Gender differences in cardiovascular risk factors among adolescents in Aseer Region, southwestern Saudi Arabia

Fruit and vegetable consumption among children in Saudi Arabia: Predictors and associations with dietary intake

BACKGROUND

Data exploring factors related to the consumption of fruits and vegetables (F&V) among children in Saudi Arabia are lacking. The present study aimed to evaluate F&V consumption among Saudi children. Predictors of F&V intake and associations with dietary intake were also explored.

METHODS

Cross-sectional data of 424 Saudi children (6-12 years) were collected from their mothers using an online survey. Phone interviews were conducted with mothers and children to provide data on dietary intake of children.

RESULTS

Most children included in the study (92.2%, n = 391) consumed less than five servings of F&V per day. Region of residency (B = -0.14, SE = 0.06, 95% confidence interval [CI] = -0.25 to -0.02, p = 0.019), paternal education level (B = 0.52, SE = 0.14, 95% CI = 0.24-0.79, p < 0.001) and family monthly income (B = 0.15, SE = 0.07, 95% CI = 0.01-0.29, p = 0.034) predicted the intake of F&V. Food neophobia and food pickiness also predicted the intake of F&V (B = -0.16, SE = 0.06, 95% CI = -0.27 to -0.05, p = 0.005 and B = -0.24, SE = 0.06, 95% CI = -0.36 to -0.12, p < 0.001, respectively). Children's intake of F&V positively predicted the intake of fibre, potassium, phosphorus, magnesium, iodine and vitamin C.

CONCLUSIONS

Limited intake of F&V was observed among Saudi children. F&V consumption was found to be associated with a number of sociodemographic factors, including region of residency, paternal education level and family income, as well as children's food neophobia and pickiness. Children's intake of F&V predicted higher intake of fibre, potassium, phosphorus, magnesium, iodine and vitamin C, suggesting that F&V consumption may contribute to improved intake of key nutrients in children.

Obesity and risk of hypertension in preadolescent urban school children: insights from Pakistan

BACKGROUND

Childhood obesity and hypertension are growing concerns globally, especially in developing countries. This study investigated the association between overall and central obesity at baseline, and prehypertension or hypertension at follow-up among preadolescent school children in urban Karachi, Pakistan.

METHODS

This is a sub study with cohort design embedded within a feasibility trial on School Health Education Program in Pakistan (SHEPP) in preadolescents aged 6-11 years, attending two private schools conducted from 2017 to 2019. Hypertension or prehypertension at follow-up were the outcomes and obesity or central obesity at baseline were the exposure variables. Hypertension was defined as systolic blood pressure and/or diastolic blood pressure ≥ 95th percentile for age, sex, and height. Obesity was defined as body mass index for-age and sex ≥ 95th percentile, whereas central obesity was determined by waist circumference measurements ≥ 85th percentile of age, sex, and height specific cut-offs. Logistic regression analysis was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) to identify risk factors for hypertension and prehypertension.

RESULTS

Analysis was conducted for 908 participants, evenly distributed with 454 boys and 454 girls. Hypertension was observed in 19.8% of the preadolescents, with rates of 18.5% in boys and 21.0% in girls. Prehypertension was found in 16.8% of preadolescents, with 18% among boys and 16% among girls. Additionally, 12.8% of preadolescents were classified as obese and 29.8% had central obesity. Obesity at baseline was associated with hypertension at followup (OR 8.7, 95% CI 3.5, 20.4) in the final model after adjusting for age, gender, physical activity, sedentary behavior, fruits, vegetable intake and hypertension at baseline. Central obesity at baseline also yielded high odds, with prehypertension (OR 1.9, 95% CI 1.4, 2.8) and hypertension (OR 2.7, 95% CI 1.9, 3.9) at follow up in the final model.

CONCLUSION

This study highlights a concerning prevalence of hypertension and prehypertension among preadolescent school-going children. Obesity and central obesity at baseline emerged as significant predictive factors for hypertension or prehypertension at followup within this cohort. The findings emphasize the urgency of implementing comprehensive school health education programs aimed at early detection and effective management of hypertension during childhood and adolescence in school settings.

