- High prevalence of chest pain among MENA physicians: 12.8% definitive angina and 45.6% possible angina.
- Panic disorder was the strongest predictor (AOR 2.76); anxiety, sleep deprivation, female sex, comorbidities, obesity, and nicotine use also independently increased risk.
- Urgent implementation of integrated occupational health programmes addressing psychological and cardiovascular risk among physicians, with targeted measures in middle income countries.
PLoS One. 2026 Aug 31;21(8):e0355946. doi: 10.1371/journal.pone.0355946. eCollection 2026.
ABSTRACT
BACKGROUND: Physicians face substantial occupational, psychological, and cardiovascular risk factors predisposing them to chest pain, yet no large-scale study has examined this in the Middle East and North Africa (MENA). This study determined the prevalence, characteristics, and determinants of chest pain among MENA physicians.
METHODS: This multinational cross-sectional study enrolled 6,224 physicians from 12 MENA countries (August-December 2023). Chest pain was classified using the Rose Angina Questionnaire. Anxiety and panic disorder were assessed using the Generalized Anxiety Disorder-7 (GAD-7) and Panic Disorder Screener (PADIS). Binary and multinomial logistic regression identified independent determinants.
RESULTS: Overall, 795 (12.8%) met criteria for definitive anginal pain and 2,836 (45.6%) for possible anginal pain. In the adjusted binary model, panic disorder was the strongest predictor (AOR = 2.76, 95% CI: 2.44-3.13), followed by physical comorbidities (AOR = 1.91), sleep deprivation (AOR = 1.61), female sex (AOR = 1.49), anxiety disorder (AOR = 1.38), and obesity (AOR = 1.30). All nicotine product categories were independently associated with chest pain. Multinomial analysis revealed stronger associations of panic disorder (AOR = 3.52) and tobacco use with definitive anginal pain, while electronic nicotine delivery system (ENDS) use was significant only for possible anginal pain. Middle-income country physicians had higher odds than those from high-income countries (AOR = 1.71).
CONCLUSION: Chest pain was highly prevalent among MENA physicians, and was strongly associated with panic disorder, anxiety, sleep deprivation, and nicotine product use. Integrated occupational health programmes addressing both psychological and cardiovascular risk are urgently needed.
PMID:42672072 | DOI:10.1371/journal.pone.0355946
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