Armed conflict is linked with an increased risk of cardiovascular disease (CVD) among civilians, even years after the conflict ends, a study has found.
The findings come from the first systematic review of the effects of armed conflict on heart disease risk. The review included 65 studies analysing 23 conflicts in low- and middle-income countries, including Syria, Lebanon, Bosnia, Croatia, Palestine, Colombia and Sudan. Outcomes included CVD and diabetes, and eight clinical and behavioural factors: blood pressure, blood glucose, lipids, tobacco, alcohol, body mass index (BMI), nutrition and physical activity.
Analysis of the data found some evidence that armed conflict is associated with an increased risk of coronary heart disease (CHD), cerebrovascular disease and endocrine disorders, in addition to increased blood pressure, lipids, alcohol and tobacco use. These associations were more consistent for mortality from chronic ischaemic heart disease or unspecified heart disease, systolic blood pressure and tobacco use.
There was no clear patterning by conflict type, length of follow-up and study quality, nor strong evidence for publication bias.
However, the authors point out that two-thirds of studies were of low quality, according to the Newcastle-Ottawa Scale (NOS).
The findings highlight a need for CVD screening in patients coming from areas of armed conflict and in post-conflict reconstruction efforts.