Determinants of Coronary Heart Disease Incidence among Indonesian Hajj Pilgrims Hospitalized in Saudi Arabia in 2019


  • Juniarty Naim Department of Epidemiology, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
  • Wahiduddin Wahiduddin Department of Epidemiology, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
  • Masni Masni Department of Biostatistics, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
  • Ridwan Amiruddin Department of Epidemiology, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
  • Irwandy Irwandy Department of Hospital Administration, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
  • M. Nadjib Bustan Department of Statistics, Faculty of Mathematics and Natural Sciences, Universitas Negeri Makassar, Makassar, Indonesia



Coronary heart disease, Blood pressure, Blood sugar levels, Low-density lipoprotein-cholesterol levels, Body mass index


BACKGROUND: Cardiovascular diseases (CVDs) are the main causes of death worldwide, including in the hajj pilgrims. Coronary heart disease (CHD) is the most common CVDs in Indonesian hajj pilgrims hospitalized in Saudi Arabia.

AIM: This study aimed to determine the determinants of the CHD incidence among Indonesian hajj pilgrims hospitalized in Saudi Arabia in 2019.

METHODS: This study was an observational analytic study with a case–control design. The study was conducted in Makassar using data from the integrated Hajj computerized system in the health sector (siskohatkes) Hajj Health Center (Puskeshaji) in January–June 2021. Cases were pilgrims hospitalized in Saudi Arabia with a diagnosis of CHD, about 186 people, and controls were pilgrims hospitalized with diagnoses other than CVDs. Selection of controls by matching age and sex with a ratio of 1:1. The determinants analyzed included education, high blood pressure, high blood sugar levels, high low-density lipoprotein (LDL) cholesterol levels, excess body mass index (BMI), and smoking. Data analysis was using the STATA program with an odds ratio (OR) test and multiple logistic regression.

RESULTS: The most respondents were 65 years (48.39%), female respondents, about 61.83%. Most respondents’ education was in elementary school, about 31.99%. Multivariate analysis showed that high blood pressure (OR = 2.32, 95% confidence index [CI] = 1.50–3.57), high blood sugar levels (RO = 1.90, 95% CI = 1.06–3.40), high LDL cholesterol levels (RO = 1.82, 95% CI = 1.15–2.88), and excess BMI (RO = 1.73, 95% CI = 1.07–2.68) were risk factors for the CHD incidence. However, education and smoking were not risk factors for CHD.

CONCLUSION: By multiple logistic regression analyzes, the study revealed that the probability of CHD when having those four risk factors was 85.69%.


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Sarwat A. Ensiklopedia Fikih Indonesia 6: Haji Dan Umrah. 1st ed. Jakarta: Gramedia Pustaka Utama; 2019. p. 1-426.

Al Shimemeri A. Cardiovascular disease in Hajj pilgrims. J Saudi Heart Assoc 2012;24:123-7.

Pusat Kesehatan Haji Kemenkes RI. Siskohatkes Shar’i. Portal Siskohatkes; 2020. Available from: https://www.siskohatkes. [Last accessed on 2020 Feb 06].

Qamariah H. Angka kematian Jemaah Haji Indonesia. Media Health Res Dev. 2001;11:44-50.

Pane M, Imari S, Alwi Q, Nyoman Kandun I, Cook AR, Samaan G. Causes of mortality for Indonesian hajj pilgrims: Comparison between routine death certificate and verbal autopsy findings. PLoS One. 2013;8(8):1-7. PMid:23991182

Unger T, Borghi C, Charchar F, Khan NA, Poulter NR, Prabhakaran D. 2020 International society of hypertension global hypertension practice guidelines. Hypertension. 2020;75(6):1334-57.

World Health Organization, International Diabetes Federation. Definition and Diagnosis of Diabetes Mellitus and Intermediate Hyperglycaemia: Report of a WHO/IDF Consultation. Geneva: World Health Organization; 2006. p. 1-50. Available from: [Last accessed on 2021 Aug 19].

National Institute of Health ATP III. ATP III Guidelines At-A-Glance Quick Desk Reference. United States: National Institute of Health, Department of Health and Human Services; 2001. p. 1-6.

Powell-Wiley TM, Poirier P, Burke LE, Després JP, Gordon- Larsen P, Lavie CJ. Obesity and cardiovascular disease: A scientific statement from the American heart association. Circulation. 2021;143(21):e984-1010. PMid:33882682

Hajar R. Risk factors for coronary artery disease: Historical perspectives. Heart Views. 2017;18(3):109-14. PMid:29184622

Mendis S, Puska P, Norrving B, editor. Global Atlas on Cardiovascular Disease Prevention and Control. Geneva: World Health Organization; 2011.

Amani R, Sharifi N. In: Gaze D, editor. Cardiovascular Disease Risk Factors,the Cardiovascular System Physiology, Diagnostics and Clinical Implications. India: InTech; 2012. p. 279-310.

Berry JD, Dyer A, Cai X, Garside DB, Ning H, Thomas A. Lifetime risks of cardiovascular disease. N Engl J Med. 2012;366(4):321-9. PMid:22276822

Maas AH, Appelman YE. Gender differences in coronary heart disease. Neth Heart J. 2010;18(12):598-603. PMid:21301622

Gao Z, Chen Z, Sun A, Deng X. Gender differences in cardiovascular disease. Med Nov Technol Devices. 2019;4:100025.

