{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T06:46:57Z","timestamp":1787726817477,"version":"build-2784847793"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,10,4]],"date-time":"2021-10-04T00:00:00Z","timestamp":1633305600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,10,4]],"date-time":"2021-10-04T00:00:00Z","timestamp":1633305600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Cardiovasc Disord"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Coronary artery disease (CAD) is a universal public health challenge, more prominently so in the low- and middle-income countries. In this study, we aimed to determine prevalence and trends of CAD risk factors in patients with documented CAD and to determine their effects on the age of CAD diagnosis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Materials and methods<\/jats:title>\n                <jats:p>We conducted a registry-based, serial cross-sectional study using the coronary angiography data bank of the Tehran Heart Center. Adult patients who had obstructive (&gt;\u200950% stenosis) CAD were included in the study. The prevalence and 11-year trends of conventional CAD risk factors were analyzed by sex and age, and their adjusted effects on the age of CAD diagnosis were calculated.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>From January 2005 to December 2015, data for 90,094 patients were included in this analysis. A total of 61,684 (68.5%) were men and 28,410 (31.5%) were women. Men were younger at diagnosis than women, with a mean age of 60.1 in men and 63.2 in women (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and had fewer risk factors at the time of diagnosis. Mean age at diagnosis had an overall increasing trend during the study period. Increasing trend was seen in body-mass index, hypertension prevalence, diabetes mellitus. All lipid profile components (total cholesterol, low-density lipoprotein cholesterol, triglycerides, and high-density lipoprotein cholesterol) decreased over time. Of particular interest, opium consumption was associated with 2.2\u00a0year earlier age of CAD diagnosis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The major results of this study (lower age of CAD diagnosis in men, lower age of diagnosis associated with most risk factors, and lower prevalence of serum lipids over time) were expected. A prominent finding of this study is confirming opium use was associated with a much younger age of CAD onset, even after adjusting for all other risk factors. In addition to recommendations for control of the traditional risk factors, spreading information about the potential adverse effect of opium use, which has only recently been associated with higher risk of CAD, may be necessary.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12872-021-02293-y","type":"journal-article","created":{"date-parts":[[2021,10,4]],"date-time":"2021-10-04T17:38:09Z","timestamp":1633369089000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Prevalence and trends of coronary artery disease risk factors and their effect on age of diagnosis in patients with established coronary artery disease: Tehran Heart Center (2005\u20132015)"],"prefix":"10.1186","volume":"21","author":[{"given":"Kaveh","family":"Hosseini","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seyedeh Hamideh","family":"Mortazavi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saeed","family":"Sadeghian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aryan","family":"Ayati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahdi","family":"Nalini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arya","family":"Aminorroaya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamed","family":"Tavolinejad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mojtaba","family":"Salarifar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamidreza","family":"Pourhosseini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afsaneh","family":"Aein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arash","family":"Jalali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Bozorgi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehdi","family":"Mehrani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farin","family":"Kamangar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,10,4]]},"reference":[{"issue":"3","key":"2293_CR1","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1161\/01.HYP.25.3.305","volume":"25","author":"VL Burt","year":"1995","unstructured":"Burt VL, et al. Prevalence of hypertension in the US adult population: results from the Third National Health and Nutrition Examination Survey, 1988\u20131991. Hypertension. 