High risk factors for developing cardiovascular disease among Saudis

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Cardiovascular disease (CVD) is the leading cause of death worldwide, contributing to 31 percent of all deaths, according to WHO reports. Cardiovascular disease has also become a major health concern in the Gulf Cooperation Council countries, including Saudi Arabia, where it is estimated that cardiovascular diseases are responsible for more than 45 percent of all deaths.
Talk to “Your Health” Prof. Dr. Khaled bin Fayez Al Habib, Consultant Cardiac Diseases and Catheterization for Adults at King Fahd Center for Cardiac Diseases and Surgery, College of Medicine, King Saud University and President of the Heart Disease Control Society (NAKEDT), explaining that the most common risk factors for cardiovascular diseases that were identified in The global studies are high blood pressure, diabetes, dyslipidemia, obesity, smoking, lack of physical activity, malnutrition and alcohol consumption. In the Gulf countries, as the lifestyle changes dramatically due to rapid urbanization with the increase in malnutrition and the adoption of a sedentary lifestyle, the rates of risk factors for cardiovascular disease and chronic non-communicable diseases among Gulf residents are also high.
Urban and rural epidemiology
This called for a future global study to determine the epidemiology of heart disease in high, middle and low income countries in which data are collected on social, environmental and individual risk factors and chronic diseases, which is the study known as “Prospective Urban and Rural Epidemiology, PURE”, a group study. International for adults between the ages of 35 and 70 in 20 countries. We have already dealt with in a previous article one of the aspects of this study, which was about the effect of air pollution on increasing the incidence of heart and stroke. In this article, we will review the results of the study on risk factors for cardiovascular, behavioral and demographic diseases in the Saudi population.
> The Saudi Arabia “PURE” study. Professor Khaled Al-Habib, in his capacity as the supervisor of this study in Saudi Arabia, adds that the Kingdom was classified as a high-income country and joined the global “PURE” study in 2012. The current “PURE-Saudi” Saudi study focuses mainly on assessing the demographics and the non-lifestyle lifestyle. Health and prevalence of CVD risk factors, broken down by age, gender and place of residence (urban versus rural). The study sample was followed up to record the incidence of cancer, myocardial infarction, stroke, heart failure, and death during the follow-up period (3.2 – 6.1 years) with an average of 3.4 years.
Participants in the PURE – Saudi study were selected from 19 urban and 6 rural communities during the period between February 2012 and January 2015. The participating urban communities were determined according to the governmental geographical distribution of regions, while the rural communities were identified as Those areas that are located at least 50 km from the center of Riyadh.
The data were classified by age, gender, and urban versus rural, and were summarized as a means and standard of deviations for continuous variables and as numbers and percentages for categorical variables. Ratios and means were compared between men and women, between age groups, and between urban and rural areas, using the Chi-square test and the t-test, respectively.
Main results. 2,047 subjects participated in the PURE – Saudi study, with an average age of 46.5 ± 9.12 years; 43.1 percent are women, 24.5 percent are rural. Overall, 69.4% had low physical activity, 49.6% obesity, 34.4% unhealthy diet, 32.1% high blood fats, 30.3% high blood pressure, 25.1% diabetes, 12.2% are currently smokers , 15.4% reported sadness, 16.9% had a history of stress, 6.8% had persistent stress, 1% had a history of stroke, 0.6% had heart failure, and 2.5% had coronary heart disease (CHD). ).
Compared to the women, more men were currently smokers and had diabetes and a history of coronary artery disease. As for women, they were more likely to suffer from obesity, central obesity, sadness, stress, feeling of constant stress, and a low level of education.
Countryside diseases
Compared to participants in urban areas, those who lived in rural areas had higher rates of diabetes, obesity, high blood pressure, lower rates of an unhealthy diet, self-sadness, stress (multiple periods), and lasting stress. Compared with middle-aged and elderly individuals, younger participants more commonly reported an unhealthy diet, constant stress, and feelings of sadness.
Professor Khaled Al-Habib adds that the PURE – Saudi study yielded two main results. First, the prevalence of risk factors for cardiovascular disease is high among the Saudi population, as half of them suffer from obesity, two-thirds suffer from low physical activity, one-third follow an unhealthy diet, another third suffer from dyslipidemia, another third are from high blood pressure, and a quarter are afflicted. Diabetes. Second, the proportion of individual risk factors for CVD varies with age, gender, and residence in urban areas than in rural areas.
