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Heartbeat: armed conflict and cardiovascular disease
  1. Catherine M Otto
  1. Division of Cardiology, University of Washington, Seattle, WA 98195, USA
  1. Correspondence to Professor Catherine M Otto, Division of Cardiology, University of Washington, Seattle, WA 98195, USA; cmotto{at}

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Armed conflict affects a substantial number of people worldwide and often interferes with efforts to prevent and treat cardiovascular disease (CVD). Jawad and colleagues1 performed a systematic review that included 66 studies of adult civilian populations from 23 conflicts. Armed conflict was associated with increased blood pressure, lipid levels, and alcohol and tobacco use (figure 1). There also was weak evidence for an association with increased coronary, cerebrovascular and endocrine diseases. The authors conclude that post-conflict reconstruction should include attention to preventative measures to reduce the risk of CVD-related morbidity and mortality.

Figure 1

Exposure to armed conflict and non-communicable disease risk—summary of results by broader-level outcomes. Bars for all studies (AS) and moderate-to-high quality studies (MHQS); n=number of studies. blue for increase with armed conflict, orange for decrease and yellow for no change.

Ansbro and Perel2 comment in an editorial that ‘This review and a recent review of diabetes care in humanitarian crises both highlight the impact of the increasing global burden of non-communicable diseases (NCDs) on crisis settings and support advocacy work to bring NCDs, including CVD and the excess crisis-associated risks, squarely onto the agendas of humanitarian and development agencies, funders and the research community.’ Main research priorities include rapid assessment tools, simple diagnostic tools and approaches, individual risk stratification, appropriate models of care, and ensuring availability and affordability of essential …

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