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Income Insufficiency, Type 2 Diabetes, and Perceived Stress in Cardiac Arrhythmia Outpatients: A Cross-Sectional

Fahad Alsaikhan1

  • 1Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, P.O. Box 173, Alkharj 11942, Saudi Arabia.

Healthcare (Basel, Switzerland)
|July 28, 2026
PubMed

Insights

Approximately 24.5% of Saudi outpatients with cardiac arrhythmia experience high perceived stress. This burden is significantly higher for individuals facing income insufficiency or type 2 diabetes mellitus (T2DM).

Area of Science:

  • Cardiology
  • Psychosocial Health
  • Public Health

Background:

  • Cardiac arrhythmias, including atrial fibrillation (AF), impose a significant psychosocial burden not fully addressed by current cardiology guidelines.
  • The interplay of economic strain, type 2 diabetes mellitus (T2DM), and perceived stress in arrhythmia patients remains understudied in Arab populations.

Purpose of the Study:

  • To determine the prevalence of high perceived stress among Saudi outpatients with cardiac arrhythmia.
  • To identify independent sociodemographic and clinical factors associated with high perceived stress, focusing on income insufficiency and T2DM.

Main Methods:

  • A cross-sectional study involving 282 adult arrhythmia outpatients in Saudi Arabia.
  • Utilized the validated Arabic 10-item Perceived Stress Scale (PSS-10); high stress defined as PSS-10 score ≥20.
  • Multivariable logistic regression with Firth penalisation identified independent correlates; sensitivity analyses and factor analysis were performed.

Main Results:

  • The prevalence of high perceived stress was 24.5% (95% CI, 19.7-29.9).
  • Income insufficiency (aOR 2.09) and T2DM (aOR 2.51) were independently associated with high perceived stress.
  • The Arabic PSS-10 demonstrated a reliable two-factor structure suitable for this population.

Conclusions:

  • Nearly one in four Saudi cardiac arrhythmia outpatients report high perceived stress.
  • Individuals with income insufficiency or T2DM bear a disproportionately higher stress burden.
  • Integrating PSS-10 screening and targeted support referrals into routine arrhythmia care warrants further investigation.

Keywords:
Saudi Arabiaatrial fibrillationcardiac arrhythmiapsychologicalpsychometricsstresstype 2 diabetes mellitus

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