Author:
Nalini Mahdi,Oranuba Ebele,Poustchi Hossein,Sepanlou Sadaf G,Pourshams Akram,Khoshnia Masoud,Gharavi Abdolsamad,Dawsey Sanford M,Abnet Christian C,Boffetta Paolo,Brennan Paul,Sotoudeh Masoud,Nikmanesh Arash,Merat Shahin,Etemadi Arash,Shakeri Ramin,Sohrabpour Amir Ali,Nasseri-Moghaddam Siavosh,Kamangar Farin,Malekzadeh Reza
Abstract
ObjectivesTo examine the causes of premature mortality (<70 years) and associated risk factors in the Golestan Cohort Study.DesignProspective.SettingThe Golestan Cohort Study in northeastern Iran.Participants50 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 measuresThe top causes of premature death, HR and their 95% CI and population attributable fraction (PAF) for risk factors.ResultsAfter 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.ConclusionIHD 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.
Funder
Cancer Research UK
Tehran University of Medical Sciences
NGIMS/NIH
Reference44 articles.
1. Mapping and Measuring Social Disparities in Premature Mortality: The Impact of Census Tract Poverty within and across Boston Neighborhoods, 1999–2001
2. Continuing with "…a heavy heart" - consequences of maternal death in rural Kenya;Pande;Reprod Health,2015
3. The long-term impact of early parental death: lessons from a narrative study
4. Intergenerational impacts of maternal mortality: Qualitative findings from rural Malawi;Bazile;Reprod Health,2015
5. World Health Organization. Noncommunicable diseases Fact sheet. 2017 http://www.who.int/mediacentre/factsheets/fs355/en/ (October 2017).
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