Ethics code: IR.IAU.K.REC.1404.081
Deniz Fardi1 
, Ali Montazeri2 , Saied Malihialzackerini *1 , Mohammadreza Seirafi1 , Tahereh Ranjbaripour1
, Ali Montazeri2 , Saied Malihialzackerini *1 , Mohammadreza Seirafi1 , Tahereh Ranjbaripour1
1- Department of Clinical and Health Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran
2- Population Health Research Group, Health Metrics Research Center, Institute for Health Sciences Research, ACECR, Tehran, Iran
2- Population Health Research Group, Health Metrics Research Center, Institute for Health Sciences Research, ACECR, Tehran, Iran
Abstract: (261 Views)
Objective (s): Quality of life is an important health-related outcome measure. This study aimed to assess quality of life in a sample of male patients with premature coronary artery disease (PCAD) and examine its relationship with blood pressure (BP) and lipoproteins (LDL and HDL).
Methods: A convenience sample of 240 male patients with confirmed premature coronary artery disease was recruited and were entered into the study. In addition to demographic information, systolic, and diastolic blood pressure, LDL and HDL values were extracted from case records. Quality of life was measure using the SF-12 version 2. Descriptive analysis was performed to analyze the data.
Results: The mean (SD) age of participants was 43.29 (*.74) years. The mean (SD) of the physical quality of life component summary score (PCS) was 46.25 (10.26) and it was 49.29 (11.29) for the mental quality of life component summary score. The findings showed that higher LDL values were significantly influenced quality of life in both dimensions while, although in the expected directions, blood pressure categories and LDH did not show statistically significant associations.
Conclusion: The findings suggest higher values of LDL could significantly harm quality of life in male patients suffering from premature coronary artery disease. Preventive measures is recommended to improve quality of life in this population.
Methods: A convenience sample of 240 male patients with confirmed premature coronary artery disease was recruited and were entered into the study. In addition to demographic information, systolic, and diastolic blood pressure, LDL and HDL values were extracted from case records. Quality of life was measure using the SF-12 version 2. Descriptive analysis was performed to analyze the data.
Results: The mean (SD) age of participants was 43.29 (*.74) years. The mean (SD) of the physical quality of life component summary score (PCS) was 46.25 (10.26) and it was 49.29 (11.29) for the mental quality of life component summary score. The findings showed that higher LDL values were significantly influenced quality of life in both dimensions while, although in the expected directions, blood pressure categories and LDH did not show statistically significant associations.
Conclusion: The findings suggest higher values of LDL could significantly harm quality of life in male patients suffering from premature coronary artery disease. Preventive measures is recommended to improve quality of life in this population.
type of study: Descriptive |
Subject:
Health Metrics
Received: 2026/04/7 | Accepted: 2026/04/20 | ePublished ahead of print: 2026/05/17
Received: 2026/04/7 | Accepted: 2026/04/20 | ePublished ahead of print: 2026/05/17
References
1. Virani SS, Alonso A, Aparicio HJ, Benjamin EJ, Bittencourt MS, Callaway CW, et al. Heart disease and stroke statistics-2025 update: a report from the American Heart Association. Circulation 2025;151:e1-e578
2. World Health Organization. Preventing chronic diseases: a vital investment. Geneva: World Health Organization; 2005, 200
3. World Heart Federation. World Heart Report 2023: Confronting the World's Number One Killer [Internet]. Geneva: World Heart Federation; 2023 [cited 2026 Apr 19]. Available from: https://heartreport23.world-heart-federation.org/
