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Background: Little is known regarding the impact of quantity and quality of sleep on the incidence of cardiovascular disease. The aim of this study was to investigate the possible independent association of late bedtime and premature coronary artery disease (PCAD). Methods: Between October 2016 and November 2019, we conducted a cross-sectional population-based study on 30 101 participants aged 20--65 years in Khuzestan Comprehensive Health Study (KCHS). Data on major risk factors of cardiovascular disease, habit history, physical activity, and sleep behavior was gathered and participants underwent blood pressure, anthropometric, and serum lipid and glucose profile measurements. PCAD was defined as documented history of developing obstructive coronary artery disease before 45 years in men and before 55 years in women. Results: Of a total of 30 101 participants (64.1% female, mean age: 41.7 ± 11.7 years) included in this study, 1602 (5.3%, 95% confidence interval: 5.1%--5.6%) had PCAD. Late bedtime was reported in 7613 participants (25.3%, 95% confidence interval: 24.9%--25.8%). Age-sex standardized prevalence for PCAD and late bedtime were 3.62 (3.43-3.82) and 27.8 (27.2--28.4), respectively. There was no significant difference (P = 0.558) regarding prevalence of PCAD between those with late bedtime (5.5%, 95% CI: 4.9%--6.0%) and those with early bedtime (5.3%, 95% CI: 5.0%--5.6%). However, after adjustment for potential confounders, late bedtime was independently associated with PCAD (OR = 1.136, 95% CI = 1.002--1.288, P = 0.046). Conclusion: In this study, late bedtime was significantly associated with presence of PCAD. Future prospective studies should elucidate the exact role of late bedtime in developing coronary atherosclerosis prematurely. [ABSTRACT FROM AUTHOR]

Background: In 2017, the American College of Cardiology/American Heart Association (ACC/AHA) provided a new guideline for hypertension prevention and management. We aimed to update the prevalence, awareness, control, and determinants of hypertension based on this guideline in Khuzestan province, southwest of Iran, and to estimate the number of people who are eligible for non-pharmacologic and pharmacologic intervention. Methods: This population-based cross-sectional study was conducted in Khuzestan, a large province in the southwest of Iran. Comprehensive information about the potential relating factors of hypertension was collected, blood pressure was measured, and anthropometric measurements were obtained. Moreover, the dietary pattern was evaluated in 2830 individuals, using a qualitative food frequency questionnaire. Results: Among 30,506 participants, 30,424 individuals aged 20–65 years were eligible for the study. In comparison with the previous guideline released by the Joint National Committee (JNC8), the prevalence of hypertension in Khuzestan dramatically increased from 15.81 to 42.85% after implementation of the ACC/AHA guideline, which was more dominant in the male population and the 45–54 age group. The sex and age adjustment of the hypertension prevalence was estimated to be 39.40%. The percentage of hypertension awareness, treatment, and control were 45.85%, 35.42%, and 59.63%, which dropped to 22.72%, 26.37%, and 28.94% after implementation of new guideline, respectively. Conclusions: In the ACC/AHA guideline, a higher number of individuals with the pre-hypertension condition were shifted into the hypertension category and the level of awareness, treatment, and control were dramatically decreased, which highlight a great need to expand the public health infrastructure for further managing the substantial increased burden on healthcare system. However, further studies with population over 65 years are required to estimate the eligibility for antihypertensive treatment in this province after implementation of new guideline. [ABSTRACT FROM AUTHOR]

Background: In 2017, the American College of Cardiology/American Heart Association (ACC/AHA) provided a new guideline for hypertension prevention and management. We aimed to update the prevalence, awareness, control, and determinants of hypertension based on this guideline in Khuzestan province, southwest of Iran, and to estimate the number of people who are eligible for non-pharmacologic and pharmacologic intervention. Methods: This population-based cross-sectional study was conducted in Khuzestan, a large province in the southwest of Iran. Comprehensive information about the potential relating factors of hypertension was collected, blood pressure was measured, and anthropometric measurements were obtained. Moreover, the dietary pattern was evaluated in 2830 individuals, using a qualitative food frequency questionnaire. Results: Among 30,506 participants, 30,424 individuals aged 20–65 years were eligible for the study. In comparison with the previous guideline released by the Joint National Committee (JNC8), the prevalence of hypertension in Khuzestan dramatically increased from 15.81 to 42.85% after implementation of the ACC/AHA guideline, which was more dominant in the male population and the 45–54 age group. The sex and age adjustment of the hypertension prevalence was estimated to be 39.40%. The percentage of hypertension awareness, treatment, and control were 45.85%, 35.42%, and 59.63%, which dropped to 22.72%, 26.37%, and 28.94% after implementation of new guideline, respectively. Conclusions: In the ACC/AHA guideline, a higher number of individuals with the pre-hypertension condition were shifted into the hypertension category and the level of awareness, treatment, and control were dramatically decreased, which highlight a great need to expand the public health infrastructure for further managing the substantial increased burden on healthcare system. However, further studies with population over 65 years are required to estimate the eligibility for antihypertensive treatment in this province after implementation of new guideline. [ABSTRACT FROM AUTHOR]

