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There was a cross-sectional study conducted in Al-Kharj region of Saudi Arabia. The study’s duration was six months, starting from January to June 2016. The estimated total population of the city at the time of the study was reported to be slightly over 0.3 million. Al-Kharj is one of the Kingdom’s major hubs, having great economic importance and up-to-date administration. It also possesses significant natural resources, an important geographical location, and population diversity (a population with a variety of ethnic backgrounds). Moreover, published studies showed that among the population of Al-Kharj, the prevalence of hypertension was 30.3%, the prevalence of obesity was 49.6%, and the risk of coronary heart disease (CHD) was 2.5%. Given the increased prevalence of these chronic conditions (hypertension, obesity, and CHD), the assessment of hypercholesterolemia and its association to certain risk factors for CHD in the current study is warranted (Al-Zahrani, Shubair, Al-Ghamdi, Alrasheed, Alduraywish, Alreshidi, Alshahrani, Alsalamah, Al-Khateeb, Ashathri, El-Metwally & Aldossari, 2021).

Elevated blood cholesterol level better known as hypercholesterolemia (HC) is an well-established risk factor for cardiovascular, cerebrovascular, and peripheral vascular diseases. Hypercholesterolemia can be either due to primary (genetic or familial), or secondary (acquired) causes. In a study by Basulaiman et al., it was reported that 65% of Saudis with HC were undiagnosed. Another study reported that the prevalence of HC was 23.7% in the young age group. There is currently a gap in the literature when it comes to HC, as there is a very limited number of studies which include young adults 18–25 years of age. This age group seems to be at a relatively lower risk of having HC; however, according to the National Cholesterol Education Program (NCEP), adults 20 years of age and older should be screened for HC at least once every 5 years. Additionally, in a surprising cross-sectional study conducted in children (9–12 years)—not even young adults—in Riyadh showed a prevalence of HC of 32.7%. Also, sex is a risk factor for HC which requires more extensive research. While some studies reported greater numbers of HC among males, other investigations have on the contrary reported higher levels in females. Furthermore, there were other ‘unusual’ factors that showed some association with HC, including insomnia and early menopause (Al-Kaabba,  Al-Hamdan, El Tahir A, Abdalla, Saeed & Hamza, 2012).

In the study, total of 1200 respondents participated in the study, with a response rate of 85%. All incomplete questionnaires in which more than 5 responses were missing were excluded. In the final analysis, the data of a total of 1019 respondents were included. A multistage sampling technique was utilized for the collection of the data. Samples were selected from different governmental and private institutions through a cluster sampling technique. Afterwards, cluster lists were made, and seven clusters were randomly selected by the investigators for inclusion in the study (Al-Zahrani, Shubair, Al-Ghamdi, Alrasheed, Alduraywish, Alreshidi, Alshahrani, Alsalamah, Al-Khateeb, Ashathri, El-Metwally & Aldossari, 2021).

The study findings show that increasing age and high BMI have significant positive associations with HC. While evaluating sociodemographic and other risk factors, it was found that HC was significantly associated with being male, married, a university graduate, a civilian worker, diabetic, a smoker, overweight or obese (Al-Nozha, Al-Hazzaa. Arafah, Al-Khadra, Al-Mazrou & Al-Maatouq, 2007). On the other hand, in the multiple regression analysis, being overweight, unemployed and being a civilian worker were significant positive predictors (Al-Kaabba,  Al-Hamdan, El Tahir A, Abdalla, Saeed & Hamza, 2012).

In short, Community-based awareness and education campaigns should be directed towards increasing individuals’ knowledge of the risk factors for HC. There is also a need for more screening studies, as most of the studies conducted in different regions of KSA show different prevalence rates. Furthermore, well-designed prospective cohort studies are warranted in the future in order to assess how the relationship between dietary intake patterns and physical activity/inactivity levels my affect the risk of HC. (Al-Ghamdi S, Shubair, Aldiab, Al-Zahrani, Aldossari &Househ, 2018).

References

Al-Zahrani J, Shubair MM, Al-Ghamdi S, Alrasheed AA, Alduraywish AA, Alreshidi FS, Alshahrani SM, Alsalamah M, Al-Khateeb BF, Ashathri AI, El-Metwally A, Aldossari KK (2021). The prevalence of hypercholesterolemia and associated risk factors in Al-Kharj population, Saudi Arabia: a cross-sectional survey. BMC Cardiovasc Disord.

Abdul Rahman Al-Nuaim, Khalid Al-Rubeaan, Yagob Al-Mazrou, Omer Al-Attas, Nasser Al-Daghari (1996). Prevalence of hypercholesterolemia in Saudi Arabia, epidemiological study, International Journal of Cardiology, Volume 54, Issue 1,1996, Pages 41-49,

Al-Ghamdi S, Shubair MM, Aldiab A, Al-Zahrani JM, Aldossari KK, Househ M (2018). Prevalence of overweight and obesity based on the body mass index: a cross-sectional study in Alkharj, Saudi Arabia. Lipids Health Dis. 2018; 17; 1: 134.5989365

Al-Nozha MM, Al-Hazzaa HM, Arafah MR, Al-Khadra A, Al-Mazrou YY, Al-Maatouq MA (2007). Prevalence of physical activity and inactivity among Saudis aged 30–70 years. Saudi Med J. 2007; 28; 4: 559-568. 17457478

Al-Kaabba AF, Al-Hamdan NA, El Tahir A, Abdalla AM, Saeed AA, Hamza MA (2012). Prevalence and correlates of dyslipidemia among adults in Saudi Arabia: results from a national survey. Open J Endocr Metab Dis. 2012; 2; 04: 89

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