fa سهم تأثیر بالقوه برخی عوامل خطر تعدیل‌پذیر در بار بیماری‌های قلبی- عروقی در ایران: ارزیابی خطر مقایسه‌ای اپیدمیولوژی Epidemiology پژوهشي Research <font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0in 0in 0pt text-align: justify line-height: normal unicode-bidi: embed direction: rtl text-justify: kashida text-kashida: 0%" dir="rtl"><b><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">زمینه و هدف</span></b><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">: افزایش شیوع عوامل خطر بیماری­های قلبی- عروقی لزوم تدوین <font size="2"><font face="B Mitra"><span style="mso-spacerun: yes"> </span>رویکردهای پیشگیرانه و اولویت بندی مداخلات مربوطه را<span style="mso-spacerun: yes"> </span>ضروری می­نماید. این مطالعه جهت بررسی برآورد سهم تأثیر بالقوه عوامل خطر تعدیل­پذیر در بار بیماری­های قلبی- عروقی در ایران انجام گردید.<o:p /></font></font></span></p><font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0in 0in 0pt text-align: justify line-height: normal unicode-bidi: embed direction: rtl text-justify: kashida text-kashida: 0%" dir="rtl"><b><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">روش کار</span></b><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">: به منظور محاسبه سهم تأثیر بالقوه عوامل خطر، از روش شناسی ارزیابی خطر مقایسه­ای</span><span dir="ltr"></span><span lang="AR-SA" style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt" dir="ltr"><span dir="ltr"></span> </span><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">سازمان جهانی بهداشت استفاده شد. شیوع عوامل خطر از سومین بررسی مراقبت عوامل خطر بیماری­های غیرواگیر و اندازه اثر مربوطه از مطالعه قند و لیپید تهران استخراج گردید. سپس اثر مشترک عوامل خطر مورد بررسی (دیابت، پرفشاری خون، چاقی مرکزی، کلسترول بالا) برآورد گردید.<o:p /></span></p><font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0in 0in 0pt text-align: justify unicode-bidi: embed direction: rtl text-justify: inter-ideograph" dir="rtl"><b><span lang="AR-SA" style="line-height: 115% font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">یافته ها: </span></b><span lang="AR-SA" style="line-height: 115% font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">اثر مشترک عوامل خطر انتخابی در سطح حداقل خطر تئوریک<font size="2"><font face="B Mitra"><span style="mso-spacerun: yes"> </span>نشان داد که پس از تغییر شیوع واقعی آنها به سطح صفر<span style="mso-spacerun: yes"> </span>در زنان 4/59% <span style="mso-spacerun: yes"> </span>(76-30= دامنه اطمینان 95%)<span style="mso-spacerun: yes"> </span>و در مردان 37% (2/50-7/21 = دامنه اطمینان 95%) از بار بیماری‌های قلبی – عروقی قابل اجتناب است. اثر مشترک عوامل خطر انتخابی در سطح حداقل خطر منطقی و سطح حداقل خطر امکان پذیر نیز در زنان بیشتر از مردان بود.<o:p /></font></font></span></p><font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0in 0in 0pt text-align: justify line-height: normal unicode-bidi: embed direction: rtl text-justify: kashida text-kashida: 0%" dir="rtl"><b><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">نتیجه</span></b><b><span style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-size: 10.0pt" dir="ltr">‌</span></b><b><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">گیری</span></b><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">: نتایج مطالعه با تکیه بر بار قابل اجتناب به دست آمده، مؤید لزوم اجرای یک برنامه غربالگری پیوسته و وسیع جمعیتی در خصوص عوامل مورد بررسی در میان بزرگسالان است.<o:p /></span></p><font face="Times New Roman" size="3"> </font> <font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0in 0in 0pt text-align: justify line-height: normal text-autospace: text-justify: inter-ideograph mso-layout-grid-align: none"><b><span style="font-family: "Times New Roman","serif" font-size: 12pt mso-bidi-language: FA">Background:</span></b><span style="font-family: "Times New Roman","serif" font-size: 12pt"> Increasing the prevalence of risk factors of cardiovascular diseases, emphasizes on health policy, priority setting and preventing cardiovascular diseases deaths. This study aimed to assess Potential Impact Fraction of modifying selected risk factors on burden of cardiovascular disease in Iran.</span><span style="font-size: 12pt mso-bidi-font-family: "B Mitra""><o:p /></span></p><font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0in 0in 0pt text-align: justify line-height: normal text-justify: inter-ideograph tab-stops: center 265.9pt"><b><span style="font-family: "Times New Roman","serif" font-size: 12pt">Methods</span></b><span style="font-family: "Times New Roman","serif" font-size: 12pt">: To calculate Potential Impact Fraction (PIF) of risk factors WHO comparative risk assessment (CRA) methodology was used. Data on the Prevalence of the risk factors were obtained from 3rd national Surveillance of Risk Factors (Diabetes, hypertension, central obesity, Hypercholesterolemia) of Non-Communicable Diseases (SuRFNCD-2007) and data on corresponding measures of effect were derived from Tehran Lipid Glucose Study (TLGS). Then joint effect of risk factors was calculated</span><font size="3"><font face="Calibri"><span style="mso-bidi-font-family: "B Mitra"">.</span><span lang="AR-SA" style="font-family: "Times New Roman","serif" font-size: 12pt" dir="rtl"><o:p /></span></font></font></p><font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0in 0in 0pt text-align: justify text-justify: inter-ideograph"><b><span style="line-height: 115% font-family: "Times New Roman","serif" font-size: 12pt">Results:</span></b><span style="line-height: 115% font-family: "Times New Roman","serif" font-size: 12pt"> The joint effect of modifying selected risk factors to the theoretical minimum risk level i. e. zero for adult female 59.4% (95% uncertainty intervals: 30.0 – 76.0) and for males 37.0% (95%<font size="3"><font face="Times New Roman"><span style="mso-spacerun: yes"> </span>uncertainty intervals: 21.7-50.2) of burden of cardiovascular disease are avoidable. The corresponding value was greater than in females at plausible and feasible minimum risk levels. </font></font></span><u><span style="color: red"><o:p /></span></u></p><font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0in 0in 0pt text-align: justify line-height: normal text-justify: inter-ideograph tab-stops: right 7.3pt center 265.9pt"><b><span style="font-family: "Times New Roman","serif" font-size: 12pt">Conclusions:</span></b><span style="color: black font-family: "Times New Roman","serif" font-size: 12pt"> Our study results which were reported based on attributable burden support the rational for implementing a national- wide and repeated screening for risk factors among adults.<o:p /></span></p><font face="Times New Roman" size="3"> </font> عوامل خطر بیماری های قلبی و عروقی، اثر مشترک، سهم تأثیر بالقوه، بار بیماری، ارزیابی خطر مقایسه‌ای. Risk factors of cardiovascular disease, Joint effect, Potential Impact Fraction, Disability Adjusted Life Years, Comparative risk assessment. 62 71 http://rjms.iums.ac.ir/browse.php?a_code=A-10-1-1429&slc_lang=fa&sid=1 Manoochehr Karami منوچهر کرمی 3900319475328460023691 3900319475328460023691 No Hamadan University of Medical Sciences دانشگاه علوم پزشکی همدان Farzaneh Mobasheri فرزانه مباشری 3900319475328460023692 3900319475328460023692 No Fasa University of Medical Sciences دانشگاه علوم پزشکی فسا Fatemeh Khosravi Shadmani فاطمه خسروی شادمانی 3900319475328460023693 3900319475328460023693 Yes Shahid Beheshti University of Medical Sciences دانشگاه علوم پزشکی شهید بهشتی