To assess cardiovascular health (CVH) metrics using the American Heart Association’s Life’s Simple 7 (LS7) tool as a comprehensive measure of several metabolic and behavioural risk factors for cardiovascular diseases.

Cross-sectional study, nationally representative Iran STEPwise approach to non-communicable diseases risk factor surveillance (STEPS) survey 2021.

Iran, 2020–2021.

25 202 adult individuals aged 25 years and older participated in the STEPS survey.

Using the LS7 framework, seven factors were assessed: current smoking, body mass index (BMI), physical activity level, modified healthy diet score components, total cholesterol, blood pressure and fasting plasma glucose (FPG). Each factor was categorised into three levels of poor, intermediate and ideal, according to the LS7 methodology.

The study participants had a sex distribution of 55.5% females. The findings revealed a high prevalence of ideal levels of smoking (80.1%; 95% CI 79.3 to 81.0), total cholesterol (69.4%; 95% CI 68.5 to 70.4) and FPG (61.0%; 95% CI 60.0 to 62.1). BMI and blood pressure were ideal in about one-third of the population (33.0%; 95% CI 32.1 to 34.0, and 30.5%; 95% CI 29.6 to 31.4, respectively). However, only 13.3% (95% CI 12.6 to 14.0) of participants achieved ideal levels of physical activity, and a mere 0.4% (95% CI 0.3 to 0.6) adhered to an ideal healthy diet. Modest disparities in CVH metrics were observed across provinces and between two sexes. Ideal CVH status was significantly associated with lower risks of major diseases such as ischaemic heart disease, diabetes and chronic kidney disease.

Despite favourable scores in some CVH metrics, critical gaps in diet and physical activity highlight the need for intensive public health efforts to enhance CVH in Iran. The study emphasises the urgency of implementing region- and sex-specific public health policies.

Chronic kidney disease (CKD) is a global health concern and a major long-term complication of diabetes, yet its burden remains understudied in regions with limited epidemiological data. This study aimed to evaluate the prevalence of CKD and its associated risk factors in the Iranian adult population, stratified by diabetes status.

Population-based cross-sectional study.

Nationally representative survey across Iran (STEPS 2021).

17 607 adults aged ≥25 years with complete kidney function and albuminuria data, selected through systematic sampling with weighting to ensure national representativeness.

CKD was defined as an estimated glomerular filtration rate (eGFR)

The national prevalence of CKD was 11.9% (95% CI 11.2% to 12.6%), with 9.1% (8.5% to 9.9%) among individuals without diabetes and 28.6% (26.2% to 31.1%) among those with diabetes. According to KDIGO classification, 88.1% (87.4% to 88.8%) were at low risk, 9.0% (8.4% to 9.6%) at moderate risk, 2.0% (1.6% to 2.4%) at high risk and 0.9% (0.7% to 1.1%) at very high risk. Albuminuria was more prevalent than low eGFR in both groups with (22.5% (20.4% to 24.8%) vs 10.3% (8.7% to 12.1%)) and without (5.7% (5.2% to 6.3%) vs 4.3% (3.8% to 4.8%)) diabetes. Diabetes was more strongly linked to albuminuria than low eGFR and was progressively associated with higher risk categories (adjusted ORs (aORs) 2.41 (2.03–2.86) for moderate, 2.63 (1.74–3.97) for high, 3.93 (2.56–6.07) for very high vs low-risk). CKD prevalence was highest in northwest Iran, increased significantly with age, with a stronger association observed for low eGFR than albuminuria, and was associated with hypertension (aOR 2.41 (2.07–2.82)), dyslipidaemia (1.60 (1.31–1.94)), obesity (1.94 (1.59–2.36)), ischaemic heart disease (1.53 (1.25–1.87)) and physical inactivity (1.40 (1.20–1.62)). Higher socioeconomic status and education were associated with lower odds of CKD.

CKD is a major burden, especially in individuals with diabetes, with regional and socioeconomic disparities. Addressing risk factors, integrating CKD into non-communicable disease surveillance and prioritising it in global health agendas, including the Sustainable Development Goals, are essential.