Coronary heart disease risks in first‐ and second‐generation immigrants in Sweden: a follow‐up study

Abstract

Objectives. To analyse whether there is an association between country of birth in first‐generation immigrants and first hospitalization for or death from coronary heart disease (CHD) and to analyse whether this association remains in second‐generation immigrants. Design. In this follow‐up study, the MigMed database at the Karolinska Institute, Stockholm, was used to identify all hospital diagnoses of and deaths from incident CHD in first‐ and second‐generation immigrants in Sweden between 1 January 1987 and 31 December 2001. Incidence ratios standardized by age, geographical region and socio‐economic status were estimated by sex in first‐ and second‐generation immigrants; the reference group was Swedish‐born people whose parents were both born in Sweden. Subjects. The total Swedish population aged 25–69 years. Results. First‐generation immigrants from Finland, central European countries, other eastern European countries and Turkey had higher rates of CHD than men or women in the reference group. First‐generation immigrant women born in southern Europe, other western European countries and Baltic countries had lower CHD risks than the reference group. Sons of both male and female first‐generation immigrants showed CHD risks similar to or slightly higher than those of their parents. Amongst second‐generation women, only subjects with Finnish fathers or mothers had higher risks of developing CHD than the reference. Conclusions. Increased risks of CHD found in some first‐generation immigrant groups often persist in second‐generation immigrant men. Healthcare professionals and policy makers should take this into account when designing and undertaking measures to prevent CHD.