A systematic review comparing cardiovascular disease among informal carers and non-carers.

Exposure to chronic stress increases the risk of cardiovascular disease (CVD). Providing informal care is known to be a stressful activity, but it is not clear whether informal caregiving is associated with CVD risk. This systematic review aimed to summarise and assess the quantitative evidence examining the association between providing informal care to others and CVD incidence in comparison with non-carers. Eligible articles were detected by searching six electronic literature databases (CINAHL, Embase, Global Health, OVID Medline, Scopus, and Web of Science). Two reviewers appraised 1887 abstracts and 34 full-text articles against a set of a priori eligibility criteria to identify articles for inclusion. Quality assessment of included studies was performed using the ROBINS-E risk of bias tool. Nine studies were identified that quantitatively assessed the association between providing informal care and CVD incidence in comparison to not providing informal care. Overall, there was no difference in the incidence of CVD between carers and non-carers across these studies. However, within the subgroup of studies that examined care provision intensity (hours/week) higher CVD incidence was observed for the most intense caregiving group compared to non-carers. One study examined only CVD-related mortality outcomes, observing a reduction in mortality for carers compared to non-carers. More research is required to explore the relationship between informal care and CVD incidence.