Cardiovascular Disease Mortality Events and Predictors in the Tehran Lipid and Glucose Study: A 20-Year Cohort Review .

Context: We summarized findings from the Tehran Lipid and Glucose Study (TLGS) on cardiovascular disease (CVD) mortality and its predictors over nearly two decades. Evidence Acquisition: A review was undertaken to retrieve TLGS publications related to CVD mortality and predictors from the January 1999 to August 5, 2025. Results: Across TLGS studies, the crude incidence rate of CVD mortality ranged from 1.7 to 4.1 per 1000 person-years in adults aged ≥ 30 years, with higher rates observed among men than women. CVD mortality was associated with traditional risk factors such as diabetes, hypertension, metabolic syndrome (MetS), and dyslipidemia, as well as emerging markers including continuous MetS severity score, anthropometric indices, dynamic weight change, kidney function decline, resting pulse rate, and adherence to cardiovascular health metric. Evidence also highlighted differential associations by age, sex, and diabetes status. Subgroup analyses indicated that elderly participants and those with metabolic abnormalities had higher CVD and sudden cardiac death (SCD) risks. Conclusions: Tehran Lipid and Glucose Study studies have provided comprehensive insights into the epidemiology and predictors of CVD mortality in the Iranian population, emphasizing both traditional and emerging risk factors. These findings can inform tailored prevention and intervention strategies, though further research incorporating dynamic risk models, omics data, and sex-specific analyses is warranted.