4. Sarrafzadegan N, Mohammadifard N. Cardiovascular disease in Iran in the last 40 years: prevalence, mortality, morbidity, challenges and strategies for cardiovascular prevention. Archives of Iranian Medicine 2019;22:204-210
5. Rallidis LS, Jovanovic A, Rallidis L. Distinctive characteristics, risk factors, and prevention of premature myocardial infarction: A narrative review. Journal of Family Medicine and Primary Care 2024;13:3509-3517 [DOI:10.4103/jfmpc.jfmpc_1874_23]
6. Zhang YM, Yu GX, Wang C, et al. Research progress on pathogenesis and prevention of premature coronary heart disease. Chinese Journal of Clinical Medicine 2024;31:491-498
7. Manolis AA, Manolis TA, Manolis AS. Early-onset or Premature Coronary Artery Disease. Current Medicinal Chemistry 2025;32:1040-1064 [DOI:10.2174/0109298673303891240528114755]
8. Vikulova D, Bevanda L, Pimstone SN, Brunham LR. Clinical and radiological testing for subclinical atherosclerosis in first-degree relatives of patients with premature coronary artery disease: feasibility and diagnostic yield. European Heart Journal. 2021;42(Suppl 1):ehab724.2510 [DOI:10.1093/eurheartj/ehab724.2460]
9. Poorzand H, Tsarouhas K, Hozhabrossadati SA, Khorrampazhouh N, Bondarsahebi Y, Bacopoulou F, et al. Risk factors of premature coronary artery disease in Iran: A systematic review and meta-analysis. European Journal of Clinical Investigation 2019;49:e13124 [DOI:10.1111/eci.13124]
10. Haji Aghajani M, Taherpour N, Parsa Mahjoob M, Kachoueian N, Alipour M, Ghorbani S. Is the prevalence of risk factors, clinical presentations and severity of coronary artery diseases (CAD) in patients with very early and premature CAD are different from mature CAD patients?: A registry-based cross-sectional study. Global Epidemiology 2024;8:100148 [DOI:10.1016/j.gloepi.2024.100148]
11. DeFilippis EM, Singh A, Divakaran S, et al. Coronary Artery Disease in Young Adults: A Hard Lesson But a Good Teacher. Journal of the American College of Cardiology 2019;74:1865-1867
12. Prasad M, Gupta S. Countries with fewer procedures for cardiovascular disease management face greater premature mortality from noncommunicable diseases. Indian Journal of Community Medicine 2025;50:318-323 [DOI:10.4103/ijcm.ijcm_420_23]
13. Asif T, Saleem M, Majeed H, et al. Evaluating Gender-Based Differences in Outcomes of Premature Coronary Artery Disease. Circulation 2024;150(Suppl 1):A4139669 [DOI:10.1161/circ.150.suppl_1.4139669]
14. Dayanand P, Rakam K, Chepuri S. Early-Onset Coronary Artery Disease in Young Adults: A Systematic Review. European Journal of Cardiovascular Medicine 2025;15:301-309
15. Akbari A, Mirshahi A, Daneshvar M, Hosseini Moghadam MS, Rohani F, Khoshavi M. Correlation between a healthy lifestyle index, quality of life, and depression in Iranian individuals with cardiovascular disease. Discover Mental Health 2025;5:138 [DOI:10.1007/s44192-025-00266-7]
16. Leung Yinko SS, Pelletier R, Behlouli H, Norris CM, Humphries KH, Pilote L, et al. Health-related quality of life in premature acute coronary syndrome: does patient sex or gender really matter? Journal of the American Heart Association 2014;3:e000901 [DOI:10.1161/JAHA.114.000901]
17. Zarepur E, Mohammadifard N, Mansourian M, Roohafza H, Sadeghi M, Khosravi A, et al. Rationale, design, and preliminary results of the Iran-premature coronary artery disease study (I-PAD): a multi-center case-control study of different Iranian ethnicities. ARYA Atherosclerosis 2020;16:295-300
18. Zarepur E, Mohammadifard N, Nedaeinia R, Sadeghi M, Asgary S, Gharipour M, et al. Preliminary Results of Iran Premature Coronary Artery Disease (IPAD study) and Implementation of IPAD Biobank: A Case-Control Study. Archives of Iranian Medicine 2024;27:479-485 [DOI:10.34172/aim.26603]
