Trends in Cardiovascular Disease Risk and Outcomes Among Asian Communities Post-COVID-19 Pandemic: A Systematic Review and Meta-Analysis

Authors

  • Lisy Augustin MAHER, CHENNAI

DOI:

https://doi.org/10.29082/IJNMS/2026/Vol10/Iss1/811

Keywords:

Cardiovascular

Abstract

Abstract

Background: The COVID-19 pandemic has significantly impacted cardiovascular health, particularly in Asian populations. These communities already experience high rates of cardiovascular diseases (CVD), exacerbated by various socio-economic, lifestyle, and genetic factors.  This systematic review and meta-analysis aimed to evaluate the impact of the COVID-19 pandemic on cardiovascular disease risks and outcomes in Asian populations.

Methods: Studies published between 2020 and 2025 were included, focusing on adults (≥18 years) from Asian countries. A random-effects model was employed to pool effect sizes, and heterogeneity was assessed using the I² statistic. Risk of bias was evaluated using the Newcastle-Ottawa Scale. Subgroup analyses were conducted based on geographic region, pre-existing comorbidities, and study design.

Results: The pooled odds ratio (OR) for increased cardiovascular risk post-COVID-19 was 3.59 (95% CI: 3.58–3.61), indicating a significant rise in risk. Individuals with pre-existing comorbidities, especially DM and HTN, faced a higher risk of severe outcomes. DM alone increased mortality risk by 69%, and when combined with cardiovascular disease, the risk was even higher (OR = 6.98).

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Author Biography

  • Lisy Augustin, MAHER, CHENNAI

    Assistant  professor, Medical and Surgical Nursing

References

REFERENCES

1.Hage FG, AlJaroudi W. Cardiovascular disease in the literature: A selection of recent original research papers. J Nucl Cardiol. 2017 May 25;24(4):1127. doi: 10.1007/s12350-017-0927-7

2.Shoaib M, Sayed N, Shah B, Hussain T, AlZubi AA, AlZubi SA, et al. Exploring transfer learning in chest radiographic images within the interplay between COVID-19 and DM. Front Public Health. 2023 Oct 18;11. doi: 10.3389/fpubh.2023.1297909

3.He F, Page JH, Tandi J, Ghosh A, Liman C, Sarkar J, et al. Major adverse cardiovascular event risk prediction in Asian patients after myocardial infarction: A novel, dynamic, machine-learning approach. J Asian Pac Soc Cardiol. 2023 Jul 4;2. doi: 10.15420/japsc.2022.26

4.Prabhakaran D, Jeemon P, Ghosh S, Shivashankar R, Ajay VS, Kondal D, et al. Prevalence and incidence of HTN: Results from a representative cohort of over 16,000 adults in three cities of South Asia. 2017.

5.Agarwala A, Satish P, Rifai MA, Mehta A, Cainzos‐Achirica M, Shah NS, et al. Identification and management of atherosclerotic cardiovascular disease risk in South Asian populations in the U.S. JACC Adv. 2023 Mar 1;2(2):100258. doi: 10.1016/j.jacadv.2023.100258

6.Shah K, Patel J, Rifai MA, Agarwala A, Bhatt AB, Levitzky YS, et al. Cardiovascular risk management in the South Asian patient: A review. Health Sci Rev. 2022 Aug 3;4:100045. doi: 10.1016/j.hsr.2022.100045

7.Nammi JY, Pasala R, Kotaru S, Bandikolla SS, Andhe N, Gouravaram PR. Cardiovascular disease prevalence in Asians versus Americans: A review of genetics, diet, and the call for enhanced prevention and screening. Cureus. 2024 Apr 16. doi: 10.7759/cureus.58361

8.McAlister FA, Parikh H, Lee DS, Wijeysundera HC. Healthcare implications of the COVID-19 pandemic for the cardiovascular practitioner. Can J Cardiol. 2022 Dec 5;39(6):716. doi: 10.1016/j.cjca.2022.11.014

9.Patel J. South Asian cardiovascular disease: Dispelling stereotypes and disparity. Am J Prev Cardiol. 2021 May 6;7:100189. doi: 10.1016/j.ajpc.2021.100189

