The undertreatment of hypercholesterolemia in Saudia Arabia and the Gulf States: Results of the CEPHEUS Study

Background and study aims Cardiovascular diseases (CVD) are the leading cause of death worldwide. Among all CVDs, coronary heart disease (CHD) is the most common. While data for CHD and its risk factors are available for different regions and countries, the Middle East lacks such reliable data. The CEPHEUS-MIDDLE EAST study (ClinicalTrials.gov ID: NCT 01031277) was performed to gain a unique perspective on the potential undertreatment of hypercholesterolemia in this area. Patients and methods This multi-centric, non-interventional study recruited a total of 5457 consecutive patients by 177 specialists and general practitioners in Saudi Arabia, United Arab Emirates, Kuwait, Qatar, Bahrain and Oman between 22 November 2009 and 07 July 2010. Data collection (Investigator and Patient Questionnaires, Patient Record Form and a fasting blood sample) occurred at a single visit. Results Subjects were 58.16% male ( n  = 3060) with a mean age of 55.56 years. The reasons for being pharmacologically treated were primary (71.54%; n  = 3773), secondary prevention (27.27%; n  = 1438) and familial hypercholesterolemia (1.19%; n  = 63). The most frequent treatments were with statins (94.43%; n  = 5260) or fibrates (3.12%; n  = 174). According to the Patient Questionnaire, only 43.91% (2304) of patients had been informed about their cholesterol levels, even though, according to the Investigator Questionnaire, physicians set individual target cholesterol levels for 70.00% of their patients. The majority of physicians (87.57% ; n  = 155), reported to use guidelines to establish target cholesterol levels, with the NCEP ATP III being the most used frequently used (46.53%; n  = 67). Conclusions Although the risk of mortality for patients with CHD is well-known and a number of guidelines exist to reduce this risk, the hypercholesterolemia of patients in the Middle-Eastern countries surveyed is still being undertreated.