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Prevalence and treatment of cardiovascular risk factors in outpatients with atherothrombosis in the Middle East
  1. Alawi A Alsheikh-Ali1,2,
  2. Wael A Al-Mahmeed1,
  3. Avi Porath3,
  4. Ismail Khalil4,
  5. Hisham Mahmoud5,
  6. Deepak L Bhatt6,
  7. P Gabriel Steg7 on behalf of the REACH Registry Investigators
  1. 1Institute of Cardiac Sciences, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
  2. 2Institute for Clinical Research and Health Policy Studies and Tufts University School of Medicine, Boston, Massachusetts, USA
  3. 3Maccabi Healthcare Services, Tel-Aviv, Israel
  4. 4Division of Vascular Surgery & Wound Care Center, Department of Surgery, American University of Beirut, Beirut, Lebanon
  5. 5Medical Affairs, Sanofi-aventis Gulf Office, Dubai, United Arab Emirates
  6. 6VA Boston Healthcare System and Brigham and Women's Hospital, Boston, Massachusetts, USA
  7. 7INSERM U-698, Université Paris 7 and AP-HP, Paris, France
  1. Correspondence to Dr Alawi A Alsheikh-Ali, Institute of Cardiac Sciences, Sheikh Khalifa Medical City, PO Box 51900, Abu Dhabi, United Arab Emirates; aalsheikhali{at}


Objective To characterise the risk-factor profile and treatment gaps among patients with, or at risk for, cardiovascular disease in the Middle East.

Design Secondary analysis of a prospective observational study.

Setting International multicentre study (Reduction of Atherothrombosis for Continued Health).

Patients Stable outpatients with established cardiovascular disease or at least three risk factors for atherothrombosis. The present analysis was based on 840 patients from the Middle East.

Intervention Observational study without a study-specific intervention.

Main outcome measures A treatment gap was defined as at least one of the following: current cigarette smoking, total cholesterol ≥200 mg/dl, serum glucose ≥126 mg/dl or blood pressure of ≥140/90.

Results The majority of Middle Eastern patients had hypertension (80.2%), more than half had a history of diabetes mellitus (52.3%), and a third had hypercholesterolaemia (34.1%). There was a high prevalence of obesity (38.6%), and nearly half the patients were former or current smokers (46%). β-Blockers and angiotensin-converting enzyme inhibitors were the most commonly prescribed antihypertensives (61.1% and 57.5%, respectively). Antiplatelet therapy (most commonly aspirin) and lipid-lowering drugs (most commonly a statin) were used in most patients (90.7% and 85.2%, respectively). Three-quarters of the participants (75.6%) had at least one uncontrolled risk factor.

Conclusion Patients with atherothrombosis in the Middle East have a high prevalence of risk factors including alarming rates of diabetes mellitus and obesity. At least one risk factor is uncontrolled in the majority of patients, presenting a pressing need for improving the care of such patients in the Middle East.

  • Cardiovascular disease
  • diabetes mellitus
  • obesity
  • risk factors
  • Middle East
  • diabetes

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  • Funding The Reduction of Atherothrombosis for Continued Health Registry is sponsored in the Middle East countries by Sanofi-Aventis.

  • Competing interests DLB discloses the following relationships: institutional research grants from Astra Zeneca, Bristol-Myers Squibb, Eisai, Ethicon, Heartscape, Sanofi Aventis and The Medicines Company. HM is employed by Sanofi-Aventis.

  • Patient consent Obtained.

  • Ethics approval Ethics approvals were obtained from the institutional review board in each country according to local requirements and signed informed consent was obtained for all patients.

  • Provenance and peer review Not commissioned; not externally peer reviewed.

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