10.Dod R, Rajendran A, Kathrotia M, Clarke A, Dodani S. Cardiovascular disease in South Asian immigrants: A review of dysfunctional HDL as a potential marker. J Racial Ethn Health Disparities. 2022 Apr 21;10(3):1194. doi: 10.1007/s40615-022-01306-6

11.Rohatgi A, Anand SS, Gadgil M, Gujral UP, Jain SS, Javed Z, et al. South Asians and cardiometabolic health: A framework for comprehensive care for the individual, community, and population - An American Society for Preventive Cardiology clinical practice statement. Am J Prev Cardiol. 2025 Apr 1;101000. doi: 10.1016/j.ajpc.2025.101000

12.Gami A, Bhattacharya R, Natarajan P, Patel J. Genetic drivers of cardiovascular risk among South Asian adults. Curr Cardiovasc Risk Rep. 2024 Aug 15;18(10):125. doi: 10.1007/s12170-024-00741-w

13.Gupta K, Baloch F, Kakar TS, Agarwal H, Rawlley B, Khan UI, et al. The pandemic of coronary heart disease in South Asia: What clinicians need to know. Curr Atheroscler Rep. 2023 May 26;25(7):359. doi: 10.1007/s11883-023-01110-5

14.Palaniappan L, Garg A, Enas E, Lewis H, Bari S, Gulati M, et al. South Asian cardiovascular disease & cancer risk: Genetics & pathophysiology. J Community Health. 2018 Jun 12;43(6):1100. doi: 10.1007/s10900-018-0527-8

15.Makshood M, Post WS, Kanaya AM. Lipids in South Asians: Epidemiology and management. Curr Cardiovasc Risk Rep. 2019 Jul 11;13(8). doi: 10.1007/s12170-019-0618-9

16.Srinivasan N, Gullapalli N, Shah K. Highlighting the South Asian heart failure epidemic. Card Fail Rev. 2024 Jul 16;10. doi: 10.15420/cfr.2023.21

17.Islam SMS, Talukder A, Awal MdA, Siddiqui MdMU, Ahamad MdM, Ahammed B, et al. Machine learning approaches for predicting hypertension and its associated factors using population-level data from three South Asian countries. Front Cardiovasc Med. 2022 Mar 31;9. doi: 10.3389/fcvm.2022.839379

18.Min LY, Islam RB, Gandrakota N, Shah M. The social determinants of health associated with cardiometabolic diseases among Asian American subgroups: A systematic review. BMC Health Serv Res. 2022 Feb 25;22(1). doi: 10.1186/s12913-022-07646-7

19.Jiang Z, Zhou Q, Shu H, Jiang L. Impact of COVID-19 on physical activity patterns in non-professional populations in Asia: A mini review of pre-, during, and post-pandemic periods. Front Public Health. 2025 Jul 15;13. doi: 10.3389/fpubh.2025.1604185

20.Luo Y, Liu J, Zeng J, Pan H. Global burden of cardiovascular diseases attributed to low physical activity: An analysis of 204 countries and territories between 1990 and 2019. Am J Prev Cardiol. 2024 Feb 5;17:100633. doi: 10.1016/j.ajpc.2024.100633

21.Netala VR, Teertam SK, Li H, Zhang Z. A comprehensive review of cardiovascular disease management: Cardiac biomarkers, imaging modalities, pharmacotherapy, surgical interventions, and herbal remedies. Cells. 2024 Sep 1;13(17):1471. doi: 10.3390/cells13171471

22.Tan SCW, Zheng B, Tang M, Chu H, Zhao YT, Weng C. Global burden of cardiovascular diseases and its risk factors, 1990-2021: A systematic analysis for the Global Burden of Disease Study 2021. QJM. 2025 Jan 23. doi: 10.1093/qjmed/hcaf022

23.Shams P, Hussain M, Karani S, Mahmood S, Hasan A, Siddiqi S, et al. Can sound public health policies stem the tide of burgeoning epidemic of cardiovascular disease in South Asians? Curr Cardiol Rep. 2021 Oct 23;23(12). doi: 10.1007/s11886-021-01612-1

