Review Article

Women in Saudi Arabia and the Prevalence of Cardiovascular Risk Factors: A Systematic Review

Table 1

Data extraction.

Author/yrs.Response rate/sampling methodPopulationOutcomePrevalence female%Tools score/9Age group/sample size/% femaleLocation

1Mahfouz et al., 2014 [20]91.80%/the sample was stratified first according to the three institutions and then by colleges, and, finally, clusters of classes were randomly selected from each stratumStudents Smoking4.6%WHO | Global youth tobacco survey (GYTS)617–24/3764/35.7%South

2Khalaf et al., 2014 [21]n/a/randomly selected female university students, multistage stratified random selection procedureStudents Obesity 17.9% overweight
5.7% obese
Metabolic Equivalent of Task (MET)7Mean age of 20.4/663 female students (100% female)South

3Ibrahim et al., 2014 [22]n/a/multistage stratified random sample method was usedStudents(1) HTN(1) HTN = 5.8%(i) JNC-7
(ii) WHO classification for DM
720–28 years/214 (75.2% females)West
(2) FBS(2) High fasting level = 2.1%
(3) Obesity(3) Overweight, 16.2 female
Obese, 10.6 female

4AlSwuailem et al., 2014 [23]67%/all register dental students in university StudentsSmokingFemale 2.4%WHO-Global Adult Tobacco Survey (GATS) questionnaires519–22 years old and above/400/42.5% femaleCentral

5Khalaf et al., 2013 [24]n/a/random multistage stratificationStudentsPhysically inactive57% inactive.
Only 43% of the participants met these guidelines
Arab Teens Life Style questionnaire (ATLS)6Mean age was 20.4 years/663/100%South

6Koura et al., 2012 [25] 97.6%/n/aStudents(1) HTN(1) 10/370 = 2.7%(i) (WHOSTEPS)
(ii) JNC7 criteria
6<20 and >20/370/100%East
(2) DM(2) 4/370 = 1.0%
(3) Smoking(3) 5/370 = 1.35%
(4) Obesity(4) Overweight/obesity: 29.1%
(5) High cholesterol(5) 3.24% (tc > 200)
(6) Physically inactive(6) 53.2% calculated

7Azhar and Alsayed, 2012 [26]96.9%/randomly distributed among female studentsStudentsSmoking 4.2%Global tobacco survey (GATS)318–25/310/100%West

8Allam et al., 2012 [27] 97%/randomization through computer numberStudents(1) Obesity (1) Overweight:
female 22/100 = 22
Obese:
female 6/100 = 6
International physical activity questionnaire (IPAQ-SF)518–26/394/50.7%North/west
(2) Physically inactive(2) Physically inactive:
female 65/100 = 65

9Abolfotouh et al., 2012 [28] n/a/n/aStudents(1) Obesity (1) Overweight: female 22.3%
Obesity 30+: female 15.3%
n/a318–26 years/501/23.55%Central
(2) HTN(2) HTN = 13.6%
(3) High cholesterol (3) High TCh female = 0.9%

10Wali, 2011 [29]n/a/n/aStudentsSmoking 9.1Self-administered, Global Adult Tobacco Survey based questionnaire5 <22–>24/643,411/(69%) femalesWest

11Mandil et al., 2010 [30]90%/sample was stratified according to college, and then clusters of classesStudentsSmoking 5.9%517–25/6793/55.5%Central

12Al Qauhiz, 2010 [31]99.8%/all university studentsStudentsObesity Overweight = 31.4%
Obesity = 16.5
n/a522–24/799/100%Central

13Subhan et al., 2009 [32]84%/all students in medical scienceStudentsSmoking 12/305 female = 3.9% n/a418–37/941/69%Central

14Al-Turki and Al-Rowais, 2008 [33]75.4%/all female students in medicine schoolStudentsSmoking Current: 8/337 = 2.4%n/a1n/a/337/100%Central

