Recent studies reveal increasing indicators that people of Arab descent, especially those residing in the United States, may face higher risks of heart disease and diabetes compared to other population groups, amid an interplay of genetic, behavioral, and social factors affecting cardiometabolic health.

Researchers emphasize that these differences are still not adequately represented in healthcare systems and clinical studies, necessitating improved early diagnosis mechanisms and development of preventive programs that consider the health characteristics of this group.

Dr. Sudir Al-Kindi, a cardiologist and co-director of the Division of Cardiovascular Disease Prevention and Wellness at Houston Methodist Hospital, says that the concept of 'cardiometabolic health' links heart disease, obesity, diabetes, and kidney disease, stressing that these diseases cannot be addressed in isolation from each other.

Al-Kindi points out that Arab communities residing in the United States are classified as white in US health databases, a classification that may mask important health differences. Studies using alternative indicators, such as language or family name, show that this group may be more susceptible to high blood pressure, stroke, and heart disease, with diabetes emerging as a major risk factor; some analyses indicate that its prevalence among Arab Americans is more than double that recorded among white Americans.

AI-assisted illustration showing the relationship between cardiovascular health and liver and gut health (Asharq Al-Awsat)

Researchers believe that these disparities are not solely due to genetic factors but also involve social and behavioral factors, such as smoking, physical inactivity, and difficulty accessing healthcare. Hookah smoking is among the most prominent of these factors; experts warn against the mistaken belief that it is less harmful than cigarettes, while a single session may expose the smoker to the smoke of dozens of cigarettes, raising blood pressure and heart rate and increasing the risk of cardiovascular disease.

Diet also presents a major paradox; studies have shown that the traditional Mediterranean diet, prevalent in large parts of the Arab region, reduces the risk of heart attacks and strokes. However, researchers note that many Arab individuals adopt Western diets after migration, which may exacerbate existing risks.

Beyond lifestyle, recent data point to potential genetic and metabolic differences. For example, some individuals from the Arab region may have harmful fat distribution, especially around the abdomen and internal organs, even if total body weight is normal. Dr. Al-Kindi notes that 'this may explain the high risk of diabetes even if obesity rates are not significantly higher.'

Other findings highlight unique risks for specific groups such as women; results show that rates of gestational diabetes among Arab women are significantly higher compared to white non-Hispanic women, raising concerns about maternal health and women's long-term health. Meanwhile, broader social determinants of health, such as women's individual income, psychological stress, discrimination against them, and their ability to access necessary healthcare, continue to influence research outcomes. In some cases, these factors disproportionately affect women, impacting both risk and disease progression.

Despite research findings, Dr. Al-Kindi warns that the population of the Middle East and North Africa is not homogeneous at all; health risks vary greatly by country of origin, culture, and migration experience, underscoring the need for more research and tailored interventions, yet he asserts that 'the prevention pathway in all cases remains familiar.'

Dr. Al-Kindi adds: 'Adhering to a healthy diet and maintaining a balanced physical activity routine helps control blood pressure and blood sugar levels. Avoiding tobacco and its derivatives, and getting adequate sleep, are healthy foundations for all people.'

Dr. Al-Kindi emphasizes that 'one size does not fit all,' so as research expands, there is a growing movement to improve identification of Middle Eastern and North African populations, especially in US healthcare systems; improve early detection, particularly of diabetes; and develop culturally appropriate interventions addressing medical and social risk factors.

Dr. Al-Kindi and his colleagues are actively studying cardiovascular disease among Arab American populations residing in Houston; they have established a longitudinal study to assess diseases among Arab Americans to better understand these risks.

Al-Kindi concludes by affirming that understanding these disparities is the first step toward developing more precise and effective healthcare, and better care for all.