Obesity and Risk of Hypertension in Preadolescent Urban School Children: Insights from a Developing Country

Background

Childhood obesity and hypertension are growing concerns globally, especially in developing countries. This study investigated the association between overall and central obesity at baseline, and prehypertension or hypertension at follow-up among preadolescent school children in Karachi, Pakistan.

Methods

This is a sub study with cohort design embedded within a feasibility trial on School Health Education Program in Pakistan (SHEPP) in preadolescent aged 6-11 years, attending two private schools, were enrolled from 2017 to 2019. Hypertension or prehypertension at follow-up were the outcomes and obesity or central obesity at baseline were the exposure variables. Hypertension was defined as systolic blood pressure and/or diastolic blood pressure ≥ 95th percentile for age, sex, and height. Obesity was defined as body mass index for-age and sex ≥ 95th percentile, whereas central obesity was determined by waist circumference measurements ≥ 85th percentile of age, sex, and height specific cut-offs. Logistic regression analysis was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) to identify risk factors for hypertension and prehypertension.

Results

Analysis was conducted for 908 participants, evenly distributed with 454 boys and 454 girls. Hypertension was observed in 19.8% of the preadolescents, with rates of 18.5% in boys and 21.0% in girls. Prehypertension was found in 16.8% of preadolescents, with 18% among boys and 16% among girls. Additionally, 12.8% of preadolescents were classified as obese and 29.8% had central obesity. Obesity at baseline was associated with hypertension (OR 8.7, 95% CI 3.5, 20.4) in the final model after adjusting for age, gender, physical activity, sedentary behavior, fruits, vegetable intake and hypertension at baseline. Central obesity at baseline also yielded high odds, with prehypertension (OR 1.9, 95% CI 1.4, 2.8) and hypertension (OR 2.7, 95% CI 1.9, 3.9) in the final model.

Conclusion

This study highlights a concerning prevalence of hypertension and prehypertension among preadolescent school-going children. Obesity and central obesity at baseline emerged as significant predictive factors for hypertension within this cohort. The findings emphasize the urgency of implementing comprehensive school health education programs aimed at early detection and effective management of hypertension during childhood and adolescence in school settings.

The burden of Cardiovascular diseases in Jordan: a longitudinal analysis from the global burden of disease study, 1990-2019

BACKGROUND

Cardiovascular Disease (CVD) is the leading cause of mortality worldwide. While countries in the Arab world continue to lack public health data and be severely understudied in health research, previous research has shown that compared to 1990, CVDs had a higher burden of disease in the Arab World in 2010. Jordan, a middle-income Arab country, is profiled with unique attributes such as a dual-sector healthcare system, political stability, and its role as a haven for refugees and migrants. These distinctive factors emphasize Jordan's suitability as a case study. This investigation aims to quantify CVD burden in Jordan and identify risk factors, contributing to a broader understanding of health challenges in the Arab region and beyond.

METHODS

The Global Burden of Disease (GBD) dataset was used to estimate prevalence, death, and disability-adjusted life-years (DALYs) as age-standardized rates from 1990 to 2019. We calculated percentage change for nine specific CVDs and reported trends by gender and age groups. Additionally, data on twelve a priori selected behavioral, clinical, and environmental risk factors attributing to overall age-standardized CVDs DALY were reported per 100,00 population.

RESULTS

In 2019, the age-standardized CVD prevalence, death, and DALYs rates in Jordan were 7980 (95% uncertainty interval [UI] 7629, 8360), 248 (95% UI 211, 288), and 4647 (95% UI 4028, 5388), respectively. Despite an increase in the absolute number of mortality and prevalence, between 1990 and 2019, the age-standardized prevalence, death, and DALYs rates all decreased by 5.5%, 45.1%, and 46.7%, respectively. In 2019, the leading risk factors contributing to overall age-standardized CVDs DALY per 100,000 population were high systolic blood pressure, high BMI, dietary risks, and high LDL cholesterol.

CONCLUSION

Despite decreasing burden rate of CVDs in Jordan between 1990 and 2019, CVDs remain the leading cause of mortality in Jordan, with an increase in the total number of prevalence and mortality. Overall, this contributes to increased healthcare costs. Further research is required to quantify the burden of CVDs and understand it better. Intervention measures and policies tailored to specific CVDs should be designed to reduce the burden of CVDs in Jordan.

