Epidemiology, risk factors, and opportunities for prevention of cardiovascular disease in individuals of South Asian ethnicity living in Europe

Cainzos‐Achirica, Miguel; Fedeli, Ugo; Sattar, Naveed; Agyemang, Charles; Jenum, Anne Karen; McEvoy, John W.; Murphy, Jack D.; Brotons, Carlos; Elosúa, Roberto; Bilal, Usama; Kanaya, Alka M.; Kandula, Namratha R.; Martínez-Amezcua, Pablo; Comín‐Colet, Josep; Pintó, Xavier

doi:10.1016/j.atherosclerosis.2019.05.014

Cited by 54 publications

(50 citation statements)

References 69 publications

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“…We observed that only South-Asian Surinamese women did not have a lower odds of having a major ECG abnormality compared with South-Asian Surinamese men, which was mainly due to the higher prevalence of major ECG abnormalities among South-Asian Surinamese women compared with other women. South-Asian populations living in Europe are already considered a highrisk population for CVD 14 and our findings may suggest that South-Asian Surinamese women specifically are a target group for CVD prevention strategies. Although women had a consistently lower odds of having a major ECG abnormality than men in all other ethnic groups (except South-Asian Surinamese), Dutch women had a larger cardiovascular advantage than the other women.…”

Section: Discussionmentioning

confidence: 73%

“…Differences in the occurrence of ECG abnormalities have been observed between ethnic groups living in similar contexts. 6 8 12 13 However, in Europe, the prevalence of major ECG abnormalities among ethnic minority populations at high risk for CVD, such as men and women of South-Asian origin, 14 is unknown. Additionally, it is unknown to what extent major ECG abnormalities vary between men and women across ethnic groups.…”

Section: Introductionmentioning

confidence: 99%

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Do sex differences in the prevalence of ECG abnormalities vary across ethnic groups living in the Netherlands? A cross-sectional analysis of the population-based HELIUS study

et al. 2020

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ObjectivesMajor ECG abnormalities have been associated with increased risk of cardiovascular disease (CVD) burden in asymptomatic populations. However, sex differences in occurrence of major ECG abnormalities have been poorly studied, particularly across ethnic groups. The objectives were to investigate (1) sex differences in the prevalence of major and, as a secondary outcome, minor ECG abnormalities, (2) whether patterns of sex differences varied across ethnic groups, by age and (3) to what extent conventional cardiovascular risk factors contributed to observed sex differences.DesignCross-sectional analysis of population-based study.SettingMulti-ethnic, population-based Healthy Life in an Urban Setting cohort, Amsterdam, the Netherlands.Participants8089 men and 11 369 women of Dutch, South-Asian Surinamese, African Surinamese, Ghanaian, Turkish and Moroccan origin aged 18–70 years without CVD.Outcome measuresAge-adjusted and multivariable logistic regression analyses were performed to study sex differences in prevalence of major and, as secondary outcome, minor ECG abnormalities in the overall population, across ethnic groups and by age-groups (18–35, 36–50 and >50 years).ResultsMajor and minor ECG abnormalities were less prevalent in women than men (4.6% vs 6.6% and 23.8% vs 39.8%, respectively). After adjustment for conventional risk factors, sex differences in major abnormalities were smaller in ethnic minority groups (OR ranged from 0.61 in Moroccans to 1.32 in South-Asian Surinamese) than in the Dutch (OR 0.49; 95% CI 0.36 to 0.65). Only in South-Asian Surinamese, women did not have a lower odds than men (OR 1.32; 95% CI 0.96 to 1.84). The pattern of smaller sex differences in ethnic minority groups was more pronounced in older than in younger age-groups.ConclusionsThe prevalence of major ECG abnormalities was lower in women than men. However, sex differences were less apparent in ethnic minority groups. Conventional risk factors did not contribute substantially to observed sex differences.

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Section: Discussionmentioning

confidence: 73%

Section: Introductionmentioning

confidence: 99%

Do sex differences in the prevalence of ECG abnormalities vary across ethnic groups living in the Netherlands? A cross-sectional analysis of the population-based HELIUS study

et al. 2020

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“…Large-scale immigration of non-European refugees peaked in 2015 in Europe but is likely to continue in upcoming years. Immigrants differ from the host population with regard to genetics, baseline risk distribution, lifestyle and health literacy (Cainzos-Achirica et al 2019 ). These differences affect the prevalence and incidence of NCDs.…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular health care and health literacy among immigrants in Europe: a review of challenges and opportunities during the COVID-19 pandemic

Wernly

Magnano

et al. 2020

J Public Health (Berl.)