Aims: Cardiovascular diseases (CVDs) are the leading cause of death in the world. Many modifiable risk factors have been reported to synergistically act in the development of CVDs. We aimed to compare the predictive power of anthropometric indices, as well as to provide the best cut-off point for these indicators in a large population of Iranian people for the prediction of CVDs and CVD risk factors. Methods and results: All the data used in the present study were obtained from Khuzestan comprehensive health study (KCHS). Anthropometric indices, including BMI (body mass index), WC (waist circumference), HC (hip circumference), WHR (waist-to-hip ratio), WHtR (waist-to-height ratio), ABSI (a body shape index), as well as CVD risk factors [dyslipidaemia, abnormal blood pressure (BP), and hyperglycaemia] were recorded among 30 429 participants. WHtR had the highest adjusted odds ratios amongst anthropometric indices for all the risk factors and CVDs. WC had the highest predictive power for dyslipidaemia and hyperglycaemia [area under the curve (AUC) = 0.622, 0.563; specificity 61%, 59%; sensitivity 69%, 60%; cut-off point 87.95, 92.95 cm, respectively], while WHtR had the highest discriminatory power for abnormal BP (AUC = 0.585; specificity 60%; sensitivity 65%; cut-off point 0.575) and WHR tended to be the best predictor of CVDs (AUC = 0.527; specificity 58%; sensitivity 64%; cut-off point 0.915). Conclusion: In this study, we depicted a picture of the Iranian population in terms of anthropometric measurement and its association with CVD risk factors and CVDs. Different anthropometric indices showed different predictive power for CVD risk factors in the Iranian population. [ABSTRACT FROM AUTHOR]

Background: Irritable bowel syndrome (IBS) is a functional disease with no exact laboratory or imaging findings. IBS is more common in areas with a history of psychological trauma and war. This study aims to report the prevalence and possible determinants of IBS in southwestern Iran, an area with a notable history of war. Methods: We randomly enrolled 1849 permanent residents in 29 cities aged 20 to 65 years. A validated for Farsi version Rome III criteria and a questionnaire, including demographic data and health history, were administered to each subject. Participants who fulfilled the Rome III criteria were categorized into three groups: Diarrhea dominant (IBS-D), Constipation dominant (IBS-C), and Mixed type (IBS-M). Results: The total prevalence of IBS was 3.2%, with 70% of subjects being of Arab descent (P = 0.004). IBS was more common in females, singles, illiterate subjects, and people younger than 30 years; however, none of these differences were statistically significant. People with depression, anxiety, self-report of psychological disorders, and very low socioeconomic status had a significantly higher prevalence of IBS (P < 0.05). After multivariable logistic regression analysis, very low socioeconomic status had an independent role in IBS predictivity (OR: 2.28, 95% CI: 1.01--5.15). Conclusion: This study shows a higher prevalence of IBS symptoms in a population-based study in the region compared to counterparts in other regions of Iran. Considering the higher prevalence of self-reported psychological disorders, further studies are recommended to focus on the exact diagnosis of mental disorders and their influence on IBS. [ABSTRACT FROM AUTHOR]

Background: Non-communicable diseases (NCDs) are the leading cause of death worldwide, with a disproportionally rising burden among low- and middle-income populations. While preventable risk factors highly contribute to this burden, populationbased studies assessing these factors and the health status of these populations, are scarce. Methods: The Khuzestan Comprehensive Health Study (KCHS)--a cross sectional study--was conducted between 2016-2019, including 30,506 Iranians aged 20 to 65 years, from 27 counties of Khuzestan province, southwest of Iran. KCHS aimed to provide a comprehensive health overview by investigating the prevalence and risk factors of NCDs and psychological disorders, along with viral hepatitis as a common communicable disease. Upon registration, 15 mL of blood and anthropometric measurements were obtained from participants. Afterwards, several interviewer-administered questionnaires were completed to gather data on demographics, socioeconomic status, sleep quality, physical activity, lifestyle habits, nutrition, and medical history. Results: The mean ± SD age of participants was 41.7 ± 11.9 years. The majority were female (64.3%), of the Arab ethnicity (49%), married (83%), and urban residents (73.1%). About 70% had an educational level below high school diploma. Overall, 10.8%, 5.2%, and 2.8% of participants had used cigarettes, hookah, and drugs at least once in their lifetime, respectively. While body mass index and serum cholesterol levels were higher in females, blood pressure was higher in males (P < 0.001). Conclusion: KCHS assessed many aspects of health in the Khuzestan province. In addition to develop a biobank along with a comprehensive dataset, KCHS will serve as a valuable infrastructure for future research. [ABSTRACT FROM AUTHOR]