Intermarriage poses threat of congenital heart disease

Marriage among cousins and under-diagnosis of heart diseases, especially among females, combine to make a "sitting time-bomb" that could have far-reaching implications for the UAE's health care if not diffused through effective lifestyle change, an expert has warned. Dr Naeem Khan Tareen, a senior cardiologist who practised for over 20 years in the US before moving to Dubai, said: "The biggest killer of women is not all the cancers combined, but heart disease. If you factor in intermarriage, the risk of heart disease goes up significantly," the Pakistani-American specialist said. Dr Tareen, one of the first specialists to introduce stent angioplasty in the early 1980s in the US, holds a clinic at the American Heart Centre in Dubai Healthcare City. Heart disease among females, he said, is a "different ball-game" altogether. In men, the ratio of heart attack victims among citizens and expatriates is around 50:50. "Traditionally, heart disease is thought to be a male disease but in reality, it is very common in females. Here, it is under-diagnosed because it does not present classically with chest pains. At times, the patient just experiences shortness of breath, indigestion or even back pain." Article continues below According to the Dubai Health Authority, six heart attack patients are admitted at the Rashid Hospital alone daily. Heart disease accounts for one out of five deaths (22 per cent) in the UAE - the second-biggest killer after road mishaps - even as the average age of cardiac patients in the UAE is 10 years lower than the global average, experts said. A new registry of heart attack patients in the Gulf revealed that eight out of 10 female heart attack patients were citizens, while two were expatriates. Experts have long suspected that autosomal recessive gene - in which two copies of an abnormal gene are present in an offspring that triggers a disease or a disorder to develop - happens due to marriage among cousins and is involved in congenital heart disease. This was confirmed by a study of 891 patients in Saudi Arabia in 1998, which showed first-cousin marriage was a significant risk factor for certain types of congenital heart diseases. "With better living standards, the rising incidence of heart disease today mirrors the level in the US in the 1970s, but it has now come under control due to early diagnosis, better management and effective information campaigns," said Dr Tareen who has performed angioplasty procedures since his fellowship at St Vincent Medical Centre in New York in 1980. In May, the DHA launched the "Go Red For Women" campaign to highlight the threat of heart disease among women.