Impact of incarceration on cardiovascular disease risk factors: a systematic review and meta-regression on weight and BMI change

Objective Cardiovascular disease is an underappreciated issue in prison medicine. Recent studies have revealed a higher prevalence of cardiovascular disease risk factors (CVDRFs) among individuals in prison, but the impact of incarceration on CVDRFs over time is not well understood. This review aime...

Full description

Saved in:
Bibliographic Details
Main Authors: Patrick Bodenmann, Constantin Bondolfi, Patrick Taffe, Aurélie Augsburger, Cécile Jaques, Mary Malebranche, Carole Clair
Format: Article
Language:English
Published: BMJ Publishing Group 2020-10-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/10/e039278.full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1846165898478485504
author Patrick Bodenmann
Constantin Bondolfi
Patrick Taffe
Aurélie Augsburger
Cécile Jaques
Mary Malebranche
Carole Clair
author_facet Patrick Bodenmann
Constantin Bondolfi
Patrick Taffe
Aurélie Augsburger
Cécile Jaques
Mary Malebranche
Carole Clair
author_sort Patrick Bodenmann
collection DOAJ
description Objective Cardiovascular disease is an underappreciated issue in prison medicine. Recent studies have revealed a higher prevalence of cardiovascular disease risk factors (CVDRFs) among individuals in prison, but the impact of incarceration on CVDRFs over time is not well understood. This review aimed to assess available literature and quantify the relationship between incarceration and trends in major CVDRFs in high-income countries.Design Systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Meta-regression on weight change and obesity.Data sources Medline, Embase, PubMed, Cochrane Central Wiley and Web of Science.Eligibility criteria for selecting studies Longitudinal studies reporting on the incidence of, or trends in any CVDRF among current or former people in prison over time, in high-income countries.Data extraction and synthesis Two authors independently screened articles for eligibility, extracted data and assessed quality using an adapted version of the Newcastle-Ottawa Scale. Trends in CVDRFs during and following incarceration were summarised and in those with sufficient data a meta-regression was performed.Results Twenty-six articles were identified. CVDRFs assessed included obesity, hypertension, diabetes, dyslipidaemia, tobacco use, physical inactivity and unhealthy diet. A meta-regression on change in weight during incarceration found a mean increase of 5.3 kg (95% CI 0.5 to 10.1) and change in body mass index of 1.8 kg/m2 (95% CI −0.9 to 4.6) at 2 years. Weight gain appeared most pronounced right after entering prison and then plateaued at 2 years. Concerning hypertension, the results were inconclusive, despite a trend towards rising blood pressure or prevalence of hypertension during incarceration, and an increased incidence of hypertension following incarceration. Results are contradictory or inconclusive for the other CVDRFs reviewed.Conclusion Possible explanations for the association between incarceration and weight include a sedentary lifestyle, unhealthy diet, forced smoking cessation, psychotropic medication use and high levels of stress. Incarceration may be an independent risk factor for cardiovascular disease.
format Article
id doaj-art-478ddedfb13b49e98584d46f93f417d4
institution Kabale University
issn 2044-6055
language English
publishDate 2020-10-01
publisher BMJ Publishing Group
record_format Article
series BMJ Open
spelling doaj-art-478ddedfb13b49e98584d46f93f417d42024-11-16T15:55:07ZengBMJ Publishing GroupBMJ Open2044-60552020-10-01101010.1136/bmjopen-2020-039278Impact of incarceration on cardiovascular disease risk factors: a systematic review and meta-regression on weight and BMI changePatrick Bodenmann0Constantin Bondolfi1Patrick Taffe2Aurélie Augsburger3Cécile Jaques4Mary Malebranche5Carole Clair6Department of Vulnerable Populations and Social Medicine, Center for Primary Care and Public Health (Unisanté), Lausanne, Vaud, SwitzerlandDepartment of Vulnerable Populations and Social Medicine, Center for Primary Care and Public Health (Unisanté), Lausanne, Vaud, SwitzerlandDivision of Biostatistics, Center for Primary Care and Public Health (Unisanté), Lausanne, Vaud, SwitzerlandDepartment of Ambulatory Care and Community Medicine, Center for Primary Care and Public Health (Unisanté), Lausanne, Vaud, SwitzerlandMedical Library, Lausanne University Hospital and University of