Body Mass Index Profile and Its Association with Social Determinants Among Adolescents from Jazan, Saudi Arabia

Purpose

Assess adolescents' body mass index (BMI) profile and the association between BMI category and social determinants.

Methods

This cross-sectional study targeted adolescents aged between 12 and 19 from Jazan, Saudi Arabia. Data was collected via an online self-administered questionnaire during 2023. The tailored questionnaire measured items related to student demographics, their history of diagnosed chronic conditions, their familial history of chronic diseases, and their eating behavior. A standard chi-square test investigated the relationship between BMI category and social determinants.

Results

Five hundred and seventy students completed the study's questionnaire. The mean age of the sample was 16 (SD: 1.9), and most of the respondents were female (60%). Among the recruited sample, 107 students (20%) are categorized as underweight, while 121 students (22%) are classified as either overweight or obese according to their age. The respondents' eating behavior indicated that the most frequently consumed meal was dinner, and the majority skipped breakfast some days of the week. Nearly one-third of the sample exhibited emotional eating. Low consumption of healthier food options, such as fruits, vegetables, low-fat products, and whole grain products among the adolescents was noted. An assessment of BMI level distribution among the respondents according to their demographic characteristics indicated a higher frequency of overweight and obesity among male adolescents, students in the secondary level, students living with a lower number of siblings, and students with a parental history of diabetes, obesity, and dyslipidemia (p values < 0.05).

Conclusion

A high frequency of BMI abnormality among adolescents was detected. Dietary behavior among the respondents suggests the presence of several unhealthy behaviors. The results of the current study detected an important influence of the family on weight status among these adolescents.

Consumption of fruits and vegetables among adolescents in Arab Countries: a systematic review

BACKGROUND

Adolescents' consumption of fruits and vegetables is inadequate in most Arab countries, leading to a higher risk of poor health outcomes. This systematic review evaluates fruits and vegetables intake among adolescents in Arab countries, the proportion of adolescents meeting the dietary guidelines in these countries, and the dietary assessment tools used to assess fruits and vegetables intake.

METHODS

Four databases were searched, MEDLINE, PUBMED, EMBASE, and Web of Science. Studies were eligible if they reported fruit or vegetable consumption among adolescents aged 10 to 19 in 22 Arab countries. The risk of bias in the included studies was assessed by two reviewers independently using the risk of bias tool developed by Hoy et al. Data were extracted and synthesized into three categories; frequency of fruits and vegetables consumption, mean fruits and vegetables consumption, and percentage of adolescents meeting fruits and vegetables consumption recommendations.

RESULTS

The review included 44 articles utilizing 41 cross-sectional studies. Most studies were school-based, and data was collected from both males and females using self-administered questionnaires. Of those, validated questionnaires were used in 28 studies. According to the World Health Organization recommendation, most studies defined five fruits and vegetables servings as the adequacy cutoff point; other definitions were used in some studies. The reported mean consumption ranged between 6.1 times per week and 4.5 servings of fruits and vegetables per day. The proportion of those who met the recommendations of eating five servings per day ranged between 10 and 29%. Fruits were shown to have a lower daily intake than vegetables (4.2 to 53.7% for fruits and 7.8 to 66.3% for vegetables).

DISCUSSION

This review indicated inadequate fruits and vegetables consumption among adolescents in Arab countries and highlighted an increased risk of non-communicable diseases and malnutrition prevalence. A limitation was the incomparability of available data between countries. Further in-depth research on the core reasons behind adolescents' inadequacy in fruits and vegetables consumption is recommended.

The Predictors of Hypertension in Children: Palestinian Perspective

Method

Cross-sectional study was performed on five hundred and nine (10–13) year old students from governmental schools in Jenin and Tubas. Anthropometric measures consist of body mass index, hip circumference (HC), waist circumference (WC), the ratio of waist to hip (WHR), and the ratio of waist to height (WHtR) were measured. Blood pressure was assessed including systolic (SBP) and diastolic (DBP) utilizing a (Dynamap) vital signs monitor.

Results

Approximately 38.7% of participants (38.8% females and 38.63% males) were considered pre-hypertensive and 7.3% of the participants (7.4% females and 7.1% males) were hypertensive. Also, there was a weak to moderate relationship between mean blood pressure (systolic and diastolic) and the anthropometric measurements. Additionally, most predictors with significant effects on early childhood hypertension were body mass index (OR 1.16, 95% CI 1.09–1.23).

