Risk Factors for Coronary Heart Disease Among Lebanese Women: A Case-Control Study.

Purpose: Women are increasingly concerned by coronary heart disease (CHD), with peculiarities of their own, particularly concerning risk factors. The aim of the study was to assess the risk factors for CHD in Lebanese women over forty. Patients and Methods: A case-control study was carried out in 6 hospitals in Beirut and Mount-Lebanon, from December 2018 to December 2019 including 1500 patients (1200 controls and 300 cases). Women were stratified into pre- and post-menopausal groups. Personal and medical data were collected from hospital records and during an interview where validated questionnaires were used. Binary logistic regressions were performed to investigate potential predictors of CHD in the 2 groups. Results: In post-menopausal women, dyslipidemia (adjusted odds ratio [aOR], 3.018; 95% confidence interval, 2.102-4.332), hypertension (aOR: 2.449, [1.386-4.327]), a family history of CHD (aOR: 2.724, [1.949-3.808]), cigarette smoking (aOR: 2.317, [1.574-3.410]) and common non-rheumatic joint pain (aOR: 1.457, [1.053-2.016]) were strongly associated with CHD. Conversely, living in Mount Lebanon seemed protective, compared to Beirut (aOR: 0.589, [0.406-0.854]), as well as having a moderate monthly income (aOR: 0.450, [0.220-0.923]), adhering to a Mediterranean diet (aOR: 0.965, [0.936-0.994]), and practicing physical activity [PA] (aOR: 0.396, [0.206-0.759] and 0.725, [0.529-0.992], respectively for high and moderate vs low PA). In pre-menopausal women, dyslipidemia (aOR: 6.938, [1.835-26.224]), hypertension (aOR: 6.195, [1.318-29.119]), family histories of dyslipidemia (aOR: 6.143, [1.560-24.191]) and CHD (aOR: 4.739, [1.336-16.805]) reached statistical significance. Conclusion: The identification of factors associated with CHD in women, some of which are frequent and trivialized in post-menopause, underlines the need to put in place specific and dedicated CHD prevention strategies in women.

The economic impact of patients with heart failure on the Lebanese healthcare system.

AIMS: This paper aimed to calculate the annual cost for heart failure (HF) patients in Lebanon. METHODS AND RESULTS: Heart failure care can reach up to $31 billion annually in the USA. Data in Lebanon are lacking. Estimating it based on USA data is biased; hence, collecting data from all healthcare providers will reflect the actual cost in Lebanon. Data were collected from all healthcare providers on HF hospitalization during the year 2012. In addition, data from 600 outpatient visits were collected by medical students to estimate the cost for outpatient care. The total cost was calculated by adding up all hospitalization cost-plus outpatient-estimated cost. There were 72 000 individuals suffering from HF. The hospitalization care in Lebanon is largely delivered by the public sector (91% public vs 9% private). However, the outpatient care is largely paid cash by patients. The direct cost for HF hospitalizations paid by the public and the private sector was $38 081 535. The average cost for each HF hospitalization was $3769. The direct cost for outpatients care was estimated at $65 592 000. The average cost for outpatient care was $911 per patient per year. The annual total direct cost was calculated at $103 673 535. The true cost was almost one third the extrapolated cost based on US statistics ($103 673 535 vs 268 370 607, respectively). CONCLUSIONS: The annual total direct cost for HF patients in Lebanon in 2012 was $103 673 535, which is much less than the extrapolated cost based on US statistics.