Factors associated with worse control of hypercholesterolemia in Saudi patients: Subanalysis of the Centralized Pan-middle East Survey on the undertreatment of hypercholesterolemia
Khalid Alnemer1, Ibrahim Alhomood2, Omalkhaire Alshaikh1, Mohammed Arafah3, Faisal Alanazi4, Shorook Alherz5, Wael Al Mahmeed6, Abdullah Shehab7, Omer Al Tamimi8, Mahmoud Alawadhi9, Ali T Al-Hinai10
1 Department of Medicine, School of Medicine, Al-Imam Muhammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
2 Department of Medicine, King Fahad Medical City, Riyadh, Saudi Arabia
3 Department of Cardiology, King Saud University, Riyadh, Saudi Arabia
4 Department of Noncommunicable Diseases, Ministry of Health, Riyadh, Saudi Arabia
5 Department of Family Medicine, National Guard Hospital, Riyadh, Saudi Arabia
6 Department of Cardiology, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
7 Department of Internal Medicine, United Arab Emirates University, Abu Dhabi, United Arab Emirates
8 Department of Medicine, Hamad Medical Corporation, Doha, Qatar
9 Department of Endocrinology, Al Amiri Hospital, Kuwait
10 Department of Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
Department of Medicine, School of Medicine, Al-Imam Muhammad Ibn Saud Islamic University, Riyadh
Source of Support: None, Conflict of Interest: None
Background: A subanalysis of the Centralized Pan-Middle East Survey on the undertreatment of hypercholesterolemia (CEPHEUS) was done to establish the factors associated with worse control of hypercholesterolemia (HC) in Saudi Arabia.
Methods and Results: CEPHEUS (NCT01031277) was a multicenter survey conducted in six Middle Eastern countries (Saudi Arabia, United Arab Emirates, Kuwait, Qatar, Bahrain, and Oman) between November 2009 and July 2010. Male and female patients aged ≥18 years on lipid-lowering drugs for ≥3 months (stable medication for ≥6 weeks) were recruited. At the study visit, investigators completed a questionnaire (experience and perception of the management of HC), patients completed a questionnaire (awareness of HC, current treatment schedule and perception, compliance), and patient fasting serum samples were collected to measure lipid profile. For the purpose of this subanalysis, patients were categorized as Saudi or non-Saudi. Multivariate analysis of the data showed that diabetes, obesity, and high waist circumference are associated with worse control of HC in Saudi Arabia. The lipid profile showed worse control of all variables except high-density lipoprotein-cholesterol. Saudi patients on statins and fibrates for primary prevention were the highest low-density lipoprotein-cholesterol (LDL-C) goal achievers. The positive predictors of achievement of LDL-C goals are age <40 years, absence of diabetes mellitus, nonsmoking status, compliance to medication, and glycated hemoglobin (HbA1c) <8%.
Conclusion: This subanalysis establishes that diabetes, obesity, and high waist circumference age >40 years, smoking, HbA1c >8% are associated with worse control of HC in Saudi Arabia.