Conclusions

Hypertension and prehypertension are present in Palestinian children. Waist hip ratio is the greatest predictor of BP, followed by body mass index. Hence, weight-reduction strategies to at-risk children are crucial to minimizing the prevalence of Palestinian childhood hypertension.

Prevalence and social determinants of overweight and obesity in adolescents in Saudi Arabia: A systematic review

Obesity in adolescents has a serious impact later in life in the form of disturbances in health and wellbeing. We aimed to evaluate the prevalence of overweight and obesity (Ow/Ob) in Saudi adolescents and to construct an ecological model of social determinants (SDs) of Ow/Ob and evaluate current evidence of their effect on Saudi adolescents. A systematic review of literature reported up until 31 December 2018 on Ow/Ob and factors that can influence them in Saudi adolescents was conducted. Fifty-one studies with n = 97 666 adolescents (55.6% males) were reviewed. The prevalence of Ow/Ob started off high and continued to increase over time. Most of the 49 reviewed SDs reports, from 19 studies, showed positive association between SDs constructed ecological model and Ow/Ob in Saudi adolescents. The prevalence of Ow/Ob among adolescents is a major public health problem in Saudi Arabia, is growing at an alarming rate and SDs play a significant role in this problem, and should be considered in all strategies targeting it. The constructed ecological model for SDs of Ow/Ob in adolescents can serve as a useful exploratory tool that helps investigating the multi-faceted aetiology of adolescent Ow/Ob and facilitates the development of effective intervention and prevention programmes.

Food Consumption Patterns and Nutrient Intakes of Children and Adolescents in the Eastern Mediterranean Region: A Call for Policy Action

The Eastern Mediterranean Region (EMR) has witnessed significant social and economic changes that may have influenced the diet of children and adolescents, and increased the risk for obesity and malnutrition in this age group. This review aims to characterize and assess food consumption patterns and nutrient intakes amongst school-aged children (5-10 years) and adolescents (10-19 years) in countries of the EMR. Electronic databases (MedLine, PubMed, Scopus, and Google Scholar) were searched for relevant articles published between 2005 and 2020; international organizations and governmental websites were also searched. Available studies documented low intakes of fruits, vegetables and fiber, inadequate consumption of water, milk and dairy products, coupled with high intakes of fat, saturated fat, and sugar sweetened beverages, as well as a frequent consumption of energy-dense, nutrient poor foods such as sweet and savory snacks. Micronutrient inadequacies were also observed, particularly for calcium, iron, zinc and vitamins A, D, C, and folate. Acknowledging the impact that nutrition may have on building societies and transforming the lives of children, adolescents and their families, there is a crucial need for a food system approach in developing and implementing national and regional policies and interventions aimed at improving the diet of children and adolescents.

Association between Vegetable Consumption and Blood Pressure, Stratified by BMI, among Chinese Adolescents Aged 13-17 Years: A National Cross-Sectional Study

The association between vegetable intake and blood pressure (BP) in adolescents is still inconsistent, and the description of the recommended daily vegetable consumption is abstract and nonfigurative. Here we aimed to investigate the association between vegetable consumption and BP and further look for a simple way to describe a satisfactory level of daily vegetable consumption for adolescents. We recruited 18,757 adolescents, aged 13-17 years, from seven provinces in China in 2013. A standard physical examination, including height, weight and BP was conducted. Information regarding vegetable intake was collected by questionnaire, and one serving of vegetables was defined as the size of an adult's fist. Multivariable linear and logistic regression models were used for analysis after adjusting for covariates. Approximately 12.2%, 38.0%, 28.7%, and 21.1% of the adolescents reported daily vegetable consumption of <1, 1~2, 2~3, and ≥3 servings, respectively. Adolescents whose daily vegetable consumption was ≥3 servings showed a lower risk of high blood pressure (HBP) (OR = 0.74, 95%CI: 0.58~0.94, p = 0.013) compared to those with daily vegetable consumptions of < 1 serving. When stratified by body mass index (BMI), in overweight adolescents, participants with 2~3 or ≥3 servings/day had an OR of 0.66 (95%CI: 0.45~0.97) or 0.63 (95%CI: 0.42~0.95) compared with the reference group. Daily vegetable intake of at least three servings (three adult's fists) is associated with a lower HBP risk in adolescents, which leads to a simple message: "consuming at least three fists of vegetables every day will improve your blood pressure profile".

