Tu Jack V, Chu Anna, Rezai Mohammad R, Guo Helen, Maclagan Laura C, Austin Peter C, Booth Gillian L, Manuel Douglas G, Chiu Maria, Ko Dennis T, Lee Douglas S, Shah Baiju R, Donovan Linda R, Sohail Qazi Zain, Alter David A
Institute for Clinical Evaluative Sciences; Schulich Heart Centre, Sunnybrook Health Sciences Centre; University of Toronto, Toronto, Ontario, Canada
Institute for Clinical Evaluative Sciences & University of Toronto, Toronto, Ontario, Canada.
Circulation. 2015 Oct 20;132(16):1549–1559. doi: 10.1161/CIRCULATIONAHA.115.015345. Epub 2015 Aug 31.
Immigrants from ethnic minority groups represent an increasing proportion of the population in many high-income countries but little is known about the causes and amount of variation between various immigrant groups in the incidence of major cardiovascular events.
We conducted the Cardiovascular Health in Ambulatory Care Research Team (CANHEART) Immigrant study, a big data initiative, linking information from Citizenship and Immigration Canada's Permanent Resident database to nine population-based health databases. A cohort of 824 662 first-generation immigrants aged 30 to 74 as of January 2002 from eight major ethnic groups and 201 countries of birth who immigrated to Ontario, Canada between 1985 and 2000 were compared to a reference group of 5.2 million long-term residents. The overall 10-year age-standardized incidence of major cardiovascular events was 30% lower among immigrants compared with long-term residents. East Asian immigrants (predominantly ethnic Chinese) had the lowest incidence overall (2.4 in males, 1.1 in females per 1000 person-years) but this increased with greater duration of stay in Canada. South Asian immigrants, including those born in Guyana had the highest event rates (8.9 in males, 3.6 in females per 1000 person-years), along with immigrants born in Iraq and Afghanistan. Adjustment for traditional risk factors reduced but did not eliminate differences in cardiovascular risk between various ethnic groups and long-term residents.
Striking differences in the incidence of cardiovascular events exist among immigrants to Canada from different ethnic backgrounds. Traditional risk factors explain part but not all of these differences.
在许多高收入国家,少数族裔移民在人口中所占比例日益增加,但对于不同移民群体中主要心血管事件发生率的差异原因及差异程度,人们了解甚少。
我们开展了门诊护理研究团队心血管健康(CANHEART)移民研究,这是一项大数据计划,将加拿大公民及移民部永久居民数据库中的信息与9个基于人群的健康数据库相链接。对截至2002年1月年龄在30至74岁之间、于1985年至2000年期间移民到加拿大安大略省的824662名来自8个主要族裔群体和201个出生国的第一代移民组成的队列,与520万长期居民组成的参照组进行了比较。与长期居民相比,移民中主要心血管事件的总体10年年龄标准化发病率低30%。东亚移民(主要是华裔)总体发病率最低(男性每1000人年为2.4例,女性为1.1例),但随着在加拿大停留时间的延长而上升。南亚移民,包括出生在圭亚那的移民,以及出生在伊拉克和阿富汗的移民,事件发生率最高(男性每1000人年为8.9例,女性为3.6例)。对传统风险因素进行调整后,不同族裔群体与长期居民之间心血管风险的差异有所减小,但并未消除。
来自不同族裔背景的加拿大移民中,心血管事件发生率存在显著差异。传统风险因素解释了部分而非全部这些差异。