The health burden of incarceration: cardiovascular risk in a Nigerian prison population.

Abstract

Purpose: Evidence regarding non-communicable diseases and cardiovascular disease (CVD) risks among people living in prison (PLP) in low- and middle-income countries is limited, particularly regarding multi-matrix electrolyte homeostasis. This study compared anthropometric indices, lipid profiles, and electrolyte balances between PLP and non-incarcerated controls in Nigeria.

Design/methodology/approach: The authors enrolled 180 adult participants from Abeokuta, Nigeria: 90 PLP (40 women, 50 men) from Ibara Correctional Facility, Abeokuta, and 90 local community controls. Anthropometric indices, hemodynamic parameters and 10-year CVD risks (QRISK®3) were evaluated. Electrolytes (sodium, potassium, calcium, magnesium) and lipid profiles were quantified across plasma, erythrocytes (RBC) and urine matrices. Data were analysed using two-way ANOVA.

Findings: Incarceration status was significantly associated with higher waist circumference, body mass index, systolic/diastolic blood pressure and 10-year CVD risk (p < 0.01) across both sexes. Compared with community controls, incarcerated participants also demonstrated altered electrolytes distributions across plasma, RBC and urine; plasma sodium and potassium were significantly elevated (p < 0.001) alongside depletion of intracellular RBC potassium reserves (p < 0.001). Lipid profiling revealed an atherogenic state in the incarcerated cohorts, characterized by significant elevations in plasma cholesterol, triglycerides and LDL-VLDL fractions, paired with lower HDL cholesterol (p < 0.001). Significant status-by-sex interactions unmasked sex-specific topological fat distribution and electrolyte variations under institutional stress.

Originality/value: Incarceration was associated with less favourable cardiometabolic profiles, altered electrolyte homeostasis and a more atherogenic lipid profile. These findings support the need for routine nutritional interventions, electrolyte monitoring and targeted preventive CVD screening programs within correctional facilities.