Cardiovascular disease in the Eastern Mediterranean region: epidemiology and risk factor burden

Key Points Cardiovascular disease (CVD) mortality in the Eastern Mediterranean region (EMR) is estimated to increase more dramatically in the next decade than in any other global region except Africa CVD risk factors such as tobacco consumption, physical inactivity, depression, overweight/obesity, hypertension, and diabetes mellitus are prominent among the population living in the EMR Despite the high risk factor and disease burden in the EMR, public knowledge and awareness of CVD symptoms and its risk factors are very low, leading to poor control of these risk factors The treatment and management of CVD in the EMR is suboptimal, and mostly involves thrombolysis, with insufficient provision of timely revascularization Secondary prevention through cost-effective strategies such as cardiac rehabilitation is limited by low availability Cardiovascular mortality among the almost 600 million people living in the Eastern Mediterranean region (EMR) has been proposed to increase more dramatically in the next decade than in any other region except Africa. Turk-Adawi and colleagues summarize the available data on cardiovascular disease burden, risk factors, and treatment modalities for the EMR population. The Eastern Mediterranean region (EMR) comprises 22 countries or territories spanning from Morocco in the west to Pakistan in the east, and contains a population of almost 600 million people. Like many other developing regions, the burden of disease in the EMR has shifted in the past 30 years from primarily communicable diseases to noncommunicable diseases such as cardiovascular disease (CVD). Cardiovascular mortality in the EMR, mostly attributable to ischaemic heart disease, is expected to increase more dramatically in the next decade than in any other region except Africa. The most prominent CVD risk factors in this region include tobacco consumption, physical inactivity, depression, obesity, hypertension, and diabetes mellitus. Many individuals living in the EMR are unaware of their risk factor status, and even if treated, these risk factors are often poorly controlled. Furthermore, infrequent use of emergency medical services, delays in access to care, and lack of access to cardiac catheterization affects the timely diagnosis of CVD. Treatment of CVD is also suboptimal in this region, consisting primarily of thrombolysis, with insufficient provision of timely revascularization. In this Review, we summarize what is known about CVD burden, risk factors, and treat