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Stroke, CHD less common in adults born outside US
Patients who currently live in the United States and were born in another country had a decreased risk for stroke and CHD compared with those born in the United States, according to a study published in the Journal of the American Heart Association.
“These results may support efforts to target high-risk groups with public health interventions,” Jing Fang, MD, MS, of the National Center for Chronic Disease Prevention and Health Promotion at the CDC, and colleagues wrote.
Researchers analyzed data from 258,862 participants (mean age, 47 years; 49% men) from the National Health Interview Survey from 2006 to 2014. Data such as birthplace information, years of living in the United States, CHD status, stroke history and demographic characteristics were self-reported.
Participants were categorized as U.S. born or foreign born (16.4%). Those who were foreign born were then further classified into one of six regions: South America, Africa, Europe, Asia, Indian subcontinent and Mexico/Central America/Caribbean.
Compared with men born in another country, men born in the U.S. were more likely to have CHD (8.21% vs. 5.51%; P < .05) and stroke (2.66% vs. 2.11%; P < .05). Women born in the U.S. vs. those born in another country also had higher incidences of stroke (2.68% vs. 1.91%; P < .05) and CHD (4.8% vs. 4.07%; P < .05).
After adjusting for behavioral, demographic and health characteristics, men born in Asia had a 53% decreased risk for CHD compared with men born in the U.S. This was also seen in men born in Mexico, Central America or the Caribbean, who had a 43% decreased risk for CHD. This risk reduction was also in women, although it was a smaller magnitude. Women born in Mexico, Central America or the Caribbean had a 17% decreased risk and women born in Asia had a 35% decreased risk compared with those born in the U.S.
The lowest prevalence of stroke was seen in women from Europe and men from Africa or South America.
The number of years living in the United States was not associated with a history of stroke or CHD after adjusting for sex, birthplace, health insurance, education, smoking status, BMI, diabetes and history of hypertension.
“Although mortality ranking data show that most countries of Europe, Asia and Africa have higher CHD or stroke mortality than the United States, our analyses found that foreign-born adults from these regions had an overall lower risk of nonfatal CHD and stroke than those US-born adults,” Fang and colleagues wrote. “This could potentially be explained by the ‘healthy immigrant effect,’ where those who decide to immigrate to another country are usually healthier than those left behind, attributable to either self-selection or physical/legal barriers to entering the receiving country.” – by Darlene Dobkowski
Disclosures: The authors report no relevant financial disclosures.