15Merdad et al., 2007 [34]95.5%/all students StudentsSmoking 11%Self-administered, Global Adult Tobacco Survey based questionnaire518–26 years old/1050/100%West

16Hashim, 2000 [35]91%/randomStudents Smoking 9%n/a218–26/647/40.8% (264)Central

17Amin et al., 2014 [36] 33.1%/all university’s employees were eligible Employees(1) HTN (1) 21.2%World Health Organization STEPwise724–63/691/28.7% (F () Males ())East
(2) DM(2) 4%
(3) Obesity(3) Overweight 38.4%
(4) High cholesterol (4) 20.2%

18Rehmani et al., 2013 [37] 71.6%/selected households were conducted from May to October 2010 at 2 National Guard housing complexes in the Eastern regionEmployees(1) HTN (1) HTN = 8.2%Health Measures Survey614–34/2054/42.6%East
(2) DM(2) DM = 5.2%
(3) Smoking(3) Smoking female 2.1%
(4) Obesity + overweight(4) Overweight + obesity = 57.1%
(5) High cholesterol(5) High serum lipid = 17.7%
(6) Physical activity(6) Practicing physical exercise 51.9%

19Siddiqui and Ogbeide, 2001 [38]66%/all hospital staffEmployeesSmoking Female = 8.3%510–51/230/53%Central

20Abalkhail et al., 2000 [39]76.6%/all university staff and a sample of school workersEmployeesHigh cholesterol 9.7%NCEP5<35–>+40/1,649/(28.7%)West

21AlQuaiz et al., 2015 [40] 80%/convenience sampling strategy, Saudi women ≥ 30 years of age were invited to participateLeisure places & healthy volunteers (1) HTN (1) HTN: 18.2%Framingham Risk, Kaiser Physical Activity Survey (KPAS).5≥30/291/100%Central
(2) DM(2) DM: 10%
(3) Smoking(3) SMOK: 3.4%.

22Elkhalifa et al., 2011 [41]n/a/randomly selected at a megamallLeisure places & healthy volunteersHTN 49.1%n/a3<30–>50/243/53.9%West

23Al-Daghri et al., 2013 [42]n/a/patients were recruited randomly from their homes using the cluster samplingLeisure places & healthy volunteersMts55%Metabolic syndrome was determined according to the IDF419–60/185/52.9%Central

24Habib, 2013 [43]n/a/n/aLeisure places & healthy volunteersObesity Mean = %WHO classification BMI 118–72/530/31.5%n/a

25Amin et al., 2014 [44]n/a/ten PHCs were randomly selectedPCC Physical inactivity 58.5% inactive Assessment of Intentional Leisure Time Physical Activity “ILTPA”: The Global Physical Activity Questionnaire (GPAQ)718–78/2127/56%
Women () Men ()
East

26Ahmed et al., 2014 [45]n/a/selected from 30/105 primary health care (PHC) centrals by simple random methodPCCObesity 71%n/a7<25–+71/5000/50%North

27Al-Saleem et al., 2013 [46]n/a/all PCCs in Aseer regionPCCObesity Overweight female 29%
Obese female 44%
WHO definition for BMI518–65+/6917 female 3483/(50.4)%South

28Al-Zahrani, 2011 [47] n/a/from patients presented for treatment at KAUFD-female sectionPCC(1) HTN(1) 18%JNC7318–>50/208/100%West
(2) DM(2) 10.6%
(3) Smoking(3) 10/208 = 4.8%

29Alqurashi et al., 2011 [48] n/a/all patients attending a primary care clinicPCC(1) DM(1) 27.6% in femalesIDF312–19 years old, >70/6024/3714 (61.65%)West
(2) Obesity(2) Overweight female = 25.5%
Obese female = 43.7%

30Ogbeide et al., 2004 [49]n/a/all patients above 13 years of age seen by the investigators in Al Kharj Health CentrePCCHigh cholesterol 43.3%NCEP4Above 13-years/994/(54.5%)Central

