Acute myocardial infarction incidence in immigrants to Sweden. Country of birth, time since immigration, and time trends over 20 years

• Published in: European journal of epidemiology Vol. 22; no. 8; pp. 493 - 503
• Main Authors: Hedlund, Ebba, Lange, Anders, Hammar, Niklas
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer 01.08.2007; Springer Nature B.V
• Subjects: Adult; Aged; Biological and medical sciences; Cardiology. Vascular system; CARDIOVASCULAR DISEASE; Cardiovascular diseases; Case-Control Studies; Censuses; Congenital heart defects; Coronary artery disease; Coronary heart disease; Countries; Cross-Cultural Comparison; Death Certificates; Economics; Emigration and Immigration - statistics & numerical data; Epidemiology; Ethnicity; Female; General aspects; Heart; Heart attacks; Humans; Immigrants; Immigration; Incidence; Male; Medical sciences; Medicin och hälsovetenskap; Men; Middle Aged; Miscellaneous; Mortality; Myocardial infarction; Myocardial Infarction - epidemiology; Myocardial Infarction - ethnology; Noncitizens; Patient Discharge - statistics & numerical data; Population decline; Predisposing factors; Public health. Hygiene; Public health. Hygiene-occupational medicine; Registries - statistics & numerical data; Risk; Social Class; Socioeconomic Factors; Socioeconomics; Sweden - epidemiology; Time Factors; Urban Health; Sweden; Europe; Netherlands; Turkey; Asia; Sweden, Stockholm; Finland; Poland; Iraq; Syria; Human; Myocardial infarction; Ethnic origin; Immigrant; Countries; Public health,Migration,Ethnicity; Acute; Migration; Coronary heart disease,Epidemiology; Trend; Cardiovascular disease; Birth; Myocardial disease; Coronary heart disease; Epidemiology; Ethnic group; Incidence; Immigration; Public health
• ISSN: 0393-2990; 1573-7284
• DOI: 10.1007/s10654-007-9147-9

This study investigates incidence of first acute myocardial infarction (MI) among foreign born persons in Sweden using case control methods, taking into consideration country of birth, gender, socio-economic group and time since immigration and evaluates if the decreasing incidence of MI in Sweden during the study period was also present in immigrants. The study base consisted of persons 30–74 years of age in Stockholm County 1977–96. All incident cases of first acute MI in the study population were identified using registers of hospital discharges and deaths. Controls were selected randomly from the study base and the sampling fractions were known, enabling estimates of person time at risk. Foreign born subjects had a higher incidence of MI than subjects born in Sweden (men RR[Relative risk]=1,17; 95% CI 1,13–1,21; women RR = 1,15; 95% CI 1,09–1,21) after adjustment for calendar year, age and socio-economic group. An increased incidence was present primarily in subjects born in Finland, other Nordic countries, Poland, Turkey, Syria and South Asia in both genders, from the Netherlands among men and from Iraq among women and was still present after more than 20 years in Sweden. The incidence rate of MI 1977–96 among foreign born persons followed the general decline in the Swedish population. We conclude that foreign born persons in Sweden have an increased incidence of first MI which persists several years after immigration and is not explained by socio-economic differences. It is likely that this to an important extent has a background in factors in the country of origin.