献

{"title":"Cardiovascular Risk Factors Among Young People in Haiti: Implications for Low-Income Countries.","authors":"Lindsey K Reif, Vanessa Rouzier, Lily D Yan, Shalom Sabwa, Genevieve Hilaire, Marie Jean Pierre, Rose Cardelle Riche, Robert Peck, Anju Ogyu, Rodney Sufra, Jean W Pape, Daniel W Fitzgerald, Margaret L McNairy","doi":"10.5334/gh.1435","DOIUrl":"10.5334/gh.1435","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiovascular disease (CVD) is a leading cause of global mortality with >80% of the burden in low-income countries. We investigate population-based estimates of CVD risk factors among young people ages 18-30 in Haiti and provide insights for CVD prevention.</p><p><strong>Methods: </strong>This is a cross-sectional study within the Haiti Cardiovascular Cohort Study. CVD risk factors include: high blood pressure (BP), dyslipidemia, kidney disease, overweight and obese, and health behaviors. Multivariate logistic regression assessed associated independent factors.</p><p><strong>Results: </strong>Among 957 participants ages 18-30 years, 23.5% had high BP (95%CI: 20.9%-26.3%), 34.9% had dyslipidemia (95%CI: 31.8%-38.1%), 6.4% had kidney disease (95%CI: 4.8%-8.4%), 16.5% were overweight (95%CI: 14.2%-19.0%), and 6.8% were obese (95%CI: 5.3%-8.6%). More males had high BP (33.6% vs. 14.0%; p < 0.001) and more females had dyslipidemia (45.1% vs. 23.9% p < 0.001). Overweight and obese participants had higher odds of high BP (aOR: 2.05, 95%CI: [1.31-3.19]; aOR 2.15, 95%CI [1.11-4.04]) and dyslipidemia (aOR: 1.70, 95%CI [1.15-2.50]); aOR 2.82, 95%CI [1.63-4.98]) compared to those with normal BMI. Participants ages 25-30 had higher odds of high BP (aOR: 1.58, 95%CI: [1.14-2.18]) and dyslipidemia (aOR: 1.81, 95%CI: [1.35-2.43]) compared to participants ages 18-24.</p><p><strong>Discussion: </strong>Prevalence of high BP and dyslipidemia are alarmingly high in Haitian young adults, with higher rates of dyslipidemia in women and elevated BP in men. These data provide evidence for routine CVD screening in young people as early as 18 years and underscore the need to identify modifiable drivers of early-onset CVD.</p>","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"52"},"PeriodicalIF":3.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12164739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower BMI in Tanzanian Adults with <i>Schistosoma mansoni</i> Infection is Not Explained by Differences in Serum Adipocytokine Levels.","authors":"Khanh Pham, Enock Miyaye, Maureen Ward, Danielle de Jong, Govert J van Dam, Paul L A M Corstjens, Jennifer A Downs, Robert N Peck, Hyasinta Jaka","doi":"10.5334/gh.1436","DOIUrl":"10.5334/gh.1436","url":null,"abstract":"","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"51"},"PeriodicalIF":3.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12143250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular Disease Care Beyond the Cardiologist: An Overview of the Rollout of Transthoracic Echocardiography Training and Services in Kenya.","authors":"Daniel Muriuki, Marietta Ambrose, Hassan Ahmed, Michael Foster, Hellen Nguchu, Lee Goldberg, Bernard Samia","doi":"10.5334/gh.1437","DOIUrl":"10.5334/gh.1437","url":null,"abstract":"<p><p>Cardiovascular diseases (CVDs) are a leading cause of mortality in low- and middle-income countries (LMICs), yet access to echocardiography remains limited due to workforce shortages. The Kenya Cardiac Society (KCS), in collaboration with the American College of Cardiology (ACC), launched a 16-week transthoracic echocardiography (TTE) training program to address this gap. This blended learning initiative trains non-cardiologist healthcare workers through online modules, hands-on workshops, and expert mentorship. Since 2022, the program has trained 95 participants, enhancing diagnostic capacity and expanding echocardiography services to underserved areas. Early outcomes include reduced patient travel distances, improved early detection of cardiac conditions, and strengthened CVD management at secondary and tertiary levels. Challenges such as limited equipment access and financial constraints persist, but strategic partnerships and innovative training models demonstrate the program's potential for scalability. The KCS-ACC-TTE program highlights the effectiveness of task-sharing and collaboration in strengthening cardiovascular care, offering a replicable framework for LMICs to improve access to essential cardiac diagnostics.