Sedentary lifestyle and Framingham risk scores: a population-based study in Riyadh city, Saudi Arabia

Background: Studies from Saudi Arabia have reported a continued increase in the prevalence of cardiovascular diseases and their associated risk factors. The objective of this study was to measure the gender differences in the cardiovascular disease (CVD) risk based on Framingham risk scores (FRS) and to explore the association of FRS with sedentary life style including physical inactivity, sitting time and central obesity among Saudi adults. Methods: A cross-sectional survey was conducted on 2997 Saudi adults (males = 968, females = 2029) selected from 18 primary health care centres in Riyadh city, from December 2014 to August 2015. A detailed interview that evaluated lifestyle and past medical history was conducted; furthermore, anthropometric measurements and blood samples were collected for lipid profiling. The FRS were calculated based on the age, gender, systolic blood pressure, treatment for hypertension, diabetes, smoking status, total blood cholesterol and high-density lipoprotein levels. These scores were categorized into low risk (FRS < 10) and high/intermediate risk (>= 10). A multivariable logistic regression analysis was performed. Results: The mean (+/- SD) age of the males and females was 43.1(+/- 11.7) vs 43.8(+/- 10.9) years (p = 0.07), respectively. The number of Saudi male participants with intermediate-to-high FRS scores (>= 10) was almost twice that of females (males 33% vs 17%). The multivariable logistic regression model after adjusting for education level and housing type, found that low physical activity (aOR & 95%CI for males 2.91 (1.45, 5.80); females 1.38 (1.06, 1.81); prolonged sitting time (aOR &95%CI for males 1.36 (0.98, 1.90) females 1.58 (1.20, 2.07), high central obesity (defined as waist circumference in males > 102 cms, and females > 88 cms) (aOR & 95%CI for males 2.38 (1.67, 3.41); females 3.35 (1.92, 5.87) were associated with high/ intermediate risk for CVD. Conclusions:A significant percentage of Saudi population revealed FRS >= 10. Females beyond the age of 50 were found to have a higher prevalence for CVD risk compared with males of the same age group. Modifiable risk factors like low physical activity, prolonged sitting time and central obesity have strong implications for primary prevention and management services that can change the risk profile of the Saudi population.