Cardiovascular disease in the Asia Middle East region: global trends and local implications.

Cardiovascular disease (CVD) is the leading cause of death worldwide and in most countries outside sub-Saharan Africa. The root causes of this modern epidemic are sedentary stressful urban lifestyles and high-calorie diets rich in saturated fats, salt, and simple sugars. Although the mortality from CVD has long peaked in most developed countries, its prevalence continues to rise because of improved survival and aging of the populations, placing tremendous strains on health care financing in some of these countries. In most Asian and Middle Eastern countries, outside East Asia, prevalence of CVD and its risk factors are high and still rising, while the rising mortality is among the highest in the world. As the predominantly young populations of these countries age, they face inadequate health care systems without assured financial coverage. Effective measures are therefore urgently needed to combat the epidemic of CVD. Comprehensive preventive measures are essential to curb the spread of this epidemic, while health care systems should be structured on the basis of locally derived data to provide adequate affordable care to the ever increasing pools of patients with CVD.

Cardiovascular diseases, diabetes mellitus, and cancer in the occupied Palestinian territory.

Heart disease, cerebrovascular disease, and cancer are the major causes of morbidity and mortality in the occupied Palestinian territory, resulting in a high direct cost of care, high indirect cost in loss of production, and much societal stress. The rates of the classic risk factors for atherosclerotic disease-namely, hypertension, diabetes mellitus, tobacco smoking, and dyslipidaemia-are high and similar to those in neighbouring countries. The urbanisation and continuing nutritional change from a healthy Mediterranean diet to an increasingly western-style diet is associated with reduced activity, obesity, and a loss of the protective effect of the traditional diet. Rates of cancer seem to be lower than those in neighbouring countries, with the leading causes of death being lung cancer in Palestinian men and breast cancer in women. The response of society and the health-care system to this epidemic is inadequate. A large proportion of health-care expenditure is on expensive curative care outside the area. Effective comprehensive prevention programmes should be implemented, and the health-care system should be redesigned to address these diseases.