{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T15:13:20Z","timestamp":1792509200953,"version":"4.5.0"},"reference-count":39,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T00:00:00Z","timestamp":1738540800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T00:00:00Z","timestamp":1738540800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Public Health"],"DOI":"10.1186\/s12889-024-21168-3","type":"journal-article","created":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T16:14:05Z","timestamp":1738599245000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Evaluation of the effectiveness of the Iran-package of essential non-communicable disease (IraPEN) program in reducing cardiovascular disease risk in pilot areas"],"prefix":"10.1186","volume":"25","author":[{"given":"Somayeh","family":"Derakhshan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davood","family":"Khalili","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alireza","family":"Mahdavi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seyed-Saeed","family":"Hashemi-Nazari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"Kavousi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatemeh","family":"Hadavandsiri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afshin","family":"Ostovar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koorosh","family":"Etemad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,2,3]]},"reference":[{"key":"21168_CR1","unstructured":"cardiovascular-diseases, [https:\/\/www.who.int\/health-topics\/cardiovascular-diseases#tab=tab_1.]"},{"key":"21168_CR2","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1007\/s00038-017-1012-3","volume":"63","author":"Burden of cardiovascular diseases in the Eastern Mediterranean Region","year":"2018","unstructured":"Burden of cardiovascular diseases in the Eastern Mediterranean Region. 1990\u20132015: findings from the global burden of Disease 2015 study. Int J Public Health. 2018;63:137\u201349.","journal-title":"Int J Public Health"},{"issue":"11","key":"21168_CR3","doi-asserted-by":"publisher","first-page":"866","DOI":"10.1016\/S2213-8587(19)30179-2","volume":"7","author":"F Azizi","year":"2019","unstructured":"Azizi F, Hadaegh F, Hosseinpanah F, Mirmiran P, Amouzegar A, Abdi H, Asghari G, Parizadeh D, Montazeri SA, Lotfaliany M. Metabolic health in the Middle East and North Africa. Lancet Diabetes Endocrinol. 2019;7(11):866\u201379.","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"7","key":"21168_CR4","doi-asserted-by":"publisher","first-page":"1646","DOI":"10.1253\/circj.CJ-13-0702","volume":"77","author":"T Ohira","year":"2013","unstructured":"Ohira T, Iso H. Cardiovascular disease epidemiology in Asia\u2013an overview\u2013. Circ J. 2013;77(7):1646\u201352.","journal-title":"Circ J"},{"issue":"6","key":"21168_CR5","doi-asserted-by":"publisher","first-page":"642","DOI":"10.1093\/eurheartj\/ehq030","volume":"31","author":"BJ Gersh","year":"2010","unstructured":"Gersh BJ, Sliwa K, Mayosi BM, Yusuf S. Novel therapeutic concepts the epidemic of cardiovascular disease in the developing world: global implications. Eur Heart J. 2010;31(6):642\u20138.","journal-title":"Eur Heart J"},{"issue":"4","key":"21168_CR6","first-page":"506","volume":"46","author":"M Sadeghi","year":"2017","unstructured":"Sadeghi M, Haghdoost AA, Bahrampour A, Dehghani M. 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"},{"issue":"10440","key":"21168_CR7","doi-asserted-by":"publisher","first-page":"2133","DOI":"10.1016\/S0140-6736(24)00757-8","volume":"403","author":"AJ Ferrari","year":"2024","unstructured":"Ferrari AJ, Santomauro DF, Aali A, Abate YH, Abbafati C, Abbastabar H, Abd ElHafeez S, Abdelmasseh M, Abd-Elsalam S, Abdollahi A. Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990\u20132021: a systematic analysis for the global burden of Disease Study 2021. Lancet. 2024;403(10440):2133\u201361.","journal-title":"Lancet"},{"key":"21168_CR8","unstructured":"noncommunicable-diseases, [https:\/\/www.who.int\/news-room\/feature-stories\/detail\/islamic-republic-of-iran-on-a-fast-track-to-beating-noncommunicable-diseases.]"},{"key":"21168_CR9","unstructured":"Derakhshan S, Khalili D, Etemad K, HASHEMI NS, Kavousi A, Hadavand F, Mahdavi A, Ostovar A. Prevalence of Cardiovascular Risk factors in Men and Women Referred to Health Centers in the Four cities of the Ira-Pen. Pilot Program; 2021. pp. 2016\u20137."},{"key":"21168_CR10","doi-asserted-by":"crossref","unstructured":"Hadavandsiri F, Khalili D, Mahdavi A, Afkar M, Ostovar A, Hashemi-Nazari S-S, Derakhshan S. Timely referral to health centers for the prevention of cardiovascular diseases: IraPEN national program. Front Public Health 2023, 11.","DOI":"10.3389\/fpubh.2023.1098312"},{"issue":"10","key":"21168_CR11","doi-asserted-by":"publisher","first-page":"e1332","DOI":"10.1016\/S2214-109X(19)30318-3","volume":"7","author":"S Kaptoge","year":"2019","unstructured":"Kaptoge S, Pennells L, De Bacquer D, Cooney MT, Kavousi M, Stevens G, Riley LM, Savin S, Khan T, Altay S. World Health Organization cardiovascular disease risk charts: revised models to estimate risk in 21 global regions. Lancet Global Health. 2019;7(10):e1332\u201345.","journal-title":"Lancet Global Health"},{"key":"21168_CR12","doi-asserted-by":"crossref","unstructured":"Motamed N, Mardanshahi A, Saravi BM, Siamian H, Maadi M, Zamani F. The 10-year absolute risk of cardiovascular (CV) events in Northern Iran: a population based study. Materia socio-medica 2015, 27(3):158.","DOI":"10.5455\/msm.2015.27.158-162"},{"issue":"1","key":"21168_CR13","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1016\/j.ijcard.2014.07.066","volume":"176","author":"S Selvarajah","year":"2014","unstructured":"Selvarajah S, Kaur G, Haniff J, Cheong KC, Hiong TG, van der Graaf Y, Bots ML. Comparison of the Framingham risk score, SCORE and WHO\/ISH cardiovascular risk prediction models in an Asian population. Int J Cardiol. 2014;176(1):211\u20138.","journal-title":"Int J Cardiol"},{"issue":"3","key":"21168_CR14","first-page":"105","volume":"15","author":"PS Bavarsad","year":"2020","unstructured":"Bavarsad PS, Kheiri S, Ahmadi A. Estimation of the 10-year risk of cardiovascular diseases: using the SCORE, WHO\/ISH, and Framingham models in the Shahrekord cohort study in southwestern Iran. J Tehran Univ Heart Cent. 2020;15(3):105.","journal-title":"J Tehran Univ Heart Cent"},{"key":"21168_CR15","doi-asserted-by":"crossref","unstructured":"Fahimfar N, Kohansal K, Asgari S, Ostovar A, Hadaegh F, Khalili D. The trend of risk for cardiovascular diseases during the past decade in Iran, applying no-lab and lab-based prediction models. Global Heart 2023, 18(1).","DOI":"10.5334\/gh.1180"},{"issue":"4","key":"21168_CR16","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1159\/000503992","volume":"2","author":"R AlHelo","year":"2020","unstructured":"AlHelo R, Elessi K. Implementation of world health organization package of essential noncommunicable disease interventions for cardiovascular risk management in gaza\/palestine: a retrospective record review study. Dubai Med J. 2020;2(4):153\u20137.","journal-title":"Dubai Med J"},{"issue":"2","key":"21168_CR17","doi-asserted-by":"publisher","first-page":"69","DOI":"10.4103\/2224-3151.213794","volume":"6","author":"CS Hyon","year":"2017","unstructured":"Hyon CS, Nam KY, Sun HC, Garg R, Shrestha SM, Ok KU, Kumar R. Package of essential noncommunicable disease (Pen) interventions in primary health-care settings in the democratic people\u2019s Republic of Korea: a feasibility study. WHO South-East Asia J Public Health. 