Population awareness of coronary artery disease risk factors in Jeddah, Saudi Arabia: a cross-sectional study

Knowledge of cardiovascular diseases and associated risk factors in the general adult population of Jeddah, Saudi Arabia: A cross-sectional study examining gender disparities

To assess knowledge about cardiovascular diseases (CVD) among the general population, we emphasized gender-related disparities and other lifestyle and health-related factors. This cross-sectional study was conducted among 395 individuals from the general population of Jeddah, Saudi Arabia. An online questionnaire was administered to assess knowledge of CVD types, symptoms, and risk factors. The majority of participants identified coronary heart disease (73.7%) as having CVD, with no sex effect. Males had higher knowledge regarding cerebrovascular disease (44% vs 31.5%) and congenital heart diseases (60% vs 51.9%) as being part of CVD, while they had lower knowledge of peripheral arterial disease (44% vs 50.7%) than females, respectively (P < .05). Males exhibited better knowledge of heart attack and stroke symptoms than females. Knowledge was optimal for major CVD risk factors, such as smoking (90.6%) and high low-density lipoprotein cholesterol levels (85.1%); however, gaps were observed in recognizing diabetes (56.2%) and stress (69.4%) as factors for CVD. The mean overall knowledge score was 16.33 ± 5.72 25, with no difference between sexes (P = .239). Predictors of good CVD knowledge included university-level education, daily healthy food consumption, and perceived life as highly stressful; nonetheless, sex showed no significant effect. While the general population displayed a suboptimal understanding of CVD, notable sex disparities were observed, highlighting the need for tailored public health interventions. Emphasizing cognitive and behavioral aspects can foster better prevention and management strategies, given the evident gender disparities.

Awareness of Risk Factors for Coronary Artery Disease in the Population of Al-Majma'ah Region, Saudi Arabia

BACKGROUND

Coronary artery disease (CAD) is a significant global health concern and a leading cause of morbidity and mortality. As a complex cardiovascular condition, CAD arises from the accumulation of atherosclerotic plaques within the coronary arteries, leading to restricted blood flow to the heart muscle. While CAD has been extensively studied, its prevalence remains a challenge, particularly in diverse populations with distinct cultural and lifestyle practices.

OBJECTIVES

 To assess the awareness of risk factors for CAD in the population of Al-Majma'ah Region, Saudi Arabia.

METHODS

 The purpose of this cross-sectional descriptive study was to determine participants' awareness of CAD risk factors among the population of Al-Majma'ah Region, Saudi Arabia. It was conducted by the use of a self-administered questionnaire that had been validated in prior research publications. Sociodemographic information as well as the prevalence of cardiovascular disease risk factors were covered in the survey. The data analysis was done using IBM SPSS Statistics for Windows, Version 26 (Released 2019; IBM Corp., Armonk, New York, United States).

RESULTS

A total of 919 individuals were enrolled in the current study after meeting the inclusion criteria. The results showed that most of the respondents 626 (68.1%) had a good level of awareness, 261 (28.4%) had a fair level of awareness, while only 32 (3.5%) of the respondents had a poor level of CAD risk factors awareness.

CONCLUSION

The majority of participants had a good level of knowledge regarding CAD risk factors. The correlation between monthly income and awareness of coronary artery risk factors was statistically significant.

Assessment of Knowledge and Awareness Regarding Coronary Artery Disease Risk Factors Among the Saudi Arabian Population: A Cross-Sectional Study

