Atrial fibrillation in immigrant groups: a cohort study of all adults 45 years of age and older in Sweden

Research output: Contribution to journalArticle

Abstract

To study the association between country of birth and incident atrial fibrillation (AF) in several immigrant groups in Sweden. The study population included all adults (n = 3,226,752) aged 45 years and older in Sweden. AF was defined as having at least one registered diagnosis of AF in the National Patient Register. The incidence of AF in different immigrant groups, using Swedish-born as referents, was assessed by Cox regression, expressed in hazard ratios (HRs) and 95% confidence intervals (CI). All models were stratified by sex and adjusted for age, geographical residence in Sweden, educational level, marital status, and neighbourhood socioeconomic status. Compared to their Swedish-born counterparts, higher incidence of AF [HR (95% CI)] was observed among men from Bosnia 1.74 (1.56–1.94) and Latvia 1.29 (1.09–1.54), and among women from Iraq 1.96 (1.67–2.31), Bosnia 1.88 (1.61–1.94), Finland 1.14 (1.11–1.17), Estonia 1.14 (1.05–1.24) and Germany 1.08 (1.03–1.14). Lower incidence of AF was noted among men (HRs ≤ 0.60) from Iceland, Southern Europe (especially Greece, Italy and Spain), Latin America (especially Chile), Africa, Asia (including Iraq, Turkey, Lebanon and Iran), and among women from Nordic countries (except Finland), Southern Europe, Western Europe (except Germany), Africa, North America, Latin America, Iran, Lebanon and other Asian countries (except Turkey and Iraq). In conclusion, we observed substantial differences in incidence of AF between immigrant groups and the Swedish-born population. A greater awareness of the increased risk of AF development in some immigrant groups may enable for a timely diagnosis, treatment and prevention of its debilitating complications, such as stroke.

Details

Authors
Organisations
External organisations
  • Uppsala University
  • University of Edinburgh
  • Dalarna University
  • Karolinska University Hospital
  • Icahn School of Medicine at Mount Sinai
  • Karolinska Institute
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Public Health, Global Health, Social Medicine and Epidemiology
  • Cardiac and Cardiovascular Systems

Keywords

  • Atrial fibrillation, First generation immigrants, Gender, Neighbourhood, Second generation immigrants, Socioeconomic status
Original languageEnglish
Pages (from-to)785-796
Number of pages12
JournalEuropean Journal of Epidemiology
Volume32
Issue number9
Early online date2017 Jul 12
StatePublished - 2017
Peer-reviewedYes