Heart Health Supplement Market

Heart Health Supplement Market Forecast and Outlook 2025 to 2035

The global heart health supplement market is projected to grow from USD 7.8 billion in 2025 to approximately USD 12.1 billion by 2035, recording an absolute increase of USD 4.3 billion over the forecast period. This translates into a total growth of 55.1%, with the market forecast to expand at a compound annual growth rate (CAGR) of 4.4% between 2025 and 2035.

The overall market size is expected to grow by nearly 1.6X during the same period, supported by increasing consumer awareness of cardiovascular health, rising adoption of preventive healthcare solutions, and growing focus on natural therapeutic ingredients across global wellness and healthcare sectors.

Quick Stats for Heart Health Supplement Market

• Heart Health Supplement Market Value (2025): USD 7.8 billion
• Heart Health Supplement Market Forecast Value (2035): USD 12.1 billion
• Heart Health Supplement Market Forecast CAGR: 4.4%
• Leading Ingredient in Heart Health Supplement Market: Omega-3 (40.0%)
• Key Growth Regions in Heart Health Supplement Market: Asia Pacific, North America, and Europe
• Key Players in Heart Health Supplement Market: Haleon, Bayer, Nestlé Health Science, Pfizer Consumer, Amway, Herbalife, DSM-Firmenich, Blackmores

Between 2025 and 2030, the heart health supplement market is projected to expand from USD 7.8 billion to USD 9.7 billion, resulting in a value increase of USD 1.9 billion, which represents 44.2% of the total forecast growth for the decade. This phase of development will be shaped by rising demand for preventive healthcare solutions, increasing applications in cardiovascular wellness optimization, and growing penetration in emerging consumer markets. Healthcare providers and supplement manufacturers are expanding their heart health capabilities to address the growing demand for advanced formulation systems in various wellness applications and therapeutic processes.

Heart Health Supplement Market Key Takeaways

Metric	Value
Estimated Value in (2025E)	USD 7.8 billion
Forecast Value in (2035F)	USD 12.1 billion
Forecast CAGR (2025 to 2035)	4.4%

From 2030 to 2035, the market is forecast to grow from USD 9.7 billion to USD 12.1 billion, adding another USD 2.4 billion, which constitutes 55.8% of the overall ten-year expansion. This period is expected to be characterized by the expansion of advanced manufacturing facilities, the integration of cutting-edge supplement technologies, and the development of customized formulation systems for specific cardiovascular applications. The growing adoption of evidence-based wellness standards and regulatory requirements will drive demand for ultra-high efficiency heart health supplement systems with enhanced bioavailability specifications and consistent therapeutic characteristics.

Between 2020 and 2025, the heart health supplement market experienced steady expansion, driven by increasing recognition of cardiovascular supplement technologies' importance in preventive healthcare operations and growing acceptance of advanced nutritional solutions in complex wellness processes. The market developed as consumers and healthcare providers recognized the need for high-efficiency supplement systems to address cardiovascular health requirements and improve overall wellness outcomes. Research and development activities have begun to emphasize the importance of advanced heart health supplement technologies in achieving better efficiency and quality in preventive healthcare processes.

Why is the Heart Health Supplement Market Growing?

Market expansion is being supported by the increasing demand for preventive cardiovascular solutions and the corresponding need for high-efficiency supplement systems in heart health applications across global wellness and healthcare operations. Modern consumers are increasingly focused on advanced heart health supplement technologies that can improve cardiovascular wellness, reduce healthcare costs, and enhance overall quality of life while meeting stringent nutritional requirements. The proven efficacy of heart health supplement services in various wellness applications makes them an essential component of comprehensive preventive healthcare strategies and wellness programs.

The growing emphasis on wellness industry transformation and advanced nutritional optimization is driving demand for ultra-efficient heart health supplement systems that meet stringent performance specifications and regulatory requirements for cardiovascular applications. Consumer preference for reliable, high-performance supplement systems that can ensure consistent wellness outcomes is creating opportunities for innovative heart health supplement technologies and customized nutritional solutions. The rising influence of healthcare guidelines and wellness protocols is also contributing to increased adoption of premium-grade heart health supplement systems across different consumer applications and wellness systems requiring advanced nutritional technology.

