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Exploring the Current Tools in Cardiovascular Risk Assessment in the Middle East and the Need for Region-Specific
Gamilah Abdulkarem Al-Ezzi1,2, Adliah Mhd Ali1, Mohammed Abdullah Kubas3,4
1Centre for Quality Management of Medicines (QMM), Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Insights
Cardiovascular disease (CVD) risk assessment tools vary across the Middle East. This review found Western tools and some national models are used, but more region-specific research is needed.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Cardiovascular diseases (CVDs) are a leading cause of global mortality and disability.
- Effective primary prevention strategies rely on accurate CVD risk assessment.
- The landscape of recommended CVD risk assessment tools in the Middle East remains unclear.
Purpose of the Study:
- To identify and summarize CVD risk assessment tools recommended for the general population in the Middle East.
- To review the existing literature on CVD risk prediction in the region.
Main Methods:
- A scoping review following PRISMA-ScR guidelines.
- Searches conducted in Web of Science, Medline, and Scopus databases.
- Included English-language articles from 2015-2024 focusing on primary CVD prevention in 16 Middle Eastern countries.
Main Results:
- Seventeen articles met inclusion criteria, covering Cyprus, Iran, Saudi Arabia, Qatar, UAE, and Egypt.
- Recommended tools include Western models (e.g., ACC/AHA PCE, SCORE 2, WHO/ISH EMR, QRISK3, PREDICT).
- Some countries (Iran, Saudi Arabia, UAE, Egypt) are developing national CVD risk tools.
Conclusions:
- Current research on CVD risk assessment in the Middle East is limited to six countries.
- A mix of Western and locally developed tools are recommended.
- Further research is needed to develop or adapt models for country-specific CVD risk factors in the region.
Background:
Cardiovascular diseases (CVDs) are a major contributor to premature mortality, disability, and reduced quality of life globally. Assessing CVD risks is central to primary prevention, prompting the development of numerous tools to predict CVD risks for the general population. However, it is unclear which tools are recommended in clinical practice in the Middle East region.
Aim:
This scoping review aims to identify, review, and summarize the available literature on CVD risk assessment tools recommended for the general population in the Middle East region.
Methods:
The scoping review synthesized the literature on CVD risk assessment tools recommended for the general population in the Middle East region. It followed PRISMA-ScR guidelines, covering searches in the Web of Science (WOS), Medline, and Scopus databases. English-language articles published between 2015 and 2024 that focused on the primary prevention of CVDs in sixteen Middle Eastern countries were included.
Results:
Seventeen articles met the inclusion criteria. The studies were distributed over Cyprus (n=1), Iran (n=7), Saudi Arabia (n=4), Qatar (n=1), the United Arab Emirates (n=3), and Egypt (n=1). Various tools are recommended in these countries, including validated Western tools such as ACC/AHA Pooled-Cohort Equations (PCE), Systematic Coronary Risk Evaluation 2 (SCORE 2), World Health Organization charts (WHO/ ISH) for the Eastern Mediterranean region (EMR), Cardiovascular Disease Risk Algorithm (QRISK3), and PREDICT. Some studies in Iran, Saudi Arabia, the United Arab Emirates, and Egypt focused on developing new CVD risk tools tailored for national use.
Conclusion:
Current studies on CVD risk assessment are limited and have been conducted in six Middle Eastern countries. These studies recommend various tools, including both validated Western models and locally developed frameworks. However, the limitations of existing tools and the gaps in current research underscore the need for further studies to develop or recalibrate models that account for country-specific CVD risk factors across the region.
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