CANHEART: Ten-Year Incidence Rates of MACE in Immigrants to Ontario

Striking variations in the incidence rates of major cardiovascular disease events among immigrants to Canada from different ethnic groups can be leveraged to create targeted health education resources and activities, according to results from the CANHEART Study released on Nov. 19 at AHA 2013.

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The population-based retrospective cohort study looked at 697,690 immigrants aged 30 to 74 years from 196 countries of birth with no history of cardiovascular disease who arrived in Ontario, Canada, between 1985 and 1998. Researchers calculated the prevalence of cardiac risk factors, access to health services and 10-year age-standardized incidence rates of major cardiovascular events between Jan. 1, 2000 and Dec. 31, 2009, including a composite outcome consisting of acute myocardial infarction, stroke, heart failure, revascularization or cardiovascular death. These were then compared to an age-matched reference cohort of 5,211,911 long-term Ontario residents.

Results indicated ten-year incidence rates of major cardiovascular disease events varied four-fold across the eight ethnic groups studied. East Asian immigrants from Taiwan, Hong Kong and China had the lowest overall risk, while South Asian immigrants from countries like Sri Lanka, Pakistan and India had the highest overall risk. Latin American females also had high overall risk. The researchers noted that when filtered by gender and country of birth, male immigrants from Guyana, Iraq, Russia and South Asian countries were at highest risk, while females at highest risk were from Guyana, Iraq and South Asian countries. "Variation between ethnic groups in the incidence of the composite outcome was most explained by variation in the prevalence of hyperlipidemia," the authors said.

Moving forward, the authors recommend developing health education activities targeted at specific groups, particularly those at highest risk, in order to reduce disparities and decrease cardiovascular disease risks.

Keywords: Ethnic Groups, Myocardial Infarction, Stroke, Hyperlipidemias, Canada, Sri Lanka, Risk Factors, Iraq, Prevalence, Incidence, Health Education, Heart Failure, India, Cardiovascular Diseases, Guyana, Emigrants and Immigrants, Pakistan

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