Physical inactivity in Saudi Arabia revisited: A systematic review of inactivity prevalence and perceived barriers to active living

OBJECTIVES

Saudi Arabia has recently witnessed enormous economic growth accompanied by undesirable lifestyle behaviors, along with an associated increase in non-communicable diseases (NCD's). This systematic review presents a comprehensive and an updated overview of the status of physical activity (PA) or inactivity among the Saudi population and examines the major barriers and correlates of PA.

METHODS

A systematic search was conducted using MEDLINE and Google Scholar databases. The electronic search yielded an initial 434 articles. However, the majority of these articles were eliminated because they did not meet the inclusion criteria. The remaining relevant papers were 65 articles that became the bases for this review.

RESULTS

The majority of Saudi children, youth and adults were not active enough to meet the recommended guidelines for moderate to vigorous PA. Saudi females were disproportionately less active than males, beginning from early school years. The proportions of Saudis who are at risk of inactivity are exceedingly higher than those at risk for other coronary heart diseases. Active Saudi boys tend to have favorable levels of blood lipids and body composition profile compared to inactive boys. Increased urbanization, crowded traffic, extreme weather, cultural barriers, lack of social support, the absence of female school PA program and lack of time and resources, all make PA a difficult choice for the Saudis.

CONCLUSION

More intensified efforts toward promoting PA and reducing sedentary behaviors among the Saudi population are needed to curtail the risks of NCD's.

Role of fruits and vegetables in adolescent cardiovascular health: a systematic review

Context

Levels of fruit and vegetable consumption are low among adolescents, and the possible effect of this on cardiovascular health in this age group is undefined.

Objective

The aim of this systematic review was to investigate the potential role of fruit and vegetable consumption in adolescent cardiovascular health.

Data Sources

Six electronic databases (BioMed Central, MEDLINE, Web of Science, CINAHL, Scopus, PsycINFO) were searched from database inception to December 2015.

Study Selection

The search strategy used the following sets of descriptors: adolescents; fruits and vegetables; cardiovascular risk indicators; cross-sectional and cohort studies.

Data Extraction

Potentially eligible articles were selected independently by 2 reviewers.

Results

Eleven articles meeting the inclusion criteria were included (10 cross-sectional, 1 cohort). The main reasons for study exclusion (n = 71) were misclassification of individuals as adolescents, an unspecified outcome that was incongruent with the definitions provided, and assessment of fruits and vegetables as part of a food pattern. Articles evaluated fruit and vegetable intake (separately, together, only vegetables, or with fruit juice) in diverse units, using food frequency questionnaires, 24-hour dietary recalls, and food records. One-third of the studies showed significant inverse associations of fruit and vegetable intake with systolic blood pressure, abdominal obesity, triglycerides, high-density lipoprotein cholesterol, and metabolic syndrome.

Conclusions

The associations between fruit and vegetable consumption and indicators of cardiovascular risk in adolescents are inconsistent, likely because of heterogeneity in the methods used to assess and classify consumption and to define cardiovascular risk in adolescents.

A systematic review of childhood obesity in the Middle East and North Africa (MENA) region: Prevalence and risk factors meta-analysis

Obesity rates are rising globally, but there is evidence that young people in the Middle East and North Africa (MENA) region are at particularly high risk. We systematically searched the literature to map the MENA region for prevalence of childhood overweight and obesity, and examine the underlying risk factors and adverse effects associated with obesity in this region. Inclusion criteria were: English-language, non-basic-science focused articles that used any of the standard obesity definitions and were conducted in the MENA countries within the last five years. We searched PubMed using combinations of key terms ((childhood) OR adolescence) AND obesity) AND (MENA or each country) AND ("last five years" [PDat]). Studies demonstrated an increasing prevalence of obesity among many countries in the MENA region, especially in the Gulf area. Notably, in Kuwait, prevalence rates of overweight and obesity were 25.6% and 34.8% among young males and 20.8% and 20.5% among females. A meta-analysis revealed that physical inactivity, increased screen time, and higher social status were risk factors for childhood obesity. Childhood and adolescent obesity is a major challenge facing countries of the MENA region. Further research is needed to fully investigate the role of nutrition and other specific risk factors and evaluate various interventions to manage this pervasive and growing health problem.

