What question did this study set out to answer?

The aim is to estimate the burden of premature atherosclerotic cardiovascular disease and its associated risk factors among young and middle-aged adults in primary care.

February 21, 2026Journal of Health Population and NutritionOpen Access

Burden of premature atherosclerotic cardiovascular disease and its risk factors among young and middle-aged adults in primary care clinics of Karachi, Pakistan

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Young and middle-aged adults aged 18-50 years for men and 18-60 years for women, attending primary care clinics in Karachi with at least one known ASCVD risk factor (n=614). Primary outcome: Prevalence of premature ASCVD and 10-year predicted risk of cardiovascular disease events.

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Key result

Karachi primary care clinics reveal ~4% premature ASCVD prevalence among young and middle-aged adults.

n=614

Why the study?

Premature ASCVD has a high occurrence among South Asians, yet Pakistan lacks the capacity and funds for targeted primary prevention programs.

Population

614 adults with at least one ASCVD risk factor visiting 4 primary-care clinics in Karachi

Design

Cross-sectional study

Authors

SMSaad Bin Zafar Mahmood SSSania Sabir SethiAga Khan University MKMuhammad Azhar Ali KhanUniversity of Haripur

Discussion

Member takes

Implication

May support early screening in Karachi primary care; leaves open impact of interventions on premature ASCVD.

Key Points

The aim is to estimate the burden of premature atherosclerotic cardiovascular disease and its associated risk factors among young and middle-aged adults in primary care.
Cross-sectional study design conducted in 4 primary-care clinics in Karachi from September 2022 to August 2023.
Participants included adults aged 18-50 years for men and 18-60 years for women with known ASCVD risk factors.
WHO risk charts were used to assess 10-year cardiovascular disease risk for adults aged 40 and above.
ASCVD risk factor count was calculated and categorized for participants under 40 years.
The prevalence of premature ASCVD among participants was 3.7%.
83% of participants were obese, and central obesity was present in 87.6%.
46.2% of adults aged over 40 years were at moderate to high 10-year risk of a cardiovascular event.
Women showed significantly lower physical activity levels compared to men, particularly in ages 30-50.

Study Design

Type

Cross-Sectional (n=614)

Multicenter

Yes

Structured PICO

Population

614 adults (men aged 18-50 years, women aged 18-60 years) visiting 4 primary care clinics in Karachi, Pakistan, who had at least one known risk factor of ASCVD (Diabetes Mellitus, Hypertension, Dyslipidemia, Obesity, Family history of premature ASCVD, Smoker). Pregnant women were excluded.

Outcome

Prevalence of premature ASCVD and its risk factors

There is a substantial burden of premature ASCVD and its risk factors, particularly central obesity and dyslipidemia, among young and middle-aged adults in primary care in Pakistan, highlighting the need for early targeted prevention.

Limitations

Cross-sectional design limits causal inference.
Study limited to primary care clinic attendees, potentially not representative of general population.
Risk prediction models used may not fully capture risk in younger adults due to reliance on risk factor counts rather than validated risk scores below age 40.

Cite This Study

Mahmood et al. (2026) conducted a cross-sectional in Young and middle-aged adults aged 18-50 years for men and 18-60 years for women, attending primary care clinics in Karachi with at least one known ASCVD risk factor (n=614). Premature ASCVD prevalence was 3.7% among young and middle-aged adults in Karachi primary care clinics, with 46.2% of adults >40 at moderate to high 10-year CVD risk and 90.6% overweight or obese.

synapsesocial.com/papers/69994a7f873532290d01ee9c https://doi.org/10.1186/s41043-026-01268-z

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Burden of premature atherosclerotic cardiovascular disease and its risk factors among young and middle-aged adults in primary care clinics of Karachi, Pakistan

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Limitations

Cite This Study

Burden of premature atherosclerotic cardiovascular disease and its risk factors among young and middle-aged adults in primary care clinics of Karachi, Pakistan

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Limitations

Cite This Study

Also Consider

Also Consider