Total cardiovascular risk approach to improve efficiency of cardiovascular prevention in resource constrain settings.

Objectives: To determine the population distribution of cardiovascular risk in eight low- and middle-income countries and compare the cost of drug treatment based on cardiovascular risk (cardiovascular risk thresholds ≥ 30%/≥ 40%) with single risk factor cutoff levels.

Study Design And Setting: Using World Health Organization (WHO) and the International Society of Hypertension risk prediction charts, cardiovascular risk was categorized in a cross-sectional study of 8,625 randomly selected people aged 40-80 years (mean age, 54.6 years) from defined geographic regions of Nigeria, Iran, China, Pakistan, Georgia, Nepal, Cuba, and Sri Lanka.

Effect on quality of life of different accelerated diagnostic protocols for management of patients presenting to the emergency department with acute chest pain.

This study assessed the effects on quality of life (QoL) of dobutamine-atropine stress echocardiography (DASE) and electrocardiogram exercise testing (EET) accelerated diagnostic protocols for early stratification of low-risk patients with acute chest pain (ACP). A total of 290 patients with ACP, a nondiagnostic electrocardiogram, and negative biomarkers were randomly assigned to an accelerated diagnostic protocol (DASE, n = 110, or EET, n = 89) or usual care (n = 91) and followed up for 2 months. QoL was assessed at discharge and 2-month follow-up using the Nottingham Health Profile questionnaire.

Comparison of early dobutamine stress echocardiography and exercise electrocardiographic testing for management of patients presenting to the emergency department with chest pain.

This study compared the cost-effectiveness of dobutamine-atropine stress echocardiography (DASE) and electrocardiographic exercise testing (EET) implemented in emergency department accelerated diagnostic protocols for the early stratification of low-risk patients presenting with acute chest pain (ACP). One hundred ninety-nine patients with ACP, nondiagnostic electrocardiographic results, and negative biomarker results were randomized to DASE (n = 110) or EET (n = 89) <6 hours after emergency department presentation. Patients with negative risk assessment results were immediately discharged and followed for 2 months.

Diabetes and associated cardiovascular risk factors in Iran: the Isfahan Healthy Heart Programme.

Introduction: Diabetes mellitus (DM) is one of the major health problems worldwide. The aim of this study was to detect the prevalence of DM and its associated risk factors in Iran.

Materials And Methods: This cross-sectional study was performed in 3 cities in the central part of Iran on participants over the age of 19 years.

Effect of some volatile oils on the affinity of intact and oxidized low-density lipoproteins for adrenal cell surface receptors.

Extensive research has shown that a high plasma concentration and oxidation of low-density lipoproteins (LDL) has an important role in atherogenesis. The affinity of LDL to its classic receptor is reduced due to oxidation. Instead, it is taken up by scavenger molecules in macrophages, as a result of which foam cells are formed that have a major role in increasing the subendothelial fat layers of the blood vessels.

Dietary fat intake and lipid profiles of Iranian adolescents: Isfahan Healthy Heart Program--Heart Health Promotion from Childhood.

Objectives: To assess the serum lipid profiles of Iranian adolescents and their correlation with dietary fat intake and to evaluate the knowledge, attitude, and practice (KAP) of students, parents, and school staff.

Methods: The subjects of this cross-sectional study were 2000 students (1000 girls and 1000 boys), ages 11-18 years, selected by multistage random sampling, and one of their parents (2000 subjects), as well as 500 school staff in urban and rural areas of two provinces in Iran (one for further interventions and the other for reference). The data were obtained by questionnaires, anthropometric measurements, 3-day food record form, and a 20-item food frequency questionnaire (FFQ).

Fat-modified diets during pregnancy and lactation and serum lipids after birth.

Objective: This study investigated the influence of modifying the maternal dietary fat on the serum lipids of infants at birth and at one year of age.

Methods: This single-blind randomized clinical trial was done on 180 4-month-pregnant women. All subjects proved to have a fat-unmodified diet through a 4-day food record dietary questionnaire.

The inhibitory effects of pure flavonoids on in vitro protein glycosylation.

