Alawi A Alsheikh-Ali1, Wael A Al-Mahmeed2, Avi Porath3, Ismail Khalil4, Hisham Mahmoud5, Deepak L Bhatt6, P Gabriel Steg7. 1. Institute of Cardiac Sciences, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates; Institute for Clinical Research and Health Policy Studies and Tufts University School of Medicine, Boston, Massachusetts, USA. 2. Institute of Cardiac Sciences, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates. 3. Maccabi Healthcare Services, Tel-Aviv, Israel. 4. Division of Vascular Surgery & Wound Care Center, Department of Surgery, American University of Beirut, Beirut, Lebanon. 5. Medical Affairs, Sanofi-aventis Gulf Office, Dubai, United Arab Emirates. 6. VA Boston Healthcare System and Brigham and Women's Hospital, Boston, Massachusetts, USA. 7. INSERM U-698, Université Paris 7 and AP-HP, Paris, France.
Abstract
OBJECTIVE: To characterise the risk-factor profile and treatment gaps among patients with, or at risk for, cardiovascular disease in the Middle East. DESIGN: Secondary analysis of a prospective observational study. SETTING: International multicentre study (Reduction of Atherothrombosis for Continued Health). PATIENTS: Stable outpatients with established cardiovascular disease or at least three risk factors for atherothrombosis. The present analysis was based on 840 patients from the Middle East. INTERVENTION: Observational study without a study-specific intervention. MAIN OUTCOME MEASURES: A treatment gap was defined as at least one of the following: current cigarette smoking, total cholesterol ≥200 mg/dl, serum glucose ≥126 mg/dl or blood pressure of ≥140/90. RESULTS: The majority of Middle Eastern patients had hypertension (80.2%), more than half had a history of diabetes mellitus (52.3%), and a third had hypercholesterolaemia (34.1%). There was a high prevalence of obesity (38.6%), and nearly half the patients were former or current smokers (46%). β-Blockers and angiotensin-converting enzyme inhibitors were the most commonly prescribed antihypertensives (61.1% and 57.5%, respectively). Antiplatelet therapy (most commonly aspirin) and lipid-lowering drugs (most commonly a statin) were used in most patients (90.7% and 85.2%, respectively). Three-quarters of the participants (75.6%) had at least one uncontrolled risk factor. CONCLUSION: Patients with atherothrombosis in the Middle East have a high prevalence of risk factors including alarming rates of diabetes mellitus and obesity. At least one risk factor is uncontrolled in the majority of patients, presenting a pressing need for improving the care of such patients in the Middle East.
OBJECTIVE: To characterise the risk-factor profile and treatment gaps among patients with, or at risk for, cardiovascular disease in the Middle East. DESIGN: Secondary analysis of a prospective observational study. SETTING: International multicentre study (Reduction of Atherothrombosis for Continued Health). PATIENTS: Stable outpatients with established cardiovascular disease or at least three risk factors for atherothrombosis. The present analysis was based on 840 patients from the Middle East. INTERVENTION: Observational study without a study-specific intervention. MAIN OUTCOME MEASURES: A treatment gap was defined as at least one of the following: current cigarette smoking, total cholesterol ≥200 mg/dl, serum glucose ≥126 mg/dl or blood pressure of ≥140/90. RESULTS: The majority of Middle Eastern patients had hypertension (80.2%), more than half had a history of diabetes mellitus (52.3%), and a third had hypercholesterolaemia (34.1%). There was a high prevalence of obesity (38.6%), and nearly half the patients were former or current smokers (46%). β-Blockers and angiotensin-converting enzyme inhibitors were the most commonly prescribed antihypertensives (61.1% and 57.5%, respectively). Antiplatelet therapy (most commonly aspirin) and lipid-lowering drugs (most commonly a statin) were used in most patients (90.7% and 85.2%, respectively). Three-quarters of the participants (75.6%) had at least one uncontrolled risk factor. CONCLUSION:Patients with atherothrombosis in the Middle East have a high prevalence of risk factors including alarming rates of diabetes mellitus and obesity. At least one risk factor is uncontrolled in the majority of patients, presenting a pressing need for improving the care of such patients in the Middle East.
Authors: E Magnus Ohman; Deepak L Bhatt; P Gabriel Steg; Shinya Goto; Alan T Hirsch; Chiau-Suong Liau; Jean-Louis Mas; Alain-Jean Richard; Joachim Röther; Peter W F Wilson Journal: Am Heart J Date: 2006-04 Impact factor: 4.749
Authors: Beverley Balkau; John E Deanfield; Jean-Pierre Després; Jean-Pierre Bassand; Keith A A Fox; Sidney C Smith; Philip Barter; Chee-Eng Tan; Luc Van Gaal; Hans-Ulrich Wittchen; Christine Massien; Steven M Haffner Journal: Circulation Date: 2007-10-23 Impact factor: 29.690