Background: Mortality from cardiovascular diseases is higher among immigrants than native Swedes. It is not clear whether the high mortality persists from the country of birth or is a result of migration. The purpose of the present study was to analyse whether all-cause and coronary heart disease mortality differ between immigrants in Sweden and in the country of birth. Methods: Two cohorts including the total population from Swedish national registers and WHO were defined. All-cause and CHD mortality are presented as age-adjusted incidence rates and incidence density ratios (IDR) in eight immigrant groups in Sweden and in their country of birth. The data were analysed using Poisson regression. Results: The all-cause mortality risk was lower among seven of eight male immigrant groups (IDR 0.39-0.97) and among six of eight female immigrant groups (IDR 0.42-0.81) than in their country of birth. The CHD mortality risk was significantly lower in male immigrants from Norway (IDR = 0.84), Finland (IDR = 0.91), Germany (IDR = 0.84) and Hungary (IDR = 0.59) and among female immigrants from Germany (IDR = 0.66) and Hungary (IDR = 0.54) than in their country of birth. In contrast, there was a significantly higher CHD mortality risk in male immigrants from Southern Europe (IDR = 1.23) than in their country of birth. Conclusion: The all-cause mortality risk was lower in the majority of immigrant groups in Sweden than in their country of birth. The differences in CHD mortality risks were more complex. For countries with high CHD mortality, such as Finland and Hungary, the risk was lower among immigrants in Sweden than in their country of birth. For low-risk countries in South Europe, the risk was higher in immigrants in Sweden than in South Europe. © 2006 Gadd et al; licensee BioMed Central Ltd.

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immigrant Effect Modifier, Epidemiologic Registries Follow-Up Studies register sex ratio human epidemiology follow up middle aged birthplace statistics and numerical data controlled study Aged geographic distribution Health Surveys quality adjusted life year ethnology Quality-Adjusted Life Years Sweden Humans classification male female Aged, 80 and over very elderly population research Incidence Article Southern Europe major clinical study adult migration data analysis Sex Distribution age distribution ischemic heart disease cohort analysis world health organization Emigration and Immigration Poisson distribution cause of death Coronary Disease coronary artery disease mortality health survey