Heart Failure In The Middle East Arab Countries: Current And Future Perspectives

Abstract

For many years, data about heart failure (HF) was only limited to Western countries but in the last few years, well designed heart failure registries have been conducted in many developing countries. The purpose of this review is to summarize the current status regarding the epidemiology and management of heart failure in Middle East Arab countries (MEACs) by analysis of the results of the latest HF registries performed in these countries and to anticipate future perspectives, quality initiatives and areas of research and development. Data has shown that the average age of affected individuals is at least 10 years younger than their Western counterparts. Heart failure with preserved ejection fraction was generally under-represented in these registries to less than 30% of the whole population of heart failure. Coronary artery disease (CAD) constitutes about 55% of causes of heart failure in this region in comparison to about 70% in Western countries. An area that needs development is the investment in establishing specialized heart failure programs to cut the circle of non-compliance and repeated HF admissions to the hospitals. Advances in heart transplantation and mechanical circulatory support will continue to slow down and we are not expecting major changes in the near future but on the other hand, implantation of electronic devices like ICD and CRT is expected to increase significantly in the coming years in these countries.

Factors Associated With Hospital Readmission of Heart Failure Patients

“…Data has shown that the average age of individuals with HF is at least 10 years younger than their Western counterparts, so this is a sign that heart failure is known to be a disease of the elderly, but when the mean age of incidence is in the late fifties to early sixties, then it is not a disease of the elderly in the Middle East; it is instead a disease of middle to old age population. (Elasfar et al, 2020). This age information was consistent in all registries done for heart failure in Arab countries.…”

“…The estimated population in this region is 250 million, and the global prevalence of HF is 1-2%, so we estimate 3.75 million patients with HF in this region. (Elasfar et al, 2020). Data has shown that the average age of individuals with HF is at least 10 years younger than their Western counterparts, so this is a sign that heart failure is known to be a disease of the elderly, but when the mean age of incidence is in the late fifties to early sixties, then it is not a disease of the elderly in the Middle East; it is instead a disease of middle to old age population.…”

“…This age information was consistent in all registries done for heart failure in Arab countries. (Elasfar et al, 2020) The early incidence of coronary artery diseases was demonstrated in many registries, which is the primary cause of heart failure in these countries. In addition, the high incidence of diabetes mellitus in these countries is a significant risk factor for CAD and, subsequently, heart failure; in some reports, for example, diabetes mellitus affects up to 25% of adults in the Gulf countries.…”

“…In addition, the high incidence of diabetes mellitus in these countries is a significant risk factor for CAD and, subsequently, heart failure; in some reports, for example, diabetes mellitus affects up to 25% of adults in the Gulf countries. (Elasfar et al, 2020). Hypertension is also among the highest prevalent diseases in the Arab population, as 40-70% of heart failure patients have a history of hypertension.…”

“…Hypertension is also among the highest prevalent diseases in the Arab population, as 40-70% of heart failure patients have a history of hypertension. (Elasfar et al, 2020). Females constitute less than one-third of the HF patients presented to the hospitals, and this can be explained by less prevalence of CAD in females before menopause and the reduced access of females to medical services compared to males in many countries of this region.…”