24.Rehman H, Samad Z, Mishra SR, Merchant AT, Narula JP, Mishra S, et al. Epidemiologic studies targeting primary cardiovascular disease prevention in South Asia. Indian Heart J. 2018 Jan 30;70(5):721. doi: 10.1016/j.ihj.2018.01.029

25.Rahut DB, Mishra R, Sonobe T, Timilsina RR. Prevalence of prehypertension and hypertension among adults in South Asia: A multinomial logit model. Front Public Health. 2023 Jan 27;10. doi: 10.3389/fpubh.2022.1006457

26.Stark BA, DeCleene NK, Desai EC, Hsu JM, Johnson CO, Castor LL, et al. Global, regional, and national burden of cardiovascular diseases and risk factors in 204 countries and territories, 1990-2023. J Am Coll Cardiol. 2025 Sep 25;86(22):2167. doi: 10.1016/j.jacc.2025.08.015

27.Zhang R, Fan S, Zhu C, Chen S, Tian F, Huang P, et al. Global trends and patterns in cardiovascular disease burden attributable to low physical activity: A systematic analysis for Global Burden of Disease Study from 1990 to 2021. PLoS ONE. 2025 May 7;20(5). doi: 10.1371/journal.pone.0323374

28.Wang W, Hu M, Liu H, Zhang X, Li H, Zhou F, et al. Global burden of disease study 2019 suggests that metabolic risk factors are the leading drivers of the burden of ischemic heart disease. Cell Metab. 2021 Sep 2;33(10):1943. doi: 10.1016/j.cmet.2021.08.005

29.Hu T, Yang X, Du Y, Zhao Y, Chen L, Sun NX, et al. Trends in the global, regional, and national burden of cardiovascular diseases attributed to high systolic blood pressure from 1990 to 2021 and projections to 2045: A systematic analysis based on GBD 2021 data. BMC Cardiovasc Disord. 2025 May 21;25(1). doi: 10.1186/s12872-025-04807-4

30.Goh RSJ, Chong B, Jayabaskaran J, Jauhari SM, Chan SP, Kueh MTW, et al. The burden of cardiovascular disease in Asia from 2025 to 2050: A forecast analysis for East Asia, South Asia, South-East Asia, Central Asia, and high-income Asia Pacific regions. Lancet Reg Health West Pac. 2024 Jul 10;49:101138. doi: 10.1016/j.lanwpc.2024.101138

31.Chaturvedi A, Zhu A, Gadela NV, Prabhakaran D, Jafar TH. Social determinants of health and disparities in hypertension and cardiovascular diseases. Hypertension. 2023 Dec 28;81(3):387. doi: 10.1161/hypertensionaha.123.21354

32.Wang Y, Wang X, Wang C, Zhou J. Global, regional, and national burden of cardiovascular disease, 1990-2021: Results from the 2021 Global Burden of Disease Study. Cureus. 2024 Nov 24;16(11). doi: 10.7759/cureus.74333

33.Goh LH, Chong B, Lubbe SCC van der, Jayabaskaran J, Nagarajan S, Chia J, et al. The epidemiology and burden of cardiovascular diseases in countries of the Association of Southeast Asian Nations (ASEAN), 1990–2021: Findings from the Global Burden of Disease Study 2021. Lancet Public Health. 2025 May 27;10(6). doi: 10.1016/s2468-2667(25)00087-8

34.Ni Z, Atluri N, Shaw RJ, Tan J, Khan K, Merk H, et al. Evaluating the feasibility and acceptability of a mobile health–based female community health volunteer program for hypertension control in rural Nepal: Cross-sectional study. JMIR Mhealth Uhealth. 2019 Dec 17;8(3). doi: 10.2196/15419

35.Shariff RER, Jiang H, Yap J, Tan SY, Cuenza L, Dwiputra B, et al. Overview of the burden and challenges of hypertension in Asia-Pacific. J Asian Pac Soc Cardiol. 2024 Dec 23;3. doi: 10.15420/japsc.2024.35

