Background
Methods
Study population
Participants and methods
Measurement of exposure
Ethical considerations
Statistical analysis
Results
Prevalence of CVD and T2D
Basic characteristics of the study participants in relation to CVD status
No cardiovascular disease | Cardiovascular disease | |||||
---|---|---|---|---|---|---|
Variable | Born in Iraq | Born in Sweden |
P
| Born in Iraq | Born in Sweden |
P
|
N = 1,311 |
N = 698 |
N = 54 |
N = 41 | |||
Age, years
| 45.8 (9.4) | 49.2 (11.1) | <0.001 | 57.1 (8.8) | 56.3 (10.8) | 0.683 |
Male sex,
n
(%)
| 757 (57.7) | 370 (53.0) | 0.042 | 44 (81.5) | 19 (46.3) | 0.001 |
Body mass index, kg/m
2
| 29.3 (4.5) | 27.2 (4.7) | 0.001 | 29.5 (3.9) | 27.9 (4.6) | 0.129 |
Waist-to-hip ratio for men
| 1.0 (0.1) | 0.9 (0.1) | <0.001 | 1.0 (0.1) | 1.0 (0.1) | 0.366 |
Waist-to-hip ratio for women
| 0.9 (0.2) | 0.8 (0.1) | <0.001 | 0.9 (0.1) | 0.8 (0.1) | 0.093 |
Systolic blood pressure, mmHg
a
| 128.6 (16.6) | 135.6 (19.5) | <0.001 | 134.9 (17.7) | 137.3 (24.5) | 0.249 |
Diastolic blood pressure, mmHg
a
| 77.8 (10.3) | 81.3 (11.3) | <0.001 | 79.2 (11.3) | 80.0 (13.4) | 0.182 |
Fasting glucose, mmol/L
b
| 5.9 (1.4) | 5.7 (1.2) | 0.054 | 7.3 (2.7) | 5.7 (0.8) | 0.839 |
C-peptide, nmol/L
| 0.8 (0.3) | 0.7 (0.3) | <0.001 | 0.9 (0.4) | 0.8 (0.4) | 0.583 |
Total cholesterol, mmol/L
c
| 4.9 (1.0) | 5.2 (1.0) | <0.001 | 4.4 (1.1) | 4.9 (1.2) | 0.226 |
p-low-density lipoprotein, mmol/L
c
| 3.2 (0.8) | 3.3 (0.9) | 0.019 | 2.7 (1.0) | 3.0 (1.0) | 0.715 |
p-high-density lipoprotein, mmol/L
c
| 1.2 (0.3) | 1.4 (0.4) | <0.001 | 1.1 (0.4) | 1.5 (0.5) | 0.032 |
p-triglycerides, mmol/L
c
| 1.6 (1.2) | 1.3 (0.8) | <0.001 | 1.9 (1.2) | 1.3 (0.6) | 0.033 |
Education level lower than high school exam,
n
(%)
| 366 (28.1) | 125 (17.9) | <0.001 | 10 (18.9) | 15 (36.6) | 0.135 |
INTERHEART risk factors [2] | ||||||
Type 2 diabetes,
n
(%)
d
| 88 (6.7) | 23 (3.3) | <0.001 | 26 (48.1) | 2 (4.9) | 0.001 |
History of hypertension,
n
(%)
e
| 146 (11.2) | 98 (14.0) | 0.465 | 25 (46.3) | 19 (46.3) | 0.623 |
Elevated p-LDL/p-HDL ratio
b
,
n
(%)
f
| 280 (22.7) | 102 (15.8) | 0.002 | 9 (18.4) | 3 (7.7) | 0.385 |
Abdominal obesity,
n
(%)
g
| 783 (60.1) | 222 (32.1) | <0.001 | 36 (67.9) | 16 (39.0) | 0.006 |
Physical activity <4 hours/week,
