Patients with ACS in the Arab Middle East are younger than in developed countries and have higher rates of diabetes and smoking. There is good adherence to evidence-based medications; however, improvement in door-to-needle time and utilisation of interventional procedures is needed.

OBJECTIVE -To estimate the prevalence of the metabolic syndrome by age and sex in the RESEARCH DESIGN AND METHODS -We analyzed data from a cross-sectional survey conducted in 2001 containing a probability random sample of 1,419 Omani adults aged Ն20 years living in the city of Nizwa. The metabolic syndrome, defined by the ATP III, was defined as having three or more of the following abnormalities: waist circumference Ͼ102 cm in men and Ͼ88 cm in women, serum triglycerides Ն150 mg/dl (1.69 mmol/l), HDL cholesterol Ͻ40 mg/dl (1.04 mmol/l) in men and Ͻ50 mg/dl (1.29 mmol/l) in women, systolic blood pressure Ն130 mmHg and/or diastolic Ն85 mmHg or on treatment for hypertension, and fasting serum glucose Ն110 mg/dl (6.1 mmol/l) or on treatment for diabetes.RESULTS -The age-adjusted prevalence of the metabolic syndrome was 21.0%. The crude prevalence was slightly lower (17.0%). The age-adjusted prevalence was 19.5% among men and 23.0% among women (P ϭ 0.236). Low HDL cholesterol was the most common component (75.4%) of the metabolic syndrome among the study population followed by abdominal obesity (24.6%). Abdominal obesity was markedly higher in women (44.3%) than in men (4.7%).CONCLUSIONS -The prevalence of the metabolic syndrome in Oman is similar to that in developed countries. Future prevention and control strategies should not overlook the importance of noncommunicable disease risk factors in rapidly developing countries. Diabetes Care 26:1781-1785, 2003P eople with abnormal glucose metabolism, hypertension, obesity, and dyslipidemia constitute a major challenge facing health systems in developed and developing countries. Such people are at substantially increased risk of developing diabetes and cardiovascular diseases (CVDs), including coronary artery, cerebrovasular, and peripheral vascular diseases necessitating long-term care (1,2).Several studies have illustrated a high prevalence of diabetes, impaired glucose tolerance, obesity, and hypertension among Arab populations of the Middle East, including Omanis (3-10). However, all of these studies focused on estimating the population distribution of major risk factors for CVDs, and only one (11) RESEARCH DESIGN AND METHODS Study populationAs part of the initiative to obtain baseline data on CVD risk factors before the implementation of a community-based healthy lifestyle intervention project, a crosssectional survey was conducted between April and June 2001 in the city of Nizwa (capital of the main Interior Province of Oman with 66,000 inhabitants and 180 km away from the national capital Muscat) (Fig. 1). The target group was all Omanis aged Ն20 years who resided in this city for at least 6 months before the date of the survey. The sample size, 1,000 men and women, was calculated for gender-specific analyses based on the estimate of the national prevalence of diabetes (10%), a nonresponse rate of 20%, and an error margin of 20% on each side of the 95% confidence intervals for any point estimate (Epinfo version 6; CDC, Atlanta, GA). Two-stage cluster sampling wa...

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The prevalence of diabetes is high in Oman and has increased over the past decade. The high rate of abnormal fasting glucose together with high rates of overweight and obesity in the population make it likely that diabetes will continue to be a major health problem in Oman. Primary prevention programmes are urgently needed to counteract major risk factors that promote the development of diabetes.

Background— The khat plant is a stimulant similar to amphetamine and is thought to induce coronary artery spasm. Khat is widely chewed by individuals originating from the Horn of Africa and the Arabian Peninsula. The aim of this study was to evaluate the clinical characteristics and outcome of khat chewers presenting with acute coronary syndrome. Methods and Results— From October 1, 2008, through June, 30, 2009, 7399 consecutive patients with acute coronary syndrome were enrolled in the Second Gulf Registry of Acute Coronary Events (Gulf RACE-2). Nineteen percent of patients were khat chewers; 81% were not. Khat chewers were older, more often male, and less likely to have cardiovascular risk factors. Khat chewers were less likely to have a history of coronary artery disease and more likely to present late and to have higher heart rate and advanced Killip class on admission. Khat chewers were more likely to present with ST-segment–elevation myocardial infarction. Overall, khat chewers had higher risk of death, recurrent myocardial ischemia, cardiogenic shock, ventricular arrhythmia, and stroke compared with non–khat chewers. After adjustment for baseline variability, khat chewing was found to be an independent risk factor of death and for recurrent ischemia, heart failure, and stroke. Conclusions— Our data confirm earlier observations of worse in-hospital outcome among acute coronary syndrome patients who chew khat. This worse outcome persists up to 1 year from the index event. This observational report underscores the importance of improving education concerning the cardiovascular risks of khat chewing.

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BACKGROUND AND OBJECTIVESLimited data are available on patients with acute coronary syndromes (ACS) and their long-term outcomes in the Arabian Gulf countries. We evaluated the clinical features, management, in-hospital, and long-term outcomes in such a population.DESIGN AND SETTINGA 9-month prospective, multicenter study conducted in 65 hospitals from 6 countries that also included 30 day and 1-year mortality follow-up.PATIENTS AND METHODSACS patients included those with ST-elevation myocardial infarction (STEMI) and non–ST-elevation acute coronary syndrome (NSTEACS), including non-STEMI and unstable angina. The registry collected the data prospectively.RESULTSBetween October 2008 and June 2009, 7930 patients were enrolled. The mean age [standard deviation (SD)], 56 (17) years; 78.8% men; 71.2% Gulf citizens; 50.1% with central obesity; and 45.6% with STEMI. A history of diabetes mellitus was present in 39.5%, hypertension in 47.2%, and hyperlipidemia in 32.7%, and 35.7% were current smokers. The median time from symptom onset to hospital arrival for STEMI patients was 178 minutes (interquartile range, 210 minutes); 22.3% had primary percutaneous coronary intervention (PCI) and 65.7% thrombolytic therapy, with 34% receiving therapy within 30 minutes of arrival. Evidence-based medication rates upon hospital discharge were 68% to 95%. The in-hospital PCI was done in 21% and the coronary artery bypass graft surgery in 2.9%. The in-hospital mortality was 4.6%, at 30 days the mortality was 7.2%, and at 1 year after hospital discharge the mortality was 9.4%; 1-year mortality was higher in STEMI (11.5%) than in NSTEACS patients (7.7%; P<.001).CONCLUSIONSCompared to developed countries, ACS patients in Arabian Gulf countries present at a relatively young age and have higher rates of metabolic syndrome features. STEMI patients present late, and their acute management is poor. In-hospital evidence-based medication rates are high, but coronary revascularization procedures are low. Long-term mortality rates increased severalfold compared with in-hospital mortality.

Background: The prevalence of type 2 diabetes in Oman is high and appears to be rising. Rising rates of diabetes and associated risk factors have been observed in populations undergoing epidemiological transition and urbanization. A previous study in Oman indicated that urbandwellers were not significantly more likely to have diabetes. This study was undertaken to determine if a more accurate urban and rural categorization would reveal different findings.