Within the next 10 years, one-fourth of all adults in Saudi Arabia will have a heart attack, according to research presented at the Saudi Heart Association (SHA) annual conference underway this week in Riyadh, Saudi Arabia.
The study examined the prevalence of risk factors for heart disease in nearly 5,000 Saudis older than 20 years who did not have a history of heart disease. The researchers calculated the subjects' risk of a heart attack or death using the Framingham Risk Score.
Diabetes was a huge risk factor for heart disease, and its prevalence was high even though most of the cohort was young, according to lead author Dr. Muhammad Adil Soofi, a cardiologist from King Fahad Medical City. Most of the people in the study were younger than 40 (85%), and 55% were women.
In the study population, fully one-quarter of the subjects had diabetes, while 34% had hypertension, 25% were smokers, 27% were obese, 86% performed no regular physical exercise, and 19% had dyslipidemia. Owing to their many risk factors, 26% of the participants were at high risk of having a heart attack or dying from a heart attack within 10 years.
Urbanization, a lack of education, and Westernization could be to blame for the unhealthy lifestyles of young Saudis, Soofi said in a statement.
"They eat more fast food and deep fried items and on top of that do not exercise," he said. "Atherosclerosis, obesity, and other risk factors set in at a very early stage and ultimately lead to heart attacks and even death at a young age."
How big a factor was diabetes? When diabetics were excluded from the analysis, the 10-year risk of heart attack or death fell to just over 4% of the population.
"Diabetes and other risk factors start at an early age in Saudi Arabia," Soofi said. Looking only at participants younger than 30 years, 14% were diabetic, 27% were obese, 31% were smokers, and 77% had sedentary lifestyles.
"So it's a whole package that will lead to heart disease in a decade," he said.
A key problem in the Gulf States is that they have sophisticated tertiary care for heart disease but no primary prevention programs, added SHA President Dr. Khalid Al Habib. Prevention needs to start immediately "so that children and young people do not spend their adult life with diabetes and heart disease," he said.
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