Background Coronary artery disease constitutes a critical public health issue due to its widespread prevalence, placing a significant burden on healthcare systems and posing considerable challenges to the well-being of the population. Limited recent data on coronary artery disease awareness in Saudi Arabia underscores the need for updated information to inform preventive programs. Methodology A cross-sectional questionnaire survey was conducted from August 2021 to October 2022, targeting individuals aged 18 and above in Saudi Arabia. The online survey collected demographic data and assessed knowledge and awareness of coronary artery disease risk factors. A scoring system categorized participants as possessing high, medium, or low levels of awareness and knowledge. Data analysis involved a multivariable regression approach to explore associations. Results The study included a total of 1,409 participants, representing a diverse demographic distribution. Knowledge scores revealed 70.3% high, 27.4% medium, and 2.3% low levels, while awareness scores showed 59.9% high, 32.9% medium, and 7.2% low levels. The study identified significant associations between knowledge scores and gender (p = 0.003) and age (p = 0.001). Similarly, awareness scores demonstrated associations with gender (p = 0.001), age (p = 0.001), marital status (p = 0.003), educational qualification (p = 0.036), and occupation (p = 0.001). These findings underscore the multifaceted nature of factors influencing awareness and knowledge levels. Conclusions The study highlights a strong foundation of knowledge and awareness among the Saudi population regarding coronary artery disease risk factors, indicating a positive starting point for preventive initiatives. However, targeted programs addressing regional variations and enhancing knowledge are recommended to improve early detection and treatment of coronary artery disease risk factors.

The Pandemic of Coronary Heart Disease in the Middle East and North Africa: What Clinicians Need to Know

PURPOSE OF REVIEW

Coronary heart disease (CHD) is the leading cause of morbidity, mortality, and disability in the Middle East and North Africa (MENA). While the prevention, diagnosis, and management of CHD have been detailed in international guidelines, we aimed in this review to quantify the pandemic of CHD in the MENA region and highlight regional patient characteristics, clinical challenges, and future directions to optimize CHD care in the region.

RECENT FINDINGS

Patients with CHD in the MENA feature younger age at presentation and worse prognosis in women. Despite the high burden of CHD risk factors, many of these factors remain underrecognized, undertreated, and uncontrolled. Additionally, CHD care is hampered by poor patient awareness, inefficient preventive strategies, and limited access to guideline-recommended therapeutics. All stakeholders involved in healthcare should work together to develop and execute strategies aimed at tackling the burden of CHD in the MENA.

High prevalence of lack of knowledge and unhealthy lifestyle practices regarding premature coronary artery disease and its risk factors among the Saudi population

OBJECTIVE

Literature regarding coronary artery disease (CAD) and awareness of its risk factors is available in Saudi Arabia (SA). However, it is lacking with respect to premature coronary artery disease (PCAD). Therefore, it is necessary to evaluate the lack of knowledge of this underrepresented critical issue and to devise a well-constructed strategy for PCAD. This study aimed to assess the knowledge of PCAD and its risk factors in SA.

METHODS

A cross-sectional questionnaire-based study was performed in the Department of Physiology, College of Medicine, King Saud University (KSU), Riyadh, SA between July 01, 2022, and October 25, 2022. A validated proforma was sent to the Saudi population. The sample size was 1046 participants.

RESULTS

Proforma results indicated that 46.1% (n = 484) of participants believed that CAD could occur in people under the age of 45, whereas 18.6% (n = 196) did not believe, and 34.8% (n = 366) did not know. There was a highly statistically significant association present between sex and the belief that CAD can affect people who are under the age of 45 (p < 0.001), with 355 (73.3%) females believing that CAD can affect people below the age of 45 compared to 129 (26.7%) males. The results also showed a highly statistically significant relationship between educational status and the belief that CAD can affect people who are under the age of 45 (bachelor's degree, 392 participants, representing 81.1%; p < 0.001). Furthermore, having employment was notably positively associated with that belief (p = 0.049) as was having a health specialty (p < 0.001). In addition, 62.3% (n = 655) of participants were not aware of their lipid profile, 49.1% (n = 516) preferred using vehicles to get to nearby places, 70.1% (n = 737) did not undergo regular medical checkups, 36.3% (n = 382) took medications without consultations, 55.9% (n = 588) did not exercise weekly, 69.5% (n = 112) were E-cigarette smokers, and 77.5% (n = 810) consumed fast food weekly.

CONCLUSIONS

Individuals from SA have an evident lack of public knowledge and poor lifestyle practices regarding PCAD, which demonstrates the need for health authorities to take a more targeted and attentive approach toward PCAD awareness. In addition, extensive media involvement is required to highlight the severity of PCAD and its risk factors in the population.

