Gulf’s cholesterol menace

BY PMA RASHEED

The Gulf Today, I July 2010

One in every two persons in the GCC countries has increased level of cholesterol, and over 25 per cent of deaths in the UAE are caused by cardiac disorders, discloses a recent study.

The epidemiological transition during the last few decades in the Gulf countries has occurred with a gradual increase in chronic diseases. The prevalence of hypercholesterolemia is estimated to be 54 per cent. Moreover, more than 70 per cent of the region’s adult population is obese, revealed the statistics.

Attributed to the major risk factors caused by the higher prevalence of hypercholesterolemia among the people living in the region, cardiovascular disease has emerged as the number one cause of mortality in this part of the world.

The negligence of hypercholesterolemic patients on the fatal burdens of cardiac disorders, coupled with substandard medical care by the doctors practicing in the Gulf countries, has boosted the predominance of cholesterol-induced challenges in the region, commented an expert.

Dr Omar K Hallak, board member of Emirates Cardiac Society and chief interventional cardiologist at American Hospital in Dubai, said that half of the UAE patients with high cholesterol don’t achieve results due to insufficient or wrong medications. The hypercholesterolemia is more prevalent in men than women.

“Most of the patients do not achieve the desired reduction in their cholesterol levels, which is attributed to the improper follow up of the treatments, diet and exercise recommendations, despite being treated with cholesterol-lowering medications,” he added.

“In many cases, the patients are not at a perfect cholesterol goal and are at higher risk of heart diseases, in spite of being under a cholesterol reducing medication,” he pointed out.

Dr Hallak was speaking to The Gulf Today in light of a comprehensive cholesterol research project, CEPHUS, carried out by Emirates Cardiac Society (ECS) and drug manufacturer AstraZeneca across the GCC countries, covering about 5,300 hypercholesterolemic patients, including 500 from the UAE.

The CEPHUS study, conducted in line with the ECS’s “Safe at Heart” programme, has revealed that lack of awareness on the seriousness of hypercholesterolemia, fact of negligence on proper continuation of medications and fear of side-effects from the medicines worsened the situation in the Gulf.

“Each patient in the region may suddenly plunge into cardiovascular complications, simply because they are not at cholesterol lowering goal,” warned Dr Hallak.

“The problem of hypercholesterolemia management is not restricted to patients who don’t take medications, but extends to those who take medications. At the global level, many patients think that they are safe because of taking medication. Actually they are not,” he said.

“A data published in Europe in the beginning of this year showed that only 50 per cent of patients on cholesterol treatment reached their desired treatment goal. But the status of patients in this region differs from that of Western patients in genes, nature of food and way of living. Until now, the Gulf lacked its own studies and precise statistics on the situation,” he elaborated.

He noted that findings of CEPHUS study will mirror the real situation in the Gulf. It’s the first step towards slapping the incidences of cardiovascular diseases, while improving the quality of cardiac care in the near future. Education programmes should be developed, focusing on patients as well as physicians.

“The Gulf people are a homogenous sample as they share similar way of living, similar food culture and severe climatic conditions,” said Dr Khalid Humaid Al-Rasadi, consultant biochemist and lipid specialist at Sultan Qaboos University Hospital in Oman.

“The significant research will give the Arab World vital data on how to effectively treat patients,” he added. “It is the first study that looks into control of the situation.”

“The metabolic syndrome in the GCC countries is around 10 to 15 per cent, higher than in most developed countries, with generally higher prevalence rates for women according to some recent systematic reviews,” he pointed out.

According to Dr Al Rasadi, hyperlipidimia is an important feature of this syndrome, which has been attributed to physical inactivity, diet quality, lower education and higher incomes.

“Addressing the modifiable risk factors of the metabolic syndrome on a population basis is a public health priority. So, the CEPHUS study will give answers on the cholesterol control in metabolic syndrome,” he added.

Dr Fadel Shaker, medical manager at AstraZeneca Gulf, said that the CEPHUS research monitored the group of patients who were taking lipid-lowering medication. Being the largest such survey in the region to date, the study forms part of a larger, earlier European project that looked at 15,000 patients.

“The European study found that poor compliance often resulted when the therapy was frequently changed or doses increased and one of the conclusions drawn was that patients should be better informed and encouraged to stick firmly to their treatment regime,” he added.

“Ten per cent overall reduction in cholesterol levels can cut heart diseases by half, with scientists saying that men over 40 years of age (a group that is particularly at risk) only have to reduce their cholesterol levels by 10 per cent to lower their risk of heart disease by 50 per cent,” explained Shaker.

Dr Hallak said, “Patients should continuously monitor their cholesterol level and consult their doctors regularly to review their plan of treatment, which is lifelong, against achieving the goal they should reach.”

“It will definitely contribute in raising the standard of cholesterol management and hence will protect thousands of patients from developing cardiovascular diseases that might be fatal for them,” he added.