Incidence of stroke and stroke subtypes in Malmö, Sweden, 1990-2000: marked differences between groups defined by birth country.
OBJECTIVE
The proportion of immigrants has increased in Sweden markedly during the last decades, as in many other Western countries. Incidence of stroke has increased during this period. However, it is primarily unknown whether incidence of stroke and stroke subtypes in Sweden is related to country of birth.


METHODS
Incidence of first-ever stroke was followed during 10 years in a cohort consisting of all 40- to 89-year-old inhabitants in the city of Malmö, Sweden (n=118,134). Immigrants from 12 different countries were compared with native-born Swedes.


RESULTS
Adjusted for age, sex, marital status, and socioeconomic indicators, the incidence of stroke (all subtypes) was significantly higher among immigrants from former Yugoslavia (relative risk [RR], 1.31; 95% CI, 1.1 to 1.6) and Hungary (RR, 1.33; CI, 1.02 to 1.7). A significantly increased incidence of intracerebral hemorrhage was observed in immigrants from Peoples Republic of China or Vietnam (RR, 4.2; CI, 1.7 to 10.4) and the former Soviet Union (RR, 2.7; CI, 1.01 to 7.3). Immigrants from Finland had a significantly higher incidence of subarachnoid hemorrhage (RR, 2.8; CI, 1.1 to 6.8). A significantly lower incidence of stroke was observed in the group from Romania (RR, 0.14; CI, 0.04 to 0.6). Immigrants from Denmark, Norway, Germany, Chile, Czechoslovakia, and Poland had approximately the same risk as citizens born in Sweden.


CONCLUSIONS
In this urban population from Sweden, there are substantial differences in stroke incidence and stroke subtypes between immigrants from different countries. To what extent this could be accounted for by exposure to biological risk factors remains to be explored.
Khan
Farhad Ali
FA
Department of Community Medicine, Malmö University Hospital, Malmö, Sweden. farhad.khan@smi.mas.lu.se
Zia
Elisabet
E
Janzon
Lars
L
Engstrom
Gunnar
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001208:Asia / Q000208:ethnology; D002677:Chile / Q000208:ethnology; D015331:Cohort Studies; D004641:Emigration and Immigration / Q000706:statistics & numerical data*; D005060:Europe / Q000208:ethnology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007182:Income; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012042:Registries; D012307:Risk Factors; D012959:Socioeconomic Factors; D020521:Stroke / Q000145:classification / Q000208:ethnology*; D013345:Subarachnoid Hemorrhage / Q000208:ethnology; D013548:Sweden / Q000453:epidemiology; D014586:USSR / Q000208:ethnology; D014505:Urban Population