2017;6(2):69.","journal-title":"WHO South-East Asia J Public Health"},{"issue":"2","key":"21168_CR18","doi-asserted-by":"publisher","first-page":"154","DOI":"10.4103\/2224-3151.206731","volume":"3","author":"D Wangchuk","year":"2014","unstructured":"Wangchuk D, Virdi NK, Garg R, Mendis S, Nair N, Wangchuk D, Kumar R. Package of essential noncommunicable disease (PEN) interventions in primary health-care settings of Bhutan: a performance assessment study. WHO South-East Asia J Public Health. 2014;3(2):154\u201360.","journal-title":"WHO South-East Asia J Public Health"},{"issue":"4","key":"21168_CR19","doi-asserted-by":"publisher","first-page":"e0124817","DOI":"10.1371\/journal.pone.0124817","volume":"10","author":"C Karam","year":"2015","unstructured":"Karam C, Beauchet A, Czernichow S, de Roquefeuil F, Bourez A, Mansencal N, Dubourg O. Trends in cardiovascular disease risk factor prevalence and estimated 10-year cardiovascular risk scores in a large untreated French urban population: the CARVAR 92 study. PLoS ONE. 2015;10(4):e0124817.","journal-title":"PLoS ONE"},{"issue":"2","key":"21168_CR20","doi-asserted-by":"publisher","first-page":"e0229081","DOI":"10.1371\/journal.pone.0229081","volume":"15","author":"LL Aye","year":"2020","unstructured":"Aye LL, Tripathy JP, Maung Maung T, Oo MM, Nwe ML, Thu HMM, Ko K, Kaung KK. Experiences from the pilot implementation of the Package of essential non-communicable disease interventions (PEN) in Myanmar, 2017-18: a mixed methods study. PLoS ONE. 2020;15(2):e0229081.","journal-title":"PLoS ONE"},{"issue":"3\u20134","key":"21168_CR21","first-page":"140","volume":"5","author":"M Moosazadeh","year":"2013","unstructured":"Moosazadeh M, Ziaaddini H, Mirzazadeh A, Ashrafi-Asgarabad A, Haghdoost AA. Meta-analysis of smoking prevalence in Iran. Addict Health. 2013;5(3\u20134):140.","journal-title":"Addict Health"},{"key":"21168_CR22","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1007\/s40520-018-0932-y","volume":"31","author":"JK Kim","year":"2019","unstructured":"Kim JK, Ailshire JA, Crimmins EM. Twenty-year trends in cardiovascular risk among men and women in the United States. Aging Clin Exp Res. 2019;31:135\u201343.","journal-title":"Aging Clin Exp Res"},{"issue":"1","key":"21168_CR23","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41598-020-68640-9","volume":"10","author":"H Malekzadeh","year":"2020","unstructured":"Malekzadeh H, Lotfaliany M, Ostovar A, Hadaegh F, Azizi F, Yoosefi M, Farzadfar F, Khalili D. 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):1\u201310.","journal-title":"Sci Rep"},{"issue":"9","key":"21168_CR24","doi-asserted-by":"publisher","first-page":"e0239164","DOI":"10.1371\/journal.pone.0239164","volume":"15","author":"F Hosseinpanah","year":"2020","unstructured":"Hosseinpanah F, Tasdighi E, Barzin M, Mahdavi M, Ghanbarian A, Valizadeh M, Azizi F. The association between transition from metabolically healthy obesity to metabolic syndrome, and incidence of cardiovascular disease: Tehran lipid and glucose study. PLoS ONE. 2020;15(9):e0239164.","journal-title":"PLoS ONE"},{"key":"21168_CR25","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1016\/j.atherosclerosis.2017.02.002","volume":"258","author":"B Mirzaei","year":"2017","unstructured":"Mirzaei B, Abdi H, Serahati S, Barzin M, Niroomand M, Azizi F, Hosseinpanah F. Cardiovascular risk in different obesity phenotypes over a decade follow-up: Tehran lipid and glucose study. Atherosclerosis. 