Influence of Social Determinants of Health on Cardiovascular Risk Profiles in Middle Eastern Patients with ASCVD: Insights from SMuRFS Stratification

Background Social determinants of health (SDOH) may significantly influence atherosclerotic cardiovascular disease (ASCVD) development and progression. However, no large-scale Middle Eastern studies have used the full SDOH framework to assess its impact on ASCVD patients. This study investigates how SDOH affect cardiovascular risk profiles in Middle Eastern ASCVD patients, with a focus on those without social, mental, and risk factors (SMuRFs). Methods Data from six established registries and the Jordan SMuRF-less study were analyzed, covering baseline demographics, cardiovascular risk factors, comorbidities, use of secondary prevention medications, and one-year outcomes for patients with 0, 1–2, or 3–4 SMuRFs. Results Significant associations were found between SMuRF categories and SDOH. Individuals with 3–4 SMuRFs had lower educational levels (71.5%) and were more likely to have health insurance (82.8%) compared to those with fewer SMuRFs. Higher education correlated with more males (72.4%) and higher smoking rates (46.8%), while lower education was linked to higher rates of hypertension, diabetes, chronic kidney disease, and heart failure. Health insurance was associated with greater medication use and higher prevalence of these conditions. Conclusion This study highlights the significant role of education and health insurance in cardiovascular risk in Middle Eastern ASCVD patients. Lower education levels are linked to higher health risks, while insured patients have better healthcare access but higher disease burdens. Targeted public health strategies are needed. Trial Registration The study is registered on ClinicalTrials.gov under the identifier (NCT06199869) as of January 9, 2024.