Department of Clinical Sciences, Cardiovascular Epidemiology, Skane University Hospital, Lund University, CRC, house 60, level 13, 20502 Malmö, Sweden.
Eur J Epidemiol. 2011 Apr;26(4):275-83. doi: 10.1007/s10654-010-9536-3. Epub 2010 Dec 24.
To explore the relation between country of birth and risk of hospitalization due to heart failure (HF). All 40-89 year-old inhabitants in the city of Malmö, Sweden (n = 114,917, of whom 15.2% were born outside Sweden) were followed from November 1st, 1990 until December 31st, 2007. During a mean follow-up of 13.5 ± 5.3 years, a total of 7,640 individuals (47.4% men) were discharged from hospital with first-ever HF as primary diagnosis. Of them, 1,243 individuals had myocardial infarction (MI) before or concurrent with the HF hospitalization. The risk of HF was compared between immigrants from selected countries and Swedish natives. The overall analysis showed substantial differences among immigrant groups (P < 0.001). Compared to Swedish natives, significantly increased HF risk was found among immigrants from Finland (HR (hazard ratio): 1.40; 95% CI, 1.10-1.81), Former Yugoslavia (1.45: 1.23-1.72) and Hungary (1.48: 1.16-1.89), taking age, sex, marital status, annual income and housing condition into account. Analysis results were similar when cases with MI before or concurrent with the HF hospitalization were included in the analysis. In general, the risk of HF was significantly higher among immigrants from high-income and middle-income countries. Marital status, annual income and housing condition were also significant independent risk factors for HF in this population. There are substantial differences in risk of hospitalization due to HF among immigrants from different countries that can not be explained by socioeconomic factors. To what extent these differences could be explained by biological risk factors remains to be explored.
探讨出生地与心力衰竭（HF）住院风险的关系。
在瑞典马尔默市，对所有 40-89 岁的居民（n=114917，其中 15.2%出生在瑞典境外）进行随访，随访时间从 1990 年 11 月 1 日至 2007 年 12 月 31 日。在平均 13.5±5.3 年的随访期间，共有 7640 名（47.4%为男性）患者因首次 HF 作为主要诊断被收治入院。其中 1243 名患者在 HF 住院前或同时发生心肌梗死（MI）。将移民与瑞典本地人进行比较，分析 HF 发病风险。
总体分析显示移民群体之间存在显著差异（P<0.001）。与瑞典本地人相比，芬兰（HR：1.40；95%CI：1.10-1.81）、前南斯拉夫（1.45：1.23-1.72）和匈牙利（1.48：1.16-1.89）移民 HF 发病风险显著增加，调整年龄、性别、婚姻状况、年收入和住房条件后差异仍有统计学意义。将 HF 住院前或同时发生 MI 的病例纳入分析，结果相似。总体而言，高收入和中等收入国家移民 HF 发病风险显著较高。婚姻状况、年收入和住房条件也是该人群 HF 的独立危险因素。不同国家移民 HF 住院风险存在显著差异，不能用社会经济因素来解释。这些差异在多大程度上可以用生物学危险因素来解释仍有待探讨。
