Journal of Internal Medicine
Volume 265, Issue 3, 2009, Pages 345-358

Migration at early age from a high to a lower coronary heart disease risk country lowers the risk of subclinical atherosclerosis in middle-aged men (Article)

Jartti L. , Rönnemaa T.* , Raitakari O.T. , Hedlund E. , Hammar N. , Lassila R. , Marniemi J. , Koskenvuo M. , Kaprio J.
  • a Department of Geriatric Medicine, Cardiorespiratory Research Unit, University of Turku, Turku, Finland
  • b Department of Medicine, Turku University, Central Hospital, Kiinamyllynkatu 4-8, FIN-20520, Turku, Finland, Department of Medicine, Cardiorespiratory Research Unit, University of Turku, Turku, Finland
  • c Department of Clinical Physiology, Cardiorespiratory Research Unit, University of Turku, Turku, Finland
  • d Division of Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
  • e Division of Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
  • f Department of Haematology, Coagulation Disorders, Helsinki University, Central Hospital, Helsinki, Finland
  • g Department of Health and Functional Capacity, National Public Health Institute, Turku, Finland
  • h Department of Public Health, University of Turku, Turku, Finland, Department of Public Health, University of Helsinki, Helsinki, Finland
  • i Department of Public Health, University of Helsinki, Helsinki, Finland, Department of Mental Health, National Public Health Institute, Helsinki, Finland

Abstract

Jartti L, Rönnemaa T, Raitakari OT, Hedlund E, Hammar N, Lassila R, Marniemi J, Koskenvuo M, Kaprio J (University of Turku, Turku, Finland; Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden; Helsinki University Central Hospital, Helsinki; National Public Health Institute, Turku; University of Helsinki, Helsinki; National Public Health Institute, Helsinki; Finland). Migration at early age from a high to a lower coronary heart disease risk country lowers the risk of subclinical atherosclerosis in middle-aged men. J Intern Med 2009; 265:345-358.Background. : Study of migrants offers a natural model to assess environmental risk of coronary heart disease (CHD) in countries differing in CHD occurrence. In Sweden, CHD risk has been markedly lower than in Finland from where a large migration occurred in the 1970s. Objectives. : To study the structural and functional markers of subclinical atherosclerosis in twin pairs discordant for migration with the main focus on age at migration, length of residence and integration into Swedish society after migration from a high to a lower CHD risk country. Methods. : Carotid intima-media thickness (IMT) and brachial artery endothelial function (EF) were assessed with high-resolution ultrasound and a set of cardiovascular, socio-economic and psychosocial risk factors were estimated in 76 middle-aged male twin pairs discordant for migration from Finland to Sweden. Results. : Men who had migrated in adolescence had lower IMT values compared with their co-twins living in Finland (0.665 ± 0.114 vs. 0.802 ± 0.167 mm, P = 0.009). Also men who integrated well to Swedish society had lower (0.720 ± 0.154 vs. 0.799 ± 0.207 mm, P = 0.013) IMT values than their twin brothers living in Finland. Associations between IMT and migration age and between IMT and integration remained significant in multivariate analyses of several CHD risk factors. The intrapair difference in IMT was significantly associated with immigration age and integration (anova, P = 0.0082), the difference being greatest among pairs where the brother living in Sweden had migrated at early age and integrated well to Swedish society. EF was better in men who had migrated to Sweden before the age of 21 years, but not later, compared with their co-twins in Finland (6.4 ± 4.6% vs. 3.8 ± 3.6%, P = 0.025). Conclusions. : Migration at an early age and good integration are beneficial to vascular health associated with moving from a high to a lower CHD risk country, suggesting that an environment-sensitive period influences atherogenesis before adulthood. © 2008 Blackwell Publishing Ltd.

Author Keywords

Endothelial function Migration Intima-media thickness Twins Subclinical atherosclerosis

Index Keywords

social psychology brachial artery Finland Tunica Media Tunica Intima cardiovascular risk Carotid Arteries intima twins society carotid artery risk human middle aged controlled study priority journal Time Factors Endothelium, Vascular artery endothelium Sweden Humans male blood vessel diameter residential area Socioeconomic Factors risk factor ultrasound socioeconomics Article major clinical study adult migration atherosclerosis Age Factors ischemic heart disease Emigration and Immigration risk reduction coronary artery disease disease marker Biological Markers
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-60349117331&doi=10.1111%2fj.1365-2796.2008.02018.x&partnerID=40&md5=295ac74bc4051bde25f2b0baa6bc0625
DOI: 10.1111/j.1365-2796.2008.02018.x
ISSN: 09546820
Cited by: 6
Original Language: English