Abstract
The prevalence of obesity has been increasing in Iran over the past decade. This study aimed to determine the population-attributable fraction (PAF) of hypertension associated with obesity, abdominal obesity, and the joint effect of both in the central provinces of Iran. Prevalence of hypertension was extracted from the Iranian Ministry of Health Non-Communicable Disease Risk Factor InfoBase 2009. Measure of association between obesity and hypertension was extracted from Tehran Lipid and Glucose Study, for males and females, in order to calculate the PAF of hypertension associated with obesity. Age standardization of the reported prevalence of obesity was done using the World Health Organization method. The PAF of hypertension associated with the joint effect of obesity and abdominal obesity in females was highest in Semnan Province: 22.7 [95% confidence interval (CI): 4.2–35.6], followed by Qom 21.09 (95% CI: 3.7–33.1), and Yazd 20.3 (95% CI: 3.5–32.1). In males, the highest PAF was observed in Qom Province 31.07 (95% CI: 16.7–41.1), followed by Semnan 29.6 (95% CI: 15.9–39.3), Qazvin 25.9 (95% CI: 13.7–34.5), Tehran 24.2 (95% CI: 12.7–32.3), and Isfahan 20.4 (95% CI: 3.5–27.4). Prevalence of hypertension is higher in more developed provinces. PAFs suggest that a sizable share of hypertension in these provinces is associated with obesity. It is recommended that health promotion programs focus on obesity in the provinces with a higher share of hypertension due to obesity.
Article PDF
Avoid common mistakes on your manuscript.
References
Hojjatzade E, Samavat T. Guidelines blood pressure measurement. Tehran: Ministry of Health and Medical Education, Department of Health, Department of Non-Communicable Diseases; 2012.
Steyn K, Jooste PL, Bourne L, Fourie J, Badenhorst CJ, Bourne DE. Risk factors for coronary heart disease in the black population of the Cape Peninsula. The BRISK study. S Afr Med J 1991;79:480–5.
Damirchi A, Mehrabani J. Prevalence of obesity, overweight and hypertension and related-risk factors in adults men. OLYMPIC 2009;17:56–61.
GHotbi M, Rafati M, Ahmadnia H. Principles of disease prevention and care. Tehran: Sepid Barge BaqeKetab; 2007 [in Persian].
Nizami F, Farooqui MS, Munir SM, Rizvi TJ. Effect of fiber bread on the management of diabetes mellitus. J Coll Phys Surg Pak 2004;14:673–6 [in Persian].
Eckel RH, Krauss RM. American Heart Association call to action: obesity as a major risk factor for coronary heart disease. AHA Nutr Committee. Circulation 1998;21:2099–100.
Mishra V, Arnold F, Semenov G, Hong R, Mukuria A. Epidemiology of obesity and hypertension and related risk factors in Uzbekistan. Eur J Clin Nutr 2006;60:1355–66.
Azizi F, Janghorbani M, Hatami H. Epidemiology and control of common disease in Iran. 4th ed. Khosravi: Publications in Association with the Institute of Endocrinology and Metabolism; 2011 [in Persian].
World Health Organization (WHO). Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep 2000;894:1–253.
Kelly T, Yang W, Chen CS, Reynolds K, He J. Global burden of obesity in 2005 and projections to 2030. Int J Obes (Lond) 2008;32:1431–7.
James PT, Rigby N, Leach R. The obesity epidemic, metabolic syndrome and future prevention strategies. Eur J Cardiovasc Prev Rehabil 2004;11:3–8.
Tran J, Mirzaei M. The population attributable fraction of stroke associated with high blood pressure in the Middle East and North Africa. J Neurol Sci 2011;308:135–8.
Institute for Health Metrics and Evaluation (IHME). GBD Compare. Seattle, WA: IHME, University of Washington, 2015. Available at: <http://vizhub.healthdata.org/gbdcompare>. Accessed 01/10/2016.
Ahmad OB, Boschi-Pinto C, Lopez AD, Murray C, Lozano R, Inoue M. 2001. Age standardization of rates: a new WHO standard. GPE Discussion Paper Series No. 31. Geneva: World Health Organization. Available at: <www.who.int/healthinfo/paper31.pdf>. Accessed 05/07/2013.
Azizi F, Esmaelzadeh A, Mirmiran P. Obesity is associated with heart disease risk factor—disease: an epidemiological study in Tehran. Iran J Endocrinol Metab 2003;5:389–97.
Khalili D, Sheikholeslami FH, Bakhtiyari M, Azizi F, Momenan AA, Hadaegh F. The incidence of coronary heart disease and the population attributable fraction of its risk factors in Tehran: a 10-year population-based cohort study. PLoS ONE 2014;9:10–1371.
Ayatollahi SM, Carpenter RG. Height, Weight, BMI and weight-for-height of adults in southern Iran: how should obesity be defined? Ann Hum Biol 1993;20:9–13 [In Persian].
Pi-sunyer FX. Obesity. In: Shils M, Olson J, Shike M, Ross AC, editors. Modern nutrition in health and disease. Lippincott Williams and Wilkins; 1998. p. 1395–419.
Khosravishademani F, Soori H, Karami M, Zayeri F, Mehmandar MR. Estimating of population attributable fraction of unauthorized speeding and overtaking on rural roads of Iran. Iran J Epidemiol 2013;8:9–11 [in Persian].
Mohammadi M, Mirzaei M. Population attributable fraction of hypertension associated with obesity in Yazd Province in 2009: a short report. J Rafsanjan Univ Med Sci 2014;13:1179–86.
Martiniuk AL, Lee CM, Lawes CM, Ueshima H, Suh I, Lam TH. Hypertension: its prevalence and population-attributable fraction for mortality from cardiovascular disease in the Asia-Pacific region. J Hypertens 2007;25:73–9.
Karami M, Khosravi Shadmani F, Najafi F. Estimating the contribution of diabetes on the attributable burden of cardiovascular diseases in Kermanshah, West of Iran. Iran J Epidemiol 2012;8:33–8.
Biderafsh A, Karami M, Faradmal J, Poorolajal J. Estimating the potential impact fraction of hypertension as main risk factor of stroke: application of distribution shift method. J Epidemiol Glob Health 2015;5:231–7.
Flegal KM, Panagiotou OA, Graubard BI. Estimating population attributable fractions to quantify the health burden of obesity. Ann Epidemiol 2015;25:201–7.
Memish ZA, El bacheraoui CH, et al. Obesity and associated factors Kingdom of Saudi Arabia. Public Health Res Pract Policy 2013;11:1–10.
Salem Z, Rezaeyan M. Check the blood pressure and its relationship with anthropometric indices at University of Medical Sciences. J Rafsanjan Univ Med Sci 2007;7:157–64.
Author information
Authors and Affiliations
Corresponding author
Additional information
Peer review under responsibility of Ministry of Health, Saudi Arabia.
Rights and permissions
This is an open access article under the CC BY-NC-ND license (https://doi.org/creativecommons.org/licenses/by-nc-nd/4.0/).
About this article
Cite this article
Mohammadi, M., Mirzaei, M. Population-attributable fraction of hypertension associated with obesity, abdominal obesity, and the joint effect of both in the Central Provinces of Iran. J Epidemiol Glob Health 7, 71–79 (2017). https://doi.org/10.1016/j.jegh.2016.11.002
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1016/j.jegh.2016.11.002