31Al-Malki et al., 2003 [50]n/a/randomly recruited healthy femalesPCCobesity Overweight = %
Obese = 21.13%
n/a316–45/600/100%Central

32Kalantan et al., 2001 [51]n/a/randomly from 30 different PCC PCCHTN Female = 29%WHO-International Society of Hypertension Guidelines.5>35/1114/672 60% FemaleCentral

33Abolfotouh et al., 2001 [52] 88%/all patients from 3 PCC in south (abha)PCC(1) Central obesity (1) 29.2% n/a4>+65/807/31.1% South
(2) HTN(2) HTN: female = 28%
(3) DM(3) DM: female = 27.1%

34Siddiqui et al., 2000 [53]n/a/randomly selected PCCHTN 3.05%WHO guidelines HTN 1Mean age of females was 23.76 years/3747/55%Central

35Karim et al., 2000 [54]n/a/randomly from the medical record PCCDMFemale 9.6%n/a2<16–+75/3747/55.08%Central

36Al-Humaidi, 2000 [55]n/a/3 centrals were randomly selected according to their geographical location in the city, including all patients PCCObesity Mean BMI 32.15, SD = 1.2BMI 430–70/696/49.6%South

37Al-Qahtani et al., 2006 [56] 74.6%/all Saudi women attending PCCPCC(1) Mts(1) 13.6% NCEP definition
16.1% IDF definition
NCEP- ATP III/IDF618–59/2577/100%North
(2) Abdominal obesity(2) 44.1% NCEP definition
67.9% by IDF

38Saeed et al., 2011 [57]n/a/multistage stratified cluster random sampling techniqueNational
all region
HTNFemale = 23.9%WHO STEPwise approach to Surveillance of (NCD)715–64/4758, 51%All region

39 Soofi and Youssef, 2015 [14] Included also in the study were attendees in the 2010 Cultural Festival in Riyadh(1) Smoking(1) 12%Framingham Risk Score620–>60/4932/55%Central
(2) Dyslipidimia(2) 18%
(3) HTN(3) 32%
(4) Obesity(4) 27%
(5) DM(5) 28%
(6) Physical inactivity(6) 96%

40Memish et al., 2014 [58]89.4%/Saudi Health Information Survey (SHIS) randomly selected from a national samplingNational,
all region
Obesity Overweight = 28%
Obese = 33.5%
WHO, BMI 815–65/10,293/53.26%All region

41El Bcheraoui et al., 2014 [59]89.4%/Saudi Health Information Survey (SHIS), randomly selected from a national samplingNational,
all region
HTNHTN female = 13%National Health and Nutrition Examination Survey (NHANES) for determining blood pressure levels915–65/10,293/53.26%All region

42Basulaiman et al., 2014 [60]89.4%/Saudi Health Information Survey (SHIS), randomly selected from a national samplingNational,
all region
High cholesterol 19.6% borderline
8.5% high
n/a815 years or older/10,735/49.36%All region

43Aljohani, 2014 [61]92.6%/multistage stratified cluster random sampling technique National,
all region
Mts Female 565/2242 = 25.5%The WHO STEPwise, IDF815–64/4, 406All region

44Al-Daghri et al., 2014 [62] n/a/participants were part of the Biomarkers Screening Program Database (RIYADH Cohort) patients PHCC which was taken as a clusterAll Riyadh region (RIYADH Cohort)(1) HTN(1) HTN = 26%NCEP-ATP III718–70/9,164/51.8% femalesCentral
(2) Mts(2) Mts = 40.3%

45Al-Baghli et al., 2010 [63]93%/community-based screening campaign eastern All eastern region screening campaignDM Female = 18.6%JNC-VII730–+70/197681/49%East

46Al-Kaabba et al., 2012 [64]94.4%/multistage stratified cluster random sampling technique was used to recruit the study subjectsAll regionHigh cholesterol Female = 19.9%WHO’s STEPwise of Non-Communicable Diseases (NCD)≥15 years/4490/51% were femalesAll region