</p>","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"50"},"PeriodicalIF":3.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abdominal Aorta Screening During Routine Transthoracic Echocardiography in Zanzibar, Tanzania: The Zanzibar Heart Survey.","authors":"Abukar Mohamed Ali, Khamis Mustafa Khamis, Ghirmay Andemichael, Muhiddin Abdi Mahmoud, Victor Aboyans, Sahrai Saeed","doi":"10.5334/gh.1432","DOIUrl":"10.5334/gh.1432","url":null,"abstract":"<p><strong>Background and objectives: </strong>Abdominal aortic (AA) aneurysms (AAA) are often incidental findings and preceded by a long period of subclinical growth in diameter. Patients may present with life-threatening complications. Therefore, screening programmes for AAA in primary care are proposed in several European countries, and opportunistic AAA screening during echocardiography is also advocated. However, data on the interest of such an approach in the sub-Saharan African population are unknown.</p><p><strong>Methods: </strong>In 2022, a total of 189 patients with cardiac symptoms visiting the Mnazi Mmoja Referral Hospital (MMH) in Zanzibar underwent standard transthoracic echocardiography (TTE). Demographics and clinical data were recorded. AA diameter was routinely assessed in 137 patients. AA was measured by the leading-edge-to-leading-edge method from a longitudinal plane, and AAA was defined as an AA diameter of ≥3.0 cm. SPSS version 29.0 was used for data analysis. The prevalence of AAA was estimated as the number of AAA cases divided by the number of all screened subjects. Correlates of AA diameter were tested in univariate and multivariate linear regression analyses.</p><p><strong>Results: </strong>AA could be visualized in 128 (93.4%) patients (43% of men and 57% of women). The mean age was 54.4 ± 15.9 years. The mean AA diameter was 2.1 ± 0.3 cm in the entire study population and was significantly greater in men than women (2.2 ± 0.3 vs 2.1 ± 0.3 cm, p = 0.005) and in individuals aged ≥60 years than those aged <60 years (2.3 ± 0.3 vs 2.1 ± 0.3 cm, p = 0.003). The prevalence of AAA was 1.6%. In a multivariate linear regression analysis, higher age, male gender, atrial fibrillation and left ventricular (LV) mass were independent correlates of greater AA diameter, adjusted for clinic systolic blood pressure, ascending aortic diameter and LV ejection fraction (multiple <i>R²</i> = 0.38, <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Abdominal aorta screening during routine TTE is feasible in Africa. Patients in Zanzibar have relatively smaller abdominal aorta diameters with a 1.6% prevalence of AAA. Abdominal aorta screening by routine echocardiography may be beneficial, provided that access to care and vascular surgery facility/expertise with appropriate follow-up is available for patients with AAA identified during screening.</p>","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"49"},"PeriodicalIF":3.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interobserver Variability in Cardiovascular FDG PET/CT Analysis in Large Vessel Vasculitis.","authors":"Redemptar Kimeu, Anoop Shah, Samuel Gitau, Gemina Doolub, Jeilan Mohamed","doi":"10.5334/gh.1433","DOIUrl":"10.5334/gh.1433","url":null,"abstract":"<p><strong>Introduction: </strong>PET/CT has a synergistic value for optimal diagnosis, disease activity monitoring, and evaluation of damage progression in large vessel vasculitis. The use of standardized uptake values (SUV) as a measurement of relative tissue uptake facilitates comparisons between patients, and has been suggested as a basis for diagnosis. The SUVmean and SUVmax reproducibility in vascular structures is not widely studied.</p><p><strong>Objective: </strong>The objective of this study was to evaluate the inter-observer variability of both qualitative visual grading of aortic ¹⁸F-FDG uptake and the quantitative aortic mean and maximum SUVs in these patients with mild to moderate covid-19 infection who underwent multimodality cardiac imaging within the COSMIC-19 trial.</p><p><strong>Study design: </strong>This is a sub-study of the COSMIC-19 trial. 30 patients were subjected to a combined Computed Tomography Coronary Angiogram and ¹⁸F-FDG PET/CT, followed by cardiac magnetic resonance. Two independent observers measured the Standardized uptake values in five regions of interest at each aortic segment. These were performed sequentially along the length of the aorta every 5 mm on the axial slices. The maximum and mean standard uptake values were measured.