The Relationship Between Ankle-Brachial Index and Number of Involved Coronaries in Patients with Stable Angina

<p class="abstract"><strong>BACKGROUND:</strong> Atherosclerosis is the commonest cause of vascular disease which can involve peripheral and/or cardiac vessels. This study was conducted to evaluate the possible link between Ankle-Brachial Index (ABI) and coronary vessel involvement in patients with stable angina.</p> <p class="abstract"><strong>&nbsp;&nbsp; METHODS:</strong><strong> </strong>This cross-sectional study was conducted in 2008 on 120 individuals who were hospitalized in Chamran Heart Center and underwent coronary angiography. A questionnaire was completed to obtain demographic information, history of previous heart disease and smoking. Body height and weight, as blood pressure on hand and foot were measured. The patients underwent angiography and the extent of coronary involvement (&gt; 75%) was determined. After12-14-hour of fasting, blood sugar was obtained to measure total cholesterol, triglyceride, low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C). The Ankle Brachial Pressure Index (ABI) was calculated as the ratio of the blood pressure in the ankles to the blood pressure in the arms. The data were analyzed by SPSS-15 using ANOVA, T-Student test, Spearman's rank correlation coefficient, and discriminant analysis.</p> <p class="abstract"><strong>&nbsp;&nbsp; RESULTS:</strong> Samples were 46 women (38.33%) and 74 men (61.67%) with a mean age of <br /> 55.50 &plusmn; 10.49. Mean and SD of ABI in men and women was 0.72 &plusmn; 0.20 and 0.80 &plusmn; 0.19 with no significant difference (p = 0.012). The correlation between ABI and extent of coronary involvement was 0.47 (p &lt; 0.0001). The group with lower ABI had the highest levels of coronary involvement (triple vessel, p &lt; 0.05).<strong>&nbsp;</strong></p> <p class="abstract"><strong>&nbsp;&nbsp; </strong><strong>CONCLUSION:</strong> ABI had a significant relationship with the degree of coronary involvement and a significant predictive value. Therefore ABI seems to be a reliable indicator of high coronary risk.</p> <p class="abstract">&nbsp;</p><table cellspacing="0" cellpadding="0" align="left"><tbody><tr><td width="35" height="12"><br /></td></tr> <tr><td><br /></td> <td>&nbsp;</td></tr></tbody></table><p class="abstract">&nbsp;</p> <br /> <p class="abstract"><strong>Keywords:</strong> Ankle to brachial index, Coronary involvement, Stable angina.</p> <p class="abstract">&nbsp;</p

Demographic, Life Style and Job-Related Determinants of Quality of Life of Industrial Manufacturing Employees: An Application of Multilevel Latent Class Regression on a Large Cross-Sectional Study

BACKGROUND: Employees are one of the key elements of an organization and measure the quality of life (QoL) provides reliable assessment of health and wellbeing in this population. This study aimed at investigating the QoL in a large sample of Iranian industrial manufacturing employees and its determinants.METHODS: In a cross-sectional study conducted was in 2015, 3063 people were selected among 16000 Esfahan Seal Company's employees using multistage cluster sampling. QoL was evaluated by EQ-5D questionnaire, mental health by GHQ-12, physical activity by IPAQ, job stress by Effort–Reward Imbalance questionnaire. Self-report questionnaire was used for gathering demographic characteristics. Multilevel latent class regression analysis was used for data analysis using R (3.4.3).RESULTS: The mean (SD) age of the study participants was 36.74 (7.31), and 91.5% of them were males. The mean (SD) sleep duration was 7.11 (1.17), and 95.4% of the participants had normal mental health. Latent class analysis classified employees into two classes (high (82.4%) and low QoL (17.6%)). Also employees’ job categories classified into high and low QoL classes (79.55% and 20.45%, respectively). Latent class regression showed that lower age (OR=0.93; P&lt; 0.0001), being male (OR=1.75; p=0.009), lower levels of education (OR=2.1; P&lt; 0.0001), normal mental health (OR=12.4; P&lt; 0.0001), higher sleep duration (OR=1.2; P&lt; 0.0001) and lower BMI (OR=0.96; P=0.016) were significant predictors of being in high QoL class.CONCLUSION: Our study provides data about the QoL of industrial manufacturing employees along with its significant determinants. The findings picture the ways for improving QoL, finally increasing the efficiency and productivity of workforce by directing health policies appropriately.

