Summary and Critique for Article
The problem of a high percentage of deaths due to cardiovascular diseases has long been a priority for the world medical community. An example of the latest research on this extremely complex issue in the article “Prevalence of cardiovascular disease and associated risk factors among the adult population in the Gulf region: A systematic review.” The study was conducted by Najlaa Aljefree and Faruk Ahmed.
Its purpose was to determine the epidemiology of the cardiovascular system diseases among adults in the Gulf region, as well as to identify the risk factors for heart disease inherent in the area. The main observation formulated by the authors was that the population of the Gulf region countries has a large percentage of those suffering from heart disease and a more significant percentage of those at risk. Except for small controversial points, the article is a well-written and clearly stated work, which was based on a professional and carefully implemented research.
Summary
The study focuses on the GCC (The Gulf Cooperation Council) countries: United Arab Emirates, Oman, Saudi Arabia, Bahrain, Kuwait, and Qatar. The selection of sources was carried out in several stages. The researchers chose the articles and reports that potentially fit the given topic, and then decided those studies among them, the data in which met the objectives of the study. These researches have been read carefully to highlight studies in which participants were suitable for analysis by age, nationality, and had a division in the data by gender.
The article is a synthesis of the critical points of more than 90 studies on the epidemiology of coronary heart disease, stroke, hypertension, dyslipidemia, as well as related factors such as obesity and sedentary lifestyle. Most of them consider patients from the Gulf region, but there are also articles on research in the United States and Europe for the part of the study, which draws a parallel with developed countries.
The authors highlight increasing mortality from cardiovascular diseases in the countries of the Gulf region and high-risk factors associated with morbidity. Researchers attribute this fact to internal economic reasons: the region has become industrial after finding oil in the area; agricultural countries were urbanized, and big cities are perfect for a sedentary lifestyle. Aljefree and Ahmed (2015) claim, that “the unique social, cultural, and environmental factors of the GCC states are blamed on the increased levels of physical inactivity in both genders but more noticeably in females” (p. 20). The inflexible way of life, in combination with unhealthy food traditions, according to the researchers, lead to the aggravation of the situation.
In conclusion, the authors summarize the data and clarify that the percentage of strokes in the Gulf region is lower than in developed countries. According to Aljefree and Ahmed (2015), “there is a need to increase the awareness of the high prevalence of the cardiovascular disease among the public along with education programs on nutrition and healthier lifestyles” (p.20). The researchers urge GCC to reconsider its habitual way of life in a changing world because the preservation of old habits combined with new risks has a significant negative impact on health.
Critique
To provide reliable data, the researchers used the method of comparative analysis of officially registered sources from several databases. Each borrowed statement in the article is accompanied by a correct citation. Each source of information is reflected in the text.
The advantage of the work is that its authors recognize and point out the inevitable shortcomings, such as the use of outdated sources. Aljefree and Ahmed (2015) claim, that “the lower rate of hypertension in Saudi Arabia may not be a true reflection of the situation as the reported study was relatively old” (p. 18). However, in 2015, when the scientific journal with this article was published, a study devoted to this topic already existed.
According to El Bcheraoui et al. (2014), “15.2% and 40.6% of Saudis were hypertensive or borderline hypertensive, respectively” (p. 2). The results of this analysis indicate that the rates of hypertension were not lower than in Qatar and Oman, but were roughly in line with the overall level of the region (Saquib, Zaghloul, Mazrou, & Saquib, 2017). Moreover, recent studies confirm that the percentage of those suffering from hypertension in Saudi Arabia is exceptionally high (Kalaf et al., 2016). The use of inaccurate information, although due to the lack of knowledge, is a shortcoming of the work.
There are other outdated sources used in work. The authors declare that there was no available information about strokes in Oman and the United Arab Emirates. However, in the same year, other works were written about the relationship between the two countries and the disease. According to Gujjar et al. (2015), “ischemic stroke in Oman reflects the high morbidity/mortality seeing in most communities in the region” (p. e380). A study on the percentage of strokes in the United Arab Emirates indicated that the statistics in that country were also not comforting (AlAmeri, AlNuaimi, & Alsaadi, 2015). This study also included Emirati residents over 15, but information about adults could be extracted from it.