</p><p><strong>Results: </strong>Qualitative assessment showed excellent agreement between observer x and y for the ascending aorta and aortic arch regions with the kappa coefficients for the inter observer agreement of 0.92 (95% CI:0.78-1.0) and 0.91 (95% CI:0.74-1.0) respectively. Quantitative assessment showed a very high positive correlation between the two observers for each of the regions measured for SUVmean as follows; ascending aorta r = 0.96 (p < 0.001), Aortic arch r = 0.90 (p < 0.001) and descending Aorta r = 0.91 (p < 0.001). The correlation coefficients for the SUVmax were substantially strong.</p><p><strong>Conclusion: </strong>This study shows an excellent inter-observer reproducibility for both qualitative and quantitative SUVmean vascular ¹⁸F-FDG measurements in patients with COVID-19 large vessel vasculitis. Quantitative SUVmax demonstrated substantially strong interobserver reproducibility.</p>","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"48"},"PeriodicalIF":3.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Candidate Interventions for Integrating Hypertension and Cardiovascular-Kidney-Metabolic Care in Primary Health Settings: HEARTS 2.0 Phase 1.","authors":"Andres Rosende, Cesar Romero, Donald J DiPette, Jeffrey Brettler, Patrick Van der Stuyft, Gautam Satheesh, Pablo Perel, Niamh Chapman, Andrew E Moran, Aletta E Schutte, James E Sharman, Vilma Irazola, Mark D Huffman, Norm R C Campbell, Abdul Salam, Fernando Lanas, Antonio Coca, Sebastian Garcia-Zamora, Alejandro Ferreiro, Patricio Lopez-Jaramillo, Jorge Rico-Fontalvo, Emily Ridley, Dean Picone, David Flood, Daniel José Piñeiro, Carolina Neira Ojeda, Gonzalo Rodriguez, Irmgardt A Wellmann, Marcelo Orias, Marcela Rivera, Matías Villatoro Reyes, Oyere Onuma, Shaun Ramroop, Taskeen Khan, Yamile Valdes Gonzalez, Weimar Kunz Sebba Barroso, Frida L Plavnik, Eric Zuniga, Ana María Grassani, Carlos Tajer, Ezequiel Zaidel, Marcos J Marin, Shana Cyr-Philbert, Ignacio Amorin, Miguel Angel Diaz Aguilera, Luiz Bortolotto, Alvaro Avezum, Antonio Luiz P Ribeiro, Sheldon Tobe, Teresa Aumala, Sonia Angell, Pablo Lavados, Sheila Ouriques Martins, Ana Munera Echeverri, Marc G Jaffe, Dorairaj Prabhakaran, Gianfranco Parati, Xin Hua Zhang, Anthony Rodgers, Salim Yusuf, Paul K Whelton, Pedro Ordunez","doi":"10.5334/gh.1428","DOIUrl":"10.5334/gh.1428","url":null,"abstract":"<p><strong>Background: </strong>HEARTS in the Americas is the regional adaptation of the WHO Global HEARTS Initiative, aimed at helping countries enhance hypertension and cardiovascular disease (CVD) risk management in primary care settings. Its core implementation tool, the HEARTS Clinical Pathway, has been adopted by 28 countries. To improve the care of hypertension, diabetes, and chronic kidney disease (CKD), HEARTS 2.0 was developed as a three-phase process to integrate evidence-based interventions into a unified care pathway, ensuring consistency across fragmented guidelines. This paper focuses on Phase 1, highlighting targeted interventions to improve and update the HEARTS Clinical Pathway.</p><p><strong>Methods: </strong>First, the coordinating group defined the project's scope, objectives, principles, methodological framework, and tools. Second, international experts from different disciplines proposed interventions to enhance the HEARTS Clinical Pathway. Third, the coordinating group harmonized these proposals into unique interventions. Fourth, experts appraised the appropriateness of the proposed interventions on a 1-to-9 scale using the adapted RAND/UCLA Appropriateness Method. Finally, interventions with a median score above 6 were deemed appropriate and selected as candidates to enhance the HEARTS Clinical Pathway.</p><p><strong>Results: </strong>Building on the existing HEARTS Clinical Pathway, 45 unique interventions were selected, including community-based screening, early detection and management of risk factors, lower blood pressure thresholds for diagnosing hypertension in high-CVD-risk patients, reinforcement of single-pill combination therapy, inclusion of sodium-glucose cotransporter-2 inhibitors for patients with diabetes, CKD, or heart failure, expanded roles for non-physician health workers in team-based care, and strengthened clinical documentation, monitoring, and evaluation.