1995;25(3):305\u201313.","journal-title":"Hypertension"},{"issue":"1","key":"2293_CR2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41598-018-23364-9","volume":"8","author":"S Asgari","year":"2018","unstructured":"Asgari S, et al. The burden of statin therapy based on ACC\/AHA and NCEP ATP-III guidelines: an Iranian survey of non-communicable diseases risk factors. Sci Rep. 2018;8(1):1\u20137.","journal-title":"Sci Rep"},{"key":"2293_CR3","doi-asserted-by":"crossref","unstructured":"Dai H, et al. Global, regional, and national burden of ischemic heart disease and its attributable risk factors, 1990\u20132017: results from the global Burden of Disease Study 2017. Eur Heart J Qual Care Clin Outcomes. 2020.","DOI":"10.1093\/ehjqcco\/qcaa076"},{"issue":"25","key":"2293_CR4","doi-asserted-by":"publisher","first-page":"2982","DOI":"10.1016\/j.jacc.2020.11.010","volume":"76","author":"GA Roth","year":"2020","unstructured":"Roth GA, et al. Global burden of cardiovascular diseases and risk factors, 1990\u20132019: update from the GBD 2019 study. J Am Coll Cardiol. 2020;76(25):2982\u20133021.","journal-title":"J Am Coll Cardiol"},{"key":"2293_CR5","doi-asserted-by":"crossref","unstructured":"Aminorroaya A, et al. Global, regional, and national quality of care of ischaemic heart disease from 1990 to 2017: a systematic analysis for the global burden of disease study 2017. Eur J Prevent Cardiol. 2021.","DOI":"10.1093\/eurjpc\/zwab066"},{"issue":"2","key":"2293_CR6","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1016\/j.pcad.2018.07.003","volume":"61","author":"A Elagizi","year":"2018","unstructured":"Elagizi A, et al. An overview and update on obesity and the obesity paradox in cardiovascular diseases. Prog Cardiovasc Dis. 2018;61(2):142\u201350.","journal-title":"Prog Cardiovasc Dis"},{"issue":"4","key":"2293_CR7","first-page":"506","volume":"46","author":"M Sadeghi","year":"2017","unstructured":"Sadeghi M, et al. Modeling the burden of cardiovascular diseases in Iran from 2005 to 2025: the impact of demographic changes. Iran J Public Health. 2017;46(4):506.","journal-title":"Iran J Public Health"},{"key":"2293_CR8","doi-asserted-by":"crossref","unstructured":"Aminorroaya A, et al. Burden of non-communicable diseases in Iran: past, present, and future. J Diabet Metabol Disord. 2020.","DOI":"10.1007\/s40200-020-00669-z"},{"key":"2293_CR9","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy369","volume-title":"The Tehran Heart Center","author":"H Poorhosseini","year":"2018","unstructured":"Poorhosseini H, Abbasi SH. The Tehran Heart Center. Oxford: Oxford University Press; 2018."},{"issue":"4","key":"2293_CR10","first-page":"204","volume":"22","author":"N Sarrafzadegan","year":"2019","unstructured":"Sarrafzadegan N, Mohammmadifard N. Cardiovascular disease in Iran in the last 40 years: prevalence, mortality, morbidity, challenges and strategies for cardiovascular prevention. Arch Iran Med. 2019;22(4):204\u201310.","journal-title":"Arch Iran Med"},{"issue":"1","key":"2293_CR11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1478-7954-9-55","volume":"9","author":"F Farzadfar","year":"2011","unstructured":"Farzadfar F, et al. National and subnational mortality effects of metabolic risk factors and smoking in Iran: a comparative risk assessment. Popul Health Metrics. 2011;9(1):1\u201311.","journal-title":"Popul Health Metrics"},{"issue":"10199","key":"2293_CR12","doi-asserted-by":"publisher","first-page":"672","DOI":"10.1016\/S0140-6736(19)31791-X","volume":"394","author":"G Roshandel","year":"2019","unstructured":"Roshandel G, et al. Effectiveness of polypill for primary and secondary prevention of cardiovascular diseases (PolyIran): a pragmatic, cluster-randomised trial. Lancet. 2019;394(10199):672\u201383.","journal-title":"Lancet"},{"issue":"1","key":"2293_CR13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41598-020-60142-y","volume":"10","author":"R Salehidoost","year":"2020","unstructured":"Salehidoost R, et al. Diabetes and all-cause mortality, a 18-year follow-up study. Sci Rep. 2020;10(1):1\u20138.","journal-title":"Sci Rep"},{"issue":"4","key":"2293_CR14","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1038\/jhh.2015.57","volume":"30","author":"S Sepanlou","year":"2016","unstructured":"Sepanlou S, et al. Hypertension and mortality in the golestan cohort study: a prospective study of 50 000 adults in Iran. J Hum Hypertens. 