Prevalence and aetiology of heart failure in an Arab population

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Abstract
Background: The epidemiology of heart failure in Arabia, with a population different from the West in cultural and ethnic origin, has not been studied before. Aims: To determine the prevalence and aetiologies of symptomatic heart failure in an indigenous Arab population over a 3-year period. Methods: All patients with heart failure ≥ 13 years of age, treated at the only secondary care hospital of the Dhakliya region of Oman between 1992 and 1994 were evaluated prospectively by clinical history and physical examination. Chest radiograph and echo-Doppler studies were used to confirm the diagnosis of heart failure. Exercise stress testing and/or coronary angiography were also performed in patients > 30 years of age, or earlier if ischaemic heart disease was suspected. Results: A total of 1164 patients were identified giving a prevalence of 5.17/1000 population during the study period (6.04/1000 among males and 4.21/1000 among females; P < 0.001). The prevalence increased with age from 1.05 / 1000 in age group < 45 years to 15.7/1000 in 45–64 years (P < 0.001) and 25.2 / 1000 in ≥ 65 years (P < 0.001). Common causes of heart failure were ischaemic heart disease (51.7%), hypertensive heart disease (24.9%) and idiopathic dilated cardiomyopathy (8.3%). Valvular heart disease and lung diseases causing heart failure were less common. Conclusion: The prevalence of symptomatic heart failure was appreciably significant in the population studied, showed a male preponderance and was frequent in people aged ≥ 45 years. Ischaemic heart disease and hypertension were the commonest aetiologies but idiopathic dilated cardiomyopathy was also present in a significant number of patients being relatively more prevalent than reported from the West.

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