Immigration presents a potential increased risk for atherosclerosis.
OBJECTIVE
Immigrants in Western countries tend to have a greater risk for cardiovascular disease (CVD) than those in their home country, but it is unclear if immigrants are at increased risk for CVD compared to non-immigrants in their new country. The purpose of this study was to determine the independent association of time since immigration with sub-clinical atherosclerosis in immigrants of Chinese, European and South Asian origin.


METHODS
A total of 460 immigrants and 158 non-immigrants of Chinese, European and South Asian origin without pre-diagnosed CVD were assessed for sub-clinical atherosclerosis by carotid artery ultrasound scan, socio-demographics, CVD risk factors and lifestyle factors. Time since immigration in years was used as a measure of exposure.


RESULTS
Participants who immigrated > or =30 years ago had a greater intima-media thickness (IMT) of the carotid artery compared to non-immigrants, and immigrants of < or =20 years. Time since immigration was associated with IMT, plaque area and IMT+plaque area. After adjustment for age, sex, ethnicity, income, education, family history of CVD and diabetes, smoking, physical activity, body mass index, visceral adipose tissue, lipids, insulin, glucose and blood pressure, time since immigration was significantly associated with IMT. For every ten years since immigration there was a 2% increase in IMT in addition to the 7% increase for every 10 years of age.


CONCLUSIONS
Immigration was associated with an increased burden of sub-clinical atherosclerosis that surpassed that of non-immigrants. This burden increased over time independent of other risk factors. Immigrants represent a high-risk group for which targeted interventions are needed.
Lear
Scott A
SA
Simon Fraser University, British Columbia, Canada. slear@providencehealth.bc.ca
Humphries
Karin H
KH
Hage-Moussa
Samantha
S
Chockalingam
Arun
A
Mancini
G B John
GB
D000328:Adult; D001208:Asia; D050197:Atherosclerosis / Q000175:diagnosis* / Q000208:ethnology* / Q000503:physiopathology; D001823:Body Composition; D002170:Canada; D002339:Carotid Arteries / Q000473:pathology; D002681:China; D054242:Emigrants and Immigrants; D005060:Europe; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D012306:Risk; D012307:Risk Factors; D012923:Social Class