2016;30(4):260\u20137.","journal-title":"J Hum Hypertens"},{"key":"2293_CR15","doi-asserted-by":"crossref","unstructured":"Fahimfar N, et al. Prediction of cardiovascular disease mortality in a middle eastern country: performance of the Globorisk and score functions in four population-based cohort studies of Iran. Int J Health Policy Manag. 2020.","DOI":"10.34172\/ijhpm.2020.103"},{"issue":"23","key":"2293_CR16","doi-asserted-by":"publisher","first-page":"e674","DOI":"10.1161\/CIR.0000000000000395","volume":"133","author":"RL Sacco","year":"2016","unstructured":"Sacco RL, et al. The heart of 25 by 25: achieving the goal of reducing global and regional premature deaths from cardiovascular diseases and stroke: a modeling study from the American Heart Association and World Heart Federation. Circulation. 2016;133(23):e674\u201390.","journal-title":"Circulation"},{"key":"2293_CR17","doi-asserted-by":"crossref","unstructured":"Sepanlou SG, et al. Levels and trends of hypertension at national and subnational scale in Iran from 1990 to 2016: a systematic review and pooled analysis. Arch Iran Med. 2021; 24(4).","DOI":"10.34172\/aim.2021.43"},{"key":"2293_CR18","unstructured":"Haghdoust A, Sadeghirad B, Rezazadeh K.M. Epidemiology and heterogeneity of hypertension in Iran: a systematic review. 2008."},{"issue":"4","key":"2293_CR19","first-page":"373","volume":"5","author":"O Tabatabaei-Malazy","year":"2014","unstructured":"Tabatabaei-Malazy O, et al. Prevalence of dyslipidemia in Iran: a systematic review and meta-analysis study. Int J Prev Med. 2014;5(4):373.","journal-title":"Int J Prev Med"},{"key":"2293_CR20","volume-title":"IDF diabetes atlas ninth","author":"ID Federation","year":"2019","unstructured":"Federation ID. IDF diabetes atlas ninth. Dunia: IDF; 2019."},{"issue":"3\u20134","key":"2293_CR21","first-page":"140","volume":"5","author":"M Moosazadeh","year":"2013","unstructured":"Moosazadeh M, et al. Meta-analysis of smoking prevalence in Iran. Addict Health. 2013;5(3\u20134):140\u201353.","journal-title":"Addict Health"},{"key":"2293_CR22","doi-asserted-by":"crossref","unstructured":"Reitsma MB, et al. Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990\u20132019: a systematic analysis from the Global Burden of Disease Study 2019. Lancet. 2021.","DOI":"10.1016\/S2468-2667(21)00102-X"},{"key":"2293_CR23","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1007\/978-1-4615-0071-1_3","volume-title":"Global behavioral risk factor surveillance","author":"R Bonita","year":"2003","unstructured":"Bonita R, et al. The WHO stepwise approach to surveillance (STEPS) of non-communicable disease risk factors. In: Global behavioral risk factor surveillance. Springer; 2003. p. 9\u201322."},{"issue":"3","key":"2293_CR24","doi-asserted-by":"publisher","first-page":"591","DOI":"10.26719\/2009.15.3.591","volume":"15","author":"AA Haghdoost","year":"2009","unstructured":"Haghdoost AA, et al. Prevalence of type 2 diabetes in the Islamic Republic of Iran: systematic review and meta-analysis. East Mediterr Health J. 2009;15(3):591\u20139.","journal-title":"East Mediterr Health J"},{"issue":"2","key":"2293_CR25","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1016\/j.diabres.2013.12.034","volume":"103","author":"A Esteghamati","year":"2014","unstructured":"Esteghamati A, et al. Trends in the prevalence of diabetes and impaired fasting glucose in association with obesity in Iran: 2005\u20132011. Diabetes Res Clin Pract. 2014;103(2):319\u201327.","journal-title":"Diabetes Res Clin Pract"},{"key":"2293_CR26","doi-asserted-by":"crossref","unstructured":"Azadnajafabad S, et al. Non-communicable diseases\u2019 risk factors in Iran; a review of the present status and action plans. J Diabetes Metabol Disord. 2021.","DOI":"10.1007\/s40200-020-00709-8"},{"key":"2293_CR27","doi-asserted-by":"crossref","unstructured":"Fattahi N, et al. Geographical, gender and age inequalities in non-communicable diseases both at national and provincial levels in Iran. J Diabetes Metabol Disord. 2021.","DOI":"10.1007\/s40200-020-00713-y"},{"issue":"1","key":"2293_CR28","doi-asserted-by":"publisher","first-page":"1500","DOI":"10.1186\/s12889-019-7827-5","volume":"19","author":"S Opoku","year":"2019","unstructured":"Opoku S, et al. Prevalence and risk factors for dyslipidemia among adults in rural and urban China: findings from the China National Stroke Screening and prevention project (CNSSPP). BMC Public Health. 