Heidari-Foroozan Mahsa, Farshbafnadi Melina, Golestani Ali, Younesian Sepehr, Jafary Hosein, Rashidi Mohammad-Mahdi, Tabatabaei-Malazy Ozra, Rezaei Nazila, Kheirabady Mostafa Moghimi, Ghotbi Arash Bagherian, Ghamari Seyyed-Hadi
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Science Institute, Tehran University of Medical Sciences, Tehran, Iran.
Student research center committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Glob Heart. 2025 May 16;20(1):43. doi: 10.5334/gh.1429. eCollection 2025.
In 2021, cardiovascular diseases (CVD) caused around 20.5 million deaths worldwide, making them a major health concern.
Incidence, prevalence, death, years of life lost (YLL), years lived with disability (YLD), and disability-adjusted life years (DALYs) were the burden measures that were assessed. All measures are reported as both all-age numbers and age-standardized rates (ASR) with 95% uncertainty intervals (UI). Decomposition analysis was conducted on CVD incidence.
From 1990 to 2021, all-age CVD prevalence in Iran increased by 182.6% (2.9 to 8.3 million cases), with males consistently showing higher age-standardized prevalence rates (ASPR) than females (11,350 vs. 9,431 per 100,000 in 2021). ASPR remained stable nationally (9,956 to 10,386 per 100,000), peaking in adults ≥80 years. Incident cases rose by 159.6% (0.36 to 0.92 million), driven by population growth (49.5%) and aging (136.2%), while age-standardized incidence rates (ASIR) declined by 28.3% (1,337 to 1,197 per 100,000); with males (1,336) exhibiting higher rates than females (1,060) in 2021. All age deaths doubled (86,527 to 169,582) during this period, but age-standardized death rates (ASDR) decreased substantially by 42.97% (446 to 255 per 100,000). DALYs increased by 53.7% (2.4 to 3.7 million), though age-standardized DALY rates dropped 45.3% (9,096 to 4,977 per 100,000), dominated by ischemic heart disease (2,731 ASR) and stroke (1,229 ASR). High systolic blood pressure, dietary risks, and LDL cholesterol remained the leading contributors to DALYs nationwide.
Iran's rising CVD burden demands prioritizing cardiac care infrastructure in underserved provinces like Golestan, enforcing sodium reduction policies aligned with Iran's existing trans-fat regulations, and integrating sex-specific programs such as tobacco control for males and community hypertension screening for women are critical. Multisectoral collaboration, including urban design promoting physical activity and subsidies for whole grains, must address provincial inequities exacerbated by Iran's aging population and dietary risks.
2021年，心血管疾病（CVD）在全球导致约2050万人死亡，使其成为一个主要的健康问题。
评估的负担指标包括发病率、患病率、死亡率、寿命损失年数（YLL）、带病生存年数（YLD）和伤残调整生命年（DALY）。所有指标均以全年龄人数和年龄标准化率（ASR）报告，并带有95%的不确定性区间（UI）。对心血管疾病发病率进行了分解分析。
从1990年到2021年，伊朗全年龄心血管疾病患病率增加了182.6%（从290万例增至830万例），男性的年龄标准化患病率（ASPR）一直高于女性（2021年分别为每10万人11350例和9431例）。全国的ASPR保持稳定（每10万人从9956例至10386例），在80岁及以上成年人中达到峰值。发病病例增加了159.6%（从36万例增至92万例），主要由人口增长（49.5%）和老龄化（136.2%）驱动，而年龄标准化发病率（ASIR）下降了28.3%（从每10万人1337例降至1197例）；2021年男性（1336例）的发病率高于女性（1060例）。在此期间，全年龄死亡人数翻了一番（从86527例增至169582例），但年龄标准化死亡率（ASDR）大幅下降了42.97%（从每10万人446例降至255例）。DALY增加了53.7%（从240万增至370万），尽管年龄标准化DALY率下降了45.3%（从每10万人9096例降至4977例），主要由缺血性心脏病（ASR为2731）和中风（ASR为1229）所致。高收缩压、饮食风险和低密度脂蛋白胆固醇仍然是全国DALY的主要促成因素。
伊朗心血管疾病负担的上升要求优先在像戈勒斯坦这样服务不足的省份建立心脏护理基础设施，执行与伊朗现有反式脂肪法规相一致的减钠政策，并且整合针对性别的项目，如针对男性的烟草控制和针对女性的社区高血压筛查，这至关重要。多部门合作，包括促进身体活动的城市设计和对全谷物的补贴，必须解决因伊朗人口老龄化和饮食风险而加剧的省份间不平等问题。