It is worth noting that this study is supported by several bodies represented by the Saudi Heart Association, the Saudi Society for the Digestive System, Dr. Muhammad Al-Faqih Hospital, and the Deanship of Scientific Research at King Saud University in Riyadh.
Diabetes and blood pressure
Compared to the general population, people with diabetes are two to four times more likely to develop cardiovascular disease. According to the Diabetes Atlas of the International Diabetes Federation (eighth edition), Saudi Arabia is among the top ten countries in the spread of diabetes, which is estimated to increase by 110 percent in the Middle East and North Africa by 2045. As for the prevalence of diabetes, according to the study Global “PURE” Saudi Arabia was among the highest recorded levels, and the disease prevalence was 11 percent, varying between income groups, with the lowest value (6.6 percent) in high-income countries and the highest (12.3 percent) in low-income countries.
As for the prevalence of hypertension, it was 40.8 per cent according to PURE Global, and the prevalence, awareness, treatment and control report on hypertension from PURE baseline data from four countries in the Middle East (Iran, Occupied Palestinian Territories, Saudi Arabia, and the United Arab Emirates) showed that A third of them had high blood pressure, about half of them were aware and treated, and only a fifth were under control. The prevalence of hypertension was highest in the United Arab Emirates (52 percent) and lowest in Iran (28 percent), while awareness, treatment and control of hypertension was higher in the Occupied Palestinian Territories and Saudi Arabia compared to the UAE and Iran.
It has been found in national studies that controlling high blood pressure is sub-optimal among the Saudi population, and forgetting to take medical treatments and the side effects of drugs may be an important obstacle to compliance, as health care and medicines are available free of charge, making them largely accessible to the population.
Obesity
The overall obesity prevalence rate in the global study was about 49.6 per cent, which is higher than the most recent national surveys conducted in Saudi Arabia, which indicates that obesity prevention programs have no effect in the Kingdom. Our findings support the results of a secondary analysis of published data that estimated trends and expectations in the age- and gender-specific prevalence of adult obesity in Saudi Arabia over a 30-year period from 1992 to 2022. The prevalence of obesity was expected to increase significantly (by more than 200 percent). Among men and women between the ages of 25 and 64, the expected prevalence of women is much higher than that of men.
One of the results of the PURE Saudi study showed that women are fatter compared to men. A possible explanation for the high prevalence of obesity among women in this group might be sociocultural factors and government regulations. Until recently, these factors included women having a driver for transportation purposes, as well as barriers to physical activities in public places. Increasing women’s access to exercise facilities and providing safe areas for walking will likely help reduce the prevalence of obesity. Recently, access to gyms for women in Saudi Arabia has become more accessible, and women are now allowed to drive on their own, which may improve access to a healthier lifestyle.
The results from the global PURE study from high-income countries reclassified the degree of risk and is similar between populations in rural and urban areas, contrary to the common notion, we have, that the risk of developing cardiovascular disease is higher in individuals who live in urban versus rural areas. However, the PURE Saudi study showed that rural residents have a higher prevalence of CVD risk factors, especially diabetes, high blood pressure, and obesity, compared to urban residents. The possible causes may be related to what some researchers have called “urbanization of rural life”, where agriculture has become automated, cars are used for transportation, road infrastructure has improved, and the consumption of processed carbohydrates, processed and processed foods increases, which will contribute to the increase in obesity.
The higher prevalence of diabetes in rural than in urban areas supports the link between diabetes and lifestyle risk factors, because lifestyle changes are less prominent in rural areas. In addition, the lower educational level among the rural population identified in this study could partly explain the differences in levels of risk factors.
The importance of primary prevention
Healthcare is the main focus of Saudi Vision 2030. Through which the Saudi government initiated radical changes in the structure and function of the health care system through the National Transformation Program to achieve quality care and provide effective services. In addition, the government has already recognized the importance of primary prevention of cardiovascular disease and has announced four major projects aimed at improving lifestyles. Moreover, the World Heart Federation has taken an initiative to develop a series of “road maps” to reduce premature deaths from cardiovascular disease by at least 25 percent by 2025. These road maps can be used as a guide for countries seeking to develop or update their national programs. For the prevention and control of noncommunicable diseases.
* Consultant in community medicine
Finally, Professor Khaled Al-Habib concludes from the “PURE-Saudi” study that the continued spread of unhealthy lifestyles and risk factors for cardiovascular disease among the adult Saudi population reflects a continuing trend in several population surveys, some of these factors were more prevalent in the countryside. In urban residents. He emphasized that there is an urgent need for national awareness programs and multi-faceted healthcare policy changes to reduce the future burden of CVD risks and deaths.

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