Lausanne, Lausanne, SwitzerlandDepartment of Medicine, University of Calgary Faculty of Medicine, Calgary, Alberta, CanadaDepartment of Ambulatory Care, University of Lausanne, Lausanne, SwitzerlandObjective Cardiovascular disease is an underappreciated issue in prison medicine. Recent studies have revealed a higher prevalence of cardiovascular disease risk factors (CVDRFs) among individuals in prison, but the impact of incarceration on CVDRFs over time is not well understood. This review aimed to assess available literature and quantify the relationship between incarceration and trends in major CVDRFs in high-income countries.Design Systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Meta-regression on weight change and obesity.Data sources Medline, Embase, PubMed, Cochrane Central Wiley and Web of Science.Eligibility criteria for selecting studies Longitudinal studies reporting on the incidence of, or trends in any CVDRF among current or former people in prison over time, in high-income countries.Data extraction and synthesis Two authors independently screened articles for eligibility, extracted data and assessed quality using an adapted version of the Newcastle-Ottawa Scale. Trends in CVDRFs during and following incarceration were summarised and in those with sufficient data a meta-regression was performed.Results Twenty-six articles were identified. CVDRFs assessed included obesity, hypertension, diabetes, dyslipidaemia, tobacco use, physical inactivity and unhealthy diet. A meta-regression on change in weight during incarceration found a mean increase of 5.3 kg (95% CI 0.5 to 10.1) and change in body mass index of 1.8 kg/m2 (95% CI −0.9 to 4.6) at 2 years. Weight gain appeared most pronounced right after entering prison and then plateaued at 2 years. Concerning hypertension, the results were inconclusive, despite a trend towards rising blood pressure or prevalence of hypertension during incarceration, and an increased incidence of hypertension following incarceration. Results are contradictory or inconclusive for the other CVDRFs reviewed.Conclusion Possible explanations for the association between incarceration and weight include a sedentary lifestyle, unhealthy diet, forced smoking cessation, psychotropic medication use and high levels of stress. Incarceration may be an independent risk factor for cardiovascular disease.https://bmjopen.bmj.com/content/10/10/e039278.full
spellingShingle Patrick Bodenmann
Constantin Bondolfi
Patrick Taffe
Aurélie Augsburger
Cécile Jaques
Mary Malebranche
Carole Clair
Impact of incarceration on cardiovascular disease risk factors: a systematic review and meta-regression on weight and BMI change
BMJ Open
title Impact of incarceration on cardiovascular disease risk factors: a systematic review and meta-regression on weight and BMI change
title_full Impact of incarceration on cardiovascular disease risk factors: a systematic review and meta-regression on weight and BMI change
title_fullStr Impact of incarceration on cardiovascular disease risk factors: a systematic review and meta-regression on weight and BMI change
title_full_unstemmed Impact of incarceration on cardiovascular disease risk factors: a systematic review and meta-regression on weight and BMI change
title_short Impact of incarceration on cardiovascular disease risk factors: a systematic review and meta-regression on weight and BMI change
title_sort impact of incarceration on cardiovascular disease risk factors a systematic review and meta regression on weight and bmi change
url https://bmjopen.bmj.com/content/10/10/e039278.full
work_keys_str_mv AT patrickbodenmann impactofincarcerationoncardiovasculardiseaseriskfactorsasystematicreviewandmetaregressiononweightandbmichange
AT constantinbondolfi impactofincarcerationoncardiovasculardiseaseriskfactorsasystematicreviewandmetaregressiononweightandbmichange
AT patricktaffe impactofincarcerationoncardiovasculardiseaseriskfactorsasystematicreviewandmetaregressiononweightandbmichange
AT aurelieaugsburger impactofincarcerationoncardiovasculardiseaseriskfactorsasystematicreviewandmetaregressiononweightandbmichange
AT cecilejaques impactofincarcerationoncardiovasculardiseaseriskfactorsasystematicreviewandmetaregressiononweightandbmichange
AT marymalebranche impactofincarcerationoncardiovasculardiseaseriskfactorsasystematicreviewandmetaregressiononweightandbmichange
AT caroleclair impactofincarcerationoncardiovasculardiseaseriskfactorsasystematicreviewandmetaregressiononweightandbmichange