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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Public Health 1/2015

Ethnic inequalities in acute myocardial infarction and stroke rates in Norway 1994–2009: a nationwide cohort study (CVDNOR)

Zeitschrift:
BMC Public Health > Ausgabe 1/2015
Autoren:
Kjersti S. Rabanal, Randi M. Selmer, Jannicke Igland, Grethe S. Tell, Haakon E. Meyer
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12889-015-2412-z) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

GT established the CVDNOR project and obtained the data use for analyses. HM and GT were responsible for the conception of the current study. KR analysed the data and drafted the first paper. JI prepared the dataset and helped with the planning of statistical analyses. RS, JI, GT and HM contributed to the analyses of data and writing of the paper. All authors read and approved the final manuscript.

Abstract

Background

Immigrants to Norway from South Asia and Former Yugoslavia have high levels of cardiovascular disease (CVD) risk factors. Yet, the incidence of CVD among immigrants in Norway has never been studied. Our aim was to study the burden of acute myocardial infarction (AMI) and stroke among ethnic groups in Norway.

Methods

We studied the whole Norwegian population (n = 2 637 057) aged 35–64 years during 1994–2009. The Cardiovascular Disease in Norway (CVDNOR) project provided information about all AMI and stroke hospital stays for this period, as well as deaths outside hospital through linkage to the Cause of Death Registry. The direct standardization method was used to estimate age standardized AMI and stroke event rates for immigrants and ethnic Norwegians. Rate ratios (RR) with ethnic Norwegians as reference were calculated using Poisson regression.

Results

The highest risk of AMI was seen in South Asians (men RR = 2.27; 95 % CI 2.08–2.49; women RR = 2.10; 95 % CI 1.76–2.51) while the lowest was seen in East Asians (RR = 0.38 in both men (95 % CI 0.25–0.58) and women (95 % CI 0.18–0.79)). Immigrants from Former Yugoslavia and Central Asia also had increased risk of AMI compared to ethnic Norwegians. South Asians had increased risk of stroke (men RR = 1.26; 95 % CI 1.10–1.44; women RR = 1.58; 95 % CI 1.32–1.90), as did men from Former Yugoslavia, Sub-Saharan Africa and women from Southeast Asia.

Conclusions

Preventive measures should be aimed at reducing the excess numbers of CVD among immigrants from South Asia and Former Yugoslavia.
Zusatzmaterial
Additional file 1: Table A1. Regions and countries of birth. Norwegian residents aged 35–64, 1994–2009. Table A2. Age standardized AMI event rates per 100 000 person-years, subjects aged 35–89 years, CVDNOR 1994–2009. Table A3. Age standardized stroke event rates per 100 000 person-years, subjects aged 35–89 years, CVDNOR 1994–2009. The additional tables provide supplementary information to the article. Table A1 lists all the countries within each region. Table A2 and A3 respectively show AMI and stroke event rates for a wider age group than the one we focused on in the article. (PDF 1020 kb)
12889_2015_2412_MOESM1_ESM.pdf
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