Cardiovascular diseases on the increase in Arab states

Children in the Arab Gulf region are more at risk of developing cardiovascular diseases (CVD) than those in other Arab states, according to a new report from the World Heart Federation.

The rapid urbanisation of Arab Gulf states means children are increasingly living in densely populated cities and suffering exposure to air and water pollution. Many are being denied access to green spaces and their health is further compromised by passive smoking and fast food.

Kuwait is the most urbanised Arab state, with 98% of its population living in cities, followed closely by Qatar with 96%. Neighbouring Saudi Arabia and the United Arab Emirates (UAE) come next, with 84% and 78% of people living in cities respectively.

"Any country which experiences a rapid transition from traditional semi-urbanised life to a modern, urbanised society is prone to get a rise in the prevalence of obesity and other cardiovascular problems," says Nooshin Bazargani, head of the CVD prevention group of Emirates Cardiac Society.

Specific statistics for CVD across the Middle East and North Africa (MENA) region are not available, but data from Syria suggests that there are 3,000 new cases of child coronary heart diseases each year among the country's 20 million residents, according to the World Heart Federation. Only a third receives the necessary treatment.

"Overall, there is a high incidence of obesity and nutrition-related non-communicable diseases among Arab countries," says Bazargani. "Among the dietary causes noted are frequent snacking, replacement of traditional foods with energy-dense fast foods, water with soft drink consumption and low fruits and vegetable intake."

Increased affluence in the Gulf Cooperation Council (GCC) countries have led to a decline in nutrition. "Studies have shown that the wealthiest households had the highest caloric intake," adds Bazargani.

At the other end of the scale, there are children in Arab states facing severe malnutrition, a critical risk factor for CVD. According to UNICEF, Yemen has the second highest rate of chronic malnutrition among children in the world. And in Egypt, 6.8% of children under five are malnourished.

Environmental and social effects

The widespread use of cars and the lack of dedicated green space in which children can play contributes to a sedentary lifestyle. According to the World Heart Federation, data suggests that 66.8% of the population in Saudi Arabia is physically inactive, 63% in Kuwait, 58% in the UAE and 47% in Lebanon.

The problem may have social roots as well. The number of people smoking is increasing in several countries, especially Saudi Arabia, where the prevalence of smoking among adults is approximately 22.6%. Consanguineous marriages are still widespread in many Arab states, which has been associated with a relative abundance of recessive disorders.

"Egypt has between 8,000 and 10,000 new cases of CVD annually, half of them requiring surgery," says Mortaga Negm, a consultant surgeon at the National Heart Institute in Cairo. "In my experience, most of these cases in young children are due to consanguineous marriages."

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