In the Gulf states rates of heart disease are rising with the economy

Rapid improvement in the socio-economic conditions of the Gulf states has been followed by lifestyle changes now contributing to high rates of cardiovascular disease. Professor Hani Najm, President of the Saudi Heart Association whose annual conference begins 21 February 2011, describes risk factor prevalence rates as "extremely high", particularly in the cities of Saudi Arabia.

Conditions commonly affecting affluent societies, such as diabetes, obesity and hypertension, have all emerged as big public health problems in the past two decades. 

• Around one in four Saudis has diabetes
• More than one in four has hypertension
• And as many as 50 per cent are obese
• Around 6 per cent have coronary disease

Moreover, a review of coronary patients referred to the King Abdulaziz Cardiac Center in Riyadh found that 60-70 per cent had diabetes. 

"Our advanced cardiac care is as good as any in the world," says Professor Najm, "but our primary care - and certainly our prevention - is not as developed. Saudis are investing in treatment, but not yet in preventing heart disease."

The 22nd annual conference of the Saudi Heart Association is the venue for the second round of the ESC's global scientific initiative, which in Riyadh will be concentrating on selected reports from the recent ESC Congress 2010, the latest ESC guidelines and clinical case studies (PDF).

The subject of both ESC Practice Clinical Guidelines featured - atrial fibrillation and cardiac resynchronisation therapy in heart failure, which were newly published at the ESC Congress 2010 - are hot topics in Saudi Arabia, as in most other developed countries. Rates of heart failure especially are increasing dramatically, with hospital admissions already putting strain on specialist services. "The treatment and prevention of heart failure are now important national strategies in the management of hospital beds," says Professor Najm. Saudi Arabia's twin epidemics of obesity and diabetes will continue to fuel an explosion in heart failure, already the world’s most prevalent chronic cardiovascular disease, unless lifestyle campaigns are more successful.

"Most of our cardiovascular problems can be attributed to a sedentary lifestyle and high rates of smoking, especially among men in our cities," adds Professor Najm. Among the priorities of the Saudi Heart Association are public health and education campaigns which recognise and encourage a healthy lifestyle, but, says Professor Najm, that will require not just a change of habits, but a change of culture too.

"Cardiology is not just about treatment, it is also prevention," says Professor Joep Perk, Chairman of the Joint European Societies Task Force on Cardiovascular Prevention, of which the ESC is a member. "And we now have good evidence that much cardiovascular disease is preventable. ESC guidelines have set benchmarks throughout the world for effective treatment, but we also wish to make a major effort with sister organisations like the Saudi Heart Association to provide guidance in prevention. In many countries, cardiovascular prevention is an open field and we are glad to share our knowledge."

The ESC's global scientific programme will also include collaborative exchanges in Latin and South America, and Malaysia, and all will develop their themes around clinical case studies with the involvement of local specialists and general physicians. "The basis of our contribution will be our expertise and guidelines," says Professor Perk, "but we wish to develop friendly relations where dialogue is the driving force."

The programme will also gain support from the ESC's Affiliated National Societies, a group of national cardiac societies and professional groups from countries outside Europe. The affiliation programme allows close collaboration with the ESC and all its activities, and is becoming an increasingly popular route for national societies to take. The Saudi Heart Association is one of 35 Affiliated National Societies.