ICS: 2001-2002

ICS2: 2013-2014

ICS:

Determining the incidence of cardiovascular diseases and their risk factors in Isfahan, Najaf-Abad and Arak

Providing a risk assessment model for cardiovascular diseases prediction

ICS2:

Determining the incidence of cardiovascular diseases, cancer and diabetes mellitus, and their risk factors in three generations in Isfahan and Najaf-Abad

ICS:

Adults aged 35 years and over of the general population in the urban and rural areas of Isfahan, Najaf Abad, and Arak

ICS2:

Adults aged 35 years and over of the general population (as first generation) in the urban and rural areas of Isfahan, Najaf Abad

The first generation’s children and grandchildren with the age of 6 years and older

Sampling method:

Simplified multi-stage random sampling

Sample size:

ICS: 6054

ICS2: First generation: 2783

Second generation: 2063

Third generation: 661

A questionnaires consist of four parts: the first part contains the demographic data of individuals (such as age, sex, level of education, occupation, and marital status) and socioeconomic status. The second part is questions about knowledge, attitude, and practice in the field of nutrition, smoking, physical activity, cardiovascular diseases and their risk factors, as well as lifestyle behaviors of individuals in these fields. A standard nutritional food frequency questionnaire (FFQ) was used to determine the nutritional practice of the individuals. Physical activity was measured based on the International Physical Activity Questionnaire (IPAQ). The third part of the questionnaire
includes strategies for coping with stress. In addition, in the second measurement in 2007, a validated General Health Questionnaire (GHQ), stress-related SLE and the WHO Quality of Life Questionnaire were also added. The fourth part was related to physical examination and questions about the history of cardiovascular risk factors such as
dyslipidemia, hypertension, diabetes mellitus, and history of the diseases in the participants or their families. Variables like height, weight, waist and pelvic circumference, systolic and diastolic blood pressure were also measured. Fasting (12 h) blood samples were obtained from all participants to measure total, HDL and LDL cholesterol, triglyceride, fasting blood glucose, apolipoprotein A, hs-CRP and CBC, and also 2 h glucose tolerance was measured.

For ICS2, knowledge and attitude questions were omitted and in each part required questions about cancers were added.

The process of completing the questionnaire, blood sampling and the measurements, physical examination and blood pressure and anthropometric measurements has been repeated each ten years for ICS and ICS2. Moreover, telephone follow up for desired events carries out every two years.

ICS:

The primary outcomes were cardiovascular events including fatal and non-fatal acute coronary syndromes, fatal and non-fatal stroke, heart failure, atrial fibrillation and sudden death, and the secondary outcomes were the related mortalities.

ICS2:

The primary and secondary outcomes for adults are cardiovascular events that consist of fatal and non-fatal acute coronary syndromes, fatal and non-fatal stroke, heart failure, atrial fibrillation and sudden death, cancers by type, cancer-related mortality, type 2 diabetes mellitus and related mortalities. Secondary outcomes include the occurrence of other types of heart disease, hospitalization related to cardiovascular diseases and its recurrence, hospitalization because of cancers and its recurrence and hospitalization because of diabetes. For children and grandchildren aged less than 18 years, type 1 diabetes and new occurrence of any risk factor or change in behaviors will be considered as outcomes, while same outcomes for adults will be followed in children or grandchildren aged more than 18 years.