Opportunity Pathways - Heart Health Supplement Market

The heart health supplement market represents a specialized growth opportunity, expanding from USD 7.8 billion in 2025 to USD 12.1 billion by 2035 at a 4.4% CAGR. As consumers prioritize cardiovascular wellness, regulatory compliance, and preventive healthcare performance in complex wellness processes, heart health supplement systems have evolved from a niche nutritional technology to an essential component enabling wellness delivery, cardiovascular optimization, and multi-stage healthcare production across consumer operations and specialized wellness applications.

The convergence of wellness expansion, increasing nutritional adoption, specialized consumer organization growth, and wellness requirements creates momentum in demand. High-efficiency formulations offering superior cardiovascular performance, cost-effective omega-3 systems balancing performance with economics, and specialized ingredient variants for critical applications will capture market premiums, while geographic expansion into high-growth Asian consumer markets and emerging market penetration will drive volume leadership. Consumer emphasis on wellness quality and cardiovascular reliability provides structural support.

• Pathway A - Omega-3 Dominance: Leading with 40.0% market share, omega-3 applications drive primary demand through complex cardiovascular wellness workflows requiring comprehensive supplement systems for therapeutic delivery. Advanced formulations enabling improved cardiovascular efficiency, reduced wellness risks, and enhanced consumer outcomes command premium pricing from consumers requiring stringent performance specifications and regulatory compliance. Expected revenue pool: USD 3.1-3.9 billion.
• Pathway B - Softgels/Capsules Leadership: Dominating with 55.0% market share through an optimal balance of performance and cost-effectiveness, softgels/capsules serve most consumer applications while meeting cardiovascular wellness requirements. This form addresses both performance standards and economic considerations, making it the preferred choice for consumer and wellness operations seeking reliable performance. Opportunity: USD 4.3-5.4 billion.
• Pathway C - Asian Market Acceleration: China (6.2% CAGR) and India (7.2% CAGR) lead global growth through consumer infrastructure expansion, cardiovascular wellness capability development, and domestic heart health supplement demand. Strategic partnerships with local wellness providers, regulatory compliance expertise, and supply chain localization enable the expansion of nutritional technology in major consumer hubs. Geographic expansion upside: USD 1.8-2.5 billion.
• Pathway D - Pharmacy Premium Segment: Pharmacies serve specialized applications requiring exceptional performance specifications for critical cardiovascular wellness processes. Pharmacy formulations supporting professional wellness requirements, complex therapeutic applications, and performance-sensitive processes command significant premiums from advanced consumer organizations and specialized wellness facilities. Revenue potential: USD 3.5-4.7 billion.
• Pathway E - Advanced Formulation & Technology Systems: Companies investing in sophisticated heart health supplement technologies, cardiovascular wellness systems, and automated nutritional processes gain competitive advantages through consistent system performance and wellness quality reliability. Advanced capabilities enabling customized specifications and rapid deployment capture premium consumer partnerships. Technology premium: USD 1.5-2.2 billion.
• Pathway F - Supply Chain Optimization & Reliability: Specialized distribution networks, strategic inventory management, and reliable supply chain systems create competitive differentiation in consumer markets requiring consistent heart health supplement service availability. Companies offering guaranteed supply security, technical support, and regulatory documentation gain preferred supplier status with compliance-focused consumers. Supply chain value: USD 1.2-1.8 billion.
• Pathway G - Emerging Applications & Market Development: Beyond traditional omega-3 formulations, heart health supplements in specialized delivery systems, combination products, and personalized wellness represent growth opportunities. Companies developing new applications, supporting R&D initiatives, and expanding into adjacent wellness markets capture incremental demand while diversifying revenue streams. Emerging opportunity: USD 0.8-1.2 billion.

Segmental Analysis

The market is segmented by ingredient, form, channel, and region. By ingredient, the market is divided into omega-3, CoQ10, plant sterols, fiber, and others. Based on form, the market is categorized into softgels/capsules, tablets, powders, and liquids/gummies. By channel, the market is divided into pharmacy, e-commerce, mass retail, and specialty. Regionally, the market is divided into Asia Pacific, North America, Europe, Latin America, Middle East & Africa.

