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. 2017 Oct;29(4):235-243.
doi: 10.1016/j.jsha.2017.03.004. Epub 2017 Mar 14.

Cardiovascular risk factors burden in Saudi Arabia: The Africa Middle East Cardiovascular Epidemiological (ACE) study

Amjad M Ahmed  1 , Ahmad Hersi  2 , Walid Mashhoud  3 , Mohammed R Arafah  2 , Paula C Abreu  4 , Mohammed Abdullah Al Rowaily  5 , Mouaz H Al-Mallah  1   5   6
Affiliations

Cardiovascular risk factors burden in Saudi Arabia: The Africa Middle East Cardiovascular Epidemiological (ACE) study

Amjad M Ahmed et al. J Saudi Heart Assoc. 2017 Oct.

Abstract

Background: Limited data exist on the epidemiology of cardiovascular risk factors in Saudi Arabia, particularly in relation to the differences between Saudi nationals and expatriates in Saudi Arabia. The aim of this analysis was to describe the current prevalence of cardiovascular risk factors among patients attending general practice clinics across Saudi Arabia.

Methods: In this cross-sectional epidemiological analysis of the Africa Middle East Cardiovascular Epidemiological (ACE) study, the prevalence of cardiovascular risk factors (hypertension, diabetes, dyslipidemia, obesity, smoking, abdominal obesity) was evaluated in adults attending primary care clinics in Saudi Arabia. Group comparisons were made between patients of Saudi ethnicity (SA nationals) and patients who were not of Saudi ethnicity (expatriates).

Results: A total of 550 participants were enrolled from different clinics across Saudi Arabia [aged (mean ± standard deviation) 43 ± 11 years; 71% male]. Nearly half of the study cohort (49.8%) had more than three cardiovascular risk factors. Dyslipidemia was the most prevalent risk factor (68.6%). The prevalence of hypertension (47.5%) and dyslipidemia (75.5%) was higher among expatriates when compared with SA nationals (31.4% vs. 55.1%, p = 0.0003 vs. p < 0.0001, respectively). Conversely, obesity (52.6% vs. 41.0%; p = 0.008) and abdominal obesity (65.5% vs. 52.2%; p = 0.0028) were higher among SA nationals vs. expatriates.

Conclusion: Modifiable cardiovascular risk factors are highly prevalent in SA nationals and expatriates. Programmed community-based screening is needed for all cardiovascular risk factors in Saudi Arabia. Improving primary care services to focus on risk factor control may ultimately decrease the incidence of coronary artery disease and improve overall quality of life. The ACE trial is registered under NCT01243138.

Keywords: ACE study; Cardiovascular risk factors; Expatriates; Saudi Arabia.

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Figures

Figure 1
Figure 1
Prevalence of cardiovascular risk factors per patient.
Figure 2
Figure 2
Eligibility of lipid-lowering medication according to the ACC/AHA guidelines. ASCVD = atherosclerotic cardiovascular disease; LDL-C = low-density lipiprotrein cholesterol.
Figure 3
Figure 3
Prevalence of newly diagnosed hypertension, diabetes mellitus, and dyslipidemia.
Figure 4
Figure 4
Prevalence of cardiovascular risk factors in patients with metabolic syndrome. All metabolic (n = 230); SA nationals (n = 64); expatriates (n = 166).
Figure 5
Figure 5
Box plot of lipid profile, blood pressure, fasting plasma glucose, and waist circumference measures across patients with metabolic syndrome. HDL-C = high-density lipoprotein cholesterol; LDL-C = low-density lipoprotein cholesterol; SA = Saudi Arabia.
See this image and copyright information in PMC

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