2017;258:65\u201371.","journal-title":"Atherosclerosis"},{"issue":"3","key":"21168_CR26","doi-asserted-by":"publisher","first-page":"412","DOI":"10.1016\/j.amjcard.2010.09.034","volume":"107","author":"F Hosseinpanah","year":"2011","unstructured":"Hosseinpanah F, Barzin M, Sheikholeslami F, Azizi F. Effect of different obesity phenotypes on cardiovascular events in Tehran lipid and glucose study (TLGS). Am J Cardiol. 2011;107(3):412\u20136.","journal-title":"Am J Cardiol"},{"key":"21168_CR27","doi-asserted-by":"crossref","unstructured":"Azizi F, Gouya M, Vazirian P, Dolatshahi P, Habibian S. The diabetes prevention and control programme of the Islamic Republic of Iran. EMHJ-Eastern Mediterranean Health Journal, 9 (5\u20136), 1114\u20131121, 2003 2003.","DOI":"10.26719\/2003.9.5-6.1114"},{"key":"21168_CR28","doi-asserted-by":"crossref","unstructured":"Amerzadeh M, Salavati S, Takian A, Namaki S, Asadi-Lari M, Delpisheh A, Farzadfar F, Ghanei M, Haghdoost AA, Haji-Aghajani M. Proactive agenda setting in creation and approval of national action plan for prevention and control of non-communicable diseases in Iran: the use of multiple streams model. J Diabetes Metabolic Disorders 2020:1\u201312.","DOI":"10.1007\/s40200-020-00591-4"},{"key":"21168_CR29","unstructured":"Package of Essential Non-Communicable (PEN). Disease Interventions for Primary Health Care in Iran (IraPEN): IranTehran: Mojassameh 2017, [http:\/\/baharestan.iums.ac.ir\/files\/baharestan\/files\/FixMohtava-Behvarz.pdf.]."},{"issue":"9810","key":"21168_CR30","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1016\/S0140-6736(11)61349-4","volume":"379","author":"F Farzadfar","year":"2012","unstructured":"Farzadfar F, Murray CJ, Gakidou E, Bossert T, Namdaritabar H, Alikhani S, Moradi G, Delavari A, Jamshidi H, Ezzati M. Effectiveness of diabetes and hypertension management by rural primary health-care workers (Behvarz workers) in Iran: a nationally representative observational study. Lancet. 2012;379(9810):47\u201354.","journal-title":"Lancet"},{"issue":"1","key":"21168_CR31","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1503\/cmaj.130550","volume":"186","author":"RD Reid","year":"2014","unstructured":"Reid RD, McDonnell LA, Riley DL, Mark AE, Mosca L, Beaton L, Papadakis S, Blanchard CM, Mochari-Greenberger H, O\u2019Farrell P. Effect of an intervention to improve the cardiovascular health of family members of patients with coronary artery disease: a randomized trial. CMAJ. 2014;186(1):23\u201330.","journal-title":"CMAJ"},{"issue":"6","key":"21168_CR32","doi-asserted-by":"publisher","first-page":"484","DOI":"10.1016\/j.ehj.2003.11.012","volume":"25","author":"J Emberson","year":"2004","unstructured":"Emberson J, Whincup P, Morris R, Walker M, Ebrahim S. Evaluating the impact of population and high-risk strategies for the primary prevention of cardiovascular disease. Eur Heart J. 2004;25(6):484\u201391.","journal-title":"Eur Heart J"},{"issue":"1","key":"21168_CR33","doi-asserted-by":"publisher","first-page":"e52963","DOI":"10.1371\/journal.pone.0052963","volume":"8","author":"DG Manuel","year":"2013","unstructured":"Manuel DG, Rosella LC, Tuna M, Bennett C, Stukel TA. Effectiveness of community-wide and individual high-risk strategies to prevent diabetes: a modelling study. PLoS ONE. 2013;8(1):e52963.","journal-title":"PLoS ONE"},{"key":"21168_CR34","doi-asserted-by":"publisher","first-page":"1075277","DOI":"10.3389\/fpubh.2023.1075277","volume":"11","author":"A Jamshidi","year":"2023","unstructured":"Jamshidi A, Daroudi R, Aas E, Khalili D. A cost-effectiveness analysis of risk-based intervention for prevention of cardiovascular diseases in IraPEN program: a modeling study. Front Public Health. 