Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Feb 10:12:200126.
doi: 10.1016/j.ijcrp.2022.200126. eCollection 2022 Mar.

Epidemiology of cardiovascular disease and its risk factors among refugees and asylum seekers: Systematic review and meta-analysis

Tala Al-Rousan  1 , Rawan AlHeresh  2 , Altaf Saadi  3 , Hannah El-Sabrout  4 , Megan Young  2 , Tarik Benmarhnia  5 , Benjamin H Han  6 , Laith Alshawabkeh  7
Affiliations

Epidemiology of cardiovascular disease and its risk factors among refugees and asylum seekers: Systematic review and meta-analysis

Tala Al-Rousan et al. Int J Cardiol Cardiovasc Risk Prev. .

Abstract

Background: This is the first systematic review and meta-analysis assessing cardiovascular disease incidence and risk factors among refugees and asylum seekers.

Methods and results: PubMed, PsycINFO, CINAHL, and Embase databases were searched for studies in English from January 1, 1977, to March 8, 2020. Inclusion criteria were (1) observation of refugee history in participants; (2) diagnosis of CVD (coronary artery disease, heart failure, stroke, or CVD mortality) and risk factors (hypertension, diabetes, tobacco use, hyperlipidemia, obesity, psychosocial factors); (3) assessment of effect size and spread, (4) adjustment for sex; and (5) comparison with non-refugee migrants or natives. Data were extracted and evaluated by multiple reviewers for study quality. Of the 1158 screened articles, Participants from 7 studies (0.6%) involving 116.989 refugees living in Denmark, Sweden, and the United States were included in the systematic review, of which three studies synthesized the quantitative analyses. A fixed-effects model was created to pool the effect sizes of included studies. The pooled incidence of CVD in refugees was 1.71 (95% CI: 1.03, 2.83) compared with non-refugee counterparts. Pyschosocial factors were associated with increased risk of CVD in refugees but evidence on CVD risk factors varied by nativity and duration since resettlement.

Conclusions: Refugee experience is an independent risk factor for CVD. Robust research on CVD in displaced populations is needed to improve the quality of evidence, clinical and preventive care, and address health equity in this marginalized population globally.

Keywords: CVD; Displaced; Migrants; Refugees; Risk factors; Stroke.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Relative Risk of Incidence of CVD in refugees compared to nonrefugees
Fig. 2
Fig. 2
PRISMA flow chart of study selection in systematic review and meta-analysis.
See this image and copyright information in PMC

References

    1. Refugees UNHC for Unhcr - refugee statistics. UNHCR. https://www.unhcr.org/refugee-statistics/
    1. Gostin L.O., Roberts A.E. Forced migration: the human face of a health crisis. JAMA. 2015;314(20):2125–2126. doi: 10.1001/jama.2015.14906. - DOI - PubMed
    1. Hossain A., Baten R.B.A., Sultana Z.Z., et al. Predisplacement abuse and postdisplacement factors associated with mental health symptoms after forced migration among Rohingya refugees in Bangladesh. JAMA Netw. Open. 2021;4(3) doi: 10.1001/jamanetworkopen.2021.1801. - DOI - PMC - PubMed
    1. Weir H.K., Anderson R.N., Coleman King S.M., et al. Heart disease and cancer deaths - trends and projections in the United States, 1969-2020. Prev. Chronic Dis. 2016;13 doi: 10.5888/pcd13.160211. E157-E157. - DOI - PMC - PubMed
    1. Collaborators GBD 2013 M and C of D. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet (London, England) 2015;385(9963):117–171. doi: 10.1016/S0140-6736(14)61682-2. - DOI - PMC - PubMed

LinkOut - more resources