Awareness of cardiovascular disease in eastern Saudi Arabia

To estimate the awareness of cardiovascular disease [CVD] and their determinants in a screening campaign in the eastern province of Saudi Arabia. All national residents in the eastern province of Saudi Arabia aged 30 years and above, were invited to participate in a screening campaign for the early detection of diabetes and hypertension at more than 300 examination posts throughout the eastern province. A pre-structured questionnaire was designed to collect data on age, gender, marital status, education level, occupation, lifestyle habits, and history of heart attack, angina, arterial disease, stroke, and transient ischemic attack. Weight, height, blood pressure, and glucose concentration were measured. Out of 197,681 participants, 5372 [2.7%] were aware of a history of a CVD. The prevalence correlated well with age. It was higher in women, widows, and subjects with lower level of education. More than 75% of affected subjects had two or more risk factors. A substantial proportion of those with a history of CVD had multiple risk factors, necessitating an effective, focused policy for the prevention and treatment. Increased effort is required to promote an awareness of cardiac disease and also probably target primary care providers involved in the screening process

Performance of body mass index in predicting diabetes and hypertension in the eastern province of Saudi Arabia

Body mass index [BMI] is the most widely used measure to define obesity and predict its complications, such as diabetes and hypertension, but its accuracy and usefulness in Saudi subjects is unknown. This study aimed to assess the validity of standard BMI cut-point values in the Saudi population. 197 681 adults participated in a cross-sectional study to detect diabetes and hypertension in the Saudi Eastern province in 2004/2005, with blood pressure, fasting blood sugar, height and weight measurements taken. Sensitivities, specificities, areas under the curves, predictive values, likelihood ratios, false positive, false negatives and total misclassification ratios were calculated for various BMI values determined from receiver operating characteristic [ROC] curves. The significance of the association between risk factors and BMI was assessed using regression analysis. For the definition of overweight, ROC curve analysis suggested optimal BMI cut-offs of 28.50 to 29.50 in men and 30.50 to 31.50 in women, but the levels of sensitivity and specificity were too low to be of clinical value and the overall misclassification was unacceptably high across all the selected BMI values [>0.80]. The relationship between BMI and the presence of diabetes and/or hypertension was not improved when a BMI of 25 was used. Using regression analyses, the odds ratios for hypertension and/or diabetes increased significantly from BMI values as low as 21-23 with no improvement in the diagnostic performance of BMI at these cutoffs. In Saudi population, there is an increased risk of diabetes and hypertension relative to BMI, starting at a BMI as low as 21 but overall there is no cutoff BMI level with high predictive value for the development of these chronic diseases, including the WHO definition of obesity at BMI of 30

Hypertension in the eastern province of Saudi Arabia: results of a screening campaign

To estimate the prevalence of hypertension through a screening campaign in the Eastern Province of Saudi Arabia, and examine its association with lifestyle factors. In 2004, all Saudi residents in the Eastern Province, aged 30 years and above were invited to participate in a screening campaign for the early detection of diabetes and hypertension. Blood pressure was recorded by trained nurses using a mercury sphygmomanometer, based on the recommendations of [JNC- VII]. A positive screening test for hypertension was defined as systolic and/or diastolic blood pressure of >/= 140 and 90 mm Hg, respectively. Subjects who had positive screening tests were asked to come on the following day for a confirmation of the reading. Hypertension was considered if there was a persistent reading of systolic and/or diastolic blood pressure of >/= 140 and 90 mmHg after confirmation, or when there was history of a previous diagnosis. 21% of the sample was positive from previous history or screening. After confirmation, the prevalence of hypertension dropped to 15.6%, pre-hypertension was 3.7%, whereas the prevalence of undiagnosed hypertension was 2.8%. The prevalence rose with age. It was higher in women than in men of all age groups and in all sectors of the eastern province, although the mean systolic and diastolic BP was higher in men than women. It was higher with lower education, in widows and divorcees than others [P<0.0001]. The yield of the screening for abnormal blood pressure was high. Systematic follow-up of subjects with abnormal screening results is vital

Overweight and obesity in the eastern province of Saudi Arabia

To describe anthropometric characteristics of participants and the influence of sociodemographic and cardiovascular risk factors involved in the prevalence of obesity in the eastern province of Saudi Arabia. In the year 2004, all Saudi residents in the Eastern province aged 30 years and above, were invited to participate in a community screening campaign for early detection of diabetes and hypertension. Demographic data, medical history, life habits, weight, height, blood pressure, and glucose concentration were recorded using a structured questionnaire. Obesity and overweight were defined by body mass index [BMI] >/= 30 kg/m2 and 25-29.9 kg/m2, respectively. Logistic regression was used to predict the association of the significant factors with the prevalence of obesity. Out of 195,874 participants, the overall prevalence of obesity was 43.8%, while 35.1% were overweight. The prevalence of underweight was 1.3%. The peak prevalence of obesity was observed in the age group 50-59 years. Obesity was higher among women than men, higher in housewives, and among the less educated than others [p<0.0001]. Linear regression analysis showed a strong proportional association of BMI with diabetes, hypertension, triglycerides and cholesterol, and an inverse proportional association with physical activity and smoking. Obesity and overweight constitute an important health problem affecting a high proportion of Saudi population. Addressing associated factors, and enhancing public health education is an important aim to focus on for weight control

Clinical growth charts for pre-school children

Growth standards are indicators for normal growth of the children and growth charts are important tools for their growth monitoring. Children from different populations are different in their growth pattern, it is important to create national standards for the growth of children in each population to develop local growth charts, and since these were not available in the Kingdom of Saudi Arabia [KSA], the aim of this study was to construct national growth standards and to develop growth charts for 0-5-years Saudi children. A cross-sectional study following World Health Organization [WHO] criteria in determining sample size was adopted, where by 24000 children from 5 regions in the KSA were selected during the period 1992 to 1995 to be the desired sample. One hundred and two Primary Health Care centers [PHCCs] were selected randomly from the 5 regions, from where the sample was drawn, and a special questionnaire was designed. Weight, height and head circumference were measured by standard procedures. The total number of children examined was 23821 [11913 boys and 11908 girls]. Saudi [0-5-years] boys weight and height for age measurements were significantly different from girls. The same difference was found between urban and rural boys and girls and between boys and girls from the different regions of the country [p<0.05]. These national standards derived from this study were used to develop national growth charts that are currently utilized to monitor growth in all Saudi health institutes