Hidden Heart Risks: Why Cardiovascular Disease in Arab Americans Deserves More Public Health Attention

Introduction

Cardiovascular disease (CVD) remains one of the leading causes of death worldwide, yet many minority populations continue to be underrepresented in health research. A recent literature review published in the American Journal of Preventive Cardiology highlights an important but often overlooked issue: Arab Americans may face significantly higher risks for cardiovascular disease and related conditions such as diabetes, hypertension, high cholesterol, and smoking-related illness.

The review examined studies involving Arab American communities across the United States, particularly in Michigan and California, and explored how cultural, social, and behavioral factors influence heart health outcomes. The findings are highly relevant not only for Arab Americans, but also for MENA and South Asian populations globally, where chronic disease rates continue to rise.

Key Findings from the Review

The article reviewed multiple studies investigating cardiovascular disease and its risk factors among Arab Americans. Several important patterns emerged:

• Arab Americans may experience higher rates of hypertension, diabetes, stroke, and heart disease compared to some other ethnic groups.
• A Michigan mortality study found that Arab American death rates exceeded White Americans beginning at ages 45–49 and exceeded Black Americans by ages 75–79.
• Among Arab Americans aged 85 years and older, mortality rates reached 27,602 per 100,000 compared to 15,867 in White Americans and 14,718 in Black Americans.
• Diabetes prevalence was particularly concerning. One study found diabetes rates of 26.2% among Yemeni Americans and Iraqi Americans, compared to 14.5% among Lebanese Americans.
• In Northern California, hyperlipidemia prevalence was higher among Arab American men (41% vs 35%) and women (32% vs 28%) compared with non-Hispanic White populations.
• Smoking rates were also elevated in some Arab American communities, with one Michigan study reporting smoking prevalence of 39% compared to the statewide rate of 29%.
• Water-pipe smoking (hookah/shisha) was identified as a major concern due to misconceptions that it is safer than cigarette smoking.
• The review also highlighted significant social and cultural barriers to healthcare, including discrimination, language barriers, lack of culturally tailored education, and acculturative stress.

Why This Matters for MENA and South Asian Communities

The findings from this review extend far beyond Arab American communities in the United States. Many countries across the Middle East, North Africa, and South Asia are currently experiencing rapid increases in diabetes, obesity, hypertension, and cardiovascular disease. Several of the same risk factors discussed in the review are also common in MENA and South Asian populations, including:

• High rates of diabetes and metabolic syndrome
• Tobacco use, including water-pipe smoking
• Sedentary lifestyles and reduced physical activity
• Limited culturally tailored chronic disease education
• Social stressors, migration-related challenges, and healthcare access barriers

The review also highlights the importance of understanding culture when designing public health interventions. For example, many Arab and South Asian communities place strong emphasis on family and social gatherings, which can influence dietary habits, smoking behaviors, and healthcare decisions. At the same time, these close family structures may also become a strength when designing community-based prevention programs.

Public Health and Policy Implications

The review supports the need for culturally tailored cardiovascular prevention programs for Arab American and MENA populations. Key public health recommendations include:

• Expanding culturally and linguistically appropriate health education
• Increasing screening for diabetes, hypertension, and cholesterol disorders
• Addressing misconceptions about water-pipe smoking & cardiovascular risk
• Supporting community-based lifestyle programs involving families & social support
• Improving representation of MENA populations in national health databases and

   research studies
• Training healthcare providers on culturally sensitive chronic disease management,

  including fasting during Ramadan for patients with diabetes

Final Thoughts

This review highlights a growing public health concern that deserves greater attention. Arab Americans remain underrepresented in health research despite evidence suggesting elevated cardiovascular risks. The study also demonstrates that health outcomes are shaped not only by biology, but also by culture, education, migration experiences, social support, and access to healthcare.

For MENA and South Asian populations globally, the message is clear: cardiovascular prevention strategies must move beyond one-size-fits-all approaches. Culturally informed public health interventions may play a critical role in reducing chronic disease burden and improving long-term heart health outcomes.

Reference

Lababidi, H., Lababidi, G., Al Rifai, M., Nasir, K., & Al-Kindi, S. (2024). Cardiovascular disease in Arab Americans: A literature review. American Journal of Preventive Cardiology, 18, 100665. https://doi.org/10.1016/j.ajpc.2024.100665