This signifies a pressing opportunity for improving the care of such patients in the Middle East. Acknowledgments The REACH Registry is endorsed by the World Heart Federation. (75.6%) had at least one uncontrolled risk factor. Conclusion Patients with atherothrombosis in the Middle East have a high prevalence of risk factors including alarming rates of diabetes mellitus and obesity. At least one risk factor is usually uncontrolled in the majority of patients, presenting a pressing need for improving the care of such patients in the Middle East. strong class=”kwd-title” Keywords: Cardiovascular disease, diabetes mellitus, obesity, risk factors, Middle East, diabetes Introduction Cardiovascular disease is the leading cause of morbidity and mortality worldwide.1 2 Over the past half century, our understanding of the epidemiology of and risk factors for cardiovascular disease has led to the development of effective measures to combat the cardiovascular epidemic, and resulted in significant improvements in patient outcomes. A substantial proportion of that improvement in cardiovascular disease outcomes was driven by implementation of primary and secondary preventive measures in stable outpatients. To date, the vast majority of the literature on patients with, or at high risk for, cardiovascular disease comes from predominantly Western populations in affluent/industrialised countries. Non-Western and mostly developing regions of the world contribute an increasingly greater share to the global burden of cardiovascular disease, yet are greatly under-represented in the literature.3 4 In the Middle East, there is growing recognition that cardiovascular disease and its associated risk factors represent a significant public-health challenge, with some Middle Eastern countries reporting some of the highest rates of diabetes and obesity worldwide.5C9 Nonetheless, relatively few data are available on risk factors and management in patients with established cardiovascular disease in the Middle East. The Reduction of Atherothrombosis for Continued Health (REACH) registry provides a unique opportunity to characterise the risk-factor profile, treatment gaps and outcomes in patients with cardiovascular disease or cardiovascular disease risk factors in the Middle East. In the present analysis, we characterise the risk-factor profile, management patterns and treatment gaps among stable outpatients from the Middle East with cardiovascular disease or cardiovascular disease risk factors enrolled in the REACH registry. Methods The REACH registry is an international, prospective, observational study of stable outpatients with or at high risk for cardiovascular disease.10 11 A detailed design and methodology have been previously published.10 12 Briefly, consecutive eligible outpatients aged 45 or older with established coronary artery disease, cerebrovascular disease or peripheral arterial disease, or with at least three atherosclerotic risk factors were enrolled in 2004. Ethics committee approval was obtained at each participating institution, and each patient gave written informed consent to participate in the registry. The diagnosis of coronary artery disease required at least one of the following: history of stable Compound 401 or unstable angina with documented coronary artery disease, prior percutaneous coronary intervention or coronary artery bypass graft surgery, or previous myocardial infarction. Documented cerebrovascular disease required a hospital or neurologist report with the diagnosis of ischaemic stroke or transient ischaemic attack. Diagnosis of peripheral arterial disease required the presence of current intermittent claudication with an ankle brachial index of 0.9 or a history of intermittent claudication with a related peripheral vascular intervention (eg, angioplasty, surgical bypass graft or amputation). In the absence of established cardiovascular disease, eligible patients had to have at least three risk factors for cardiovascular disease either documented in the medical record or for which they were Compound 401 receiving treatment. The qualifying risk factors were: treated diabetes mellitus, diabetic nephropathy (microalbuminuria 30?g/ml), asymptomatic ankle brachial index of 0.9 or asymptomatic carotid stenosis of 70% or higher, at least one carotid plaque as evidenced by intima-media thickness exceeding twice that of neighbouring sites, systolic blood pressure of 150?mm Hg despite therapy for at least 3?months, hypercholesterolaemia currently treated with medication, current smoking ( 15 cigarettes per day), or age 65?years for a male, and 70?years for a female. Data were joined on standardised international case report forms completed at the study sites and then collected centrally. Baseline measurements included height, weight, waist circumference, seated systolic and diastolic blood pressure, and fasting glucose and total cholesterol levels. Body mass.While most patients were prescribed medications to control risk factors and prevent cardiovascular events, treatment gaps were prevalent, with three-quarters of these high-risk patients having at least one treatment gap. The high prevalence of diabetes mellitus and obesity in the present analysis is consistent with previous observations from the Middle East.13 14 In the Gulf Registry of Acute Coronary Events (Gulf RACE), a multinational registry of more than 8000 patients admitted with