19. Haji Aghajani M, Sadeghi R, Parsa Mahjoob M, Heidari A, Omidi F, Sistanizad M, et al. The Coronary Angiography and Angioplasty Registry (CAAR) in Iran: Registry Protocol and Results of the Pilot Study. Medical Journal of the Islamic Republic of Iran 2024;38:80 [DOI:10.47176/mjiri.38.80]
20. Ghasempour Dabaghi G, Zarepur E, Rabiee Rad M, Mohammadifard N, Haghighatdoost F, Khosravi A, et al. Dietary patterns and premature coronary artery disease: result from the Iran premature coronary artery disease (IPAD) study. BMC Cardiovascular Disorders 2024;24:683 [DOI:10.1186/s12872-024-04333-9]
21. Moezi Bady SA, Salmani F, Zarepur E, et al. Investigating ethnic differences in risk factors and severity of developing premature coronary artery disease: Predicting the effect of risk factors through decision tree analysis in a multicenter case-control study; Results from Iran Premature Coronary Artery Disease (IPAD study). Journal of Cardiovascular and Thoracic Research 2025;17:49-57 [DOI:10.34172/jcvtr.025.33190]
22. Jamali N, Tofighi S, et al. Health-related quality of life and its related factors in patients undergoing coronary angioplasty, Zanjan, northwest Iran. International Journal of Ayurveda and Medicine 2022;13:164-174 [DOI:10.47552/ijam.v13i1.2323]
23. Karamali-Shorkaei M, et al. Effect of multimorbidity on quality of life in adult with cardiovascular disease: A cross-sectional study. Health and Quality of Life Outcomes 2017;15:237 [DOI:10.1186/s12955-017-0820-8]
24. Abbasi SH, Kassaian SE, Sadeghian S, Karimi A, Saadat S, Peyvandi F, et al. Introducing the Tehran Heart Center's Premature Coronary Atherosclerosis Cohort: THC-PAC Study. Journal of Tehran University Heart Center 2015;10:34-42
25. Ware JE, Kosinski M, Keller SD. A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Medical Care 1996;34:220-233 [DOI:10.1097/00005650-199603000-00003]
26. Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Medical Care 1992;30:473-483 [DOI:10.1097/00005650-199206000-00002]
27. Ware JE, Kosinski M, Turner-Bowker DM, Gandek B. How to score version 2 of the SF-12 health survey. 1st Edition, Lincoln (RI): QualityMetric Incorporated: USA, 2002
28. Ware JE, Kosinski M, Keller SD. SF-12: How to score the SF-12 physical and mental health summary scales. 2st Edition, The Health Institute, New England Medical Center: Boston (MA), 1995
29. Gandek B, Ware JE, Aaronson NK, et al. Cross-validation of item selection and scoring for the SF-12 Health Survey in nine countries: results from the IQOLA Project. Journal of Clinical Epidemiology 1998;51:1171-1178 [DOI:10.1016/S0895-4356(98)00109-7]
30. Montazeri A, Vahdaninia M, Mousavi SJ, Omidvari S. The Iranian version of 12-item Short Form Health Survey (SF-12): factor structure, internal consistency and construct validity. BMC Public Health 2009;9:341 [DOI:10.1186/1471-2458-9-341]
31. Montazeri A, Vahdaninia M, Mousavi SJ, Asadi-Lari M, Omidvari S, Tavousi M. The 12-item medical outcomes study short form health survey version 2.0 (SF-12v2): a population-based validation study from Tehran, Iran. Health and Quality of Life Outcomes 2011;9:12 [DOI:10.1186/1477-7525-9-12]
32. Dreyer RP, Wang Y, Strait KM, et al. Gender differences in pre-event health status of young patients with acute myocardial infarction: A VIRGO study analysis. European Heart Journal: Acute Cardiovascular Care 2015;5:43-54 [DOI:10.1177/2048872615568967]
33. Sharma SK, Singh SK, Sharma AK, et al. Premature coronary artery disease, risk factors, clinical presentation, angiography and interventions: Hospital based registry. Indian Heart Journal 2022;74:391-397 [DOI:10.1016/j.ihj.2022.08.003]
34. Bucholz EM, Strait KM, Dreyer RP, et al. Sex differences in young patients with acute myocardial infarction: A VIRGO study analysis. Circulation 2014;130 (Suppl 2):A12345
