Key result
Metabolic syndrome affects ~43% of Middle Eastern ASCVD patients and tracks with multiple risk factors.
Why the study?
Atherosclerotic cardiovascular disease remains the leading cause of mortality in the Middle East, with metabolic syndrome as a key clinical factor increasing ASCVD incidence and mortality, yet its prevalence and clinical profile in this population were not well characterized.
Does the presence of metabolic syndrome associate with a higher burden of modifiable risk factors and comorbidities in Middle Eastern patients with ASCVD?
Cross-Sectional (n=1,016)
Yes
Does the presence of metabolic syndrome associate with a higher burden of modifiable risk factors and comorbidities in Middle Eastern patients with ASCVD?
Metabolic syndrome affects nearly half of Middle Eastern ASCVD patients and heavily clusters with multiple modifiable cardiometabolic risk factors, emphasizing the need for comprehensive secondary prevention programs.
Metabolic syndrome marks higher modifiable risk burden in Middle Eastern ASCVD; supports hypothesis-generating research on clustered secondary prevention.
Background: Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of mortality for people living in the Middle East and North Africa (MENA) region. Accumulation of modifiable ASCVD risk factors such as hypertension, type 2 diabetes mellitus (T2DM), dyslipidemia, smoking, obesity, and physical inactivity leads to a higher magnitude of ASCVD burden. Metabolic syndrome (MetS) is a fundamental clinical factor associated with increased incidence and mortality of ASCVD. This study aimed to assess the prevalence and clinical profiles of MetS among Middle Eastern patients with ASCVD using a newly proposed definition incorporating six modifiable risk factors. Methods: We used data from the Jordan absence of standard modifiable risk factors (SMuRF-Less) study, to evaluate demographic, clinical, and laboratory characteristics along with the presence and co-existence of six modifiable risk factors between ASCVD patients with and without MetS. Results: A total of 5540 patients with ASCVD (mean age 57.13 ± 12.31 years) were included. MetS status was available for 1,016 patients, of whom 434 (42.7%) met the criteria for MetS. Patients with MetS were more likely to be aged 46-65 years and had a higher prevalence of hypertension, dyslipidemia (notably hypertriglyceridemia and low HDL levels), T2DM, obesity, and physical inactivity. Additionally, MetS patients showed higher rates of heart failure, chronic kidney disease, obstructive sleep apnea, lower educational levels, higher smoking prevalence, and lack of health insurance. Conclusion: Nearly half of ASCVD patients in this Middle Eastern cohort had MetS. In regions with a high burden of cardiovascular risk factors, effective ASCVD prevention strategies should prioritize early detection and comprehensive management of MetS through control of modifiable risk factors and the establishment of dedicated MetS clinics. Trial Registration Number: : NCT06199869.
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Alsheyyab et al. (2026) conducted a cross-sectional in Atherosclerotic cardiovascular disease (ASCVD) (n=1,016). Metabolic syndrome vs. Without metabolic syndrome was evaluated on Prevalence of metabolic syndrome. Metabolic syndrome was present in 42.7% of Middle Eastern patients with ASCVD and was significantly associated with a higher burden of hypertension, diabetes, dyslipidemia, and physical inactivity.
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