Comparing Gerd and Non-GERD Patients Regarding Knowledge Level of Acute Myocardial Infarction Symptoms, Risk Factors and Immediate Action Must Be Taken in Eastern Province, Saudi Arabia

INTRODUCTION

A major cause of death globally is cardiovascular disease (CVD). Chest pain, nausea, vomiting, and heartburn are common symptoms of acute myocardial infarction (AMI). Chest pain is also the main symptom of gastroesophageal reflux disease (GERD). Therefore, the differential diagnosis of chest pain can become more challenging when GERD and AMI coincide. This study evaluated and compared the knowledge of the signs, symptoms, and immediate action that must be taken regarding AMI among GERD and non-GERD patients.

METHODOLOGY

An observational cross-sectional study using an online questionnaire was created and published between October and November 2022 to collect data from Saudi males and females 18 or older willing to participate in the study. Participants who were not Saudi had declined to complete the survey or had not fully completed it was excluded. The questionnaire contained three sections; after collecting informed consent, it made inquiries regarding respondents' GERD status, demographic information, and knowledge and attitudes regarding GERD.

RESULTS

This study included 691 responses from 300 non-GERD participants and 391 GERD participants. The study showed a high level of awareness (75.5%) of GERD, with significant differences in the level of awareness according to marital status, education levels, and occupation status. There was no significant difference in the level of awareness according to gender and GERD diagnosis, where the p-value > 0.05. The most common source of information about AMI was the Internet, followed by health care professionals. The most commonly known symptoms of AMI were sudden pain or discomfort in the chest, followed by a sudden shortness of breath. Additionally, there was no significant association between the diagnosis of GERD and known risk factors. The association between GERD and other diseases (chi-square = 46.94, p-value 0.01). Obesity and smoking were the two main risk factors for heart attacks.

CONCLUSION

This study demonstrated that there was no significant difference between GERD and non-GERD participants regarding the knowledge and awareness level of AMI. Moreover, it showed that there was a lack of general knowledge and awareness of AMI in Saudi Arabia. The authors recommend initiating more awareness programs in Saudi Arabia to inform people about AMI and cardiovascular disease. More research is required to determine whether other patients are aware of AMI.

Saudi Heart Association Guidelines on Best Practices in the Management of Chronic Coronary Syndromes

Background

The prevalence of both chronic coronary syndrome (CCS) and its risk factors is alarming in Saudi Arabia and only a minority of patients achieve optimal medical management. Context-specific CCS guidelines outlining best clinical practices are therefore needed to address local gaps and challenges.

Consensus panel

A panel of experts representing the Saudi Heart Association (SHA) reviewed existing evidence and formulated guidance relevant to local clinical practice considering the characteristics of the Saudi population, the Saudi healthcare system, its resources and medical expertise. They were reviewed by external experts to ensure scientific and medical accuracy.

Consensus findings

Recommendations are provided on the clinical assessment and management of CCS, along with supporting evidence. Risk reduction through non-pharmacological therapy (lifestyle modifications) remains at the core of CCS management. Great emphasis should be placed on the use of available pharmacological options (anti-anginal therapy and event prevention) only as appropriate and necessary. Lifestyle counseling and pharmacological strategy must be optimized before considering revascularization, unless otherwise indicated. Revascularization strategies should be carefully considered by the Heart Team to ensure the appropriate choice is made in accordance to current guidelines and patient preference.

Conclusion

Conscientious, multidisciplinary, and personalized clinical management is necessary to navigate the complex landscape of CCS in Saudi Arabia considering its population and resource differences. The reconciliation of international evidence and local characteristics is critical for the improvement of healthcare outcomes among CCS patients in Saudi Arabia.

Ethnicity affects the risk factors of acute myocardial infarction and should be considered in educational programs

Acute Myocardial infarction is a non-communicable disease representing the leading cause of death in Saudi Arabia. Studying the ethnicity in its risk factors has been poorly investigated.

Awareness of Coronary Artery Disease Risk Factors Among the Population of Taif City, Saudi Arabia

BACKGROUND

Coronary artery disease (CAD) is responsible for significant mortality and morbidity among patients. Many factors are associated with the increasing prevalence of CAD in a population, including diet and lifestyle, physical inactivity, high cholesterol levels, and others.

OBJECTIVES

The purpose of this study is to assess the awareness level and knowledge about CAD risk factors and its prevalence among the general population in Taif city, Saudi Arabia.