Psychological Status and Quality of Life in relation to the Metabolic Syndrome: Isfahan Cohort Study

Objective. Current study was designed to investigate the association of metabolic syndrome (MetS) with depression, anxiety, psychological distress, and quality of life (QoL). Design. Two hundred and fifteen contributors with MetS and 253 participants without MetS were randomly selected from 2151 participants of Isfahan Cohort Study who were residents of Isfahan city. Measurements consisted of fasting blood samples, anthropometrics, and self-reported data of 12-item General Health Questionnaire, Hospital Anxiety and Depression Scale, and European Quality of Life-5 Dimension. Binary logistic regression analysis was used to find the association between MetS and four psychological factors. Results. Participants mean age was 56.3 ± 9.8 years. Male/female ratio was 0.86 (217/251). Mean score of depression (P = 0.003), anxiety (P = 0.018), distress (P = 0.047), and QoL (P ≤ 0.001) was significantly higher in MetS group. There were significant increasing relationships between depression (OR 1.10, 95% CI 1.03–1.22), anxiety (OR 1.03, 95% CI 1.05–1.11), and QoL (OR 1.13, 95% CI 1.05–1.23) and MetS when associations were adjusted for other risk factors, but it was not the case for distress (OR 1.03, 95% CI 0.99–1.08). Conclusion. It might be better to consider MetS as a combination of biological and psychological risk factors. Thus, a person with metabolic disease should be recognized as a patient with these factors and be screened for all of them

Stress Level and Smoking Status in Central Iran: Isfahan Healthy Heart Program

<p class="abstract"><strong>BACKGROUND:</strong> Individuals are faced with numerous stressful life events which can negatively influence mental health. Many individuals use smoking as a means of confronting stress. Given the relatively high prevalence of smoking in central Iran, the present study was conducted to compare stress levels in smokers, non-smokers and those who had quit smoking.</p> <p class="abstract"><strong>&nbsp;&nbsp; METHODS:</strong><strong> </strong>This study was conducted as part of Isfahan Cardiovascular Research Program on 9752 individuals in the cities of Isfahan, Arak, and Najafabad in 2008. Sampling was performed using multi-stage cluster randomization method. Data on age, sex, demographic characteristics, and smoking status was collected through interviews. Stress level detected by General Health questionnaire.Logistic regression and chi- squere test was used for data analyzing<strong>.</strong></p> <p class="abstract"><strong>&nbsp;&nbsp; RESULTS:</strong> In the present study, 30% of non-smokers, 32.1% ex- smoker and 36.9% of smokers had GHQ of 4 and higher (P = 0.01). In regression analysis, the final model which was controlled for age, sex, socioeconomic statues (including place of residence, marital status and education level) showed that the odds ratio of stress in smokers and ex- smoker was significantly higher than in non-smokers (OR = 1.66 and OR = 1.12, respectively).<strong></strong></p> <p class="abstract"><strong>&nbsp;&nbsp; </strong><strong>CONCLUSION:</strong> Since in conducted studies, mental problems and stresses have had an important role in people&rsquo;s smoking, it seems suitable to use the results of this study to present intervention for correct methods of coping with stress towards reducing the prevalence of smoking in the community.</p><p class="abstract"><strong>Keywords:</strong> Cigarette, Stress, Community-based Program.</p

Evaluation of heart rate reserve and exercise capacity in individuals with and without metabolic syndrome in Isfahan

Introduction: Heart rate progressively increases with exercise through the function of sympathetic and parasympathetic nerves. These nerves control the performance of sinoatrial node. Lack of heart rate increase proportionate to the exercise is associated with poor prognosis. Moreover, exercise capacity (EC) is considered as a predictor of cardiac events. The current study compares these two indices in individuals with and without metabolic syndrome in Isfahan. Methods: The study was performed on 203 people without metabolic syndrome and 123 patients with metabolic syndrome registered in the Isfahan Cohort Study. The demographic data, abdominal circumference, blood pressure, height, and weight of the participants were recorded. Moreover, the serum triglyceride, fasting blood sugar, total cholesterol, high density lipoprotein (HDL), and low density lipoprotein (LDL)levels were measured. Exercise test was carried out according to the Bruce standard protocol and heart rate reserve (HRR) and exercise capacity (EC) were determined and recorded. The age-adjusted data were analyzed using SPSS software, version 15, by the generalized linear model. Findings: The two groups were not significantly different with regard to HRR (p= 0.27). The level of EC in the metabolic syndrome group was significantly lower than that observed in the group without metabolic syndrome (p= 0.022). Conclusion: We could not find relationship between HRR and metabolic syndrome or lack of the syndrome. However, the relationship between metabolic syndrome and the EC level indicates that in individuals with metabolic syndrome, when EC decreased, HRR did not change significantly

Multidisciplinary approach to functional somatic syndromes:study protocol for a population-based prospective cohort study

