Epidemiological aspects of ischaemic heart disease in Amman, Jordan

Abstract

Research into the prevalence of ischaemic heart disease and associated risk factors was carried out in Amman, Jordan between 1.4.1978 and 31.3.1979. The study population comprised 1,444 men and 963 women aged 30-60 working in the same organization. The objectives of this study were to determine the prevalence of ischaemic heart disease; to compare the associated risk factors and their prevalence in different age and sex groups; to initiate studies of incidence in this population; and to provide a basis for preventive programmes. The data were collected by an interviewer-administered standard questionnaire. It included the London School of Hygiene and Tropical Medicine cardio-vascular questionnaire and questions on exercise in leisure time, diet, smoking, alcohol and oral contraceptive use. It also included questions on social and demographic variables, family and past history. Physical examination included measurement of height, weight and blood pressure. A standard resting 12-lead ECG was recorded and the tracings classified by two observers according to the Minnesota code. Plasma cholesterol and fasting blood glucose were estimated. The methods and instructions for the interviews, examinations and measurements were standardized and based on the recommendations of the World Health Organization (Rose and Blackburn, 1968). The methods were tested for reliability and validity. The collected data were punched on IBM cards, four cards being used for each individual. The data were edited verified and then transferred to tapes .Univariate and multivariate analyses were used. The results of the study showed that there was a high prevalence of ischaemic heart disease in this cohort. They also showed a significant correlation between ischaemic heart disease and hypercholesterolaemia, hypertension, cigarette smoking, physical inactivity and type A behaviour pattern. There were fewer cases of ischaemic heart disease among those who ate protective diet than those who ate detrimental diet. This difference was statistically significant only with ischaemic-type ECG changes without symptoms. A similar trend was observed with fat intake. The difference was statistically significant only with ischaemic-type ECG changes and ischaemic-type ECG changes without symptoms. There was, however, a significant inverse correlation between ischaemic heart disease and high fibre diet from brown bread intake. Hyperglycaemia was associated with prevalence of ischaemic heart disease in univariate analysis, but this association may not be independent of other risk factors as it was not evident in multivariate analysis. A lack of a significant and independent correlation was also noted with body mass index. The results of the study suggest that rapid urbanization and development and adoption of affluent and sedentary lifestyles may be associated with increased risk of ischaemic heart disease. They identify a need for preventive action and further research,