METHODS

This study was a community-based cross-sectional descriptive study carried out from August 2022 to September 2022 by an online questionnaire previously validated in published studies and then distributed via different social media platforms to assess participants' knowledge of risk factors for CAD. The survey included questions about socio-demographic data and risk factors of cardiovascular diseases and their prevalence.

RESULTS

A total of 2439 participants met the inclusion criteria and finally enrolled in the current study. About 1671 (68.5%) were found to have good awareness levels, 718 (29.4%) of the participants were considered to be having fair awareness levels, and only 50 (2.1%) of the participants were with poor awareness levels.

CONCLUSION

Most participants have a good level of knowledge and awareness about CAD. Few knowledge gaps were regarding certain factors, including age, gender, and family history of CAD. High educational level and age were found to be linked with a higher level of knowledge regarding CAD.

Public awareness of early symptoms of acute myocardial infarction among Saudi population

Introduction:

Globally speaking, cardiovascular disease is the leading cause of mortality, with coronary artery disease (CAD) contributing to half of the cases. A major complication of CAD is myocardial infarction (MI). The clinical outcomes of MI are predominantly time-dependent; therefore, it is paramount that the general public is familiar with the early symptoms of MI.

Aim:

The main objective is to gauge the local public awareness of the early symptoms of MI, and their knowledge of the best course of action to be taken from the onset of symptoms.

Method:

A cross-sectional study was conducted using google forms. Participants were randomly selected through multiple social media platforms. The study included Saudi citizens who were 18 years or older, with no current or prior experience in the health care field. The questionnaire assessed the participants' awareness of 14 risk factors for CAD. The variables investigated were participants' knowledge of the symptoms, causes, appropriate course of action to be taken, and the risk factors of CAD.

Results:

A total of 1689 participants were involved in this study. Sixty percent were females, and 29.2% were in the age group of 18–24 years. Seventy-three percent of the participants knew the definition of heart attack, and 90% knew that chest pain is a symptom of a heart attack. Approximately, 75% of the participants recognized that hypertension, cigarette smoking, and high cholesterol are the risk factors of MI. In terms of knowledge, Al Madinah province obtained the highest score when compared with other regions.

Conclusion:

This study showed the overall knowledge and awareness of CAD was suboptimal, indicating that awareness initiatives and patient education of CAD need more work in Saudi Arabia, especially in high-risk groups and lower education groups. More studies are needed to identify the efficiency and population access of different approaches for CAD awareness.

Assessment of Cardiovascular Diseases Knowledge and Risk Factors Among Adult Population in the South Region of Saudi Arabia

Cardiovascular diseases are the main cause of mortality and disability worldwide. This study aimed to assess knowledge of cardiovascular disease and risk factors among the adult population in the south region of Saudi Arabia. A web-based cross-sectional survey of 1,049 participants was completed during August 2021. Data were collected by using 25-item heart disease fact questionnaire. The study population included 526 men (50.1%) and 523 women (49.9%) with a mean age of 36 ± 12 years. The average total knowledge score was 65.7 ± 20.80. The items with the highest knowledge were smoking, overweight, aging, high cholesterol, hypertension, diabetes, and family history. Findings revealed that knowledge regarding cardiovascular diseases is inadequate with a high prevalence of risk factors among the Saudi Arabian population. Healthcare professionals and organizations have a crucial role in raising public awareness regarding health promotion, regular screening, and lifestyles modifications. Interventional studies are needed to investigate the actual magnitude of CVDs and counteract them.

Stroke Risk Factor Awareness Among Populations in Saudi Arabia

Background

Stroke is considered the second leading cause of death and the third leading cause of disability in the world. The incidence of stroke in Saudi Arabia is 43.8 per 100,000, due to the lack of knowledge and awareness of the population. This study intends to determine the level of stroke risk factor awareness among the Saudi population.

Methods

A cross-sectional study was conducted in Saudi Arabia on 898 participants older than 18 years old. The validated online survey was randomly distributed and consisted of 20 questions in both English and Arabic languages to evaluate the level of awareness of stroke risk factors among the population.