A systematic review of childhood obesity in the Middle East and North Africa (MENA) region: Health impact and management

Childhood obesity has serious consequences both immediately and in adulthood. The rates of obesity in children and adolescents are rising rapidly in the Middle East and North Africa (MENA) region. We systematically searched the literature to explore adverse effects associated with childhood obesity in this region and the management efforts for dealing with it. Inclusion criteria were: English-language, non-basic-science focused articles that used any of the standard obesity definitions and were conducted in the MENA countries within the last five years. We searched PubMed using combinations of key terms ((childhood) OR adolescence) AND obesity) AND (MENA or each country) AND ("last five years" [PDat]). Studies that examined adverse effects of childhood obesity gave fairly consistent results, revealing associations with higher blood pressure, pre-diabetes, metabolic abnormalities, and cardiovascular risk. Little or no overall effect on rates of childhood obesity has yet been demonstrated by interventions used to manage the problem. Obesity has a considerable impact on the health of children and adolescents, and the countries of the MENA region should endorse strategies and programs to prevent and manage this problem in an effective way.

Arab Adolescents: Health, Gender, and Social Context

This article reviews the evidence about adolescent health in the Arab world, against the background of social, economic, and political change in the region, and with a particular focus on gender. For the literature review, searches were conducted for relevant articles, and data were drawn from national population- and school-based surveys and from the Global Burden of Disease project. In some parts of the Arab world, adolescents experience a greater burden of ill health due to overweight/obesity, transport injuries, cardiovascular and metabolic conditions, and mental health disorders than those in other regions of the world. Poor diets, insufficient physical activity, tobacco use, road traffic injuries, and exposure to violence are major risk factors. Young men have higher risks of unsafe driving and tobacco use and young women have greater ill-health due to depression. Several features of the social context that affect adolescent health are discussed, including changing life trajectories and gender roles, the mismatch between education and job opportunities, and armed conflict and interpersonal violence. Policy makers need to address risk factors behind noncommunicable disease among adolescents in the Arab region, including tobacco use, unhealthy diets, sedentary lifestyles, unsafe driving, and exposure to violence. More broadly, adolescents need economic opportunity, safe communities, and a chance to have a voice in their future.

Pediatric hypertension in the Eastern Province of Saudi Arabia

Objectives:

To compare the levels of blood pressure (BP) between male and female adolescents in the Eastern Province of Saudi Arabia and reference percentiles for Saudi adolescents. A secondary aim was to explore the distribution of BP among the participants based on age and gender.

Methods:

This cross-sectional study was conducted among 146 boys and girls attending intermediate and secondary schools in 2 regions (Al-Mallaha and Al-Mubarraz) in the Eastern Province of Saudi Arabia. Weight, random blood glucose, and BP were collected by a team of health educators in the morning of the school day between April and May 2014.

Results:

Of the current sample of adolescents originally from the Eastern Province, 30% had systolic blood pressure (SBP) of ≥140 mm Hg and 22% had diastolic blood pressure of ≥90 mm Hg. For girls between 13 and 16 years old, the SBP was greater than the 95th percentile of Saudi national norms. Participants were classified by gender and school stage, and one-way analysis of variance showed significant differences in the means of SBP between intermediate boys (127±2.5 mm Hg) and secondary boys (136±2.1 mm Hg) (p<0.05), and between intermediate boys and intermediate girls (138±1.6 mm Hg) (p<0.01).

Conclusion:

The increased level of BP among adolescents originally from the Eastern Province raises the need to update the current BP nomograms, considering possible differences for specific geographic areas across the country. Implementing therapeutic life style management in girls’ schools is recommended.

Risk Factors of Cardiovascular Disease and Their Related Socio-Economical, Environmental and Health Behavioral Factors: Focused on Low-Middle Income Countries- A Narrative Review Article

BACKGROUND

In order to decrease the burden of cardiovascular disease (CVD), social determinants for CVD risk factors have been extensively studied in developed countries. However, few studies about them have been performed in low-middle-income countries. This study describes factors related to CVD risk factors in low-middle-income countries at a national level.