2023;11:1075277.","journal-title":"Front Public Health"},{"issue":"3","key":"21168_CR35","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1016\/S2213-8587(17)30015-3","volume":"5","author":"P Ueda","year":"2017","unstructured":"Ueda P, Woodward M, Lu Y, Hajifathalian K, Al-Wotayan R, Aguilar-Salinas CA, Ahmadvand A, Azizi F, Bentham J, Cifkova R. Laboratory-based and office-based risk scores and charts to predict 10-year risk of cardiovascular disease in 182 countries: a pooled analysis of prospective cohorts and health surveys. Lancet Diabetes Endocrinol. 2017;5(3):196\u2013213.","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"3","key":"21168_CR36","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1093\/aje\/kws204","volume":"176","author":"D Khalili","year":"2012","unstructured":"Khalili D, Hadaegh F, Soori H, Steyerberg EW, Bozorgmanesh M, Azizi F. Clinical usefulness of the Framingham cardiovascular risk profile beyond its statistical performance: the Tehran lipid and glucose study. Am J Epidemiol. 2012;176(3):177\u201386.","journal-title":"Am J Epidemiol"},{"key":"21168_CR37","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1016\/j.ijcard.2015.03.067","volume":"184","author":"D Khalili","year":"2015","unstructured":"Khalili D, Asgari S, Hadaegh F, Steyerberg EW, Rahimi K, Fahimfar N, Azizi F. A new approach to test validity and clinical usefulness of the 2013 ACC\/AHA guideline on statin therapy: a population-based study. Int J Cardiol. 2015;184:587\u201394.","journal-title":"Int J Cardiol"},{"issue":"2","key":"21168_CR38","first-page":"210","volume":"11","author":"N Fahimfar","year":"2020","unstructured":"Fahimfar N, Fotouhi A, Mansournia MA, Malekzadeh R, Sarrafzadegan N, Azizi F, Mansourian M, Sepanlou SG, Emamian MH, Hadaegh F. 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 Manage. 2020;11(2):210.","journal-title":"Int J Health Policy Manage"},{"key":"21168_CR39","doi-asserted-by":"crossref","unstructured":"Khalili D, Azizi F, Asgari S, Zadeh-Vakili A, Momenan AA, Ghanbarian A, Eskandari F, Sheikholeslami F, Hadaegh F. Outcomes of a longitudinal population-based cohort study and pragmatic community trial: findings from 20 years of the Tehran lipid and glucose study. Int J Endocrinol Metabolism 2018, 16(4 Suppl).","DOI":"10.5812\/ijem.84748"}],"container-title":["BMC Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12889-024-21168-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12889-024-21168-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12889-024-21168-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T04:03:27Z","timestamp":1738641807000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpublichealth.biomedcentral.com\/articles\/10.1186\/s12889-024-21168-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,3]]},"references-count":39,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["21168"],"URL":"https:\/\/doi.org\/10.1186\/s12889-024-21168-3","relation":{},"ISSN":["1471-2458"],"issn-type":[{"value":"1471-2458","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,3]]},"assertion":[{"value":"28 January 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 December 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 February 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"IraPEN is a national program approved and delivered by the Ministry of Health and Medical Education that did not require informed consent from participants. We adhered to the ethical standards set by the Institutional Review Board of Shahid Beheshti University of Medical Sciences, which approved the study protocol under ethics committee code IR.SBMU.ENDOCRINE.REC.1401.003.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"KE, AO and AM have been among the supervisors of IraPEN program and all authors declare that they have no conflict of interest.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"429"}}