47Al-Daghri et al., 2011 [65] n/a/patients were recruited randomly from their homes using the clusterAll Riyadh region (RIYADH Cohort)Obesity Female = 36.5% (WHO) proposed cut-offs or DMT2 and Seventh Joint National Committee67–80/9,149/(41.4%) 3,792 Central

48Albedah et al., 2011 [66]n/a/patients were recruited randomly from their homes using the clusterAll regionSmoking 2.9%Standard international questionnaire developed by the BMRB515–≥50/7003/49%All region

49Al-Turki et al., 2010 [67]93%/community-based screening campaign easternAll eastern region screening campaignSmoking Female 5.0%n/a530 years and above/197,681/49%East

50Al-Daghri et al., 2010 [68] n/a/participants were part of the Biomarkers Screening Program Database (RIYADH Cohort) patients PHCC which was taken as a clusterAll Riyadh region (RIYADH Cohort)Mts Female 34.1% NCEP ATP III618–55/2850/53.2% 1515 femaleCentral

51Al-Baghli et al., 2009 [69]93%/community-based screening campaign easternAll eastern region screening campaignHTNFemale = 15.6%JNC7 6>30/197,681/49%East

52Al-Turki et al., 2008 [70]93%/community-based screening campaign easternAll eastern region screening campaignHTN Female = 18.1%JNC76>30/197,681/49%East

53Al-Nozha et al., 2008 [71]n/a/subjects were selected using a 2-stage stratified cluster sampling procedure, urban and rural being the strata.National,
all region
High cholesterol Female TC > 5.2 mmol = 53.2%
Female >TG = 33.7%
NCEP, ATP III830–70/16819/52.3%All region

54Al-Baghli et al., 2008 [72]93%/community-based screening campaign easternAll eastern region screening campaignObesity Overweight
female 29.7%
Obese
female 51.8%
NIH study identifies ideal body mass index6>30/195,874/49%East

55Al-Othaimeen et al., 2007 [73]n/a/random house hold selectionNational,
all region
Obesity Overweight
female 28.4%
Obese
female 23.6%
World Health Organization (WHO) BMI5≥18/17,892, 51.5% femaleAll region

56Al-Nozha et al., 2007 [74]98%/subjects were selected using a 2-stage stratified cluster sampling procedure, urban and rural being the strataNational,
all region
Physical inactive98.1% Metabolic equivalent: MET630–70/17395/52.3%All region

57Al-Nozha et al., 2007 [75] n/a/subjects were selected using a 2-stage stratified cluster sampling procedure, urban and rural being the strataNational,
all region
HTNFemale 2148/9006 = 23.9%JNC7630–70/17,230/52.3%All region

58Al-Nozha et al., 2005 [76]n/a/subjects were selected using a 2-stage stratified cluster sampling procedure, urban and rural being the strataNational,
all region
Obesity 31.8% overweight
44.0% obese
WHO BMI630–70/17,232/52.3%All region

59Al-Nozha et al., 2005 [77]n/a/subjects were selected using a 2-stage stratified cluster sampling procedure, urban and rural being the strataNational,
all region
Mts Female: 22%ATP III630–70/17,232/52%All region

60Al-Nozha et al., 2004 [78]98.2%/2 stage stratified cluster sampling procedures, urban and rural being the strataNational,
all region
DM Female: 21.5%ADA, Hg A1C > 7 mmol 630–70/17,232/52%All region

61Moradi-Lakeh et al., 2015 [79]95.88%/Saudi Health Interview Survey was a cross-sectional national multistage survey of individuals aged ≥15, and households were randomly selected from each blockNational,
all region
Smoking Female: 1.1%They asked for current use and current daily smoking of tobacco products749.4%All region

score = quality score, n/a = not available, Mts = metabolic syndrome, DM = diabetes mellitus, HTN = hypertension, JNC7 = Joint National Committee, WHO = World Health Organization, NCEP = National Cholesterol Education Program, High TCh = high total cholesterol.