Canadian Journal of Cardiology

The Risk of Ischemic Heart Disease and Stroke Among Immigrant Populations: A Systematic Review



      The increasing frequency of global migration to Canada and other high-income countries has highlighted the need for information on the risk of ischemic heart disease (IHD) and stroke among migrant populations.


      Using the MEDLINE and EMBASE databases, we conducted an English-language literature review of articles published from 2000 to 2014 to study patterns in the incidence of IHD or stroke in migrant populations to high-income countries. Our search revealed 17 articles of interest. All studies stratified immigrants according to country or region of birth, except 2 from Canada and 1 from Denmark, in which all immigrant groups were analyzed together.


      The risk of IHD or stroke varied by country of origin, country of destination, and duration of residence. In our review we found that most migrant groups to Western Europe were at a similar or higher risk of IHD and stroke compared with the host population. Those at a higher risk included many Eastern European, Middle-Eastern, and South Asian immigrants. When duration of residence was considered, it appeared that in most migrants the risk of IHD worsened over time. In contrast, immigrants overall were at lower risk of myocardial infarction and stroke in Ontario compared with long-term residents of Canada.


      The risks of IHD and stroke vary widely in immigrant populations in Western Europe. Detailed studies of immigrants to Canada according to country of birth and duration of residence should be undertaken to guide future cardiovascular health promotion initiatives.



      L’accroissement de la fréquence de la migration internationale vers le Canada et les autres pays à revenu élevé a fait ressortir le besoin d’information sur le risque de cardiopathie ischémique (CI) et d’accident vasculaire cérébral (AVC) chez les populations migrantes.


      À partir des bases de données MEDLINE et EMBASE, nous avons mené une revue de la littérature de langue anglaise des articles publiés de 2000 à 2014 pour étudier les profils d’incidence de la CI ou de l’AVC des populations migrantes vers les pays à revenu élevé. Notre recherche a révélé 17 articles d’intérêt. Dans toutes les études, les immigrants étaient stratifiés selon le pays ou la région de naissance, à l’exception de 2 études du Canada et 1 du Danemark pour lesquelles tous les groupes d’immigrants étaient analysés ensemble.


      Le risque de CI ou d’AVC variait selon le pays d’origine, le pays de destination et la durée de résidence. Dans notre revue, nous avons observé que la plupart des groupes de migrants vers l’Europe occidentale étaient exposés à un risque similaire ou plus élevé de CI et d’AVC comparativement à la population hôte. Ceux exposés à un risque plus élevé comprenaient plusieurs immigrants de l’Europe orientale, du Moyen-Orient et de l’Asie du Sud. Lorsque la durée de résidence était considérée, il semblait que chez la plupart des migrants le risque de CI s’exacerbait avec le temps. En revanche, les immigrants étaient dans l’ensemble exposés à un risque plus faible d’infarctus du myocarde et d’AVC en Ontario comparativement aux résidents de longue durée du Canada.


      Les risques de CI et d’AVC varient grandement entre les populations immigrantes en Europe occidentale. Des études approfondies sur les immigrants du Canada selon leur pays de naissance et la durée de résidence devraient être entreprises pour orienter les futures initiatives de promotion de la santé cardiovasculaire.
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