Relevance of cholesterol screening in the United Arab Emirates

The incidence of ischemic heart disease is rising rapidly in many of the affluent Arab countries and it is known that hypercholesterolemia is a well established risk factor for coronary artery disease. This community-based study was undertaken to determine if elevated cholesterol is a problem in the United Arab Emirates in order to be able to evaluate the contribution of cholesterol as a risk factor for atherosclerosis in this environment. Volunteers were recruited at busy urban public sites. Data on age, sex, nationality, weight, blood pressure and smoking history were collected, and blood samples were taken for estimation of total cholesterol, hemoglobin and individual blood group. A raw data set was developed, with calculation of body mass index and subsequent statistical analysis carried out on a PC using the SPSS programme. In the 834 patients, there were 19 nationalities represented which were pooled into 7 groups (5 Arab and 2 non Arab) according to their ethnic origins. The prevalence of hypercholesterolemia varied from 47.2–53% in the Arab Nationals and from 22.7 to 44.5% in the non Arabs. The mean cholesterol levels of the Arab subgroups were similar and showed no difference, statistically. However, they were significantly higher than non Arabs, i.e. Indians (p<0.001) and Iranians (p<0.001). Similarly, within the Arab subgroups, the median cholesterol levels were no different but were higher than the non Arabs, i.e. Indians (p<0.05) and Iranians (p<0.001). No statistical difference was found in the distribution of cholesterol (high, borderline high or desirable levels) among the seven ethnic groups. Hypercholesterolemia appears to be a problem in most nationalities living within the UAE. Overall, it afflicts nearly 50% of the adult population. Although the ethnic Arab groupings have a wide range of socioeconomic attributes, the similarity of the distribution of cholesterol may point to an underlying innate genetic etiology or an environmental cause such as dietary overindulgence, or both. Urgent public health measures such as education, case finding and further screening programs are required.