Dyslipidaemia in the Middle East: Current status and a call for action

Abstract

The increase in the cardiovascular disease (CVD)-associated mortality rate in the Middle East (ME) is among the highest in the world. The aim of this article is to review the current prevalence of dyslipidaemia and known gaps in its management in the ME region, and to propose initiatives to address the burden of dyslipidaemia. Published literature on the epidemiology of dyslipidaemia in the ME region was presented and discussed at an expert meeting that provided the basis of this review article. The high prevalence of metabolic syndrome, diabetes, familial hypercholesterolaemia (FH) and consanguineous marriages, in the ME region, results in a pattern of dyslipidaemia (low high-density lipoprotein cholesterol and high triglycerides) that is different from many other regions of the world. Early prevention and control of dyslipidaemia is of paramount importance to reduce the risk of developing CVD. Education of the public and healthcare professionals and developing preventive programs, FH registries and regional guidelines on dyslipidaemia are the keys to dyslipidaemia management in the ME region.

Effect of different commercial fat sources on brain, liver and blood lipid profiles of rats in growth phase

“…In general, the pathophysiological basis for cardiovascular events is atherosclerosis, a chronic inflammatory disease closely associated with certain cardiovascular risk factors such as hypercholesterolemia, hypertriacylglyceridemia, lowering of HDL cholesterol (HDL-c), hypertension, diabetes mellitus and obesity 2 . Hypercholesterolemia, in particular, stands out for being one of the main responsible for metabolic disorders of lipids, and considered the greatest risk factor for CVD 3 . It is evident, therefore, the role of different dietary patterns on the modulation of atherosclerosis and cardiovascular risk factors, especially with regard to the presence of lipids in the diet.…”

“…These fatty acids play important role in numerous physiological and biochemical functions in the body, and substitution of SFA by monounsaturated (MUFA) and PUFA fat sources in the diet is considered an effective strategy for the control of hypercholesterolemia and consequent reduction in the incidence of CVD. Numerous evidence also emphasize PUFA may influence the improvement of autonomic function, antiarrhythmic, decreased platelet aggregation and blood pressure, improved endothelial function, stabilization of atheromatous plaque and triacylglycerols levels 3 . Furthermore, deficiencies in these fatty acids may have various health damages 10 , especially on the cognitive function of the individual, related, for example, to the docosahexaenoic acid (DHA, 22:6 n-3) deficiency 11 .…”

Genome-wide association study identifies novel recessive genetic variants for high TGs in an Arab population

“…Middle East exhibits a high prevalence of metabolic syndrome (37), diabetes (38,39), and familial hypercholesterolaemia (40); these disorders along with the practice of consanguineous marriages has resulted in a pattern of dyslipidemia (low high-density lipoprotein cholesterol and high triglycerides) that is different from many other regions of the world (41). These lifestyle disorders have reached the proportion of public health crisis; this epidemic is primarily a consequence of recent environmental changes that have triggered the effect of pre-existing susceptibility genes via gene-environment interactions (42).…”

Consensus clinical recommendations for the management of plasma lipid disorders in the Middle East

“…In addition to these high prevalence rates, the profile of plasma lipid disorders observed in the Middle Eastern population differs somewhat to that seen in many other regions, with metabolic dyslipidaemia (high TG, low HDL-C and high or normal LDL-C) being one of the most common types [9]. The presentation of high TG and low HDL-C levels has also been observed among patients in the region who are already receiving chronic statin treatment; the DYSIS Middle East study (n = 2182) found that 62% still have high LDL-C levels, 56% have low HDL-C levels, and 49% have high TG levels [17].…”

“…Disorders of plasma lipids are a well-known problem in the Western world [8], and are an issue of increasing importance in the Middle East. Although estimates are hampered by a lack of clinical studies in the region and by inconsistencies in the definitions and thresholds used in those studies that have been conducted, the prevalence of plasma lipid disorders in the region is high [9]. Available data vary in their estimates [10][11][12][13][14][15][16], with prevalence as high as 50% or more in some areas.…”