Prevalence of cardiovascular risk factors in the Middle East: a systematic review

The aim of this study was to determine the prevalence of key cardiovascular risk factors in the Middle East region. We conducted a systematic review of the literature through searches in the MEDLINE/PubMed and PARLINE databases between January 1980 and April 2005. Cohort studies published from 1980, in English, which included at least 1000 participants that reported the prevalence of at least one of the following; diabetes mellitus, obesity (body mass index > or =30 kg/m(2)), hypertension, hyperlipidemia, and smoking in the Middle East region. Data were abstracted using standardized data abstraction forms. Studies were combined using random-effect models. In total, 51 studies (267 537 participants) were included. On the basis of a random-effect model, the overall prevalence of obesity was 24.5% [95% confidence interval (CI): 21.8-27.5; I(2): 99.3%; 24 studies], diabetes mellitus was 10.5% (95% CI: 8.6-12.7%; I(2): 99.4%; 24 studies), hypertension was 21.7% (95% CI: 18.7-24.9; I(2): 99.5%; 24 studies), smoking was 15.6% (95% CI: 12.3-19.6%; I(2): 99.7%; 21 studies). Smoking was more common in men than women, whereas obesity and hypertension were more common in women. The overall prevalence was not calculated because of marked variations in the definition of dyslipidemia among studies. There is a high prevalence of diabetes mellitus, obesity, hypertension, and smoking in the Middle East. The prevalence of obesity and hypertension was higher in women, whereas prevalence of smoking was higher in men. These data suggest that cardiovascular disease will be a major health problem in the Middle East.