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March 29, 2026Scientific Reports0 citationsOpen Access

Epidemiology and cardiometabolic care in adults with ASCVD and high 10-year ASCVD risk: 2021 WHO STEPS study in Iran

HFHossein FarrokhpourMNMaryam NasserinejadNANaser Ahmadi

Key Result

Among 27,822 Iranian adults, the prevalence of ASCVD was 7.4%, with significant gaps in cardiometabolic care, as only 12.5% and 14.3% of patients with ASCVD had controlled hypertension and diabetes.

Key Points

  • The research aims to evaluate the epidemiology of ASCVD and assess cardiometabolic care among adults in Iran.
  • Conducted cross-sectional analysis using data from the 2021 Iran STEPS study
  • Assessed ASCVD prevalence and 10-year risk in participants aged 40–75 without ASCVD
  • Evaluated cardiometabolic care for hypertension, diabetes mellitus, and hypercholesterolemia
  • Utilized AHA/ACC pooled cohort equations to estimate ASCVD risk
  • ASCVD prevalence was found to be 7.4% among participants
  • 19.1% of those without ASCVD had intermediate risk, while 5.4% had high risk
  • 77.0% of the ASCVD group had hypertension, but only 12.5% had it controlled
  • 34.7% of the ASCVD group had diabetes mellitus, with only 14.3% controlled
  • High prevalence of hypertension (47.4-94.4%), diabetes (7.2-59.3%), and hypercholesterolemia (33.5-48.7%) was observed

Study Design

Type

Cross-Sectional (n=27,822)

Multicenter

Yes

Structured PICO

P
Population
Adults aged ≥ 18 years residing in rural and urban areas of all 31 provinces of Iran (with a sub-analysis of adults aged 40-75 without ASCVD for 10-year risk)
O
Outcome
Prevalence of ASCVD, recent annual event rate, 10-year ASCVD risk, and cardiometabolic care metrics (hypertension, diabetes mellitus, and hypercholesterolemia control)

There is a high burden of ASCVD and future cardiovascular risk in Iran, compounded by significant gaps in the treatment and control of key cardiometabolic risk factors like hypertension and diabetes.

Abstract

Abstract Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of mortality and health burden worldwide. We aimed to assess ASCVD epidemiology, 10-year risk, and cardiometabolic care using nationally representative data in Iran. Using the 2021 Iran STEPS study, a cross-sectional analysis was conducted to evaluate ASCVD (self-reported myocardial infarction, angina, revascularization, or stroke) prevalence and annual event rate. The 2013 AHA/ACC pooled cohort equations estimated 10-year ASCVD risk in 10,298 participants aged 40–75 without ASCVD. Cardiometabolic care for hypertension, diabetes mellitus (DM), and hypercholesterolemia was assessed, along with statin use and cardiovascular health (CVH) metrics. Among 27,822 participants, representing 57.5 million adults, ASCVD prevalence was 7.4%. Among those without ASCVD, 19.1% had an intermediate and 5.4% had a high ASCVD risk. In the ASCVD group, hypertension and DM affected 77.0% and 34.7%, yet only 12.5% and 14.3% of the entire ASCVD group had them controlled, respectively. In adults without ASCVD, 2.9–5.3% of the entire risk groups achieved hypertension targets, 2.5–16.8% achieved glycemic targets, and 7.7–16.7% achieved lipid goals, despite condition prevalence spanning 47.4–94.4% for hypertension, 7.2–59.3% for DM, and 33.5–48.7% for hypercholesterolemia. CVH metrics were also unfavorable. The study revealed a high ASCVD burden and future risks with gaps in coverage, treatment, and control.

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Cite This Study

Farrokhpour et al. (2026) conducted a cross-sectional in Atherosclerotic cardiovascular disease (ASCVD) (n=27,822). Among 27,822 Iranian adults, the prevalence of ASCVD was 7.4%, with significant gaps in cardiometabolic care, as only 12.5% and 14.3% of patients with ASCVD had controlled hypertension and diabetes.

synapsesocial.com/papers/69c8c2b8de0f0f753b39d246https://doi.org/10.1038/s41598-026-45344-0
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