Arch Iran Med. 2018;21(3): 86-94.
PMID: 29688733
Scopus ID: 85065474905
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Original Article

Drug Use for Secondary Prevention of Cardiovascular Diseases in Golestan, Iran: Results From the Golestan Cohort Study

Mahdi Nalini 1,2, Sadaf G. Sepanlou 1, Akram Pourshams 1,3, Hossein Poustchi 1,3, Maryam Sharafkhah 1,4, Hossein Bahrami 5, Farin Kamangar 3,6, Reza Malekzadeh 1,3*

1 Digestive Disease Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
2 Cardiovascular Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
3 Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
4 Department of Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
5 Division of Cardiovascular Medicine, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
6 Department of Biology, School of Computer, Mathematical, and Natural Sciences, Morgan State University, Baltimore, Maryland, USA
*Corresponding Author: Corresponding Author: Reza Malekzadeh MD; Digestive Disease Research Institute, Sharati Hospital, Tehran University of Medical Sciences, North Kargar St., Tehran, Iran, P. O. Box: 14117-13135. Tel:+98-21-82415169, Email: malek@tums.ac.ir


Background: Little is known about secondary prevention of cardiovascular diseases, using cardio-protective drugs, in the community-level, especially in low- and middle-income countries. We aimed to assess main drug use and its predictors in Northeast of Iran.

Methods: This is a cross-sectional analysis on the Golestan Cohort Study data (2004–2008) with 50 045 participants. We assessed drug use in those with a history of ischemic heart disease (IHD) or stroke, recorded by face-to-face interviews. We explored drug use predictors (i.e., age, gender, wealth, education, residency, smoking, body mass index, physical activity, hypertension, and diabetes) through multivariable logistic regression.

Results: A total of 3371 (6.7%) participants (56.7 ± 9.0 years, 58.1% female) reported a history of IHD, stroke or both. Median duration since diagnosis was 3.14 years (IQR: 1.25-6.30). Rates of using anti-platelets, statins, angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers, and beta-blockers were 28.8% (95% CI: 27.3–30.3), 5.4 (4.7–6.2), 15.7 (14.5–17.0), and 40.6 (38.9–42.3), respectively. About 43% (41 – 45) of patients did not use any protective drugs. Use of ≥ three drugs was only 7.3% (6.6–8.2). Indicators of ≥1 drug use were: older age (OR for ≥60 vs. <50: 1.37), high wealth score (fifth vs first quintile: 1.60), literacy (1.56), city dwelling (1.32), body mass index (<18.5 and ≥30 vs. 25–29: 0.55 and 1.25, respectively), physical activity (third vs. first tertile: 0.64), hypertension (3.47), and diabetes (1.29); (all P < 0.05).

Conclusion: Drug use after IHD or stroke is low in Northeast of Iran. Comprehensive efforts to promote secondary prevention are urgently needed.

Cite this article as: Nalini M, Sepanlou SG, Pourshams A, Poustchi H, Sharafkhah M, Bahrami H, et al. Drug use for secondary prevention of cardiovascular diseases in Golestan, Iran: results from the Golestan Cohort Study. Arch Iran Med. 2018;21(3):86–94.
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Submitted: 24 Oct 2017
Accepted: 27 Dec 2017
ePublished: 01 Mar 2018
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