By Ingredient, Omega-3 Segment Accounts for 40.0% Market Share

The omega-3 segment is projected to account for 40.0% of the heart health supplement market in 2025, reaffirming its position as the category's dominant ingredient type. Consumers increasingly recognize the optimal balance of performance and cost-effectiveness offered by omega-3 for most cardiovascular applications, particularly in wellness delivery and preventive healthcare processes. This ingredient addresses both performance requirements and economic considerations while providing reliable cardiovascular support across diverse consumer applications.

This ingredient forms the foundation of most wellness protocols for cardiovascular applications, as it represents the most widely accepted and commercially viable level of heart health supplement technology in the industry. Performance control standards and extensive clinical testing continue to strengthen confidence in omega-3 formulations among consumer and wellness providers. With increasing recognition of the cost-performance optimization requirements in cardiovascular wellness, omega-3 systems align with both operational efficiency and consumer health goals, making them the central growth driver of comprehensive preventive healthcare strategies.

By Form, Softgels/Capsules Segment Accounts for 55.0% Market Share

Softgels/capsules are projected to represent 55.0% of heart health supplement demand in 2025, underscoring their role as the primary form segment driving market adoption and growth. Consumers recognize that softgel/capsule requirements, including complex absorption processes, specialized bioavailability needs, and multi-stage delivery systems, often require advanced formulation services that standard supplement technologies cannot adequately provide. Softgels/capsules offer enhanced absorption efficiency and regulatory compliance in consumer wellness applications.

The segment is supported by the growing nature of consumer adoption, requiring sophisticated delivery systems, and the increasing recognition that advanced softgel/capsule technologies can improve wellness performance and cardiovascular outcomes. Additionally, consumers are increasingly adopting evidence-based wellness guidelines that recommend specific softgel/capsule services for optimal cardiovascular outcomes. As understanding of nutritional complexity advances and consumer requirements become more stringent, softgels/capsules will continue to play a crucial role in comprehensive wellness strategies within the consumer market.

By Channel, Pharmacy Segment Accounts for 45.0% Market Share

Pharmacies are projected to represent 45.0% of heart health supplement demand in 2025, underscoring their role as the primary channel segment driving market distribution and growth. Consumers recognize that pharmacy requirements, including professional consultation processes, specialized product knowledge, and regulated distribution systems, often require advanced retail services that standard distribution channels cannot adequately provide. Pharmacies offer enhanced product credibility and professional guidance in consumer wellness applications.

The segment is supported by the growing nature of professional wellness consultation, requiring sophisticated distribution systems, and the increasing recognition that pharmacy channels can improve consumer confidence and wellness outcomes. Additionally, consumers are increasingly adopting evidence-based purchasing guidelines that recommend pharmacy channels for optimal cardiovascular supplement selection. As understanding of wellness complexity advances and consumer requirements become more stringent, pharmacies will continue to play a crucial role in comprehensive distribution strategies within the heart health supplement market.

What are the Drivers, Restraints, and Key Trends of the Heart Health Supplement Market?

The heart health supplement market is advancing steadily due to increasing recognition of cardiovascular wellness technologies' importance and growing demand for high-efficiency supplement systems across the consumer and wellness sectors. However, the market faces challenges, including complex regulatory processes, potential for efficacy variations during manufacturing and distribution, and concerns about supply chain consistency for specialized nutritional ingredients. Innovation in heart health supplement technologies and customized wellness protocols continues to influence product development and market expansion patterns.

Expansion of Advanced Manufacturing Facilities and Heart Health Supplement Technologies

The growing adoption of advanced manufacturing facilities is enabling the development of more sophisticated heart health supplement production and quality control systems that can meet stringent regulatory requirements. Specialized manufacturing facilities offer comprehensive supplement services, including advanced formulation and bioavailability processes that are particularly important for achieving high-efficiency requirements in consumer applications. Advanced manufacturing channels provide access to premium services that can optimize wellness performance and reduce production costs while maintaining cost-effectiveness for large-scale consumer operations.

Integration of Digital Consumer Systems and Wellness Management Systems

Modern consumer organizations are incorporating digital technologies such as real-time performance monitoring, automated distribution systems, and supply chain integration to enhance heart health supplement manufacturing and distribution processes. These technologies improve service performance, enable continuous wellness monitoring, and provide better coordination between manufacturers and consumers throughout the supplement lifecycle. Advanced digital platforms also enable customized performance specifications and early identification of potential service deviations or supply disruptions, supporting reliable consumer wellness production.