acute coronary syndromes in six Middle Eastern countries, 40% of the patients had a history of diabetes, and 67% were overweight or obese.15 Patients with diabetes in Gulf RACE tended to have worse in-hospital outcomes. (80.2%), more than half had a history of diabetes mellitus (52.3%), and a third had hypercholesterolaemia (34.1%). There was a high prevalence of obesity (38.6%), and nearly half the patients were former or current smokers (46%). -Blockers and angiotensin-converting enzyme inhibitors were the most commonly prescribed antihypertensives (61.1% and 57.5%, respectively). Antiplatelet therapy (most commonly aspirin) and lipid-lowering drugs (most commonly a statin) were used in most patients (90.7% and 85.2%, respectively). Three-quarters of the participants (75.6%) had at least one uncontrolled risk factor. Conclusion Patients with atherothrombosis in the Middle East have a high prevalence of risk factors including alarming rates of diabetes mellitus and obesity. At least one risk factor is usually uncontrolled in the majority of patients, presenting a pressing need for improving the care of such patients in the Middle East. strong class=”kwd-title” Keywords: Cardiovascular disease, diabetes mellitus, obesity, risk factors, Middle East, diabetes Introduction Cardiovascular disease is the leading cause of morbidity and mortality worldwide.1 2 Over the past half century, our understanding of the epidemiology of and risk factors for cardiovascular disease has led to the development of effective measures to combat the cardiovascular epidemic, and resulted in significant improvements in patient outcomes. A substantial proportion of that improvement in cardiovascular disease outcomes was driven by implementation of primary and secondary preventive measures in stable outpatients. To date, the vast majority of the literature on patients with, or at high risk for, cardiovascular disease comes from predominantly Western populations in affluent/industrialised countries. Non-Western and mostly developing regions of the world contribute an increasingly greater share to the global burden of cardiovascular disease, yet are greatly under-represented in the literature.3 4 In the Middle East, there is growing recognition that cardiovascular disease and its associated risk factors represent a significant public-health challenge, with some Middle Eastern countries reporting some of the highest rates of diabetes and obesity worldwide.5C9 Nonetheless, relatively few data are available on risk factors and Compound 401 management in patients with established cardiovascular disease in the Middle East. The Reduced amount of Atherothrombosis for Continued Wellness (REACH) registry offers a unique possibility to characterise the risk-factor profile, treatment spaces and results in individuals with coronary disease or coronary disease risk elements in the centre East. In Compound 401 today’s evaluation, we characterise the risk-factor profile, administration patterns and treatment spaces among steady outpatients from the center East with coronary disease or coronary disease risk elements signed up for the REACH registry. Strategies The REACH registry can be an worldwide, prospective, observational research of steady outpatients with or at risky for coronary disease.10 11 An in depth design and methodology have already been previously released.10 12 Briefly, consecutive eligible outpatients aged 45 or older with founded coronary artery disease, cerebrovascular disease or peripheral arterial disease, or with at least three atherosclerotic risk factors had been signed up for 2004. Ethics committee authorization was acquired at each taking part organization, and each individual gave written educated consent to take part in the registry. The analysis of coronary artery disease needed at least among the pursuing: background of steady or unpredictable angina with recorded coronary artery disease, previous percutaneous coronary treatment or coronary artery CDC46 bypass graft medical procedures, or earlier myocardial infarction. Documented cerebrovascular disease needed a medical center or neurologist record with the analysis of ischaemic heart stroke or transient ischaemic assault. Analysis of peripheral arterial disease needed the current presence of current intermittent claudication with an ankle joint brachial index of 0.9 or a brief history of intermittent claudication having a related peripheral vascular intervention (eg, angioplasty, surgical bypass graft or amputation). In the lack of established coronary disease, eligible individuals needed at least three risk elements for coronary disease either recorded in the medical record or that they were getting treatment. The qualifying risk elements had been: treated diabetes mellitus, diabetic nephropathy (microalbuminuria 30?g/ml), asymptomatic ankle joint brachial index of 0.9 or asymptomatic carotid stenosis of 70% or more, at least one carotid plaque as evidenced by intima-media thickness exceeding twice that of neighbouring sites, systolic blood circulation pressure of 150?mm Hg despite therapy for at least 3?weeks, hypercholesterolaemia currently treated with medicine, current cigarette smoking ( 15 smoking cigarettes each day), or age group 65?years to get a man, and 70?years for a lady. Data were entered on standardised international case record forms completed in the scholarly research sites and collected.