One in four adults in Saudi Arabia is set to have a heart attack within the next 10 years, reveals research presented at the 26th Annual Conference of the Saudi Heart Association (SHA), held 13 to 16 February in Riyadh, Saudi Arabia. The conference features sessions from the European Society of Cardiology (ESC) on hot topics in cardiovascular disease including prevention.1

Dr Muhammad Adil Soofi, first author of the research and assistant consultant in adult cardiology at Prince Salman Heart Centre, King Fahad Medical City in Riyadh, said: “The majority of people we studied were between 20 and 40 years old and 26% were at high risk of a heart attack or death from a heart attack in 10 years. Unhealthy lifestyles start at a young age in the Gulf and people reap the consequences early in life.”

Dr Soofi’s study investigated the prevalence of risk factors for heart disease in more than 4,900 Saudis living in urban areas who were over 20 years old and had no history of heart disease. Their 10 year risk of a heart attack or death from a heart attack was calculated using the Framingham Risk Score.

Most people in the study (85%) were less than 40 years old and 55% were women. The researchers found that 25% had diabetes, 34% had hypertension, 25% were smokers, 27% were obese, 86% were not involved in any physical exercise and 19% had dyslipidemia. As a result of the high level of risk factors, 26% of participants were at high risk of having a heart attack or dying from a heart attack in 10 years.

Diabetes had a major impact on risk. When diabetes was excluded as a risk factor, the proportion at high risk of a heart attack or death from a heart attack fell to just over 4%. Dr Soofi said: “Diabetes doesn’t occur in isolation. Diabetic individuals had a significantly increased prevalence of other risk factors such as obesity, hypertension, smoking and dyslipidemia.”

He added: “Diabetes and other risk factors start at an early age in Saudi Arabia. When we looked just at people under the age of 30, we found that 14% were diabetic, 27% were obese, 31% were smokers and 77% were not physically active. So it’s a whole package that will lead to heart disease in a decade.”

Dr Soofi said that urbanisation, lack of education and Westernisation could be to blame for the unhealthy lifestyles of young Saudis. He said: “They eat more fast food and deep fried items and on top of that do not exercise. Atherosclerosis, obesity and other risk factors set in at a very early stage and ultimately lead to heart attacks and even death at a young age.”

He continued: “We need to educate the public on their doorstep. That means using radio, television and the internet to communicate how to eat healthily, exercise and quit smoking. If the situation remains as it is now, today’s 30 year olds will be a burden on society rather than active contributors by age 50.”

Professor Roberto Ferrari, a past president of the ESC and course director of the ESC programme in Riyadh, said: “There are strong links between diabetes and the development of heart disease2 but both are preventable. Even at a young age our behaviours will impact our chances of developing these conditions which is why ESC guidelines advocate healthy lifestyles in children.”3

Professor Hani Najm, SHA vice president, past president and head of international affairs, said: “Most Gulf countries have young populations. In Saudi Arabia 50% of people are less than 25 years old and their unhealthy lifestyles mean we are facing a serious epidemic of heart disease in 15 to 20 years. One in four people are diabetic and many will be heart disease patients in10 years.”

He added: “Healthy lifestyles are a rare occurrence in the Gulf region and bad habits start early. Nearly one-third of teenagers smoke in some areas and the levels are even higher in others. Young people’s addiction to smart phones and social media has turned them into electronic potatoes, today’s version of the couch potato but no longer confined to one room as with television. They have zero intention of being physically active. Governments should have a responsibility to provide free indoor gyms and green spaces for exercise.”

Dr Khalid AlHabib, SHA president, said: “The Gulf States have sophisticated tertiary care for heart disease patients but, alarmingly, we lack primary prevention programmes. These need to start today so that children and young people do not spend their adult life with diabetes and heart disease.”