Religion, Spirituality and Risk of Coronary Heart Disease: A Matched Case–Control Study and Meta-Analysis

Although the association between religion/spirituality (R/S) and psychological outcomes is well established, current understanding of the association with cardiovascular disease remains limited. We sought to investigate the association between Islamic R/S and coronary heart disease (CHD), and place these findings in light of a meta-analysis. In this case–control study, 190 cases with non-fatal CHD were identified and individually matched with 383 hospital-based controls. R/S was measured by self-administered 102 items questionnaire. A tabular meta-analysis was performed of observational studies on R/S (high level versus low level) and CHD. In addition, a dose–response meta-analysis was conducted using generalized least-squares regression. Participants in the top quartile had decreased odds of CHD comparing to participants in the lowest quartile of religious belief (OR 0.20, 95 confidence interval (CI) 0.06–0.59), religious commitment (OR 0.36, CI 95 0.13–0.99), religious emotions (OR 0.39, CI 95 0.18–0.87), and total R/S score (OR 0.30, CI 95 0.13–0.67). The meta-analysis study showed a significant relative risk of 0.88 (CI 95 0.77–1.00) comparing individuals in high level versus low level of R/S. In dose–response meta-analysis, comparing people with no religious services attendance, the relative risks of CHD were 0.77 (CI 95 0.65–0.91) for one times attendance and 0.27 (CI 95 0.11–0.65) for five times attendance per month. R/S was associated with a significantly decreased risk of CHD. The possible causal nature of the observed associations warrants randomized clinical trial with large sample size. © 2018, Springer Science+Business Media, LLC, part of Springer Nature