Zhu D, Chung H, Dobson AJ, Pandeya N, Giles GG, Bruinsma F. Articles age at natural menopause and risk of incident cardiovascular disease : A pooled analysis of individual patient data. Lancet Public Health. 2019;4(11):553-64. PMid:31588031

Rosengren A, Smyth A, Rangarajan S, Ramasundarahettige C, Bangdiwala SI, AlHabib KF. Socioeconomic status and risk of cardiovascular disease in 20 low-income, middle-income, and high-income countries: The prospective urban rural epidemiologic (PURE) study. Lancet Glob Health. 2019;7(6):e748-60.

Psaltopoulou T, Hatzis G, Papageorgiou N, Androulakis E, Briasoulis A, Tousoulis D. Socioeconomic status and risk factors for cardiovascular disease: Impact of dietary mediators. Hellenic J Cardiol. 2017;58(1):32-42. PMid:28161284

Farshidi H, Rahimi S, Abdi A, Salehi S, Madani A. Factors associated with pre-hospital delay in patients with acute myocardial infarction. Iran Red Crescent Med J. 2013;15(4):312-6.

Ghani L, Susilawati MD, Novriani H. Faktor risiko dominan penyakit jantung koroner di Indonesia. Bul Penelit Kesehat. 2016;44(3):153-64.

Xu J, Lee ET, Peterson LE, Devereux RB, Rhoades ER, Umans JG. Differences in risk factors for coronary heart disease among diabetic and nondiabetic individuals from a population with high rates of diabetes: The strong heart study. J Clin Endocrinol Metab. 2012;97(10):3766-74. PMid:22802089

Escobar E. Hypertension and coronary heart disease. J Hum Hypertens. 2002;16(1):S61-3. PMid:11986897

Nelwan EJ, Widjajanto E, Andarini S, Djati MS. Modified risk factors for coronary heart disease (CHD) in Minahasa ethnic group from Manado city Indonesia. J Exp Life Sci. 2016;6(2):88-94.

Biswas A, Singh SK, Singh RK. Linkages between hypertension and coronary heart disease in India: Evidence from India human development survey-2 (2011-2012). Indian J Community Med. 2017;42(4):200-3. PMid:29184318

Matsunaga M, Yatsuya H, Iso H, Yamashita K, Li Y, Yamagishi K. Similarities and differences between coronary heart disease and stroke in the associations with cardiovascular risk factors: The Japan collaborative cohort study. Atherosclerosis. 2017;261:124- 30. PMid:28292514

Severino P, D’Amato A, Netti L, Pucci M, De Marchis M, Palmirotta R. Diabetes mellitus and ischemic heart disease: The role of ion channels. Int J Mol Sci. 2018;19(3):802. PMid:29534462

Huxley R, Barzi F, Woodward M. Excess risk of fatal coronary heart disease associated with diabetes in men and women: Meta-analysis of 37 prospective cohort studies. Br Med J. 2006;332(7533):73-6. PMid:16371403

Hermida N, Balligand JL. Low-density lipoprotein-cholesterol-induced endothelial dysfunction and oxidative stress: The role of statins. Antioxid Redox Signal. 2014;20(8):1216-37. PMid:23924077

Chilton RJ. Pathophysiology of coronary heart disease: A brief review. J Am Osteopath Assoc. 2004;104(9):7-10. PMid:15467017

Gao S, Liu J. Association between circulating oxidized low-density lipoprotein and atherosclerotic cardiovascular disease. Chronic Dis Transl Med. 2017;3(2):89-94. PMid:29063061

Schubert J, Lindahl B, Melhus H, Renlund H, Leosdottir M, Yari A. Low-density lipoprotein cholesterol reduction and statin intensity in myocardial infarction patients and major adverse outcomes: A Swedish nationwide cohort study. Eur Heart J. 2021;42(3):243-52.

Nakamura K, Fuster JJ, Walsh K. Adipokines: A link between obesity and cardiovascular disease. J Cardiol. 2014;63(4):250-9. PMid:24355497

Lassale C, Tzoulaki I, Moons KG, Sweeting M, Boer J, Johnson L. Separate and combined associations of obesity and metabolic health with coronary heart disease: A pan-European case-cohort analysis. Eur Heart J. 2018;39(5):397-406. PMid:29020414

Kivimäki M, Kuosma E, Ferrie JE, Luukkonen R, Nyberg ST, Alfredsson L. Overweight, obesity, and risk of cardiometabolic multimorbidity: Pooled analysis of individual-level data for 120 813 adults from 16 cohort studies from the USA and Europe. Lancet Public Health. 2017;2(6):e277-85. PMid:28626830

Puig-Cotado F, Tursan d’Espaignet E, St Claire S, Bianco E, Bhatti L, Schotte K. Tobacco and Coronary Heart Disease: WHO Tobacco Knowledge Summaries. Geneva: World Health Organization; 2020.




How to Cite

Naim J, Wahiduddin W, Masni M, Amiruddin R, Irwandy I, Bustan MN. Determinants of Coronary Heart Disease Incidence among Indonesian Hajj Pilgrims Hospitalized in Saudi Arabia in 2019. Open Access Maced J Med Sci [Internet]. 2021 Sep. 7 [cited 2022 Oct. 1];9(E):798-804. Available from:





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