Clinical research - prevention/rehabilitationCardiovascular Risk Factor Profiles of Recent Immigrants vs Long-term Residents of Ontario: A Multi-ethnic Study
Section snippets
Study population and variables
Data from the Statistics Canada's cross-sectional National Population Health Survey (NPHS) 1996 and Canadian Community Health Survey (CCHS) Cycles 1.1 (2001), 2.1 (2003), 3.1 (2005), and 4.1 (2007)12 were combined13 to create the study population. Details about the surveys are found in Online Appendix SI.
We analyzed people living in Ontario, who were aged 12 years or older and who identified themselves, when asked to which racial-cultural group they belonged, as ‘White,' ‘South Asian’ (ie,
Study population
This study included a total of 163,797 participants: 154,653 White, 3364 South Asian, 3038 Chinese, and 2742 Black. The mean age for each ethnic subgroup was approximately 42 years and 49.1% were male. More details about the sociodemographic characteristics of the study population can be found in Online Appendix SIV and Online Table S1.
Cardiovascular risk factors
Table 1 displays the age- and sex-standardized prevalence of major cardiovascular risk factors for recent immigrants and long-term residents in each of the 4
Discussion
In this population-based, multi-ethnic study in Ontario, we found that major cardiovascular risk factors were more prevalent among long-term residents than among recent immigrants. This negative acculturation effect was observed within all 4 ethnic groups examined, however, the largest effect was observed among the Chinese, followed by the White, Black, and South Asian groups. The changes in the Chinese and White groups were mainly driven by an increase in the prevalence of diabetes and the
Funding Sources
This study was supported by an operating grant from the Heart and Stroke Foundation of Ontario (HSFO) to the Institute for Clinical Evaluative Sciences (ICES), a Canadian Institutes of Health Research (CIHR) Frederick Banting and Charles Best Canada Graduate Scholarship Doctoral Award to Maria Chiu and a CIHR Team Grant in Cardiovascular Outcomes Research. ICES is funded by the Ontario Ministry of Health and Long-Term Care. Peter Austin is supported by a Career Investigator Award from the HSFO.
Disclosures
The authors have no conflicts of interest to disclose.
Acknowledgements
The authors acknowledge that the data used in this publication are from Statistics Canada's National Population Health Survey and Canadian Community Health Surveys. The authors thank all the participants of these surveys, as well as the staff from Statistics Canada who assisted in the collection and management of the survey data.
References (33)
- et al.
Duration of residence in the United States as a new risk factor for coronary artery disease (The Konkani Heart Study)
Am J Cardiol
(2004) - et al.
Differences in risk factors, atherosclerosis, and cardiovascular disease between ethnic groups in Canada: the Study of Health Assessment and Risk in Ethnic groups (SHARE)
Lancet
(2000) - et al.
Immigrant obesity and unhealthy assimilation: alternative estimates of convergence or divergence, 1995-2005
Soc Sci Med
(2009) - et al.
Fruit and vegetable intake and risk of cardiovascular disease in US adults: the first National Health and Nutrition Examination Survey Epidemiologic Follow-up Study
Am J Clin Nutr
(2002) - et al.
Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study
Lancet
(2004) - et al.
Cigarette smoking among native and foreign-born African Americans
Ann Epidemiol
(1999) - et al.
Development of scales to measure dietary acculturation among Chinese-Americans and Chinese-Canadians
J Am Diet Assoc
(2001) - et al.
Secular trends in acute coronary syndrome hospitalization from 1994 to 2005
Can J Cardiol
(2010) Projections of the Diversity of the Canadian Population 2006 to 2031
(2010)Research and Statistics: Permanent Resident Landings
(2008)
Facts and figures: Summary tables – Permanent residents by province or territory and urban area, 2006-2010Citizenship and Immigration Canada, 2010
Integrating ethnicity and migration as determinants of Canadian women's health
BMC Womens Health
Obesity among US immigrant subgroups by duration of residence
JAMA
Acculturation to Western society as a risk factor for high blood pressure: a meta-analytic review
Psychosom Med
Association between length of residence and cardiovascular disease risk factors among an ethnically diverse group of United States immigrants
J Gen Intern Med
Age- and sex-related prevalence of diabetes mellitus among immigrants to Ontario, Canada
CMAJ
Cited by (68)
Barriers to Access to Cardiac Surgery: Canadian Situation and Global Context
2024, Canadian Journal of CardiologyGender differences in acculturation and cardiovascular disease risk-factor changes among Chinese immigrants in Italy: Evidence from a large population-based cohort
2021, International Journal of Cardiology: Cardiovascular Risk and PreventionCitation Excerpt :The first consideration is that these countries are characterized by different habits and lifestyles from those of the Mediterranean area. Second, all the studies conducted on the Chinese population [8–10] were based on self-reported data and therefore may be prone to misclassification or differential reporting. Third, no clear information was given regarding possible gender differences in the effects of acculturation of the Chinese population.
Establishing a process to translate and adapt health education materials for natives and immigrants: The case of Mandarin adaptations of cardiac rehabilitation education
2021, Heart and LungCitation Excerpt :While immigrants are often healthier than their non-immigrating counterparts, over time the stresses of acculturation and adoption of Western lifestyles increase the risk of CVD.4,5 The burden of CVD in Chinese immigrants is also then important to address,6,7 particularly given their higher mortality after hospitalization.8 Secondary prevention strategies – particularly where they are culturally-relevant and hence readily implementable by patients9–12 – can mitigate this burden.
Immigrants, Ethnicity, and Adherence to Secondary Cardiac Prevention Therapy: A Substudy of the ISLAND Trial
2021, CJC OpenCitation Excerpt :Our results are consistent with those of previous studies that have reported statin adherence and cardiac rehabilitation participation outcomes in ethnic and immigrant populations. For example, Chiu et al.41 reported that major cardiovascular risk factors, including smoking status and diabetes, were more prevalent among long-term Ontario residents compared with recent immigrants.41 Participants with a postsecondary education were significantly more likely to complete cardiac rehabilitation.
Immigration, region of origin, and the epidemiology of venous thromboembolism: A population-based study
2018, Research and Practice in Thrombosis and Haemostasis
See page 25 for disclosure information.