Results

A total of 898 participants completed the survey. The results showed that the median risk factor score was 5 (IQ 3–8) out of 14. A total of 2.2% could recognize all 14 risk factors. Personal history of hypertension was chosen as a risk factor by the majority of the participants (81.7%) followed by personal history of stroke (74.1%) and personal history of dyslipidemia (57.2%).

Conclusion

This study showed that there is an insufficient level of stroke risk factor awareness in Saudi Arabia. More than half of the participants identified the term (stroke), while only 2.2% could recognize all 14 risk factors. Hence, public education is needed to identify people with stroke risk factors.

A Community-Based, Cross-Sectional Study Assessing the Level of Awareness and Insight Related to Cardiovascular Diseases

Objective

The disease outcome had been shown to improve with improving patient knowledge. The study had two objectives, firstly to assess the level of knowledge about cardiovascular diseases (CVDs) in the general population, and secondly, to provide written educational material regarding the risk factors, major symptoms, and the prevention of CVDs.

Method

The target population was the residents living in the Western region of Saudi Arabia, aged 18 years and above. All were invited to participate voluntarily. A pre-structured questionnaire was designed to collect data related to age, gender, marital status, education level, occupation, lifestyle habits, and a history of heart diseases, as well as cardiac symptoms, and risk factors. The educational material was provided after the questionnaire.

Results

The majority of the participants were female (74.8%). The risk factors most frequently identified were lack of exercise, stress, and obesity. Chest pain was recognized as a major symptom (87.6%). Other symptoms included dyspnea, syncope, and excessive sweating. The level of knowledge regarding the risk factors for cardiovascular disease was poor. Only 18.5% were knowledgeable about the risk factors. The majority (60%) could identify the preventable factors, including smoking cessation (92.2%), a high level of cholesterol (88.6%), and hypertension (78.7%). The majority (83.7%) read the educational material and 99% reported that the lecture increased their knowledge about cardiovascular disease.

Conclusion

Although cardiovascular risk factors are common, there is a big gap in the knowledge in our population. Further, alarming symptoms that bring the patients to medical care are also deficient. A call for action at different levels is urgent. Simple educational material in a basic language and virtual education are useful and cheap tools that must be practiced wherever possible. Education is welcomed by the participants.

Awareness and prevalence of coronary artery disease risk factors among Saudi adults in Dawadmi, Riyadh province: A cross-sectional study

Objective:

Coronary artery disease (CAD) is one of the leading causes of death and disability worldwide. Amongst the Middle East countries, Saudi Arabia is facing rapid progressive urbanization by the adoption of a westernized lifestyle and food habits, which contribute to the rising burden of CAD. We aim to evaluate the awareness and prevalence of CAD risk factors among Saudi adults.

Methods:

This was a cross-sectional study conducted between January and March 2020. Data were collected through an online survey using a self-administered questionnaire. Data assessed on socio-demographic variables, family history of CAD, knowledge of risk factors, symptoms, and complications of CAD. Results data were entered and analyzed using IBM SPSS statistics, version 25. All comparisons were considered significant at P < 0.05.

Results:

A total of 311 subjects (48.6% men and 51.4% women) included, and most of the participants were between 18 and 25 years. A majority of the participants did not hear about CAD (82%) and unaware of any risk factors (26.4%), symptoms (25.1%), and complications (72.7%) of CAD. The prevalence of a family history of CAD (9.3%), overweight/obesity (58.6%), physical inactivity (79.1%), and smoking (24.1%) observed considerably high among the participants.

Conclusion:

The present study reveals that a significantly low level of awareness and a high prevalence of CAD risk factors found among Saudi adults. Therefore, the awareness program is needed at the public level to increase the knowledge of CAD risk factors so that persons with high risk for future CAD can be prevented.

