https://www.selleckchem.com/products/Sunitinib-Malate-(Sutent).html 81 ± 0.75 vs. 5.19 ± 1.22, P less then 0.001) and (72.50 ± 4.38 vs. 55.50 ± 7.42, P less then 0.001), respectively]. Also results showed that self-caring and adherence to treatment significantly increased after being adjusted for baseline measurement (P less then 0.001). The findings showed that DBT had effect on adherence to treatment and self-caring behavior of patients with CHD. CONCLUSION On the basis of results, it could be said that DBT intervention can have positive impact on adherence to treatment and self-caring behavior of patients with CHD. © 2019 Isfahan Cardiovascular Research Center & Isfahan University of Medical Sciences.BACKGROUND Cardiovascular disease (CVD) is one of the common diseases and today, it is considered as not only an important cause of mortality but also a significant aspect of health geography. The evidence presented in the literature indicates that hard water may reduce the cases of sudden death caused by CVDs because drinking water contains significant amounts of calcium and magnesium, which play a crucial role in the electrical activity of heart. Hence, the present study aimed at investigating the relationship between water hardness and CVD mortality rate in Isfahan, Iran. METHODS In this ecological study, the available data regarding the cardiovascular mortality rate and water hardness have been used. Preparation of zoning map has been conducted using the Geographic Information System (GIS) software considering Inverse Distance Weighting (IDW) interpolation models. Moreover, statistical analysis has been conducted using SPSS software. RESULTS A reverse relationship was observed between cardiovascular mortality rate and water hardness. However, the observed relationship was not statistically significant (2013 r = -0.066, 2014 r = -0.155, 2015 r = -0.051, P > 0.050). CONCLUSION The results of mapping with GIS and statistical analysis with SPSS both indicated a non-s