</p><p><strong>Conclusion: </strong>HEARTS 2.0 Phase 1 identifies key interventions to integrate and improve hypertension and cardiovascular-kidney-metabolic care within primary care, enabling their seamless incorporation into a unified and effective clinical pathway. This process will inform an update to the HEARTS Clinical Pathway, optimizing resources, reducing care fragmentation, improving care delivery, and advancing health equity, thereby supporting global efforts to combat the leading causes of death and disability.</p>","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"45"},"PeriodicalIF":3.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrated Care Using the ABC_stroke Pathway Improves Cardiovascular Outcomes and Survival in Patients with First-Ever Ischaemic Stroke.","authors":"Christopher T W Tsang, Sylvia E Choi, Tommaso Bucci, Jia-Yi Huang, Qing-Wen Ren, Mei-Zhen Wu, Wen-Li Gu, Ran Guo, Jing-Nan Zhang, Anthony O T Ma, Steven H M Lam, Yap-Hang Chan, Kui-Kai Lau, Hung-Fat Tse, Azmil H Abdul-Rahim, Gregory Y H Lip, Kai-Hang Yiu","doi":"10.5334/gh.1430","DOIUrl":"10.5334/gh.1430","url":null,"abstract":"<p><strong>Background: </strong>A recent position paper of the European Society of Cardiology Council on Stroke proposed an integrated ABC_stroke pathway to optimise post-stroke management. We evaluated the impact of ABC_stroke pathway adherence on post-stroke cardiovascular outcomes.</p><p><strong>Methods: </strong>Patients with first-ever ischaemic stroke in Hong Kong between 2006 and 2022 were included in this retrospective cohort study. Multivariable Cox regression analysis was performed to evaluate the association between physicians' adherence to the ABC_stroke pathway and the primary outcome, which was a composite of recurrent ischaemic stroke, transient ischaemic attack, haemorrhagic stroke, myocardial infarction, heart failure and all-cause mortality.</p><p><strong>Results: </strong>Of the 9,669 included patients with ischaemic stroke (mean age 69.6 ± 13.4 years; 57.5% male), 58.1% were optimally managed according to all three ABC_stroke pillars. After 1 year of follow-up, adherence to the ABC_stroke pathway was associated with a lower risk of the primary composite endpoint (hazard ratio (HR): 0.80; 95% confidence interval (CI): 0.72-0.88), as well as a lower risk of haemorrhagic stroke (subdistribution hazard ratio (SHR): 0.50; 95% CI: 0.38-0.67), heart failure (SHR: 0.771; 95% CI: 0.596-0.998), cardiovascular death (SHR: 0.64; 95% CI: 0.45-0.90), and all-cause mortality (HR: 0.72; 95% CI: 0.62-0.85). Risk reductions in the primary endpoint increased progressively with a higher number of ABC_stroke criteria obtained. No significant interaction was observed in the association according to age, sex, or stroke severity.</p><p><strong>Conclusions: </strong>In this cohort of Asian patients with first-ever ischaemic stroke, optimal management according to the ABC_stroke pathway was associated with a reduction in the risk of adverse outcomes.</p>","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"46"},"PeriodicalIF":3.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medication Adherence and Contributing Factors in Patients with Heart Failure Within the Middle East: A Systematic Review.","authors":"Mohammed Alfaqeeh, Ramez Abdullah, Neily Zakiyah, Auliya A Suwantika, Maarten J Postma, Fita Rahmawati, Anna Wahyuni Widayanti, Baharudin Ibrahim","doi":"10.5334/gh.1431","DOIUrl":"10.5334/gh.1431","url":null,"abstract":"<p><p>Medication adherence among heart failure (HF) patients in the Middle East remains a critical, under-explored issue. This systematic review examines medication adherence rates and their influencing factors in this region. A search of PubMed, Scopus, and Google Scholar identified 12 studies published between 2013 and 2023, revealing an average non-adherence rate of 60%. Influential factors include socioeconomic status, education, psychiatric conditions, and medication-related issues. Significant gaps in research methodologies and reporting were noted. The review highlights the impact of socio-economic determinants on adherence and calls for more robust research and targeted interventions to address these barriers. Improving patient education and healthcare provider communication are crucial to enhancing adherence rates. These findings underscore the importance of addressing regional challenges through tailored approaches and suggest further studies are needed to develop effective strategies for improving adherence among HF patients in the Middle East.