Undetected and undertreated: shaping policy on atrial fibrillation in Saudi Arabia

February 28, 2024


Undetected and undertreated: shaping policy on atrial fibrillation in Saudi Arabia

February 28, 2024

Clare Roche

Manager - Health Policy & Insights

Clare is a manager in the Health Policy and Insights practice at Economist Impact. Clare has over ten years of experience working in the healthcare industry in the Middle East. At Economist Impact, Clare is involved in project management, consultancy and custom research with a focus on the MENA region. Before joining Economist Impact, Clare worked with PwC’s Middle East Healthcare practice as a strategy and operations consultant and Enterprise Ireland, the trade and technology arm of the Irish Government, as an advisor to healthcare and life science companies. Clare holds a Bachelor in International Commerce from NUI Galway and is currently completing an MSc in Health Economics, Policy and Management at the London School of Economics and Political Science (LSE).


Among the diseases referred to as silent killers, atrial fibrillation (AF) is an increasingly important public health problem, with incidence expected to double over the next three decades. The global incidence of AF has increased by approximately 30% over the past 20 years, and more than 37m people are estimated to be living with AF, significantly impacting health, mortality risk and quality of life.

Patients with AF are at higher risk for concurrent stroke, heart failure, hypertension and other cardiovascular diseases. Owing to its asymptomatic presentation in a significant proportion of patients, approximately 30%, many people with AF currently go undetected and therefore untreated, with potentially lethal consequences.

The complex interplay between AF and other underlying and comorbid conditions makes the actual burden of AF difficult to untangle. For example, AF accounts for 25% of the global stroke burden. Approximately 20% of patients who experience a stroke associated with AF are first diagnosed with AF at the time of the stroke.

Undetected and undertreated: shaping policy on atrial fibrillation in Saudi Arabia is an Economist Impact report, supported by Johnson and Johnson. The report explores the burden of atrial fibrillation (AF) in Saudi Arabia, particularly key barriers to care across current patient pathways and the local policy environment. The report also presents best practices in AF prevention, screening, diagnosis, treatment and management relevant to Saudi Arabia, and assesses how stakeholders in the Kingdom can work together to enhance awareness, prevention and control of AF.

The rising tide of AF in Saudi Arabia

Saudi Arabia is confronting an epidemic of chronic disease with alarming rates of obesity, hypertension and diabetes—all significant public health problems and risk factors for AF. This, combined with a rapid growth in the older population means that AF will continue to be a major disease in Saudi Arabia in the next 20 years. The high prevalence of chronic disease may explain the earlier onset of AF in the region. Increasing age as a risk factor for AF is especially critical for a country like Saudi Arabia, where the population aged over 65 is projected to increase by almost 600% over the next two decades, from over 1m in 2023 to 5.7m by 2040.

The Saudi healthcare sector is undergoing extensive reforms in line with the country’s Health Sector Transformation Programme, as part of Vision 2030, the country’s national development plan. Identifying the prevalence of non- communicable diseases in the country as a major public health concern, Vision 2030 explicitly targets the management of heart disease, stroke and diabetes.

The following key takeaways and proposed solutions are intended to guide successful policy implementation and long-term action on AF in Saudi Arabia, ultimately improving AF prevention, diagnosis and care, and enhancing quality of life for AF patients.

Data and Research: Maintain and expand AF patient registries and prioritise AF and CVDs as part of the national research agenda.

Primary and secondary prevention: Prevent the onset and progression of AF by way of lifestyle intervention, education campaigns, early detection through increased clinical awareness and effective management of comorbid chronic conditions.

Early detection: Determine appropriate guidelines for AF detection and screening unique to the population demographics, health system capacity, and financing structure.

Care pathways: Standardise care pathways through adopting an integrated model of AF care with an established referral system and raising awareness of AF among diverse medical disciplines.

Digital: Prepare the health system to adopt emerging digital health technologies, leverage electronic health records (EHRs) to support population screening and monitoring and expand equitable access to AF care through telehealth.

Patient Engagement: Engage patients in treatment decisions and empower them with the tools to proactively manage their condition and ensure higher treatment adherence.


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