JEDDAH, 19 October — A group of medical experts has been formed to implement a program to reduce the occurrence of heart attack and recurrent stroke in Saudi Arabia.

Announcing the details at a press conference following a daylong meeting, held at Durrah Beach Resort in Obhur over the weekend were Adnan Awada, consultant neurologist and head of neurology at King Fahd National Guard Hospital, Riyadh, said: "Although the incidence of heart attack and recurrent stroke is minimal because the majority of the Saudi population is young, things may not remain like that."

What they propose to do is address the risk factors, including diabetes — a chronic disease that affects all body systems and is common among older people. Bad diet, laziness and obesity are among the other factors that should be concentrated on.The panelists said stroke was the second leading cause of death worldwide, but the burden of the disease went beyond the mortality rate.

Fifty percent of survivors were left with cognitive and physical disabilities and about 50 percent would suffer depression, creating millions of disabled patients each year.World health statistics indicate about five million people die from stroke every year and at least 15 million others suffer non-fatal strokes that are frequently disabling. About one in five survivors will suffer another stroke or heart attack within five years, according to a panelist.

Experts pointed out that at present blood pressure (BP) lowering drugs were given to only a minority of people who suffered a stroke or transient ischemic attack (ministroke).

"There’s a strong case for making these drugs available to most stroke patients, irrespective of their age and BP, and of the other treatments they might be receiving since patients were known to be receiving aspirin or antihypertensive drugs. The benefits are unusually large and occur in a wide range of patients," another panelist said. At present, he added, aspirin was the only treatment given widely to patients after stroke, but it was not suitable for people who had suffered some particularly dangerous types of stroke, such as cerebral hemorrhage.

Boholega referred to big reductions in heart attack and recurrent stroke reported in a recent landmark six-year study of BP lowering treatments in more than 6,000 stroke sufferers worldwide, including those without high BP.

The study describes overall reductions of one quarter to one-third in the risk of heart attacks and further strokes among stroke patients from Asia, Australia and Europe who were given BP lowering treatment based on the ACE inhibitor drug, perindopril. In addition to a 28 percent reduction in total strokes, the study treatment achieved a 26 percent reduction in major coronary events and a 26 percent reduction in major cardiovascular events (non-fatal stroke, non-fatal myocardial infarction and cardiovascular death).

The results show that one in every 18 stroke sufferers given perindopril, with or without the diuretic drug, indapamide, avoided either heart attack, death or further stroke over five years of treatment.

Study Chairman John Chalmers, also from the University of Sydney and the Royal Prince Alfred Hospital (Sydney), described the study results as a "huge step forward."

According to him, "it was thought that BP lowering drugs were only useful for patients with high BP, but we’ve shown that perindopril and indapamide have beneficial effects, not only for those with high BP, but also for the much larger number of stroke patients with normal BP."

Dr. Khoja said more than two-thirds of all strokes occur in people who do not have high BP as defined by World Health Organization standards.

The study was conducted in 172 hospitals in Asia, Australia and Europe by PROGRESS, an independent group of medical researchers, supported by grants from national medical research agencies in Australia and New Zealand together with the French pharmaceutical company, Servier.