1887
Volume 2013, Issue 1
  • ISSN: 2225-9228
  • EISSN:

Abstract

Cardiovascular diseases (CVD) continue to be the leading cause of death worldwide. Countries in the Arabian Gulf region are prime examples of major shifts in demographic and epidemiologic profiles leading to an increased burden of chronic illness. This study estimated the association between five preventable conditions and risk factors and the development of myocardial infarction (MI) and cerebrovascular accidents (CVA) in the population of Qatar. We conducted a case control study among patients admitted to Hamad Medical Corporation with acute MI ( = 512) or CVA ( = 262) from June 2006–June 2008. Controls ( = 382) were randomly selected from unrelated inpatient and outpatient departments. Data collected included socio-demographic information, medical/family history, lifestyle characteristics, and depression assessments. Over two thirds of MI and half of CVA cases were younger than 55 years, with 12% and 7%, respectively, being under age 40. Cases were predominantly males, and Qatari nationals constituted 13% of MI and 25% of CVA cases. Approximately 40% of participants were overweight and an additional 30% were obese. Diabetes was the strongest preventable risk factor for MI (adjusted odds ratio [OR] = 3.31, 95% CI 1.97–5.57) and CVA (adjusted OR = 3.67, 95% CI 2.00–6.74). Hypertension was the second major preventable risk factor for CVA (adjusted OR = 2.73, 95% CI 1.59–4.68) and an important factor for MI (adjusted OR = 1.69, 95% CI 1.05–2.72). Minimal physical activity (defined as lack of vigorous or moderate activity for at least 10 minutes in the past month) increased the risk of MI and CVA by approximately 80%, while smoking increased the risk of MI two-fold. Exploratory analyses of the determinants of CVD among Qatari nationals identified diabetes, hypertension, high cholesterol, and smoking as potential preventable risk factors, but with higher odds ratios than other groups. Public health strategies to prevent MI and CVA should be based on alteration of risk factors found elsewhere in the world. However, the magnitude of these factors in Qatar suggests that the effectiveness of altering these risk factors is even more likely to have a significant impact. Designing population-level prevention interventions with awareness campaigns and supporting a culture of preventive health are critical for both Qatari nationals and the expatriate population.

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2013-11-01
2024-12-26
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References

  1. Aje TO, Miller M. Cardiovascular disease: A global problem extending into the developing world. World J Cardiol. 2009; 1::310.
    [Google Scholar]
  2. Akala FA, El-Saharty S. Public-health challenges in the Middle East and North Africa. Lancet. 2006; 367::961964.
    [Google Scholar]
  3. Rosengren A, Wallentin L, Simoons M, Gitt AK, Behar S, Battler A, Hasdai D. Cardiovascular risk factors and clinical presentation in acute coronary syndromes. Heart. 2005; 91::11411147.
    [Google Scholar]
  4. Musaiger AO. Diet and prevention of coronary heart disease in the Arab Middle East countries. Med Princ Pract. 2002; 11:Suppl 2:916.
    [Google Scholar]
  5. Benamer HT, Grosset D. Stroke in Arab countries: a systematic literature review. J Neurol Sci. 2009; 284::1823.
    [Google Scholar]
  6. World Migration 2005. Costs and Benefits of International Migration; 2005.
  7. Yusuf S, Reddy S, Ounpuu S, Anand S. Global burden of cardiovascular diseases: part I: general considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation. 2001; 104::27462753.
    [Google Scholar]
  8. Bener A, Al Suwaidi J, El-Menyar A, Gehani A. The effect of hypertension as a predictor of risk for congestive heart failure patients over a 10-year period in a newly developed country. Blood Pressure. 2004; 13::4146.
    [Google Scholar]
  9. Chaikhouni A, Chouhan L, Pomposiello C, Banna A, Mahrous F, Thomas G, al-Hassan NA, Khalifa S, Jaddan A, Bsata MW. Myocardial infarction in Qatar: the first 2515 patients. Clin Cardiol. 1993; 16::227230.
    [Google Scholar]
  10. Khan FY. Risk factors of young ischemic stroke in Qatar. Clin Neurol Neurosurg. 2007; 109::770773.
    [Google Scholar]
  11. Khan FY, Yasin M, Abu-Khattab M, El Hiday AH, Errayes M, Lotf AK, Ibrahim AS, Abbas MT, Matar I, Alsamawi M, Alhail H. Stroke in Qatar: a first prospective hospital-based study of acute stroke. J Stroke Cerebrovasc Dis. 2008; 17::6978.
    [Google Scholar]
  12. Akhtar N, Kamran SI, Deleu D, D'Souza A, Miyares F, Elsotouhy A, Al-Hail H, Mesraoua B, Own A, Salem K, Kamha A, Osman Y. Ischaemic posterior circulation stroke in State of Qatar. Eur J Neurol. 2009; 16::10041009.
    [Google Scholar]
  13. Bener A, Al Suwaidi J, Ghaffar A. Is hypertension a predictor for heart failure? A cross cultural comparison over a 10-year period. Eur J Heart Fail. 2005; 7::784786.
    [Google Scholar]
  14. National Health and Nutrition Examination [www.cdc.gov/nchs/nhanes.htm].
  15. Elashoff JD. Cork, Statistical Solutions. Cork, Ireland: Statistical Solutions 2007.
    [Google Scholar]
  16. Mushlin AI, Christos PJ, Abu-Raddad L, Chemaitelly H, Deleu D, Gehani AR. The importance of diabetes mellitus in the global epidemic of cardiovascular disease: the case of the state of Qatar. Trans Am Clin Climatol Assoc. 2012; 123::193207; discussion 207–8.
    [Google Scholar]
  17. Yusuf S, Hawken S, Ôunpuu S, Dans T, Avezum A, Lanas F, McQueen M, Budaj A, Pais P, Varigos J, Lisheng L, on behalf of the INTERHEART Study Investigators . Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004; 364::937952.
    [Google Scholar]
  18. Hossain MM, Kotekar ND, Dhar VK, Sunny PF. Clinical epidemiology of acute myocardial infarction in Sharjah, United Arab Emirates. Int J Cardiol. 1997; 58::7782.
    [Google Scholar]
  19. Bener A, Tewfik I. Prevalence of overweight, obesity, and associated psychological problems in Qatari's female population. Obes Rev. 2006; 7::139145.
    [Google Scholar]
  20. Bener A, Zirie M, Musallam M, Khader YS, Al-Hamaq AOAA. Prevalence of Metabolic Syndrome According to Adult Treatment Panel III and International Diabetes Federation Criteria: A Population-Based Study. Metab Syndr Relat D. 2009; 7::221229.
    [Google Scholar]
  21. Woo D, Haverbusch M, Sekar P, Kissela B, Khoury J, Schneider A, Kleindorfer D, Szaflarski J, Pancioli A, Jauch E, Moomaw C, Sauerbeck L, Gebel J, Broderick J. Effect of untreated hypertension on hemorrhagic stroke. Stroke. 2004; 35::17031708.
    [Google Scholar]
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