Supervisors info:
Θεοδώρα Ψαλτοπούλου, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Μαρία Γαβριατοπούλου, Επίκουρη Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Θεόδωρος Σεργεντάνης, Επίκουρος Καθηγητής, Τμήμα Πολιτικών Δημόσιας Υγείας, Πανεπιστήμιο Δυτικής Αττικής
Summary:
Background: Economic crises threaten public health worldwide and related to
cardiovascular morbidity and mortality. This systematic review investigates the association of factors contributing to cardiovascular health and to observe changes in the trends and the severity of the established CVD, among the general population living in countries exposed to financial crises.
Methods: Systematic search conducted in PubMed, EMBASE and Google Scholar
databases (end-of-search:May 12,2020). Studies examined the relationship between
economic crisis and cardiovascular health in 20 th and 21 st century. The quality of included studies was assessed using the Newcastle-Ottawa Quality scale and AHRQ standards.
Results: 44 eligible studies focused on impact of economic downturns on IHD,
hypertensive, cerebrovascular diseases, and HF;28 ecological studies, 10 cohort studies, 4
register-based studies and 2 cohort surveys included. Of those, 22(50%) were considered
as high, 20(45%) at moderate, and only 2(5%) at low risk of bias. Although there were
observed equivocal findings, there was some evidence that incidence of IHDs and
cerebrovascular diseases in women was increased after economic crisis; ACS, STEMI, or
NSTEMI occurs more often in men than in younger women, but after 75 years, this was
reversed. Regarding hypertension, women are more affected than men. Moreover, a
positive relationship found between HF and economic recessions.
Discussion: Stress, worklessness, low income, lifestyle and changes in SES, constitute
probably the main reasons why the cardiovascular health might deteriorate in times of
economic hardship. The CVDs associated with unemployment are mainly CHD and
hypertension. Additional quantitative analysis on CVDs and economic factors seems
desirable.
Keywords:
Economic crisis, Recession, Cardiovascular health, Heart diseases, Systematic review