2019;19(1):1500.","journal-title":"BMC Public Health"},{"issue":"6","key":"2293_CR29","doi-asserted-by":"publisher","first-page":"918","DOI":"10.1016\/0002-9149(75)90129-0","volume":"35","author":"MC Fishbein","year":"1975","unstructured":"Fishbein MC, Obma R, Roberts WC. Unruptured sinus of Valsalva aneurysm. Am J Cardiol. 1975;35(6):918\u201322.","journal-title":"Am J Cardiol"},{"issue":"1","key":"2293_CR30","doi-asserted-by":"publisher","first-page":"11724","DOI":"10.1038\/s41598-020-68640-9","volume":"10","author":"H Malekzadeh","year":"2020","unstructured":"Malekzadeh H, et al. Trends in cardiovascular risk factors in diabetic patients in comparison to general population in Iran: findings from National Surveys 2007\u20132016. Sci Rep. 2020;10(1):11724.","journal-title":"Sci Rep"},{"key":"2293_CR31","unstructured":"National trends in total cholesterol obscure heterogeneous changes in HDL and non-HDL cholesterol and total-to-HDL cholesterol ratio: a pooled analysis of 458 population-based studies in Asian and Western countries. Int J Epidemiol. 2020;49(1):173\u2013192."},{"issue":"1","key":"2293_CR32","doi-asserted-by":"publisher","first-page":"4928","DOI":"10.1038\/s41598-018-23364-9","volume":"8","author":"S Asgari","year":"2018","unstructured":"Asgari S, et al. The burden of statin therapy based on ACC\/AHA and NCEP ATP-III guidelines: an Iranian survey of non-communicable diseases risk factors. Sci Rep. 2018;8(1):4928.","journal-title":"Sci Rep"},{"key":"2293_CR33","doi-asserted-by":"crossref","unstructured":"Hamid M, et al. Trends in cardiovascular risk factors in diabetic patients in comparison to general population in Iran: findings from National Surveys 2007\u20132016. Sci Rep.2020;10(1).","DOI":"10.1038\/s41598-020-68640-9"},{"issue":"7","key":"2293_CR34","first-page":"456","volume":"19","author":"A Esteghamati","year":"2016","unstructured":"Esteghamati A, et al. Awareness, treatment and control of pre-hypertension and hypertension among adults in Iran. Arch Iran Med. 2016;19(7):456\u201364.","journal-title":"Arch Iran Med"},{"key":"2293_CR35","doi-asserted-by":"publisher","first-page":"446","DOI":"10.1196\/annals.1316.055","volume":"1025","author":"K Kulsudjarit","year":"2004","unstructured":"Kulsudjarit K. Drug problem in southeast and southwest asia. Ann N Y Acad Sci. 2004;1025:446\u201357.","journal-title":"Ann N Y Acad Sci"},{"issue":"1","key":"2293_CR36","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1093\/eurjpc\/zwaa006","volume":"28","author":"M Nalini","year":"2021","unstructured":"Nalini M, et al. Long-term opiate use and risk of cardiovascular mortality: results from the Golestan Cohort Study. Eur J Prev Cardiol. 2021;28(1):98\u2013106.","journal-title":"Eur J Prev Cardiol"},{"issue":"6","key":"2293_CR37","doi-asserted-by":"publisher","first-page":"482","DOI":"10.1016\/j.ihj.2020.10.003","volume":"72","author":"P Roayaei","year":"2020","unstructured":"Roayaei P, et al. Opium and cardiovascular health: a devil or an angel? Indian Heart J. 2020;72(6):482\u201390.","journal-title":"Indian Heart J"}],"container-title":["BMC Cardiovascular Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12872-021-02293-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12872-021-02293-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12872-021-02293-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,5]],"date-time":"2021-10-05T00:42:37Z","timestamp":1633394557000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmccardiovascdisord.biomedcentral.com\/articles\/10.1186\/s12872-021-02293-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,4]]},"references-count":37,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["2293"],"URL":"https:\/\/doi.org\/10.1186\/s12872-021-02293-y","relation":{},"ISSN":["1471-2261"],"issn-type":[{"value":"1471-2261","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,4]]},"assertion":[{"value":"2 July 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 September 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 October 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Based on the local ethical regulations at THC, informed consent was obtained from all patients at the time of admission, for possible anonymous report of the medical data. In addition, the proposal of this project was approved by the Ethical Committee of Tehran University of Medical Sciences (Ethics code: THC.TUMS.1398.03.12).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"All authors have consent for publication of the article.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"All authors declare that there were no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"477"}}