Non-enzymatic glycosylation of proteins is the major cause of diabetic complications, such as cardiovascular disorders, retinopathy, nephropathy and neuropathy. It seems that protein glycosylation can be inhibited effectively by antioxidants. Several flavonoids, such as rutin, kaempferol, quercetin, apigenin, naringin, morin and biochanin A were selected to determine their antioxidant effects on in vitro insulin, hemoglobin and albumin glycosylation.

Antioxidant activity of three extracts of Morus nigra.

The antioxidant effect of three different extracts of Morus nigra fruit (fruit juice, hydroalcoholic and polyphenolic) on haemoglobin glycosylation, peroxidative damage to human erythrocytes, liver hepatooytes of rats and human low-density lipoprotein (LDL) were studied. The results show that all three extracts inhibited haemoglobin glycosylation induced by glucose to differing degrees. The haemolysis of human erythrocytes induced by hydrogen peroxide was also inhibited.

Tobacco use among Iranian men, women and adolescents.

The aim of this study was to evaluate the self-reported and serum cotinine based prevalence rates of smoking among Iranian men, women and adolescents. The study was carried out on 2626 men and women aged 19 years and above and 836 high school students aged 14-18 years, randomly selected from different clusters and schools in Isfahan. The WHO smoking standard questionnaire was completed for all samples and serum cotinine level was measured using high-performance liquid chromatography in 10% and 20% of the original adult and adolescent samples, respectively.

Isfahan Healthy Heart Programme: a comprehensive integrated community-based programme for cardiovascular disease prevention and control. Design, methods and initial experience.

The Isfahan Healthy Heart Programme (IHHP) is a five to six year comprehensive integrated community-based programme for cardiovascular diseases (CVD) prevention and control via reducing CVD risk factors and improvement of cardiovascular healthy behaviour in a target population. IHHP started late in 1999 and will be finished in 2005-2006. A primary survey was done to collect baseline data from interventional (Isfahan and Najaf-Abad) and reference (Arak) communities.

Obesity and associated modifiable environmental factors in Iranian adolescents: Isfahan Healthy Heart Program - Heart Health Promotion from Childhood.

Objective: To evaluate the prevalence of overweight and obesity among Iranian adolescents and their relationship with modifiable environmental factors.

Methods: The subjects of the present study were 1000 girls and 1000 boys, aged between 11 and 18 years selected by multistage random sampling, their parents (n = 2000) and their school staff (n = 500 subjects) in urban and rural areas of two provinces in Iran. Data concerning body mass index (BMI), nutrition and the physical activity of the subjects were analyzed by SPSSV10/Win software.

Anti-oxidant effect of flavonoids on the susceptibility of LDL oxidation.

In vitro studies have demonstrated increased atherogenicity of oxidized low-density lipoprotein (ox-LDL) compared to native LDL. Oxidative modification of LDL alters its structure allowing LDL to be taken up by scavenger receptors on macrophage, endothelial, and smooth muscle cells, leading to the formation of lipid-laden foam cells, the hallmark of early atherosclerotic lesions. The susceptibility of LDL to in vitro oxidation was assessed essentially by the technique described by Esterbauer et al.

Vitamin E can reduce blood pressure in mild hypertensives.

This triple-blind placebo-controlled clinical trial was performed to determine the effects of the anti-oxidant vitamin E on blood pressure and heart rate in patients with mild hypertension. A total of 70 new mild hypertensive subjects (systolic blood pressure, SBP: 140-160 mmHg; diastolic blood pressure, DBP: 90-100 mmHg) without secondary hypertension were selected from among people referred to the Hypertension Unit of Isfahan Cardiovascular Research Center and divided randomly into two groups of drug (DG) and placebo (PG). All subjects were aged from 20 to 60 years old, without any other cardiovascular risk factors.

Atherosclerosis risk factors in children and adolescents with or without family history of premature coronary artery disease.

Background: Although coronary artery disease (CAD) becomes symptomatic much later in life, the early identification and modification of risk factors may reduce its later incidence.

Material/methods: 100 subjects 2-18 years old, evenly divided by sex, were randomly selected from among children of patients suffering from premature myocardial infarction (<55 years); the controls were 100 age- and sex-matched subjects without a similar family history. In the Pediatric Preventive Cardiology Clinic at the Isfahan Cardiovascular Research Center, the subjects completed a special questionnaire consisting of anthropometric data, blood pressure, skinfold thickness, rate of physical activity, and active or passive cigarette smoking.