Analysis of the Heart Health Supplement Market by Key Country

Country	CAGR (2025-2035)
India	7.2%
China	6.2%
Mexico	4.3%
USA	4.0%
Germany	3.9%
South Korea	3.6%
Japan	3.0%

The heart health supplement market is experiencing varied growth globally, with India leading at a 7.2% CAGR through 2035, driven by the expansion of consumer wellness infrastructure development, increasing cardiovascular health awareness, and growing domestic demand for high-efficiency heart health supplement systems. China follows at 6.2%, supported by wellness expansion, growing recognition of advanced cardiovascular technology importance, and expanding consumer capacity. USA records 4.0% growth, with a focus on developing the nutritional technology and wellness industries. Germany shows 3.9% growth, representing a mature market with established consumer patterns and regulatory frameworks. Japan demonstrates 3.0% growth, emphasizing consumer infrastructure expansion and systematic wellness approaches.

India Demonstrates Growing Market Potential with Consumer Infrastructure Development

Revenue from heart health supplements in India is projected to exhibit robust growth with a CAGR of 7.2% through 2035, driven by ongoing consumer expansion and increasing recognition of high-efficiency heart health supplement systems as essential wellness components for complex cardiovascular processes. The country's expanding consumer infrastructure and growing availability of specialized wellness capabilities are creating significant opportunities for heart health supplement adoption across both domestic and export-oriented consumer facilities. Major international and domestic wellness companies are establishing comprehensive manufacturing and distribution networks to serve the growing population of consumers and wellness facilities requiring high-performance heart health supplement systems across cardiovascular and wellness applications throughout India's major consumer hubs.

The Indian government's strategic emphasis on wellness modernization and cardiovascular health advancement is driving substantial investments in specialized nutritional capabilities. This policy support, combined with the country's large domestic consumer market and expanding wellness requirements, creates a favorable environment for the heart health supplement market development. Indian consumers are increasingly focusing on high-value nutritional technologies to improve wellness capabilities, with heart health supplements representing a key component in this consumer transformation.

• Government initiatives supporting wellness development and cardiovascular health modernization are driving demand for high-efficiency heart health supplement systems throughout major consumer and wellness centers, including Mumbai, Delhi, and Bangalore regions.
• Consumer capacity expansion and nutritional system development are supporting appropriate utilization of heart health supplements among consumers and wellness facilities nationwide, with particular growth in retail operations and wellness services.

China Demonstrates Exceptional Market Potential with Consumer Growth

Revenue from heart health supplements in China is expanding at a CAGR of 6.2%, supported by increasing consumer accessibility, growing cardiovascular wellness awareness, and developing nutritional market presence across the country's major consumer clusters. The country's large consumer sector and increasing recognition of advanced heart health supplement systems are driving demand for effective high-efficiency cardiovascular solutions in both wellness and consumer applications. International wellness companies and domestic providers are establishing comprehensive distribution channels to serve the growing demand for quality heart health supplement systems while supporting the country's position as an emerging nutritional technology market.

China's consumer sector continues to benefit from favorable wellness policies, expanding consumer capabilities, and cost-competitive nutritional infrastructure development. The country's focus on becoming a global wellness technology hub is driving investments in specialized heart health supplement technology and nutritional infrastructure. This development is particularly important for heart health supplement applications, as consumers seek reliable domestic sources for critical cardiovascular technologies to reduce import dependency and improve supply chain security.

• Rising awareness about advanced cardiovascular options and improving consumer capabilities are creating opportunities for specialized heart health supplement systems across wellness and consumer settings in major hubs like Beijing, Shanghai, and Guangzhou.
• Growing consumer infrastructure development and technology adoption are supporting increased access to high-efficiency heart health supplements among organizations requiring comprehensive cardiovascular capabilities, particularly in wellness and consumer organizations.

Mexico Shows Strong Regional Market Development

Mexico's heart health supplement market is expanding at a 4.3% CAGR through 2035, driven by improving consumer healthcare access, growing awareness of preventive cardiovascular solutions, and increasing adoption of wellness technologies across major urban centers. The country's developing consumer infrastructure and rising middle-class population are creating substantial opportunities for heart health supplement adoption in both domestic retail and healthcare applications. International and regional wellness companies are establishing distribution networks to serve Mexico's growing demand for quality cardiovascular supplements while capitalizing on the country's strategic position as a gateway to Latin American markets.