Cardiovascular Disease among Patients with Diabetes: The Current Scenario in Saudi Arabia

One of the well-recognized conditions linked to diabetes mellitus (DM) is cardiovascular disease (CVD). Those affected by DM face greater risk for early onset of CVD. Although huge strides have been made in cardiovascular therapy and prevention, with striking results in decreasing diabetesrelated coronary mortality in developed countries, the morbidity and mortality due to CVD continue to remain high among patients with diabetes. While there is an increasing incidence of cardiovascular event survivors with DM across the world, the number of DM patients with higher cardiovascular risk is predicted to soar, presenting a massive challenge for health care systems globally, including Saudi Arabia. A report of the Saudi Scientific Diabetes Society indicates that more than 50% of patients with DM die due to cardiovascular causes. In fact, Saudi Arabia globally ranks among the top 10 countries in the prevalence of diabetes. However, the incidence of CVD and its risk factors among patients with diabetes in Saudi Arabia have not yet been well documented. This review aims to present an overview of CVD among patients with DM in Saudi Arabia, through a comprehensive review of currently available published literature. The findings indicate that diabetes linked CVD burden in Saudi Arabia is expected to exponentially increase to a very high degree unless a wide-ranging epidemic control program is initiated. The findings emphasize the need for maintenance of a healthy diet accompanied by exercise, an active lifestyle and weight control measures among the population. It is essential that the health care system focus on raising awareness among the population, and implement appropriate measures for prevention, early detection and suitable management of CVD among patients with DM.

Echocardiographic and Clinical Correlates of Ejection Fraction Among 2000 Patients with Heart Failure in Western Saudi Arabia

Introduction

Heart failure (HF) affects about 320,000 Saudi individuals and is associated with a considerable negative impact on the patients’ quality of life. In literature, there is a lack of data about the echocardiographic abnormalities of HF patients in Saudi Arabia.

Aim of Work

To describe the echocardiographic findings of HF patients in Western Saudi Arabia.

Methodology

This was a retrospective record review study conducted on 2000 patients with chronic HF in Saudi Arabia. Demographic, clinical and echocardiographic data were collected and compared among patients with HF with reduced ejection fraction (HFrEF), ie, EF≤40%; HF with mid-range EF (HFmrEF), ie, EF=41–49%; and HF with preserved EF (HFpEF), ie, EF≥50%.

Results

Among the 2000 patients studied, females constituted 46.3% of the sample. About 52% of females had HFpEF, whilst 70% of males had HFrEF (p<0.0001). Diastolic dysfunction occurred in 98% of HFpEF versus 78% of HFrEF (p<0.0001). Patients with HFrEF had higher left-ventricular diastolic (LVd) volume (1536 versus 826), higher left-ventricular systolic (LVs) volume (1660 vs 772), higher left atrial volume (1344 vs 875), higher aortic root dimension (1144 vs 929) and lower fractional shortening (FS) (267 vs 1213) than patients with HFpEF (p<0.0001).

Conclusion

HFpEF was more common among females and was associated with higher rates of diastolic dysfunction and higher FS. HFrEF was prevalent among males and associated with higher LVd, LVs, left atrium volume and aortic root dimensions.

The Perception of Coronary Artery Disease and Cardiac Catheterization in Saudi Arabia: "What the Public Know"

Objective Coronary artery disease (CAD) constitutes a significant health hazard in middle-aged individuals in Saudi Arabia. We sought to assess the level of knowledge of cardiovascular risk factors and describe the perception of coronary intervention among the general population in the city of Jeddah in the western part of Saudi Arabia. Methods A cross-sectional study was conducted in the city of Jeddah during the period from April 2019 to September 1, 2019, by using a structured online questionnaire to assess the participants' awareness of risk factors for CAD and coronary intervention. The survey included questions about socio-demographic data, risk factors of cardiovascular diseases, symptoms of heart attack, knowledge of coronary catheterizations, as well as resources of knowledge about coronary heart disease. Results The study included 984 participants. The majority of the participants had university diplomas (78.1%). Only 38.5 % were healthcare workers. Dyslipidemia and smoking were identified by 70.5% and 66.7%, respectively, as a recognized risk factor for CAD. Diabetes was mentioned by 32.1%. Participants without CAD risk factors had a significantly lower level of knowledge regarding the strong association between diabetes mellitus (DM) II and CAD (p-value=0.02). Healthcare professionals had a significantly lower level of knowledge regarding cardiac catheterization as compared to non-healthcare professionals. A higher percentage of healthcare professionals would agree to have cardiac catheterization if indicated (p-value=0.003). Awareness campaigns were the most common source of information for the public. Conclusion The current level of knowledge of CAD in the western part of Saudi Arabia is fair. National awareness campaigns are required to improve the level of healthcare education.