n
(%)
| 1004 (84.9) | 327 (52.1) | <0.001 | 35 (85.4) | 21 (65.6) | 0.058 |
Intake of fruit/vegetables < once daily,
n
(%)
| 676 (52.5) | 343 (49.2) | 0.703 | 25 (47.2) | 23 (56.1) | 0.201 |
Alcohol consumption,
n
(%)
| 229 (18.7) | 575 (83.5) | <0.001 | 17 (40.5) | 26 (66.7) | 0.006 |
Tobacco smoking,
n
(%)
h
| 310 (23.9) | 172 (24.7) | 0.307 | 17 (32.7) | 18 (43.9) | 0.087 |
Depression,
n
(%)
i
| 194 (16.1) | 15 (2.5) | <0.001 | 5 (11.9) | 3 (10.7) | 0.981 |
Stress,
n
(%)
k
| 492 (37.8) | 138 (19.8) | <0.001 | 20 (38.5) | 16 (39.0) | 0.839 |
Economic difficulties > once last year,
n
(%)
l
| 675 (52.2) | 104 (14.9) | <0.001 | 26 (49.1) | 10 (24.4) | 0.030 |
Life events >1,
n
(%)
m
| 886 (67.6) | 605 (86.7) | <0.001 | 40 (74.1) | 36 (87.8) | 0.205 |
Odds of CVD
Total study population (N = 1,695) | Born in Iraq (N = 1,113) | Born in Sweden (N = 582) | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Risk factor | Model I | SD OR | Model II | SD OR | Model II | SD OR | ||||||
OR | 95% CI | OR | 95% CI | OR | 95% CI | |||||||
Born in Iraq | 0.7 | 0.4 | 1.6 |
-
|
-
| |||||||
Age | 1.1***
| 1.1 | 1.1 | 1.8 | 1.2***
| 1.0 | 1.1 | 2.3 | 1.1 | 0.9 | 1.1 | |
Male sex | 1.6 | 0.8 | 3.1 | 2.5 | 0.8 | 7.6 | 1.2 | 0.4 | 2.8 | |||
T2D | 4.1***
| 2.0 | 8.3 | 1.4 | 6.8***
| 2.8 | 16.2 | 1.6 | 1.2 | 0.2 | 6.4 | |
History of hypertension | 3.7***
| 2.0 | 6.9 | 1.5 | 3.3**
| 1.4 | 7.8 | 1.4 | 6.2***
| 2.2 | 17.3 | 1.9 |
Abdominal obesity | 0.6 | 0.3 | 1.2 | 0.7 | 0.2 | 1.8 | 0.6 | 0.2 | 1.8 | |||
Elevated p-LDL/p-HDL ratio | 0.8 | 0.4 | 1.8 | 0.9 | 0.3 | 2.5 | 0.6 | 0.1 | 2.7 | |||
Tobacco smoking | 2.3**
| 1.3 | 4.2 | 1.4 | 2.2 | 0.9 | 5.0 | 2.0 | 0.8 | 5.1 | ||
Alcohol consumption | 0.9 | 0.5 | 1.8 | 1.6 | 0.6 | 3.8 | 0.5 | 0.2 | 1.3 | |||
Physical activity <4 h/week | 1.1 | 0-6 | 1.8 | 1.3 | 0.4 | 3.8 | 1.2 | 0.5 | 3.0 | |||
Intake of fruit or vegetables < once daily | 1.1 | 0.6 | 1.8 | 0.8 | 0.3 | 1.7 | 1.4 | 0.6 | 3.3 | |||
Depression | 0.8 | 0.3 | 2.0 | 0.5 | 0.1 | 1.7 | 4.9 | 0.9 | 25.4 | |||
Stress | 2.5**
| 1.3 | 4.7 | 1.5 | 2.1 | 0.8 | 5.1 | 3.4**
| 1.3 | 8.8 | 1.6 | |
Two or more life events | 1.2 | 0.6 | 2.5 | 1.7 | 0.7 | 4.3 | 0.7 | 0.2 | 2.2 | |||
Economic difficulties | 0.7 | 0.3 | 1.4 | 0.4*
| 0.2 | 0.16 | 0.6 | 2.6 | 0.8 | 8.9 |