International Journal of Epidemiology
Volume 31, Issue 5, 2002, Pages 1054-1060

Migration within Great Britain and cardiovascular disease: Early life and adult environmental factors (Article) (Open Access)

Wannamethee S.G.* , Shaper A.G. , Whincup P.H. , Walker M.
  • a Dept. Primary Care/Population Sci., Royal Free/Univ. College Med. School, London, United Kingdom
  • b Dept. Primary Care/Population Sci., Royal Free/Univ. College Med. School, London, United Kingdom
  • c Department of Public Heath Sciences, St. George's Hospital Medical School, London, United Kingdom
  • d Dept. Primary Care/Population Sci., Royal Free/Univ. College Med. School, London, United Kingdom

Abstract

Aim. To examine the relative contributions of early life and adult life factors to risk of cardiovascular disease (CVD) in middle-aged men using migration within Great Britain (GB). Methods. Prospective study of 7735 men (40-59 years) drawn from one group practice in each of 24 British towns. Zones of birth and/or examination: South of England and rest of GB (Midlands and Wales, North of England, and Scotland). Results. There were 1392 coronary heart disease (CHD) events and 1154 cardiovascular deaths during 21.8 years mean follow-up. Regardless of birth zone, men examined in the South showed lower risk of CHD events and CVD mortality than those examined in the rest of GB. Migrants from South to rest of GB showed a small increase in cardiovascular risk. Men born and examined in the rest of GB showed the highest adjusted risk of CHD events (RR = 1.15, 95% CI: 0.96-1.38) and CVD mortality (RR = 1.28, 95% CI: 1.04-1.57). Men born in the rest of GB who moved to the South showed adjusted risks of CHD events and CVD mortality similar to those born and examined in the South. Zone of examination was more strongly associated with CHD events and CVD mortality than zone of birth (RR = 1.23 versus 0.95 for CHD; RR = 1.26 versus 1.04 for CVD mortality). Smokers, irrespective of zone of birth or examination, showed higher risk than non-smokers. Conclusion. Factors in adult life appear to be dominant in determining cardiovascular risk in middle and older age although this does not exclude early life effects on cardiovascular risk.

Author Keywords

cardiovascular disease Migration Place of birth risk factors

Index Keywords

birth cardiovascular risk medical examination human risk assessment life event controlled study priority journal geographic distribution cardiovascular disease smoking male environmental factor Article major clinical study adult migration United Kingdom ischemic heart disease heart death

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-0036816886&doi=10.1093%2fije%2f31.5.1054&partnerID=40&md5=11da761a6b1f4f427fd1595bec23d8ca

DOI: 10.1093/ije/31.5.1054
ISSN: 03005771
Cited by: 20
Original Language: English