Mexico's healthcare modernization initiatives and government wellness programs are driving investments in consumer health infrastructure. The country's focus on reducing healthcare costs through preventive measures is creating favorable conditions for heart health supplement market expansion. Mexican consumers are increasingly recognizing the value of proactive cardiovascular wellness, with heart health supplements becoming integral to comprehensive healthcare strategies.

• Healthcare accessibility improvements and consumer wellness education programs are driving demand for effective heart health supplement systems throughout major metropolitan areas including Mexico City, Guadalajara, and Monterrey.
• Expanding retail infrastructure and e-commerce adoption are supporting increased access to premium heart health supplements among consumers seeking reliable cardiovascular wellness solutions.

USA Maintains Technology Leadership

USA's advanced nutritional technology market demonstrates sophisticated wellness deployment with documented heart health supplement effectiveness in consumer departments and wellness centers through integration with existing consumer systems and cardiovascular infrastructure. The country leverages wellness expertise in nutritional technology and consumer systems integration to maintain a 4.0% CAGR through 2035. Consumer centers, including major metropolitan areas, showcase premium installations where heart health supplement systems integrate with comprehensive consumer information systems and wellness platforms to optimize cardiovascular accuracy and operational workflow effectiveness.

American consumers prioritize system reliability and regulatory compliance in wellness development, creating demand for premium systems with advanced features, including quality validation and integration with US consumer standards. The market benefits from established consumer industry infrastructure and a willingness to invest in advanced heart health supplement technologies that provide long-term operational benefits and compliance with regulatory requirements.

Germany Shows Strong Regional Leadership

Germany's market expansion benefits from diverse consumer demand, including wellness modernization in Berlin and Munich, cardiovascular development programs, and government wellness programs that increasingly incorporate heart health supplement solutions for wellness enhancement applications. The country maintains a 3.9% CAGR through 2035, driven by rising consumer awareness and increasing adoption of cardiovascular benefits, including superior wellness capabilities and reduced health complexity.

Market dynamics focus on cost-effective heart health supplement solutions that balance advanced wellness features with affordability considerations important to German consumer operators. Growing consumer infrastructure creates demand for modern cardiovascular systems in new wellness facilities and consumer equipment modernization projects.

Strategic Market Considerations:

• Consumer and wellness segments leading growth with focus on cardiovascular enhancement and operational efficiency applications
• Regional consumer requirements are driving a diverse product portfolio from basic heart health supplement systems to advanced wellness platforms
• Import dependency challenges offset by potential local development partnerships with international nutritional manufacturers
• Government wellness initiatives beginning to influence procurement standards and cardiovascular requirements

South Korea Demonstrates Advanced Technology Integration

South Korea's heart health supplement market is growing at a 3.6% CAGR through 2035, characterized by sophisticated consumer preferences for technology-integrated wellness solutions and premium cardiovascular supplements. The country's advanced digital infrastructure and health-conscious population are driving demand for innovative heart health supplement formulations that integrate with digital wellness platforms and personalized health monitoring systems. Korean consumers demonstrate strong preference for scientifically-backed supplements with proven cardiovascular benefits and advanced delivery mechanisms.

The market benefits from South Korea's position as a technology leader in wellness innovation, with companies developing next-generation heart health supplements that incorporate digital health tracking and personalized nutrition protocols. Government support for healthcare technology advancement and preventive wellness initiatives creates favorable conditions for premium heart health supplement adoption across urban centers.

• Technology integration requirements and consumer preference for premium wellness solutions are driving demand for advanced heart health supplement systems in Seoul, Busan, and other major metropolitan areas.
• Digital wellness platform integration and personalized nutrition trends are supporting increased adoption of high-technology heart health supplements among tech-savvy consumers seeking comprehensive cardiovascular wellness solutions.

Japan Emphasizes Precision and Integration Excellence

Japan demonstrates steady market development with a 3.0% CAGR through 2035, distinguished by consumer operators' preference for high-quality heart health supplement systems that integrate seamlessly with existing wellness equipment and provide reliable long-term operation in specialized cardiovascular applications. The market prioritizes advanced features, including precision wellness algorithms, quality validation, and integration with comprehensive consumer platforms that reflect Japanese consumer expectations for technological sophistication and operational excellence.

