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

Objective - Cardiovascular diseases, especially coronary artery disease (CA D), 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 Ros e 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 3 5-79 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 w omen compared to men (p < 0.05), also a greater prevalence of EGG-based pos sible ischaemia was observed among woman than men (12.3% vs. 7.5%) (P < 0.0 5). However, definite and possible MI and definite ischaemia based on ECG a bnormalities were higher among men than women (p < 0.05). The total prevale nce of symptomatic CAD was 9.3% and about 22% of those with symptoms of CAD on Q have some evidence on EGG. 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 promotio n and lifestyle changes and further stud ies to assess the used epidemiolog ical methods for estimating CAD prevalence, especially among women.