Alert-associated cardiovascular events in Gulf civilian populations: emerging risks and surveillance opportunities.

Conflict and disaster settings are increasingly recognized as triggers for acute cardiovascular events; however, little attention has been given to civilian populations exposed to intermittent conflict alerts in non-war environments. This Perspective highlights the potential for alert-associated cardiovascular events, including overt myocardial infarction and subclinical myocardial injury, in Gulf host populations with high baseline cardiometabolic risk. Drawing on evidence from conflict and disaster literature, we propose that acute stress responses triggered by missile alerts or security warnings may precipitate arrhythmias and acute coronary syndromes within short temporal windows. We further argue that current surveillance systems are not designed to detect such transient events due to the lack of integration between alert timelines and cardiovascular data. The Gulf's advanced digital health infrastructure presents a unique opportunity to develop time-linked cardiovascular monitoring through the integration of civil defence alerts, hospital registries, and wearable technologies. Addressing this gap could transform an under-recognized cardiovascular risk into a measurable and preventable component of public health preparedness. Future research should focus on defining diagnostic criteria, improving data integration, and ensuring equitable inclusion of migrant populations.