TY - JOUR
T1 - Causes of premature death and their associated risk factors in the Golestan Cohort Study, Iran
AU - Nalini, Mahdi
AU - Oranuba, Ebele
AU - Poustchi, Hossein
AU - Sepanlou, Sadaf G.
AU - Pourshams, Akram
AU - Khoshnia, Masoud
AU - Gharavi, Abdolsamad
AU - Dawsey, Sanford M.
AU - Abnet, Christian C.
AU - Boffetta, Paolo
AU - Brennan, Paul
AU - Sotoudeh, Masoud
AU - Nikmanesh, Arash
AU - Merat, Shahin
AU - Etemadi, Arash
AU - Shakeri, Ramin
AU - Sohrabpour, Amir Ali
AU - Nasseri-Moghaddam, Siavosh
AU - Kamangar, Farin
AU - Malekzadeh, Reza
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2018/7/1
Y1 - 2018/7/1
N2 - Objectives To examine the causes of premature mortality (<70 years) and associated risk factors in the Golestan Cohort Study. Design Prospective. Setting The Golestan Cohort Study in northeastern Iran. Participants 50 045 people aged 40 or more participated in this population-based study from baseline (2004-2008) to August 2017, with over 99% success follow-up rate. Main outcome measures The top causes of premature death, HR and their 95% CI and population attributable fraction (PAF) for risk factors. Results After 444 168 person-years of follow-up (median of 10 years), 6347 deaths were reported, of which 4018 (63.3%) occurred prematurely. Ischaemic heart disease (IHD) accounted for 33.9% of premature death, followed by stroke (14.0%), road injuries (4.7%), stomach cancer (4.6%) and oesophageal cancer (4.6%). Significant risk/protective factors were: wealth score (HR for highest vs lowest quintile: 0.57, PAF for lowest four quintiles vs top quintile: 28%), physical activity (highest vs lowest tertile: 0.67, lowest two tertiles vs top tertile: 22%), hypertension (1.50, 19%), opium use (1.69, 14%), education (middle school or higher vs illiterate: 0.84, illiterate or primary vs middle school or higher: 13%), tobacco use (1.38, 11%), diabetes (2.39, 8%) and vegetable/fruit consumption (highest vs lowest tertile: 0.87, lowest two tertiles vs top tertile: 8%). Collectively, these factors accounted for 76% of PAF in men and 69% in women. Conclusion IHD and stroke are the leading causes of premature mortality in the Golestan Cohort Study. Enhancing socioeconomic status and physical activity, reducing opium and tobacco use, increasing vegetable/fruit consumption and controlling hypertension and diabetes are recommended to reduce premature deaths.
AB - Objectives To examine the causes of premature mortality (<70 years) and associated risk factors in the Golestan Cohort Study. Design Prospective. Setting The Golestan Cohort Study in northeastern Iran. Participants 50 045 people aged 40 or more participated in this population-based study from baseline (2004-2008) to August 2017, with over 99% success follow-up rate. Main outcome measures The top causes of premature death, HR and their 95% CI and population attributable fraction (PAF) for risk factors. Results After 444 168 person-years of follow-up (median of 10 years), 6347 deaths were reported, of which 4018 (63.3%) occurred prematurely. Ischaemic heart disease (IHD) accounted for 33.9% of premature death, followed by stroke (14.0%), road injuries (4.7%), stomach cancer (4.6%) and oesophageal cancer (4.6%). Significant risk/protective factors were: wealth score (HR for highest vs lowest quintile: 0.57, PAF for lowest four quintiles vs top quintile: 28%), physical activity (highest vs lowest tertile: 0.67, lowest two tertiles vs top tertile: 22%), hypertension (1.50, 19%), opium use (1.69, 14%), education (middle school or higher vs illiterate: 0.84, illiterate or primary vs middle school or higher: 13%), tobacco use (1.38, 11%), diabetes (2.39, 8%) and vegetable/fruit consumption (highest vs lowest tertile: 0.87, lowest two tertiles vs top tertile: 8%). Collectively, these factors accounted for 76% of PAF in men and 69% in women. Conclusion IHD and stroke are the leading causes of premature mortality in the Golestan Cohort Study. Enhancing socioeconomic status and physical activity, reducing opium and tobacco use, increasing vegetable/fruit consumption and controlling hypertension and diabetes are recommended to reduce premature deaths.
KW - Iran
KW - cause of death
KW - premature mortality
KW - risk factor
UR - http://www.scopus.com/inward/record.url?scp=85053066242&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2018-021479
DO - 10.1136/bmjopen-2018-021479
M3 - Article
C2 - 30021753
AN - SCOPUS:85053066242
SN - 2044-6055
VL - 8
JO - BMJ Open
JF - BMJ Open
IS - 7
M1 - e021479
ER -