比较瑞典和外国出生的初级保健患者的弗雷明汉 10 年心血管风险。

Comparison of Framingham 10-year cardiovascular risks in Sweden- and foreign-born primary health care patients in Sweden.

机构信息

Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Alfred Nobels allé 23, Huddinge, S-141 83, Stockholm, Sweden.

Academic Primary Health Care Centre, Stockholm County Council, Box 45436, 104 31, Stockholm, Sweden.

出版信息

BMC Public Health. 2023 Mar 22;23(1):543. doi: 10.1186/s12889-023-15449-6.

DOI:10.1186/s12889-023-15449-6

PMID:36949436

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10031948/

Abstract

BACKGROUND

The prevalence of cardiovascular disease around the world varies by ethnicity and region of birth. Immigrants living in Sweden may have a higher prevalence of cardiovascular diseases than native-born Swedes, but little is known about their actual cardiovascular risk. This study aimed to examine the relationship in Sweden between 10-year cardiovascular risk and birthplace.

METHOD

This cross-sectional study was based on cardiovascular risk factor data obtained from the 4D Diabetes Project, a Programme 4D subproject in Sweden. Participants were recruited from two primary healthcare centres in Stockholm without a history of diabetes or pre-diabetes. The outcome variable was 10-year cardiovascular risk based on the calculation of a Framingham Risk Score with six risk factors: age, sex, LDL, HDL, BP, diabetes and smoking for each participant. Multiple linear regression was performed to generate β-coefficients for the outcome.

RESULTS

There was an average of 8.86% cardiovascular risk over 10 years in Sweden-born participants and a 5.45% 10-year risk in foreign-born, (P < 0.0001). Foreign-born participants were about 10 years younger (mean age 46 years vs. 56 years, P < 0.001), with a significantly higher proportion of smokers (23.9% vs. 13.7%; P = 0.001). To be born in Sweden (with parents born in Sweden) was significantly associated with a 10-year cardiovascular risk in the crude model (β- coefficient = 3.40, 95% CI 2.59-4.22; P < 0.0001) and when adjusted for education and alcohol consumption (β- coefficient = 2.70 95% CI 1.86-3.54; P < 0.0001). Regardless of the birthplace, 10-year cardiovascular risk was lower for those with higher education compared to those with less than 10 years of education.

CONCLUSION

This study found a relationship between 10-year calculated cardiovascular risk and place of birth. Sweden-born participants had a higher association with 10-year cardiovascular risk than foreign-born participants. These results contradict previous reports of higher rates of CVD in residents of Middle-Eastern countries and Middle-Eastern immigrants living in Sweden.

摘要

背景

心血管疾病的患病率在世界各地因种族和出生地的不同而有所差异。生活在瑞典的移民可能比瑞典本土出生的人患心血管疾病的风险更高，但关于他们实际的心血管风险却知之甚少。本研究旨在探讨瑞典移民的 10 年心血管风险与出生地之间的关系。

方法

本横断面研究基于 4D 糖尿病项目（瑞典 4D 项目的一个子项目）中获得的心血管危险因素数据。参与者是从斯德哥尔摩的两家初级保健中心招募的，他们没有糖尿病或前期糖尿病的病史。因变量是根据每位参与者的 6 个危险因素（年龄、性别、LDL、HDL、BP、糖尿病和吸烟）计算得出的Framingham 风险评分的 10 年心血管风险。采用多元线性回归生成因变量的β系数。

结果

在瑞典出生的参与者中，10 年内的心血管风险平均为 8.86%，而在外国出生的参与者中，10 年内的心血管风险为 5.45%（P<0.0001）。外国出生的参与者平均年龄为 46 岁，比瑞典出生的参与者年轻 10 岁（平均年龄分别为 56 岁和 46 岁，P<0.001），且吸烟者的比例明显更高（23.9% vs. 13.7%；P=0.001）。在未调整模型中，出生于瑞典（父母均出生于瑞典）与 10 年内的心血管风险显著相关（β系数=3.40，95%CI 2.59-4.22；P<0.0001），在调整了教育程度和饮酒量后，仍有显著相关性（β系数=2.70，95%CI 1.86-3.54；P<0.0001）。无论出生地如何，与受教育程度低于 10 年的人相比，受教育程度较高的人 10 年内的心血管风险更低。