American Heart Association's Life's Simple 7 for cardiovascular health assessment among Iranian adults: a national cross-sectional study from STEPwise approach to non-communicable diseases risk factor surveillance (STEPS) survey 2021.

The majority of Iranian adults achieved ideal levels for smoking, total cholesterol, and fasting plasma glucose.

• Ideal smoking status prevalence: 80.1% (95% CI 79.3 to 81.0)
• Ideal total cholesterol prevalence: 69.4% (95% CI 68.5 to 70.4)
• Ideal fasting plasma glucose (FPG) prevalence: 61.0% (95% CI 60.0 to 62.1)
• Study sample: 25,202 adult individuals aged 25 years and older from the Iran STEPS survey 2020–2021
• Sex distribution of participants was 55.5% females

Ideal BMI and blood pressure were each achieved by approximately one-third of the Iranian adult population.

• Ideal BMI prevalence: 33.0% (95% CI 32.1 to 34.0)
• Ideal blood pressure prevalence: 30.5% (95% CI 29.6 to 31.4)
• Both metrics were categorised using the LS7 framework into poor, intermediate, and ideal levels

Physical activity and healthy diet were the worst-performing cardiovascular health metrics among Iranian adults.

• Only 13.3% (95% CI 12.6 to 14.0) of participants achieved ideal levels of physical activity
• A mere 0.4% (95% CI 0.3 to 0.6) adhered to an ideal healthy diet
• These two metrics represent the most critical gaps in cardiovascular health in the Iranian population
• Diet was assessed using modified healthy diet score components within the LS7 framework

Modest disparities in cardiovascular health metrics were observed across Iranian provinces and between sexes.

• Sex distribution of the sample was 55.5% females
• Province-level and sex-specific variations were identified across the seven LS7 metrics
• Disparities were characterized as 'modest' by the authors
• The findings emphasize the need for region- and sex-specific public health policies

Ideal cardiovascular health status was significantly associated with lower risks of major chronic diseases.

• Ideal CVH status was associated with lower risk of ischaemic heart disease
• Ideal CVH status was associated with lower risk of diabetes
• Ideal CVH status was associated with lower risk of chronic kidney disease
• The association was described as 'significant' in the context of the LS7 framework applied to the Iranian population

The study used the American Heart Association's Life's Simple 7 framework to assess cardiovascular health in a nationally representative Iranian sample.

• Seven factors were assessed: current smoking, BMI, physical activity level, modified healthy diet score components, total cholesterol, blood pressure, and fasting plasma glucose
• Each factor was categorised into three levels: poor, intermediate, and ideal
• Data were drawn from the Iran STEPwise approach to non-communicable diseases risk factor surveillance (STEPS) survey 2021 (conducted 2020–2021)
• Sample size was 25,202 adult individuals aged 25 years and older
• Study design was cross-sectional and nationally representative