Heart Attack Under 50 in the UAE: Risk Factors
Research in Gulf populations highlights earlier heart disease and accumulating metabolic risks. Explore the role of lifestyle, heat and an individual cardiac assessment.
Heart attack under 50 in the UAE is associated with a combination of risks, including lipid disorders, smoking, abdominal obesity, diabetes and hypertension. Heat and lifestyle changes can also influence cardiovascular risk. Living in the UAE does not itself mean that someone will have a heart attack.
In the Gulf RACE registry, the mean age of people with acute coronary syndrome was around 56, compared with 66 in the international GRACE registry. The INTERHEART Middle East study reported a mean age of 51.2 at first heart attack.
Why is heart attack under 50 a concern in the region?
Abdominal obesity, diabetes, hypertension and lipid disorders can contribute to cardiovascular risk from a relatively early age. In INTERHEART Middle East, an atherogenic ApoB/ApoA1 profile, smoking and abdominal obesity were among the most significant factors associated with heart attack.
How can risk change for expatriates?
Expatriates’ cardiometabolic risk can change with lifestyle and time spent living in the UAE. The UAE National Diabetes and Lifestyle Study, or UAEDIAB, found obesity in 32.3%, diabetes in 15.5%, hypertension in 31.8% and high cholesterol in more than half of the expatriates studied, whose average age was about 38.
Among expatriates from India, Pakistan and Bangladesh, the likelihood of abdominal obesity increased with time spent living in the UAE. After 10 years, it was almost twice that of people who had lived in the country for 1–5 years.
Researchers relate this to a weakening of the healthy migrant effect. A person may arrive in relatively good health, while their metabolic profile gradually changes alongside their lifestyle.
Can extreme heat contribute?
Extreme heat increases cardiovascular strain and can contribute to dehydration and electrolyte loss. A large meta-analysis by Liu and colleagues, including 266 studies, reported an average increase of approximately 17% in cardiovascular mortality during heatwaves. Heat is better understood here as a trigger than as the cause of atherosclerotic plaque formation.
Its indirect effects may also matter. When temperatures are very high for much of the year, everyday life can become a journey from home to car to office and back again. Walking and spontaneous activity decrease, while indoor and sedentary time increase.
Changes in food habits, easy access to energy-dense meals and delivery services, sugary drinks, chronic stress and air pollution can further contribute to an unfavorable metabolic profile. Living in the UAE does not itself cause a heart attack, but the combination of environment, lifestyle and individual susceptibility can help cardiovascular risks accumulate earlier.
Which markers should be discussed after 35–40?
Relevant markers for a heart assessment include blood pressure, LDL-C, HDL-C, triglycerides, ApoB, glucose, HbA1c and Lp(a). Assessment should begin before chest pain develops.
Depending on individual risk factors, assessment may include ECG, echocardiography, exercise testing or stress echocardiography. Coronary imaging, such as coronary CT angiography, may be considered when indicated.
At Longevium Clinic, we can assess individual cardiovascular risk, perform laboratory investigations, ECG and echocardiography, and evaluate how the heart responds to exercise. Arriving in Dubai in good health 5–10 years ago does not mean that today's cardiovascular risk is unchanged. Prevention begins well before the first symptoms.
Our Longevity Day page describes broader assessment options; the doctor selects the appropriate investigations. For more on one of the risk factors, read about high cholesterol in Dubai.
Author: Dr. Yulia Marshintseva, MD, PhD — General Practitioner, Longevity Physician.