A Summary of Cardiometabolic Disorders in the Maghreb: Insights from the 2025 Saclay Cardiometabolic Summit

The inaugural 2025 Cardiometabolic Summit in Saclay, France, aimed to (i) disseminate the latest research on cardiometabolic diseases (CMDs) from the Maghreb and/or Middle East and North Africa region; (ii) discuss CMD management and provide clinical practice suggestions for improving adherence and reducing clinical inertia; and (iii) suggest policy and clinical practice initiatives to improve outcomes in patients with CMDs. Cardiovascular disease (CVD) is the leading cause of death worldwide, with 80% of CVD fatalities occurring in low- and middle-income countries. This trend is mirrored in Algeria, Morocco and Tunisia, three countries in the Maghreb region. In these countries, CMDs, such as type 2 diabetes mellitus (T2DM) and hypertension, have high prevalence and are undertreated. At the Cardiometabolic Summit, attended by 110 clinicians from Algeria, Morocco and Tunisia, regional CMD epidemiology and management data were presented, along with evidence on regional research initiatives to reduce the burden of CMDs and CVD and how Ramadan fasting affects adults with T2DM. Context-specific holistic strategies to improve the management of patients with multimorbidities were reviewed, including targeting modifiable risk factors to prevent T2DM and hypertension. Two barriers to optimal CMD management were addressed: (i) poor patient treatment adherence and (ii) clinician-related therapeutic inertia, noting the latter may be a greater contributor to poor outcomes. Prescription of single-pill combinations was recommended for initial blood pressure control, and a cost-effective sulfonylurea plus a sodium-glucose cotransporter 2 inhibitor or glucagon-like peptide 1 receptor agonist (whenever feasible) was recommended for glycaemic control plus cardiorenal protection. Polypills may be appropriate where intervention for additional CMDs is required. Strategies for enhancing patient adherence and opportunities for reducing therapeutic inertia were presented. Finally, policy actions and clinical practice priorities were suggested. These steps provide a realistic path towards reducing CMD and CVD burden in the Maghreb.