Japanese consumers focus on system reliability and precision in heart health supplement development, creating demand for premium systems with advanced features including automated quality monitoring and comprehensive wellness support. The market benefits from established consumer research infrastructure and investment in cardiovascular technology that provides long-term wellness benefits.

Strategic Market Indicators:

• Premium focus on precision systems with advanced wellness algorithms and high-reliability capabilities
• Integration requirements with existing consumer information systems and wellness management platforms
• Emphasis on heart health supplement reliability and long-term performance in consumer applications

Competitive Landscape of the Heart Health Supplement Market

The heart health supplement market is characterized by competition among established nutritional manufacturers, specialty wellness companies, and consumer technology suppliers focused on delivering high-efficiency, consistent, and reliable heart health supplement systems. Companies are investing in nutritional technology advancement, performance control enhancement, strategic partnerships, and customer technical support to deliver effective, efficient, and reliable heart health supplement solutions that meet stringent consumer and wellness requirements. Formulation optimization, performance validation protocols, and supply chain strategies are central to strengthening product portfolios and market presence.

Haleon leads the market with comprehensive high-efficiency heart health supplement system offerings with a focus on performance consistency and cardiovascular reliability for consumer applications. Bayer provides specialized nutritional systems with emphasis on wellness applications and comprehensive technical support services. Nestlé Health Science focuses on advanced heart health supplement technologies and customized consumer solutions for wellness systems serving global markets. Pfizer Consumer delivers established nutritional systems with strong performance control systems and customer service capabilities.

Amway operates with a focus on bringing innovative heart health supplement technologies to specialized consumer applications and emerging markets. Herbalife provides comprehensive wellness system portfolios, including advanced heart health supplements, across multiple consumer applications and wellness processes. DSM-Firmenich specializes in customized nutritional solutions and performance management systems for consumer systems with emphasis on regulatory compliance. Blackmores provides reliable supply chain solutions and technical expertise to enhance market accessibility and customer access to essential heart health supplement systems.

Key Players in the Heart Health Supplement Market

• Haleon
• Bayer
• Nestlé Health Science
• Pfizer Consumer
• Amway
• Herbalife
• DSM-Firmenich
• Blackmores
• Swisse
• NOW Foods
• Jamieson
• Nature's Bounty
• Church & Dwight
• Costco (Kirkland)
• Danone

Scope of the Report

Items	Values
Quantitative Units (2025)	USD 7.8 billion
Ingredient	Omega-3, CoQ10, Plant Sterols, Fiber, Others
Form	Softgels/Capsules, Tablets, Powders, Liquids/Gummies
Channel	Pharmacy, E-commerce, Mass Retail, Specialty
Regions Covered	Asia Pacific, North America, Europe, Latin America, Middle East & Africa
Countries Covered	China, USA, Germany, Japan, India, South Korea, Mexico and 40+ countries
Key Companies Profiled	Haleon, Bayer, Nestlé Health Science, Pfizer Consumer, Amway, Herbalife, DSM-Firmenich, and Blackmores
Additional Attributes	Dollar sales by ingredient and form, regional demand trends, competitive landscape, consumer preferences for specific heart health supplement systems, integration with specialty wellness supply chains, innovations in nutritional technologies, performance monitoring, and cardiovascular optimization

Heart Health Supplement Market by Segments

• Ingredient:

  • Omega-3
  • CoQ10
  • Plant Sterols
  • Fiber
  • Others

• Form:

  • Softgels/Capsules
  • Tablets
  • Powders
  • Liquids/Gummies

• Channel:

  • Pharmacy
  • E-commerce
  • Mass Retail
  • Specialty

• Region:

  • Asia Pacific

    • China
    • India
    • Japan
    • South Korea
    • ASEAN
    • Australia & New Zealand
    • Rest of Asia Pacific

  • North America

    • United States
    • Canada
    • Mexico

  • Europe

    • Germany
    • United Kingdom
    • France
    • Italy
    • Spain
    • Nordic
    • BENELUX
    • Rest of Europe

  • Latin America

    • Brazil
    • Argentina
    • Chile
    • Rest of Latin America

  • Middle East & Africa

    • Kingdom of Saudi Arabia
    • Other GCC Countries
    • Turkey
    • South Africa
    • Other African Countries
    • Rest of Middle East & Africa