36.Wu X, Sha J, Yin Q, Gu Y, He X. Global burden of hypertensive heart disease and attributable risk factors, 1990–2021: Insights from the Global Burden of Disease Study 2021. Sci Rep. 2025 Apr 26;15(1). doi: 10.1038/s41598-025-99358-1

37.Sukonthasarn A, Borghi C, Chan YH, Cheng F, Choi HI, Mehta R, et al. East meets West: Bringing the ESH 2023 hypertension guidelines into Asia. Eur J Intern Med. 2024 Jul 2;127:25. doi: 10.1016/j.ejim.2024.06.026

38.Rahman A, Magno JDA, Cai J, Han M, Lee H, Nair T, et al. Management of hypertension in the Asia-Pacific region: A structured review. Am J Cardiovasc Drugs. 2024 Feb 8;24(2):141. doi: 10.1007/s40256-023-00625-1

39.Abba MS, Nduka C, Anjorin S, Mohamed SF, Agogo E, Uthman OA. Influence of contextual socioeconomic position on hypertension risk in low- and middle-income countries: Disentangling context from composition. BMC Public Health. 2021 Dec 1;21(1). doi: 10.1186/s12889-021-12238-x

40.Metlock F, Hinneh T, Benjasirisan C, Alharthi A, Ogungbe O, Turkson-Ocran R, et al. Impact of social determinants of health on hypertension outcomes: A systematic review. Hypertension. 2024 Jun 18;81(8):1675. doi: 10.1161/hypertensionaha.123.22571

41.Sevillano L, Bacong AM, Maglalang DD. Explaining the variance in cardiovascular health indicators among Asian Americans: A comparison of demographic, socioeconomic, and ethnicity. medRxiv. 2024 Aug 1. doi: 10.1101/2024.07.30.24311252

42.Chowdhury MAB, Uddin MJ, Haque MR, Ibrahimou B. Hypertension among adults in Bangladesh: Evidence from a national cross-sectional survey. BMC Cardiovasc Disord. 2016 Jan 25;16(1). doi: 10.1186/s12872-016-0197-3

43.Zhang M, Xia X, Wang Q, Pan Y, Zhang GY, Wang Z. Application of machine learning algorithms in predicting new onset hypertension: A study based on the China Health and Nutrition Survey. Environ Health Prev Med. 2025 Jan 1;30:3. doi: 10.1265/ehpm.24-00270

44.Kario K, Okura A, Hoshide S, Mogi M. The WHO global report 2023 on hypertension warning the emerging hypertension burden in the globe and its treatment strategy. Hypertens Res. 2024 Mar 5;47(5):1099. doi: 10.1038/s41440-024-01622-w

45.Kang H, Wang J, Cho EJ, Kim H, Lee CJ, Park JH, et al. Addressing cardiovascular diseases challenges in South Korea: Strategies to improve outcomes. Korean Circ J. 2025 Jan 1;55(7):557. doi: 10.4070/kcj.2024.0385

46.Roth GA, Mensah GA, Johnson CO, Addolorato G, Ammirati E, Baddour LM, et al. Global burden of cardiovascular diseases and risk factors, 1990–2019. J Am Coll Cardiol. 2020 Dec 1;76(25):2982. doi: 10.1016/j.jacc.2020.11.010

47.Mishra SR, Satheesh G, Khanal V, Nguyen TN, Picone DS, Chapman N, et al. Closing the gap in global disparities in hypertension control. Hypertension. 2025 Feb 19;82(3):407. doi: 10.1161/hypertensionaha.124.24137

48.Goorani S, Zangene S, Imig JD. Hypertension: A continuing public healthcare issue. Int J Mol Sci. 2024 Dec 26;26(1):123. doi: 10.3390/ijms26010123

49.Lamloum D, Fassio F, Osetinsky B, Tediosi F. Care cascades for hypertension in low-income settings: A systematic review and meta-analysis. Int J Public Health. 2023 Oct 12;68. doi: 10.3389/ijph.2023.1606428

50.Marques‐Vidal P. High blood pressure puts a high pressure in low- and middle-income countries. Eur J Prev Cardiol. 2022;30:916. doi: 10.1093/eurjpc/zwac207

51.Deeb J, Al-Jabri A, Al-Marzooqi A, Alowais S, Alsaqaf S, Al Marzooqi H, et al. Clinical characteristics and predictors of mortality in patients with COVID-19 in Abu Dhabi, United Arab Emirates: A single-center study. Infect Dis Ther. 2021;10(1):475-88.

