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Worldwide, cardiovascular disease is estimated to be the leading cause of death and disability. Most of cardiovascular disease events nowadays are taking place in low and middle income countries with 80% of the burden occurring in these countries. The INTERHEART study showed striking variation in the age of first presentation of acute myocardial infarction in various regions of the world, with the youngest patients in the region of the Middle East (median age 51 years). The highest proportion of cases with first acute myocardial infarction at age 40 years or younger was in men from Middle East also (12.6%). The development of major cardiovascular risk factors at an early age is closely related to clustering of risk factors and health behaviour. Hypertension, dyslipidemia, glucose intolerance and overweight are usually tolerated at a younger age, however, overtime these conditions especially if associated with poor dietary habits, smoking or physical inactivity; can lead to excessive morbidity and mortality from cardiovascular disease later in adulthood. Exposure to these risk factors early in life was shown to induce permanent changes in the arterial tree that eventually leads to development of atherosclerosis
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