Association Between Dietary Habits and Risk Factors for Atherosclerotic Cardiovascular Diseases in Assiut Governorate

Atherosclerotic cardiovascular diseases (ASCVD) has become the largest single cause of death worldwide. It is responsible for an estimated 17 million deaths and led to 151 million disability-adjusted life years (DALYs) lost (~30.0% of all deaths and 14.0% of all DALYs lost).1 Further, by 2020, 32.0% of the world population deaths will be caused by ASCVD and by 2030; it's expected to be responsible for 33.0% of all deaths (24.2 million).2 Most of atherosclerotic cardiovascular disease events nowadays are taking place in low- and middle-income countries with 80% of the burden occurring in these countries.3

In Egypt, since 1990, ASCVD related mortality was increased over three folds; to be responsible for over 40% of deaths compared with 12% reported two decades earlier.4 Egypt was categorized as a "very-high-risk country for ASCVD" (according to 2016 ESC Guidelines on cardiovascular disease prevention in clinical practice).5 According to (WHO 2014), ASCVD related mortality in Egypt has been increased to account for 46% of total deaths.

Multiple risk factors are attributed to causing ASCVD. These risk factors fall into the categories of either nonmodifiable or modifiable risk factors.6 Nonmodifiable risk factors consist of those conditions that a person cannot alter, including age, heredity, ethnicity and type 1 diabetes.

Whereas modifiable risk factors are conditions that can be altered by making certain lifestyle changes.

In 2003, the Canadian Heart and Stroke Foundation identified nine major modifiable risk factors for ASCVD, namely, tobacco smoking, alcohol abuse, physical inactivity, unhealthy dietary habits, obesity, high BP, high concentrations of dietary fat and blood lipids, and high blood glucose concentrations.7 Sudden stress, frequent migraine and the use of oral contraceptives have also been identified as risk factors for the increased incidence of coronary disease and stroke.8,9 The Egyptian National Hypertension Project (NHP)10,11 was conducted between year 1991 and 1993 in six Egyptian governorates to define the prevalence of ASCVD risk factors in adult Egyptians. The project documented an extremely high prevalence and prominent clustering of ASCVD risk factors in adult men and women particularly obesity.