35. Amlak BT, Getie A, Messelu MA, Ayenew T, GebreEyesus FA, Emire MS, et al. Health-related quality of life among adult hypertensive patients globally: a systematic review and meta-analysis. BMJ Public Health 2025;3:e001662 [DOI:10.1136/bmjph-2024-001662]
36. Wesselbaum D. Association of Hypertension with Well-Being: Results from the Behavioral Risk Factor Surveillance System (BRFSS) Study. High Blood Pressure and Cardiovascular Prevention 2024;31:401-404 [DOI:10.1007/s40292-024-00653-1]
37. Aydemir O, Ozdemir C, Koroglu E. The impact of co-morbid conditions on the SF-36: a primary-care-based study among hypertensives. Archives of Medical Research 2005;36:136-141 [DOI:10.1016/j.arcmed.2004.12.009]
38. Mamedov MN, Mardanov BU, Akhmedova EB. Quality of life and comorbidity index in patients with arterial hypertension and comorbidities. Profilakticheskaya Meditsina 2023;26:56-62 [DOI:10.17116/profmed20232602156]
39. Otieno P, Asiki G, Wilunda C, Wami W, Agyemang C. Cardiometabolic multimorbidity and associated patterns of healthcare utilization and quality of life: Results from the Study on Global AGEing and Adult Health (SAGE) Wave 2 in Ghana. PLOS Glob Public Health 2023; 3: e0002215 [DOI:10.1371/journal.pgph.0002215]
40. Soto ME, Rodríguez G, Hernández E, et al. Lipid control and health-related quality of life in patients with acute coronary syndrome: A prospective cohort study. Journal of Clinical Lipidology 2023;17:512-520
41. Jain V, Al Rifai M, Turpin R, et al. Evaluation of Factors Underlying Sex-Based Disparities in Cardiovascular Care in Adults With Self-reported Premature Atherosclerotic Cardiovascular Disease JAMA Cardiology 2022;7:284-291 [DOI:10.1001/jamacardio.2021.5430]
42. Thompson Coon J, Abbott R, Bailey N, et al. Association between LDL cholesterol control and health-related quality of life in patients with cardiovascular disease: A systematic review and meta-analysis. European Journal of Preventive Cardiology 2023;30:1245-1256
43. Alothman L, et al. Health-related quality of life in homozygous familial hypercholesterolemia: A systematic review and meta-analysis. Journal of Clinical Lipidology 2022;16:52-65 [DOI:10.1016/j.jacl.2021.11.014]
44. Jannes CE, et al. Health related quality of life in individuals at high risk for familial hypercholesterolemia undergoing genetic cascade screening in Brazil. Atherosclerosis 2018;278:239-246
45. Lalonde L, O'Connor A, Joseph L, Grover S. Health-related quality of life with coronary heart disease prevention and treatment. Journal of Clinical Epidemiology 2001;54:1011-1018 [DOI:10.1016/S0895-4356(01)00361-4]
46. Rodriguez A. High HDL-Cholesterol Paradox: SCARB1-LAG3-HDL Axis. Current Atherosclerosis Reports 2021;23:13 [DOI:10.1007/s11883-020-00902-3]
47. HDL Cholesterol Guide: The Good Cholesterol Story [Internet]. Superpower; 2025 [cited 2026 Apr 28]. Available from: https://superpower.com/biomarker-guides/hdl-cholesterol
48. Madsen CM, Varbo A, Nordestgaard BG. Extreme high high-density lipoprotein cholesterol is paradoxically associated with high mortality in men and women: two prospective cohort studies. European Heart Journal 2017;38:2478-2486 [DOI:10.1093/eurheartj/ehx163]
49. Lin WY, Chan CC, Liu YL, Yang AC, Tsai SJ, Kuo PH. Sex-specific autosomal genetic effects across 26 human complex traits. Human Molecular Genetics 2020;29:1218-1228 [DOI:10.1093/hmg/ddaa040]
50. Ansell BJ, Fonarow GC, Fogelman AM. The paradox of dysfunctional high-density lipoprotein. Current Opinion in Lipidology 2007;18:427-434 [DOI:10.1097/MOL.0b013e3282364a17]
51. Pereira de Lima M, Conopca S, Miyabara R, Romeiro G, Campos LA, Baltatu OC. Cardiovascular and Quality of Life Outcomes of a 3-Month Physical Exercise Program in Two Brazilian Communities. International Journal of Environmental Research and Public Health 2022;19:9021
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