Associations of cardiovascular risk factors in Al Ain- United Arab Emirates

Background: Over the last 30 years the citizens of the United Arab Emirates have experienced major changes in life-style secondary to increased affluence. Currently, 1 in 5 adults have diabetes mellitus, but the associations (clustering) among risk factors, as well as the relevance of the concept of the metabolic syndrome, in this population is unknown. Aim: To investigate the prevalence and associations among cardiovascular risk factors in this population, and explore to what extent associations can be explained by the metabolic syndrome according to ATP-III criteria. Method: A community based survey, of conventional risk factors for cardiovascular disease was conducted among 817 national residents of Al Ain city, UAE. These factors were fasting blood sugar, blood pressure, lipid profile, BMI, waist circumference, smoking, or CHD family history. Odds ratios between risks factors, both unadjusted and adjusted for age and sex as well as adjusted for age, sex, and metabolic syndrome were calculated. Results: Various risk factors were positively associated in this population; associations that are mostly unexplained by confounding by age and sex. For example, hypertension and diabetes were still strongly related (OR 2.5; 95% Cl 1.7-3.7) after adjustment. An increased waist circumference showed similar relationship with hypertension (OR 2.3; 95% Cl 1.5-3.5). Diabetes was related to an increased BMI (OR 1.5; 96% Cl 1.0-2.3). Smoking was also associated with diabetes (OR 1.9, 95% Cl 1.0-3.3). Further adjustment for metabolic syndrome reduced some associations but several remained. Conclusion: In this population risk-factors cluster, but associations do not appear to be explained by the presence/absence of the ATP-III metabolic syndrome. Associations provide valuable information in planning interventions for screening and management.