Background: The prevalence of the major conventional cardiovascular risk factors - cigarette smoking, diabetes mellitus, hypertension, and dyslipidemia - among coronary heart disease (CHD) patients in the Middle East has not been studied extensively.
Methods and results: The Jordan Hyperlipidemia And Related Targets Study (JoHARTS) evaluated the prevalence of the 4 conventional risk factors in 5000 individuals including 1692 (34%) women. CHD was present in 1534 (31%) individuals (1202 men and 332 women). Among CHD patients, at least one risk factor was present in the majority of men (95%) and women (96%). Compared with women who had CHD, men had significantly higher prevalence of smoking (45% vs. 11%, p < 0.0001) and low levels of high-density lipoprotein cholesterol (60% vs. 39%, p < 0.0001), and lower prevalence of diabetes (40% vs. 64%, p < 0.0001), hypertension (38% vs. 63%, p < 0.0001), and hypercholesterolemia (19% vs. 27%, p = 0.003). Diabetes was more prevalent among men and women with CHD than men and women without CHD (40% vs. 18% for men, and 64% vs. 24% for women p < 0.0001). Similarly, smoking was more prevalent in men and women with CHD than those without CHD (45% vs. 32% for men, and 11% vs. 7%, p < 0.0001). Low levels of high-density lipoprotein cholesterol were also more prevalent in men with CHD than those without CHD (60% vs. 51%, p < 0.001) and among women with CHD than those without CHD (39% vs. 24%, p = 0.0001). Prevalence rates of hypertension, hypercholesterolemia, and hypertriglyceridemia were not different among individuals with or without CHD.
Conclusion: These results further challenge claims that patients with CHD commonly lack conventional risk factors. The great majority (>95%) of CHD patients studied have at least one risk factor. Detection, evaluation and management of these factors are essential steps to control CHD in the region.