Cardiovascular risk and physical activity in Syrians living in England compared with the population of North West England: a cross-sectional study

Abstract

Objective: This study aims to assess the 10-year cardiovascular risk and physical activity among Syrians residing in England and compare them with the North West England population.

Design: Cross-sectional study.

Setting: Bilingual online questionnaire distributed through social media platforms from 21 June to 23 July 2023.

Participants: Syrian individuals in England (aged 25-69, migrated post-2010) and residents of North West England within the same age bracket. All participants had no history of cardiovascular disease (CVD).

Primary and secondary outcome measures: Primary outcome measures included differences in QRISK3 score, 10-year relative risk (RR), metabolic equivalent of task (MET) and self-reported physical activity between the two groups. Secondary outcome measures included subgroup analyses based on sex and age.

Results: Of the 273 eligible participants (137 in the Syrian group and 136 in the Northwest England group), the QRISK3 score was twofold higher in the Syrian group (2.20, 5.50) than in the North West England group (1.20, 3.15) (p=0.042). The 10-year RR was approximately three times higher in the Syrian group (p<0.001), while MET was about twice as high in the Northwest England group (p<0.001).

Conclusions: Despite relocating to England, Syrians face substantially elevated cardiovascular risks attributed to an unhealthy lifestyle, including smoking, reduced physical activity, increased body mass index and diabetes, coupled with a strong family history of CVD in first-degree relatives under the age of 60. The study underscores the need for early assessment, risk factor identification and tailored interventions for this population. Raising awareness, particularly in the context of smoking, and promoting physical activity are crucial for mitigating cardiovascular risks. The findings emphasise the importance of culturally sensitive interventions to address the unique health challenges of Syrians in the UK.

Keywords: Cardiovascular Disease; Cross-Sectional Studies; PUBLIC HEALTH; Risk Factors.

Figure 1

The flow chart of the study.

Figure 2

Smoking prevalence in the two groups.

Figure 3

Subgroup analysis based on age groups and sex. (A) The difference in relative risk (RR) between the two groups according to age groups. (B) The difference in the QRISK3 score between the two groups according to age groups. (C) The difference in MET between the two groups according to age groups. (D) The difference in truncated total activity between the two groups according to age groups. (E) The difference in RR between the two groups according to sex. (F) The difference in QRISK3 between the two groups according to sex. (G) The difference in MET between the two groups according to sex. (H) The difference in truncated total activity between the two groups according to sex. The differences were calculated using the Mann–Whitney U test, and statistically significant associations were lined (*: P value <0.05, **: P value <0.01, ***: P value <0.001, ns: not significant).