Prevalence and aetiology of heart failure in an Arab population

Abstract

Background: The epidemiology of heart failure in Arabia, with a population different from the West in cultural and ethnic origin, has not been studied before. Aims: To determine the prevalence and aetiologies of symptomatic heart failure in an indigenous Arab population over a 3-year period. Methods: All patients with heart failure G 13 years of age, treated at the only secondary care hospital of the Dhakliya region of Oman between 1992 and 1994 were evaluated prospectively by clinical history and physical examination. Chest radiograph and echo-Doppler studies were used to confirm the diagnosis of heart failure. Exercise stress testing andror coronary angiography were also performed in patients ) 30 years of age, or earlier if ischaemic heart disease was suspected. Results: A total of 1164 patients were identified giving a prevalence of 5.17r1000 Ž . population during the study period 6.04r1000 among males and 4.21r1000 among females; P -0.001 . The prevalence Ž . increased with age from 1.05r1000 in age group -45 years to 15.7r1000 in 45᎐64 years P-0.001 and 25.2r1000 in G 65 Ž . Ž . Ž . years P -0.001 . Common causes of heart failure were ischaemic heart disease 51.7% , hypertensive heart disease 24.9% Ž . and idiopathic dilated cardiomyopathy 8.3% . Valvular heart disease and lung diseases causing heart failure were less common. Conclusion: The prevalence of symptomatic heart failure was appreciably significant in the population studied, showed a male preponderance and was frequent in people aged G 45 years. Ischaemic heart disease and hypertension were the commonest aetiologies but idiopathic dilated cardiomyopathy was also present in a significant number of patients being relatively more prevalent than reported from the West. ᮊ

Smoking water-pipe, chewing nass and prevalence of heart disease: a cross-sectional analysis of baseline data from the Golestan Cohort Study, Iran

“…In the most recent available national mortality data from Iran (2004), IHD The International Classification of Diseases (ICD10 codes I20 to I25) was the cause of 21.8% of all mortality cases in Iran, approximately 7-times more than hypertensive HD (ICD 10 codes I10 to I13, which included heat failure), which was the cause of death in 3.2% of cases. 38 Similarly, in the few available reports on incidence in Iran, HF was associated with IHD in 60-65% of admitted patients, 39 40 with similar proportions observed in studies from adjacent countries (40-60%), [41][42][43][44][45] and those from the West. 5 46 Furthermore, we analysed medication use in our study and observed that only 5% of our cases used digoxin, a medication commonly prescribed for symptomatic HF, 47 48 and even among those using digoxin, one-third also used nitrate compounds, indicated for IHD.…”

Worldwide risk factors for heart failure: A systematic review and pooled analysis

“…South Asia was excluded from the analysis because the one paper screened from this region did not include data on participants’ age;[16] Middle East was excluded because only one study met inclusion criteria. [17] Therefore, results were estimated for six geographic regions. A paper from Singapore was excluded because 1) the relatively small size of the Singapore population compared with those of South Korea and Japan, 2) the participants’ ethnicities differed markedly from the other Asia Pacific High Income region studies (60% Chinese, 24% Malay, and 15% Indian ethnicities), and 3) a distinctly different heart failure risk factor pattern appeared (for example, 85% IHD).…”

Review article: Left ventricular dysfunction and heart failure in metabolic syndrome and diabetes without overt coronary artery disease — do we need to screen our patients?

“…In Western populations, between 6 and 10% of cases of heart failure are thought to be due to hypertension, 107,108 with significant ethnic variations. 109 Hypertension increases the risk of heart failure twofold in men and threefold in women over that seen in normotensive subjects. 110 Hypertension in men is more likely than in women to cause systolic heart failure.…”