</p>","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"47"},"PeriodicalIF":3.1,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship Between Leptin and Heart Failure: A Meta-Analysis.","authors":"Xin Sun, Caihong Xin, Jiayi Yao, Hongli Wang","doi":"10.5334/gh.1434","DOIUrl":"10.5334/gh.1434","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) is a diverse and potentially fatal condition affecting more than 60 million people worldwide. Previous studies have identified a close relationship between leptin levels and HF, and that leptin levels in patients with HF are higher than those in healthy individuals. However, some studies have reported inconsistent results. Therefore, the association between leptin levels and HF remains controversial.</p><p><strong>Methods: </strong>A literature search was conducted on the Web of Science, Wiley Online Library, Embase, and PubMed databases. The title or abstract search term 'leptin' was used in combination with 'heart failure' and 'HF'. Meta-analysis results were reported as standardized mean differences (SMD) with corresponding 95% confidence intervals (CI).</p><p><strong>Results: </strong>Eighteen studies comprising 1149 patients with HF and 622 healthy controls were included in the meta-analysis. Leptin levels in patients with HF were significantly higher than those in healthy individuals (SMD, 0.54; 95% CI [0.15, 0.93]).</p><p><strong>Conclusions: </strong>To our knowledge, this systematic review is the first to evaluate the relationship between leptin and HF. Determining the role of leptin in HF will significantly contribute to its diagnosis and treatment.</p>","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"44"},"PeriodicalIF":3.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National and Subnational Burden of Cardiovascular Diseases in Iran from 1990 to 2021: Results from Global Burden of Diseases 2021 study.","authors":"Mahsa Heidari-Foroozan, Melina Farshbafnadi, Ali Golestani, Sepehr Younesian, Hosein Jafary, Mohammad-Mahdi Rashidi, Ozra Tabatabaei-Malazy, Nazila Rezaei, Mostafa Moghimi Kheirabady, Arash Bagherian Ghotbi, Seyyed-Hadi Ghamari","doi":"10.5334/gh.1429","DOIUrl":"10.5334/gh.1429","url":null,"abstract":"<p><strong>Introduction: </strong>In 2021, cardiovascular diseases (CVD) caused around 20.5 million deaths worldwide, making them a major health concern.</p><p><strong>Methods: </strong>Incidence, prevalence, death, years of life lost (YLL), years lived with disability (YLD), and disability-adjusted life years (DALYs) were the burden measures that were assessed. All measures are reported as both all-age numbers and age-standardized rates (ASR) with 95% uncertainty intervals (UI). Decomposition analysis was conducted on CVD incidence.</p><p><strong>Results: </strong>From 1990 to 2021, all-age CVD prevalence in Iran increased by 182.6% (2.9 to 8.3 million cases), with males consistently showing higher age-standardized prevalence rates (ASPR) than females (11,350 vs. 9,431 per 100,000 in 2021). ASPR remained stable nationally (9,956 to 10,386 per 100,000), peaking in adults ≥80 years. Incident cases rose by 159.6% (0.36 to 0.92 million), driven by population growth (49.5%) and aging (136.2%), while age-standardized incidence rates (ASIR) declined by 28.3% (1,337 to 1,197 per 100,000); with males (1,336) exhibiting higher rates than females (1,060) in 2021. All age deaths doubled (86,527 to 169,582) during this period, but age-standardized death rates (ASDR) decreased substantially by 42.97% (446 to 255 per 100,000). DALYs increased by 53.7% (2.4 to 3.7 million), though age-standardized DALY rates dropped 45.3% (9,096 to 4,977 per 100,000), dominated by ischemic heart disease (2,731 ASR) and stroke (1,229 ASR). High systolic blood pressure, dietary risks, and LDL cholesterol remained the leading contributors to DALYs nationwide.</p><p><strong>Conclusion: </strong>Iran's rising CVD burden demands prioritizing cardiac care infrastructure in underserved provinces like Golestan, enforcing sodium reduction policies aligned with Iran's existing trans-fat regulations, and integrating sex-specific programs such as tobacco control for males and community hypertension screening for women are critical. Multisectoral collaboration, including urban design promoting physical activity and subsidies for whole grains, must address provincial inequities exacerbated by Iran's aging population and dietary risks.</p>","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"43"},"PeriodicalIF":3.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}