Introduction Isfahan functional disorders (ISFUN) cohort study aims to describe the interplay of genetic and environmental factors in shaping the characteristics of functional somatic syndromes (FSS). This study is primarily intended to investigate the epidemiology, risk factors, course and prognosis of FSSs in a sample of adult Iranian population. The other aim is to develop a new delimitation of FSSs based on an integrated multidisciplinary approach comprising of phenotypic and multiomics data. Methods and analysis ISFUN is a population-based prospective cohort study designed to follow a population of randomly selected seemingly healthy adults (18-65 years) through annual visits during a 4-year observation period. Structured questionnaires are used for data collection and clinical assessment of the participants. Questionnaire-based diagnosis of FSSs are validated in a medical interview. Human DNA genotyping, microbial amplicon sequencing and urine analysis is under progress for genomics, microbiota and metabolomics profiling, respectively. Enrolment began in September 2017, and study completion is expected in 2022. A total number of 1943 participants were initially recruited. Ethics and dissemination Ethical approval for data collection was granted by the National Research Ethics Committee of the Iranian Ministry of Health and Medical Education and the Research Ethics Committee of Isfahan University of Medical Sciences (IR.MUI.REC.1395.1.149). Following the description of the study procedure, we obtained written informed consent from all study participants. Study findings will be disseminated through peer-reviewed publications and presentations at scientific meetings

The Association between Stress Levels and Food Consumption among Iranian Population

Background: Stress has been considered as a highly common disorder that has a complicated relation with dietary intake and has been linked with both increased and decreased dietary intake. Objective: This study was conducted to assess the association between food consumption and stress levels in an Iranian adult population. Methods: In this cross-sectional study, data from the third phase of Isfahan Healthy Heart Program (IHHP) that was conducted for cardiovascular diseases prevention and health promotion were used. Nine thousand five hundred forty-nine adults aged a >= 18 years participated in the study. Dietary habits were assessed by a 49- item Food Frequency Questionnaire (FFQ). Stress levels were assessed by General Health Questionnaire-12 (GHQ-12). The participants were separated on the basis of their stress levels into two groups as the low- and high- stress groups. Results: Individuals in the low- stress group were significantly younger and tended to have higher physical activity and education level, lower LDL cholesterol, and were less likely to be current smokers. Dietary intake of unsaturated oils, grains, fruits, vegetables, meat, and dairy products was significantly higher in the low- stress group whereas dietary intake of saturated oils was significantly lower; moreover, Global Dietary Index (GDI) was lower in the low- stress group. We found a significant positive association between stress level, GDI (OR: 1.24; 95% Cl: 1.14 - 1.35), and saturated oils (OR: 1.17; 95% Cl: 1.08 - 1.28) and inverse association between stress level and intake of unsaturated oils (OR: 0.84; 95% Cl: 0.77 - 0.91), fruits and vegetables (OR: 0.83; 95% Cl: 0.76 - 0.90), meat (OR:0.88; 95% CI:0.82 - 0.97) and dairy products (OR: 0.88 ; 95% CI: 0.81 - 0.96) after adjustments based on sex, age, smoking, and physical activity. Conclusion: Our results showed a significant positive association between dietary intake and stress. We must have a special attention to dietary intake in stress management program of high- stress individuals, and in dietary recommendations, psychologic aspects should be considered. However, prospective longitudinal studies are needed to assess the causal relationship between stress and dietary factors

PERSONALITY TRAITS ARE DIFFERENTLY ASSOCIATED WITH DEPRESSION AND ANXIETY: EVIDENCE FROM APPLYING BIVARIATE MULTIPLE BINARY LOGISTIC REGRESSION ON A LARGE SAMPLE OF GENERAL ADULTS

Background: The purpose of this study was to explore the association of five factors personality traits, as predictor variables, with the anxiety and depression as joint dependent variables in an Iranian adult population. Subjects and methods: A total of 3175 subjects living in Isfahan participated in this cross-sectional population-based “study (SEPAHAN) and completed self-administered questionnaires about demographic, life style, gastrointestinal disorders, personality traits, social support, and psychological problems. Data was analyzed using bivariate multiple binary logistic regression in R Free statistical software. Results: The results indicated high scores of neuroticisms increase the risk of anxiety and depression after adjustment for the potential confounders in total sample (OR (95% CI): 1.22 (1.19-1.24) and 1.19 (1.17-1.21), respectively) as well as in both male and female. In contrast, joint inverse associations were found between anxiety and depression with high extraversion (OR (95% CI): 0.90 (0.88-0.92) and 0.91 (0.89-0.92), respectively), agreeableness (0.93 (0.91-0.96) and 0.94 (0.92-0.96) respectively) and conscientiousness scores (0.95 (0.93-0.97) and 0.95 (0.94-0.97) respectively) as well as in both male and female. Furthermore, higher scores of openness had significant inverse association with depression in male. Conclusion: The present study indicated that higher scores of neuroticism, however lower extraversion, conscientiousness and agreeableness scores are risk factors for both anxiety and depression in Iranian adult population. It is suggested to perform family studies or twin and genetic association studies with considering combinations of personality traits (personality styles), and also measuring personality traits at the facet level