Prevalence of cardiovascular disease risk factors and long-term outcomes in the Saudi population: Results from the Prospective Urban Rural Epidemiology study (PURE-Saudi)

ObjectiveWe report the prevalence of unhealthy lifestyle behaviors, cardiovascular disease (CVD) risk factors, and long-term outcomes within the Saudi population, stratified by age, sex, and place of residence.MethodsThe Prospective Urban Rural Epidemiology (PURE) study is a global cohort study including adults of 35–70 years old in 20 countries. PURE-Saudi study participants were recruited from 19 urban and 6 rural communities randomly selected from the Central province (Riyadh and Alkharj) between February 2012 and January 2015. Clinical follow-up of major CVD events and mortality is ongoing.ResultsThe PURE-Saudi study enrolled 2047 participants (mean age, 46.5 ± 9.12 years; 43.1% women; 24.5% rural). Overall, 69.4% had low physical activity, 49.6% obesity, 34.4% unhealthy diet, 32.1% dyslipidemia, 30.3% hypertension, 25.1% diabetes, 12.2% were current smokers, 15.4% self-reported feeling sad, 16.9% had history of stress (several periods), 6.8% had permanent stress, 0.98% had history of stroke, 0.64% had heart failure, and 2.5% had coronary heart disease (CHD). Compared to women, men were more likely to be current smokers (21% vs. 0.45%, p<0.001), have diabetes (28.2% vs. 21.3%, p<0.001), and have history of CHD (3.2% vs. 1.6%, p=0.02); while women were more likely to be obese (58.6% vs. 42.8%, p<0.001), have central obesity (70.7% vs. 32.7%, p<0.001), self-report sadness (22.7%, vs. 9.9% p<0.001), experience stress (several periods), feel permanent stress (9.9% vs. 4.5%, p<0.001), and have low education (46.6% vs. 20.2%, p<0.001). Compared to participants in urban areas, those in rural areas had higher rates of diabetes (31.1% vs. 23.3%, p<0.001), obesity (56.6% vs. 47.3%, p<0.001), and hypertension (35.5% vs. 28.6%, p=0.004); and lower rates of unhealthy diet, self-reported sadness, stress (several periods), and permanent stress. Compared to middle- and old-age individuals, younger participants more commonly reported unhealthy diet, permanent stress, and self-reporting of being sad. ConclusionPURE-Saudi, the first population cohort study in Saudi Arabia, revealed a high prevalence of CVD risk factors in the adult Saudi population, with higher rates in rural than urban areas. National public awareness programs and multi-faceted healthcare policy changes are urgently needed to reduce the future burden of CVD risk and mortality.