Jeremy D Kark1, Rita Fink, Bella Adler, Nehama Goldberger, Sylvie Goldman. 1. Epidemiology Unit, Hadassah Medical Organization and Hebrew University-Hadassah School of Public Health and Community Medicine, Ein Kerem, Jerusalem 91120, Israel. jeremy1@vms.huji.ac.il
Abstract
BACKGROUND: Lifestyle factors relevant to coronary risk factors differ between Palestinians and Israelis. Both have been exposed, albeit differently, to the stressors of the long-term conflict. We determined the incidence of coronary heart disease, previously unreported in Palestinians, in these Mediterranean populations and made international comparisons with the MONICA Programme. METHODS: We applied the rigorous World Health Organization MONICA protocol, which enables standardized international population-based comparisons, to determine all acute myocardial infarction events and coronary deaths among Palestinians and Israelis aged 25-74, residents of the Jerusalem district in 1997. RESULTS: We confirmed a total of 265 coronary events among 76,200 Arabs and 698 among 226,500 Jews. Rates among Arabs were substantially higher than in Jews, particularly so in women. Age-adjusted rate ratios (RRs) for coronary events were 1.58 [95% confidence interval (95% CI) 1.34-1.87] among men and 2.37 (95% CI 1.81-3.10) among women. When restricted to coronary deaths, Arab: Jewish RRs were 2.79 (95% CI 2.09-3.73) in men and 2.66 (95% CI 1.77-4.00) in women. Compared with MONICA populations in 20 countries, Arabs ranked first in total coronary event rates and first in non-fatal myocardial infarction rates, exceeded populations in Finland, Scotland, and Northern Ireland, and showed striking differences from the participating Mediterranean centres. CONCLUSIONS: Coronary risk appears to be particularly high in Palestinian Arabs. Determinants of these unexpected findings should be sought and prevention programmes initiated.
BACKGROUND: Lifestyle factors relevant to coronary risk factors differ between Palestinians and Israelis. Both have been exposed, albeit differently, to the stressors of the long-term conflict. We determined the incidence of coronary heart disease, previously unreported in Palestinians, in these Mediterranean populations and made international comparisons with the MONICA Programme. METHODS: We applied the rigorous World Health Organization MONICA protocol, which enables standardized international population-based comparisons, to determine all acute myocardial infarction events and coronary deaths among Palestinians and Israelis aged 25-74, residents of the Jerusalem district in 1997. RESULTS: We confirmed a total of 265 coronary events among 76,200 Arabs and 698 among 226,500 Jews. Rates among Arabs were substantially higher than in Jews, particularly so in women. Age-adjusted rate ratios (RRs) for coronary events were 1.58 [95% confidence interval (95% CI) 1.34-1.87] among men and 2.37 (95% CI 1.81-3.10) among women. When restricted to coronary deaths, Arab: Jewish RRs were 2.79 (95% CI 2.09-3.73) in men and 2.66 (95% CI 1.77-4.00) in women. Compared with MONICA populations in 20 countries, Arabs ranked first in total coronary event rates and first in non-fatal myocardial infarction rates, exceeded populations in Finland, Scotland, and Northern Ireland, and showed striking differences from the participating Mediterranean centres. CONCLUSIONS: Coronary risk appears to be particularly high in Palestinian Arabs. Determinants of these unexpected findings should be sought and prevention programmes initiated.
Authors: Guy Vishnevsky; Ronit Sinnreich; Hisham Nassar; Dafna Merom; Maya Ish-Shalom; Jeremy D Kark; Hagai Levine Journal: Am J Mens Health Date: 2022 Jul-Aug
Authors: Arsalan Abu-Much; Eyal Nof; Nicola Luigi Bragazzi; Anan Younis; David Hochstein; Arwa Younis; Nir Shlomo; Alexander Fardman; Ilan Goldenberg; Robert Klempfner; Roy Beinart Journal: Front Cardiovasc Med Date: 2021-06-30