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

BMC Cardiovascular Disorders

Bo Hedblad²  Birgitta Essén¹  Gunnar Engström²  Yan Borné² 

[1] Department of Women's and Children's Health, International Maternal and Child Health (IMCH), Uppsala University, 751 85 Uppsala, Sweden;Department of Clinical Sciences, Cardiovascular Epidemiology, Skåne University Hospital, Lund University, 20502 Malmö, Sweden

关键词: epidemiology;    case-fatality;    cohort study;    risk factors;    heart failure;    Immigrant status;   

Others  :  1085183
DOI  :  10.1186/1471-2261-12-20

 received in 2011-12-07, accepted in 2012-03-26,  发布年份 2012

【 摘 要 】

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 Malmö 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.

【 授权许可】

   
2012 Borné et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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