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Immigrant status and increased risk of heart failure: the role of hypertension and life-style risk factors

Borné, Yan LU ; Engström, Gunnar LU ; Essen, Birgitta and Hedblad, Bo LU (2012) In BMC Cardiovascular Disorders 12(20).
Abstract
Background: Studies from Sweden have reported association between immigrant status and incidence of cardiovascular diseases. The nature of this relationship is unclear. We investigated the relationship between immigrant status and risk of heart failure (HF) hospitalization in a population-based cohort, and to what extent this is mediated by hypertension and life-style risk factors. We also explored whether immigrant status was related to case-fatality after HF. Methods: 26,559 subjects without history of myocardial infarction (MI), stroke or HF from the community-based Malmo Diet and Cancer (MDC) cohort underwent a baseline examination during 1991-1996. Incidence of HF hospitalizations was monitored during a mean follow-up of 15 years.... (More)
Background: Studies from Sweden have reported association between immigrant status and incidence of cardiovascular diseases. The nature of this relationship is unclear. We investigated the relationship between immigrant status and risk of heart failure (HF) hospitalization in a population-based cohort, and to what extent this is mediated by hypertension and life-style risk factors. We also explored whether immigrant status was related to case-fatality after HF. Methods: 26,559 subjects without history of myocardial infarction (MI), stroke or HF from the community-based Malmo Diet and Cancer (MDC) cohort underwent a baseline examination during 1991-1996. Incidence of HF hospitalizations was monitored during a mean follow-up of 15 years. Results: 3,129 (11.8%) subjects were born outside Sweden. During follow-up, 764 subjects were hospitalized with HF as primary diagnosis, of whom 166 had an MI before or concurrent with the HF. After adjustment for potential confounding factors, the hazard ratios (HR) for foreign-born were 1.37 (95% CI: 1.08-1.73, p = 0.009) compared to native Swedes, for HF without previous MI. The results were similar in a secondary analysis without censoring at incident MI. There was a significant interaction (p < 0.001) between immigrant status and waist circumference (WC), and the increased HF risk was limited to immigrants with high WC. Although not significant foreign-born tended to have lower one-month and one-year mortality after HF. Conclusions: Immigrant status was associated with long-term risk of HF hospitalization, independently of hypertension and several life-style risk factors. A significant interaction between WC and immigrant status on incident HF was observed. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Immigrant status, heart failure, risk factors, cohort study, case, fatality, epidemiology
in
BMC Cardiovascular Disorders
volume
12
issue
20
publisher
BioMed Central
external identifiers
  • wos:000302898300001
  • scopus:84858738095
ISSN
1471-2261
DOI
10.1186/1471-2261-12-20
language
English
LU publication?
yes
id
d74936a2-bd1a-47d8-bd15-ef9fe518fbb4 (old id 2571160)
date added to LUP
2012-06-01 08:54:28
date last changed
2017-10-08 04:03:49
@article{d74936a2-bd1a-47d8-bd15-ef9fe518fbb4,
  abstract     = {Background: Studies from Sweden have reported association between immigrant status and incidence of cardiovascular diseases. The nature of this relationship is unclear. We investigated the relationship between immigrant status and risk of heart failure (HF) hospitalization in a population-based cohort, and to what extent this is mediated by hypertension and life-style risk factors. We also explored whether immigrant status was related to case-fatality after HF. Methods: 26,559 subjects without history of myocardial infarction (MI), stroke or HF from the community-based Malmo Diet and Cancer (MDC) cohort underwent a baseline examination during 1991-1996. Incidence of HF hospitalizations was monitored during a mean follow-up of 15 years. Results: 3,129 (11.8%) subjects were born outside Sweden. During follow-up, 764 subjects were hospitalized with HF as primary diagnosis, of whom 166 had an MI before or concurrent with the HF. After adjustment for potential confounding factors, the hazard ratios (HR) for foreign-born were 1.37 (95% CI: 1.08-1.73, p = 0.009) compared to native Swedes, for HF without previous MI. The results were similar in a secondary analysis without censoring at incident MI. There was a significant interaction (p &lt; 0.001) between immigrant status and waist circumference (WC), and the increased HF risk was limited to immigrants with high WC. Although not significant foreign-born tended to have lower one-month and one-year mortality after HF. Conclusions: Immigrant status was associated with long-term risk of HF hospitalization, independently of hypertension and several life-style risk factors. A significant interaction between WC and immigrant status on incident HF was observed.},
  author       = {Borné, Yan and Engström, Gunnar and Essen, Birgitta and Hedblad, Bo},
  issn         = {1471-2261},
  keyword      = {Immigrant status,heart failure,risk factors,cohort study,case,fatality,epidemiology},
  language     = {eng},
  number       = {20},
  publisher    = {BioMed Central},
  series       = {BMC Cardiovascular Disorders},
  title        = {Immigrant status and increased risk of heart failure: the role of hypertension and life-style risk factors},
  url          = {http://dx.doi.org/10.1186/1471-2261-12-20},
  volume       = {12},
  year         = {2012},
}