title: Cardiovascular risk factor burden in Africa and the Middle East: the Africa Middle East Cardiovascular Epidemiological (ACE) study.
abstract: BACKGROUND
  Increased urbanization in the developing world parallels a rising burden of chronic diseases. Developing countries account for ∼ 80% of global cardiovascular (CV) deaths, but contribute a paucity of systematic epidemiological data on CV risk factors.
  
  
  OBJECTIVE
  To estimate the prevalence of CV risk factors in rural and urban cohorts attending general practice clinics in the Africa and Middle East (AfME) region.
  
  
  METHODS
  In a cross-sectional epidemiological study, the presence of CV risk factors (hypertension, diabetes mellitus (diabetes), dyslipidemia, obesity, smoking and abdominal obesity) were evaluated in stable adult outpatients attending general practice primary care clinics. A rural population was defined as isolated (>50 km or lack of easy access to commuter transportation) from urban centers.
  
  
  RESULTS
  4,378 outpatients were systematically recruited from 94 clinics across 14 AfME countries. Mean age was 46 ± 14 years and 52% of outpatients were female. A high prevalence of dyslipidemia (70%) and abdominal obesity (68%) were observed, followed by hypertension (43%) and diabetes (25%). The vast majority of outpatients (92%) had at least one modifiable CV risk factor, many (74%) had more than one, and half (53%) had 3 or more. These findings were observed in both genders and across urban and rural centers. Among outpatients with pre-existing hypertension or dyslipidemia, many were not at their target blood pressure or LDL-cholesterol goals.
  
  
  CONCLUSIONS
  Cardiovascular risk factors are highly prevalent among relatively young, stable outpatients attending general practice clinics across AfME. The findings support opportunistic screening for CV risk factors whenever outpatients visit a general practitioner and provide an opportunity for early identification and management of CV risk factors, including lifestyle interventions.
authors.affiliation: Institute of Cardiac Sciences, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates.
authors.forename: Alawi A
authors.initials: AA
authors.lastname: Alsheikh-Ali
authors.affiliation: Pfizer AfME, Dubai Media City, Dubai, United Arab Emirates.
authors.forename: Mohamed I
authors.initials: MI
authors.lastname: Omar
authors.affiliation: Department of Medicine, Faculty of Health Sciences, Johannesburg Hospital, Johannesburg, South Africa.
authors.forename: Frederick J
authors.initials: FJ
authors.lastname: Raal
authors.affiliation: Mubarak Al Kabeer Hospital, Al Jabriya, Kuwait.
authors.forename: Wafa
authors.initials: W
authors.lastname: Rashed
authors.affiliation: Clemenceau Medical Center, Beirut, Lebanon.
authors.forename: Omar
authors.initials: O
authors.lastname: Hamoui
authors.affiliation: L'Hopital General de Grand Yoff, Dakar, Senegal.
authors.forename: Abdoul
authors.initials: A
authors.lastname: Kane
authors.affiliation: Mohammed V University, Rabat, Morocco.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Alami
authors.affiliation: Pfizer Inc., New York, New York, United States of America.
authors.forename: Paula
authors.initials: P
authors.lastname: Abreu
authors.affiliation: Pfizer Saudi Arabia, King's Tower, Jeddah, Saudi Arabia.
authors.forename: Walid M
authors.initials: WM
authors.lastname: Mashhoud
mesh_terms: D000349:Africa / Q000453:epidemiology; D000367:Age Factors; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D015331:Cohort Studies; D017281:Cost of Illness; D003920:Diabetes Mellitus / Q000453:epidemiology; D050171:Dyslipidemias / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D008877:Middle East / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology; D010045:Outpatients; D015995:Prevalence; D012111:Residence Characteristics; D012307:Risk Factors; D012727:Sex Characteristics; D012907:Smoking / Q000453:epidemiology
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