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Objectives Europe is a destination for many migrants, a group whose proportion of the overall population will increase over the next decades. The cardiovascular (CV) risk distribution and outcomes, as well as health literacy, are likely to differ from the host population. Challenges related to migrant health status, cardiovascular risk distribution and health literacy are compounded by the ongoing coronavirus disease 2019 (COVID-2019) crisis. Methods We performed a narrative review of available evidence on migrant CV and health literacy in Europe. Results Health literacy is lower in migrants but can be improved through targeted interventions. In some subgroups of migrants, rates of cardiovascular disease (CVD) risk factors, most importantly hypertension and diabetes, are higher. On the other hand, there is strong evidence for a so-called healthy migrant effect, describing lower rates of CV risk distribution and mortality in a different subset of migrants. During the COVID-19 pandemic, CV risk factors, as well as health literacy, are key elements in optimally managing public health responses in the ongoing pandemic. Conclusions Migrants are both an opportunity and a challenge for public health in Europe. Research aimed at better understanding the healthy migrant effect is necessary. Implementing the beneficial behaviors of migrants could improve outcomes in the whole population. Specific interventions to screen for risk factors, manage chronic disease and increase health literacy could improve health care for migrants. This pandemic is a challenge for the whole population, but active inclusion of immigrants in established health care systems could help improve the long-term health outcomes of migrants in Europe.

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“…Cardiovascular diseases (CVDs) are the single most common cause of death from non-communicable diseases globally, and about 17.6 million individuals died of CVDs worldwide in 2012 [1]. In the Asian population, a higher risk of mortality has been observed compared to other ethnicities [2][3][4], which may result from the rapid urbanization process and the absence of related health policies [4]. There are different subtypes of CVDs, which include myocardial infarction (MI), acute coronary syndrome (ACS), coronary heart disease, and atherosclerosis [5].…”

Section: Introductionmentioning

confidence: 99%

The Correlation of Central Serous Chorioretinopathy and Subsequent Cardiovascular Diseases of Different Types: A Population-Based Cohort Study

Hsu

Lee

Chao

et al. 2019

IJERPH

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The aim of the present study was to survey the relationship between central serous chorioretinopathy (CSC) and several cardiovascular diseases (CVDs) with different severities using the National Health Insurance Research Database. A retrospective cohort study was conducted. Subjects with CSC were enrolled according to the relevant diagnostic codes, and an age-and gender-matched population was used as the control group with a 1:4 ratio. The main outcome being considered was the development of CVD after CSC exposure. Cox proportional hazard regression was applied to calculate the adjusted hazard ratio (aHR) of CSC and CVD of different types. A total of 2865 patients that were diagnosed with CSC were enrolled in the study group, while another 11,460 non-CSC subjects were selected as the control group. There were 171 events of CVD which occurred in the study group, while another 557 cases were found in the control group. No significant differences were observed among the CVD cases between the study and control group, whether they had an acute or chronic form, according to the aHR. In the subgroup analysis, there was a significantly higher risk of CVD development in the male population aged from 40 to 59 years (aHR: 1.351, confidence interval (CI): 1.063-1.716), which was mainly due to the higher risk of mild CVD (aHR: 1.391, CI: 1.062-1.822). On the contrary, there was no significant difference in CVD development in any of the age subgroups of the female population. In conclusion, the existence of CSC is correlated with a higher rate of chronic CVD occurrence in the middle-aged male population.

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Epidemiology, risk factors, and opportunities for prevention of cardiovascular disease in individuals of South Asian ethnicity living in Europe

Cited by 54 publications

References 69 publications

Do sex differences in the prevalence of ECG abnormalities vary across ethnic groups living in the Netherlands? A cross-sectional analysis of the population-based HELIUS study

Do sex differences in the prevalence of ECG abnormalities vary across ethnic groups living in the Netherlands? A cross-sectional analysis of the population-based HELIUS study

Cardiovascular health care and health literacy among immigrants in Europe: a review of challenges and opportunities during the COVID-19 pandemic

The Correlation of Central Serous Chorioretinopathy and Subsequent Cardiovascular Diseases of Different Types: A Population-Based Cohort Study

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