title: The influence of gender and place of residence on cardiovascular diseases and their risk factors. The Isfahan cohort study.
abstract: OBJECTIVE
  To determine the impact of gender and place of residence on cardiovascular disease (CVD) events and related risk factors.
  
  
  METHODS
  In a prospective cohort study, 6323 participants free of CVD (3255 women), with age of more than 35 years from 3 cities (Isfahan, Najafabad, and Arak) and their rural districts in central Iran were followed-up from 2001 to 2007. This study was carried out at the Cardiovascular Research Institute of Isfahan University of Medical Sciences, Isfahan, Iran. Endpoints were defined as fatal- and nonfatal  myocardial infarction, sudden cardiac death, unstable angina and stroke that constituted CVD events.
  
  
  RESULTS
  Subjects in the rural area had significantly better risk factor profile in terms of most CVD risk factors in both genders, but it was reverse for low density lipoprotein (LDL)-cholesterol in both genders, and smoking in men. Except for smoking, men had an overall better risk factor profile compared to women. The age and risk factors adjusted hazard ratio of living in rural area was 0.71 (95% confidence interval [CI]: 0.51-0.99) for men, and 0.63 (95% CI: 0.44-0.91) for women. The age of CVD occurrence was similar in men and women, and in rural and urban areas. Hypertension was the strongest predictor of these events except for rural men showing that high LDL-cholesterol was the strongest risk factor.
  
  
  CONCLUSIONS
  The findings in this study documented differences in CVD risk factors affecting the occurrence of CVD events according to gender and place of residence. Such differences should be taken into account in future preventive public health strategies for CVD prevention.
authors.affiliation: Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, PO Box 814651148, Isfahan, Iran. nsarrafzadegan@gmail.com
authors.forename: Nizal
authors.initials: N
authors.lastname: Sarrafzadegan
authors.forename: Mohammad
authors.initials: M
authors.lastname: Talaei
authors.forename: Roya
authors.initials: R
authors.lastname: Kelishadi
authors.forename: Nafiseh
authors.initials: N
authors.lastname: Toghianifar
authors.forename: Masoumeh
authors.initials: M
authors.lastname: Sadeghi
authors.forename: Shahram
authors.initials: S
authors.lastname: Oveisgharan
authors.forename: Payam
authors.initials: P
authors.lastname: Kabiri
authors.forename: Aliakbar
authors.initials: A
authors.lastname: Tavassoli
authors.forename: Noushin
authors.initials: N
authors.lastname: Mohammadifard
authors.forename: Graham N
authors.initials: GN
authors.lastname: Thomas
authors.forename: Tom
authors.initials: T
authors.lastname: Marshall
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000517:prevention & control; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000175:diagnosis / Q000453:epidemiology; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology; D015994:Incidence; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011634:Public Health; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D015996:Survival Rate; D014505:Urban Population / Q000706:statistics & numerical data*