Temporal Trends of the Incidence of lschemic Heart Disease in Iran Over 15 Years: A Comprehensive Report from a Multi-Centric Hospital-Based Registry

Abstract

Background: We sought to explore the temporal trend of ischemic heart disease (IHD) incidence rate (IR) in a large city of Iran. Methods: The study population comprised hospitalized patients who were living in Isfahan, Iran, with first or recurrent IHD during the period of 2001 to 2016. To identify patients, clinical diagnostic codes were applied according to the International Classification of Diseases 10 (ICD-10: 120.0,121-125) and the "World Health Organization Monitoring Trends and Determinants in Cardiovascular Disease" diagnostic categories (WHO-MONICA). Using a direct method, we calculated age-, sex-, and place-of-residence-adjusted incidence rates based on multiple reference populations. To examine the long-term trend for the IR, a bootstrap robust zero-truncated negative binomial regression model was used. Results: A total of 102,254 hospitalized patients, with a mean (SD) age of 61.85 (12.79), were registered between 2001 and 2016. After an initial reduction from 2006 to 2010, crude and adjusted IRs of IHD increased between 2010 and 2016. We further observed a significant increasing long-term temporal trend in the IR with an average annual change of 1.42 to 3.36 over the study period. Conclusion: Our findings showed a decreasing trend in the IR of IHD between 2006 and 2010, possibly attributed to the comprehensive community-based interventions named "Isfahan Healthy Heart Program" performed from 2001 to 2007, followed by an increase in the adjusted IR of IHD between 2010 and 2016 in Isfahan; this indicates the importance of continuing the preventive measures to preclude the risk factors of cardiovascular diseases in our population.