METHODS

Data were assembled from international databases for 47 low-middle-income countries and were collected from various sources including WHO, World Bank, and previous studies. Coefficient estimates between male and female CVD risk factor prevalence and each independent variable were calculated via linear regression.

RESULTS

Statistically significant inverse associations were observed between adult literacy rate and systolic blood pressure, blood glucose. Pump price for gasoline was negatively associated with blood glucose also. Associations for female unemployment, adult literacy rate, paved roads and urban population, alcohol and western diet were positively associated with CVD risk factors. Unemployment, urban population and alcohol were positively associated with CVD risk factors in males.

CONCLUSION

The effectiveness of intervention program for the prevention of cardiovascular disease in populations in developing countries should be explored, and more attention should be given to women.

Correlates of cardiovascular disease risk scores in women in Riyadh, Kingdom of Saudi Arabia

Saudi Arabia has a high prevalence of obesity and physical inactivity. We measured cardiovascular (CVD) risk scores and determined the factors associated with them in women in Riyadh, Saudi Arabia. A cross-sectional study using a self-administered questionnaire was conducted on 291 women aged ≥ 30 years. Information was collected on socio-demographics and physical health status. Anthropometric and blood pressure measurements were taken. Physical activity was measured using Kaiser's Physical Activity Survey and Godin's Leisure Time Exercise questionnaire. CVD risk scores were calculated using the non-laboratory-based Framingham Risk (FRS) prediction model for primary care. FRS scores ranged from 0.50 to 21.9. A total of 2.7% (n = 8) of women had a high FRS score (>20), 5.5% (n = 16) had intermediate scores (11-20), and 91.8% (n = 267) of women had low scores (<10) CVD risk scores. Multiple linear regression results indicated that a one-unit change in physical activity (household/caregiver index), strenuous exercise, waist circumference, number of children, television watching, and knee pain were significantly associated with -0.20 (p < .01), -0.12 (p = .03), 0.19 (p = .001), 0.29 (p < .01), 0.13 (p = .04), and 0.11 (p = .05) unit change in CVD risk scores, respectively. Household activities and strenuous exercise had a protective role in females in relation to CVD risk. Programs recommending physical activity at all levels should be encouraged.

Clinical presentation and short-term outcome of acute coronary syndrome in native young Saudi population

OBJECTIVES

To investigate acute coronary syndromes (ACS) in the young Saudi population in Aseer Region, southwestern Saudi Arabia.

MATERIALS AND METHODS

We retrospectively reviewed our database between January 2006 and May 2009, 924 patients were diagnosed to have ACS. Among them 107 patients (11.6%) met our definition of young [66 (61.7%) male < 45 years, and 41 (38.3%) female < 55 years]. We compared this study population to a control group of 50 elderly patients consecutively enrolled in a contemporary period.

RESULTS

The overall age was 42.3 ± 7.9 and 68.7 ± 10.1 years in the study population and control respectively. 100% of the population and 92% of the control group presented with chest pain. Diabetes mellitus (DM) prevalence was 46.7% in the study population (63.4% in females), and 62% in the control group. Hypertension, smoking, dyslipidemia and overweight/obesity were reported in 31.8%, 25.2%, 21.5% and 44.9% of the study population and 58%, 6%, 26% and 42% of the control group, respectively. Past history of coronary artery disease was documented in 16.8% of the study population and 38% of the control group. The discharge diagnoses were ST-segment elevation myocardial infarction (STEMI) in 41 (38.3%) (representing 4.4% of the whole ACS population) and 11 (22%) patients of the study population and control group respectively, non-ST-segment elevation myocardial infarction in 36 (33.6%) and 23 (46%) patients of the study population and control group, respectively, and unstable angina in 30 (28.0%) and 15 (30%) patients of the study population and control group, respectively. Coronary angiography was performed in 86 (80.4%) and 41 (82%) patients in the study population and control group respectively. In hospital, one young patient had acute ischemic stroke and one elderly patient died, 22.4% of the study population and 32% of control group were discharged with clinical diagnosis of heart failure or in need for diuretics.

CONCLUSION

In our study, the young Saudi population with ACS had chest pain as the leading symptom. STEMI was the major final diagnosis and among one of the highest reported worldwide. There is a high prevalence of DM; however, they have favorable in hospital and short-term outcome.