Also, the distribution of factors affecting the development of certain heart diseases specified in the article is questionable. According to Aljefree and Ahmed (2015), “the risk factors for CHD and stroke can be categorized into two groups: metabolic risk factors (obesity, hypertension, diabetes, and dyslipidemia) and behavioural risk factors (diet, smoking, and physical activity)” (p.18). However, there are other reasons for the development of heart disease that do not depend on the country, which should not be ignored.
For example, researchers from around the world identify stress and social isolation among the factors affecting the deterioration of the cardiovascular system (Valtorta, Kanaan, Gilbody, Ronzi, & Hanratty, 2016). These reasons are particularly evident in large cities, where people face great pressure at work and school.
One of the statements made in the article is not entirely ethically correct. Aljefree and Ahmed (2015) say, that “the patterns of risk factors were very similar between the Gulf countries; this may be due to the similarity in culture, religion, cuisine, lifestyle, and environmental factors between these countries” (p. 20). However, despite the almost identical religion, the countries of the region have extremely different historical experience (Fahy, 2018). Everyday traditions in these countries are indistinguishable only at first glance.
The authors naturally linked all the studied scientific literature on the topic to form their own conclusion. They are valuable to the scientific world, as they have for the first time summarized most of the available information on heart disease in the region. The problem is fully understood; additional conclusions from the collected data would be redundant. The main advantage of the article is that its recommendations have practical application. The data clearly show a negative trend in the health of people from six countries, and there is a high probability that the medical community in the region has paid attention to the study.
Conclusion
The authors assess their work and come to the conclusion that, although for some countries and factors, there was too little information for an objective assessment, the study was performed as intended. This statement can be considered correct, since the objectives of the study have been achieved, and the evidence is sufficiently presented. The article has some inaccuracies, but they are not critical and do not interfere with the definite impression of the work done and its design.
References
AlAmeri, M., AlNuaimi, A., & Alsaadi, T. (2015). Stroke in young adults: A 4-year retrospective hospital-based study, first report from United Arab Emirates (P1. 020). Neurology, 84(14 Supplement), P1-020.
Aljefree, N., & Ahmed, F. (2015). Prevalence of cardiovascular disease and associated risk factors among adult population in the Gulf region: A systematic review. Advances in Public Health, 2015.
Gujjar, A. R., Nandhagopal, R., Jacob, P. C., Al-Azri, F., Ganguly, S. S., Shoaib, H. R., & Al-Asmi, A. R. (2015). Ischemic stroke outcomes in Oman: Experience of a university-hospital based stroke registry. Journal of the Neurological Sciences, 357, e380.
Kalaf, H., AlMesned, A., Soomro, T., Lasheen, W., Ewid, M., & Al-Mohaimeed, A. A. (2016). Cardiovascular disease risk profile among young Saudi women of Al-Qassim, Saudi Arabia: A cross-sectional study. International Journal of Health Sciences, 10(1), 29.
Saquib, N., Zaghloul, M. S., Mazrou, A., & Saquib, J. (2017). Cardiovascular disease research in Saudi Arabia: A bibliometric analysis. Scientometrics, 112(1), 111-140.
Valtorta, N. K., Kanaan, M., Gilbody, S., Ronzi, S., & Hanratty, B. (2016). Loneliness and social isolation as risk factors for coronary heart disease and stroke: Systematic review and meta-analysis of longitudinal observational studies. Heart, 102(13), 1009-1016.
El Bcheraoui, C., Memish, Z. A., Tuffaha, M., Daoud, F., Robinson, M., Jaber, S.,… & Al Rabeeah, A. A. (2014). Hypertension and its associated risk factors in the kingdom of Saudi Arabia, 2013: A national survey. International Journal of Hypertension, 2014.
Fahy, J. (2018). The international politics of tolerance in the Persian Gulf. Religion, State & Society, 1-17.