International Health
Volume 11, Issue 3, 2019, Pages 193-202

Atrial fibrillation in immigrants under the age of 45 y in Sweden (Article)

Wändell P.* , Carlsson A.C. , Li X. , Gasevic D. , Ärnlöv J. , Holzmann M.J. , Sundquist J. , Sundquist K.
  • a Division of Family Medicine and Primary Care, Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
  • b Division of Family Medicine and Primary Care, Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
  • c Center for Primary Health Care Research, Lund University, Malmö, Sweden
  • d Usher Institute of Population Health Sciences and Informatics, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, United Kingdom, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
  • e Division of Family Medicine and Primary Care, Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden, School of Health and Social Studies, Dalarna University, Falun, Sweden
  • f Functional Area of Emergency Medicine, Karolinska University Hospital, Huddinge, Sweden, Department of Internal Medicine Solna, Karolinska Institutet, Stockholm, Sweden
  • g Center for Primary Health Care Research, Lund University, Malmö, Sweden, Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine, New York, United States, Center for Community-based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Japan
  • h Center for Primary Health Care Research, Lund University, Malmö, Sweden, Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine, New York, United States, Center for Community-based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Japan

Abstract

Aim: To study association between country of birth and risk of first-onset atrial fibrillation (AF) in first- A nd second-generation immigrants to Sweden under 45 y of age. Methods: The study population included all individuals (n = 3 248 457) under the age of 45 y in Sweden, including immigrants (n = 722 249). AF was defined as first registered diagnosis in the National Patient Register. Association between country of birth and risk of AF was assessed by Cox regression, calculating HRs and 95% CIs, using Swedish-born individuals as referents. All models were stratified by sex, and in different models were adjusted for age, area of residence in Sweden, educational level, marital status, neighbourhood socioeconomic status and co-morbidity(ies). Results: A higher fully adjusted HR of incident AF was found in the total sample of first-generation immigrants, 1.44 (95% CI 1.35 to 1.54), in males born in Denmark, Lebanon and Iraq, and in females born in Turkey and Iraq. Lower HRs were found in male and female immigrants from Latin America and Iran, and female immigrants from Finland. Among second-generation immigrants, the fully adjusted HR was significantly lower, 0.70 (95% CI 0.58 to 0.83). Conclusions: Clinicians may show a greater awareness of AF in some groups of younger immigrants to enable early diagnosis. © The Author(s) 2018.

Author Keywords

Atrial fibrillation co-morbidity younger immigrants Gender

Index Keywords

educational status immigrant South and Central America proportional hazards model Finland cardiovascular risk atrial fibrillation cardiovascular disease assessment sex ratio human comorbidity Denmark controlled study Turkey (republic) Iraq priority journal geographic distribution hazard ratio neighborhood marriage Confidence interval Lebanon Sweden social status migrant disease course Humans male Emigrants and Immigrants female risk factor Risk Factors population research Article major clinical study adult age distribution
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85064837373&doi=10.1093%2finthealth%2fihy075&partnerID=40&md5=bf5e4032202e3325ce8f486f929858bc
DOI: 10.1093/inthealth/ihy075
ISSN: 18763413
Original Language: English