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Coronary artery disease in Africa and the Middle East
Wael Almahmeed1, Mohamad Samir Arnaout, Rafik Chettaoui
1Heart and Vascular Institute, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates.
Insights
Cardiovascular disease is a major health challenge in Africa and the Middle East, with younger heart attack patients and rising mortality. Beta-blockers remain effective for cardiovascular disease prevention and management.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Cardiovascular disease (CVD) poses a significant health burden in Africa and the Middle East.
- High prevalence of risk factors like smoking, hypertension, dyslipidemia, diabetes, and sedentary lifestyles contributes to coronary heart disease (CHD).
- Patients in this region experience myocardial infarction at younger ages, with projected mortality rates exceeding other global areas.
Purpose of the Study:
- To highlight the substantial and growing burden of cardiovascular disease in Africa and the Middle East.
- To discuss the challenges in data collection and the emerging insights from national registries.
- To emphasize the importance of lifestyle modifications and appropriate pharmacologic treatments, including beta-blockers.
Main Methods:
- Review of existing epidemiological data and national registry findings.
- Analysis of cardiovascular risk factors prevalent in the region.
- Evaluation of the therapeutic role of beta-blockers in cardiovascular disease management.
Main Results:
- Coronary heart disease is prevalent due to multiple risk factors.
- Younger age of myocardial infarction presentation and increasing mortality projected for the region.
- National registries are beginning to provide crucial epidemiological data.
- Lifestyle improvements face cultural and environmental barriers.
- Beta-blockers are effective in preventing cardiovascular disease and concerns about their use are overstated.
Conclusions:
- Addressing the high burden of cardiovascular disease in Africa and the Middle East requires multifaceted strategies.
- Lifestyle interventions and pharmacologic therapies, including beta-blockers, are essential for prevention and management.
- Further research and robust data from national registries are needed to guide public health initiatives.
Abstract:
Countries in Africa and the Middle East bear a heavy burden from cardiovascular disease. The prevalence of coronary heart disease is promoted in turn by a high prevalence of cardiovascular risk factors, particularly smoking, hypertension, dyslipidemia, diabetes, and sedentary lifestyles. Patients in Africa and the Middle East present with myocardial infarction at a younger age, on average, compared with patients elsewhere. The projected future burden of mortality from coronary heart disease in Africa and the Middle East is set to outstrip that observed in other geographical regions. Recent detailed nationally representative epidemiological data are lacking for many countries, and high proportions of transient expatriate workers in countries such as Saudi Arabia and the United Arab Emirates complicate the construction of such datasets. However, the development of national registries in some countries is beginning to reveal the nature of coronary heart disease. Improving lifestyles (reducing calorie intake and increasing physical activity) in patients in the region will be essential, although cultural and environmental barriers will render this difficult. Appropriate prescribing of pharmacologic treatments is essential in the prevention and management of cardiovascular disease. In particular, recent controversies relating to the therapeutic profile of beta-blockers may have reduced their use. The current evidence base suggests that beta-blockers are as effective as other therapies in preventing cardiovascular disease and that concerns relating to their use in hypertension and cardiovascular disease have been overstated.
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