Socioeconomic Disparities and Smoking Habits in Metabolic Syndrome: Evidence from Isfahan Healthy Heart Program

Background: The metabolic syndrome (Mets) consists of major clustering of cardiovascular disease (CVD) risk factors. This study determines the association of socioeconomic determinants and smoking behavior in a population- based sample of Iranians with Mets. Methods: This cross-sectional survey comprised 12600 randomly selected men and women aged ≥ 19 years living in three counties in central part of Iran. They participated in the baseline survey of a community-based program for CVD prevention entitled” Isfahan Healthy Heart Program” in 2000-2001. Subjects with Mets were selected based on NCEP- ATPIII criteria. Demographic data, medical history, lifestyle, smoking habits, physical examination, blood pressure, obesity indices and serum lipids were determined. Results: The mean age of subjects with Mets was significantly higher. The mean age of smokers in both groups was higher than non-smokers but with lower WC and WHR. Marital status, age and residency were not significantly different in smokers with Mets and non-smokers with Mets. Smoking was more common in the middle educational group in the income category of Quartile 1-3. Mets was significantly related to age, sex and education. Middle-aged and elderly smokers were at approximately 4-5 times higher risk among Mets subjects. Low education decreased the risk of Mets by 0.48; similarly in non-smokers, 6-12 years of education decreased the risk of Mets by 0.72. Conclusion: More educated persons had a better awareness and behavior related to their health and role of smoking. In the lower social strata of the Iranian population, more efforts are needed against smoking habits.