Cardiovascular Patients With no Standard Modifiable Risk Factors

Conditions

Cardiovascular Risk Factors

Keywords

Atherosclerotic cardiovascular disease, Standard modifiable risk factors (SMuRFs), Middle Eastern population

Brief summary

A growing number of patients develop atherosclerotic cardiovascular disease (ASCVD) despite the absence of standard modifiable risk factors (SMuRF-less). There is scarcity of studies that address this issue in the Middle Eastern population.

Detailed description

Atherosclerotic coronary artery disease (ASCAD) claims millions of lives annually on a global level and is the leading cause of death in the Middle East. There are four standard modifiable cardiovascular risk factors (SMuRFs): hypertension, type 2 diabetes mellitus, dyslipidemia, and smoking. These are very common in the Middle East and are crucial to be screened for and addressed in an affective manner. However, an increasing proportion of patients with ASCVD have none of these individual factors (SMuRF-less). Globally, this proportion comprises 11.6% of individuals with stable coronary disease and heart attack. No prior study has addressed the issue of the prevalence of SMuRF-less patients among the whole population of individuals with ASCVD in the Middle East.

A Hammoudeh, Mo’men Aldalal’ah, Fakhri Al-Malkawi, Enad Haddad, Aseel Rizik et al. (14 authors)

Frontiers in Cardiovascular Medicine2026-08-06

10.3389/fcvm.2026.1785553

Association of SMuRFs with cardiovascular risk factors, disease burden, and pharmacological management in Middle Eastern patients with ASCVD and a family history of premature CVD.

Alrida NA, Albikawi Z, Alotaibi N, Alkouri O, Saifan AR, Jarrah M, Hammoudeh A, Khader Y, Alenezy A, Al-Zu'bi BM, Alharbi A, Alhalaiqa F, AbuRuz ME.

2025-11-27

10.3389/fcvm.2025.1678767

Prevalence of physical activity and its association with atherosclerotic cardiovascular risk factors in young women in the middle east: a sub-analysis of the ANCHORS study.

Alkouri O, Alrida NA, Alabkal RM, Khader Y, Albikawi Z, Ababneh A, Alobaidly A, Qaladi O, Alharbi A, Jarrah M, Alotaibi N, Al-Bashaireh AM, Hammoudeh A, AbuRuz ME, Almustafa LA, Khraisat O, Al-Nsair N.

2025-10-01

10.1186/s12889-025-24595-y

Absence of Standard Modifiable Risk Factors in Middle Eastern Patients with Atherosclerotic Cardiovascular Disease. The Jordan Absence of Standard Modifiable Risk Factors (SMuRF-Less) Study

Ayman Hammoudeh, Mo’men Aldalal’ah, Elham Smadi, Dima Alrishoud, Amal F. Alomari et al. (9 authors)

Vascular Health and Risk Management2025-02-013 citations

10.2147/vhrm.s499355

Interventions

OTHEREvaluation of risk factors by direct interview with subjects who have atherosclerotic cardiovascular patients

Individuals identified with a diagnosis of ASCVD will fill a one page form of the associated risk factors they have

Study design

Observational model

CASE_ONLY

Time perspective

CROSS_SECTIONAL

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Inclusion criteria

* A diagnosis of atherosclerotic cardiovascular disease (ASCVD). * Ability to fill the clinical form that evaluates the presence or absence of cardiovascular risk factors including the 4 SMuRFs.

Exclusion criteria

* Atherosclerotic cardiovascular disease diagnosed before the age of 18 years. * Inability to give detailed history of prespecified risk factors.

Design outcomes

Primary

Measure	Time frame	Description
Prevalence of patients who do not any of the four SMuRFs	Up to 4 weeks after study enrollment	Group of patients with definite ASCVD who do not have hypertension, diabetes, dyslipidemia or smoking.

Countries

Jordan

Outcome results

None listed