OBJECTIVE: Traumatic brain injury (TBI) is recognized as a chronic health condition. The primary objective was to investigate the association between TBI and cardiovascular disease (CVD).
SETTING: Ovid MEDLINE, Ovid MEDLINE Epub Ahead of Print and In-Process, In-Data-Review and Other Non-Indexed Citations, Ovid Embase, Ovid APA PsycInfo, and the Cochrane Library were systematically searched until June 5, 2025.
DESIGN: Observational studies that compared diagnoses of CVD, including atherosclerosis, coronary artery disease (CAD), heart failure, cardiomyopathy, arrhythmias, myocardial infarction, hypertension, hyperlipidemia, and cardiac death, between adults with and without TBI were included. Studies that focused on preinjury CVD and conditions, case reports, case series, letters, editorials, conference abstracts, reviews, and interventional studies were excluded. Study quality was evaluated using the National Institutes of Health quality assessment tool. DerSimonian-Laird random-effects meta-analyses were performed.
MAIN MEASURES: The outcomes of interest were presence of any CVD, including atherosclerosis, CAD, heart failure, cardiomyopathy, arrhythmias, myocardial infarction, hypertension, hyperlipidemia, and cardiac death.
RESULTS: This systematic review included 21 studies, with 18 studies involving 3,954,962 participants included in the meta-analysis. Two studies were rated as poor quality, with the rest fair to good. Individuals with TBI had higher odds of any CVD (odds ratio [OR] 1.78, 95% confidence interval [CI] 1.39-2.29), CAD (OR 1.40, 95% CI 1.20-1.63), arrhythmia (OR 1.42, 95% CI 1.12-1.80), cardiac death (risk ratio [RR] 3.07, 95% CI 2.17-3.98), hypertension (OR 1.42, 95% CI 1.07-1.90), and hyperlipidemia (OR 1.86, 95% CI 1.25-2.77) in unadjusted analysis. No association was found with heart failure (OR 1.16, 95% CI 0.96-1.39). The adjusted analysis was consistent with unadjusted findings for CAD, cardiac death, hypertension, and heart failure.
CONCLUSION: Individuals with TBI have higher odds of CVD, hypertension, hyperlipidemia, CAD, arrhythmia, and cardiovascular death than the general population, highlighting the need for clinical screening, prevention, and management strategies after TBI.