52.Sharif A, Chowdhury MA, Nasrin R, Akter S, Hasan M, Islam M, et al. Clinical characteristics and outcomes of COVID-19 patients with and without pre-existing cardiovascular diseases and diabetes: A retrospective cohort study in Bangladesh. Cardiovasc Diabetol. 2021;20(1):60.

53.Islam MA, Rahman MS, Barna SD, Konika TR, Khan ZT, Debnath R, et al. Risk factors for mortality among COVID-19 patients in Bangladesh: A retrospective cohort study. PLOS ONE. 2020;15(11):e0242211.

54.Mohandas M, Anitha T, Shobha U. Predictors of mortality in patients hospitalized with COVID-19 in a tertiary care center in South India. J Public Health Res. 2021;10(2):2035.

55.Alamdari A, Kakaei G, Rabbani K, Farhadi A, Gholamali S. Mortality rate and its predictors in COVID-19 patients admitted to a referral center in Tehran, Iran. Arch Iran Med. 2020;23(7):450-4.

56.Baqi N, Rizvi SA, Hashmi SM, Naqvi SA, Irfanullah. Clinical characteristics and outcomes of hospitalized COVID-19 patients in Karachi, Pakistan. J Infect Dev Ctries. 2021;15(1):79-85.

57.Moftakhar R, Karimi A, Shahriarirad R, Vahid F, Rahimi Z, Hajikhani B, et al. Epidemiological and clinical characteristics and prognostic factors for COVID-19 mortality in Southwestern Iran: A retrospective cohort study. BMC Infect Dis. 2021;21(1):401.

58.Nikpouraghdam M, Esmaeili S, Rahnama M, Amini P, Rahmatizadeh S, Esmaeili S, et al. Clinical characteristics and outcomes of 2,968 patients with COVID-19 in Iran. BMC Infect Dis. 2020;20(1):861.

59.Priya M, Selvaraj T, Kannan S, Shanmughavelu V, Nambirajan P. Risk factors associated with mortality in hospitalized COVID-19 patients in Madurai, Southern India: A cross-sectional study. J Family Med Prim Care. 2021;10(3):1219-24.

60.Rashidi F, Barco S, Kamangard F, Heresi GA, Emadi A, Kaymaz C, et al. Incidence of symptomatic venous thromboembolism following hospitalization for coronavirus disease 2019: Prospective results from a multi-center study. Thromb Res. 2021;198:135-8.

61.Surendra H, Elyazar IRF, Djaafara BA, Ekawati LL, Saraswati K, Adrian V, et al. Clinical characteristics and mortality associated with COVID-19 in Jakarta, Indonesia: A hospital-based retrospective cohort study. Lancet Reg Health West Pac. 2021;9:100108.

62.Yu X, Sun X, Cui P, Pan H, Lin S, Han R, et al. Epidemiological and clinical characteristics of 333 confirmed cases with coronavirus disease 2019 in Shanghai, China. Transbound Emerg Dis. 2020;67(4):1697-707.

63.Kim E, Kim YC, Park JY, Jung J, Lee JP, Kim H. Evaluation of the Prognosis of COVID-19 Patients According to the Presence of Underlying Diseases and Drug Treatment. Int J Environ Res Public Health. 2021;18(10):5342.

64.Du H, Pan X, Liu N, Chen J, Chen X, Werring DJ, et al. The effect of vascular risk factor burden on the severity of COVID-19 illness, a retrospective cohort study. Respir Res. 2020;21(1):241.

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Published

2026-05-08

How to Cite

Trends in Cardiovascular Disease Risk and Outcomes Among Asian Communities Post-COVID-19 Pandemic: A Systematic Review and Meta-Analysis. (2026). International Journal of Nursing and Midwifery Science (IJNMS), 10(1), 79-95. https://doi.org/10.29082/IJNMS/2026/Vol10/Iss1/811

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