Abstract
Objective
Immigrants in Western countries tend to have a greater risk for cardiovascular disease
(CVD) than those in their home country, but it is unclear if immigrants are at increased
risk for CVD compared to non-immigrants in their new country. The purpose of this
study was to determine the independent association of time since immigration with
sub-clinical atherosclerosis in immigrants of Chinese, European and South Asian origin.
Methods
A total of 460 immigrants and 158 non-immigrants of Chinese, European and South Asian
origin without pre-diagnosed CVD were assessed for sub-clinical atherosclerosis by
carotid artery ultrasound scan, socio-demographics, CVD risk factors and lifestyle
factors. Time since immigration in years was used as a measure of exposure.
Results
Participants who immigrated ≥30 years ago had a greater intima-media thickness (IMT)
of the carotid artery compared to non-immigrants, and immigrants of ≤20 years. Time
since immigration was associated with IMT, plaque area and IMT + plaque area. After adjustment for age, sex, ethnicity, income, education, family history
of CVD and diabetes, smoking, physical activity, body mass index, visceral adipose
tissue, lipids, insulin, glucose and blood pressure, time since immigration was significantly
associated with IMT. For every ten years since immigration there was a 2% increase
in IMT in addition to the 7% increase for every 10 years of age.
Conclusions
Immigration was associated with an increased burden of sub-clinical atherosclerosis
that surpassed that of non-immigrants. This burden increased over time independent
of other risk factors. Immigrants represent a high-risk group for which targeted interventions
are needed.
Keywords
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Article Info
Publication History
Published online: February 02, 2009
Accepted:
December 23,
2008
Received in revised form:
December 17,
2008
Received:
October 17,
2008
Identification
Copyright
© 2009 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
