A 10-Year Atherosclerotic Cardiovascular Disease Risk Assessment and 5-Year Follow-Up in the Sabzevar PERSIAN Cohort Center, Northeast Iran

Abstract

Background: Atherosclerotic cardiovascular disease (ASCVD) remains a leading cause of global morbidity and mortality. This study assessed the 10-year ASCVD risk and evaluated 5-year follow-up outcomes among adults in the Sabzevar PERSIAN Cohort Center, northeast Iran.

Methods: Baseline data were collected in 2018, with follow-up completed in 2023. Risk factors including age, gender, blood pressure, cholesterol levels, smoking status, and diabetes were assessed. The 10-year ASCVD risk was calculated using the American College of Cardiology's risk estimator and categorized as low (<5%), borderline (5–7.4%), intermediate (7.5–19.9%), or high (≥20%). A Cox proportional hazards model evaluated the association between age, gender, diabetes, and ASCVD events.

Results: Among 2,871 participants, men had higher blood pressure, while women had higher levels of total cholesterol, HDL, and LDL (P < 0.05). Hypertension was more prevalent in men than in women (P < 0.001). Diabetes was present in 13.8% (n = 397) of participants, with no significant difference between men and women. The distribution of 10-year ASCVD risk was as follows: low (74.58%), borderline (9.3%), intermediate (13.96%), and high (2.16%). Men had a significantly higher ASCVD risk than women (P < 0.001). During the 5-year follow-up, 1.2% (n = 34) of participants experienced ASCVD events. In multivariable analysis, age (P < 0.001), male gender (P < 0.001), and diabetes (P = 0.013) were significant predictors of ASCVD events.

Conclusion: ASCVD risk estimation and early intervention, particularly for older adults and individuals with diabetes, are essential. These findings support targeted prevention efforts in northeast Iran and similar populations.