Ethnic and sex differences in the incidence of hospitalized acute myocardial infarction: British Columbia, Canada 1995-2002

Abstract

BackgroundAs populations in Western countries continue to change in their ethnic composition, there is a need for regular surveillance of diseases that have previously shown some health disparities. Earlier data have already demonstrated high rates of cardiovascular mortality among South Asians and relatively lower rates among people of Chinese descent. The aim of this study was to describe the differences in the incidence of hospitalized acute myocardial infarction (AMI) among the three largest ethnic groups in British Columbia (BC), Canada.MethodsUsing hospital administrative data, we identified all patients with incident AMI in BC between April 1, 1995, and March 31, 2002. Census data from 2001 provided the denominator for the entire BC population. Ethnicity was determined using validated surname analysis and applied to the census and hospital administrative datasets. Direct age standardization was used to compare incidence rates.ResultsA total of 34,848 AMI cases were identified. Among men, South Asians had the highest age standardized rate of AMI hospitalization at 4.97/1000 population/year, followed by Whites at 3.29, and then Chinese at 0.98. Young South Asian men, in particular, showed incidence rates that were double that of young Whites and ten times that of young Chinese men. South Asian women also had the highest age-standardized rate of AMI hospitalization at 2.35/1000 population/year, followed by White women (1.53) and Chinese women (0.49).ConclusionsSouth Asians continue to have a higher incidence of hospitalized AMI while incidence rates among Chinese remain low. Ethnic differences are most notable among younger men.

First and recurrent ischaemic heart disease events continue to decline in New Zealand, 2005–2015

“…By contrast, stable, rather than decreasing, IHD hospitalisation trends have been reported in Hong Kong8 and British Columbia,9 and increasing IHD mortality rates in South and East Asia 3. The continued decline in IHD mortality in most high-income countries has been attributed to a combination of improved primary (improvements in risk factors) and secondary (improved treatment of acute and chronic IHD) prevention 26 27.…”

Differences between immigrants at various durations of residence and host population in all-cause mortality, Canada 1991–2006

“…For example, compared to non-immigrants, Canadian immigrants have lower rates of smoking (McDonald 2006;Newbold and Neligan 2012) and alcohol consumption (Beiser 2005;Veldhuizen et al 2007), both of which are major risk factors for cardiovascular disease and cancer. Although there are variations across countries of origin, overall immigrants also have a health advantage over non-immigrants for cardiovascular diseases (Newbold and Danforth 2003;Nijjar et al 2010) and certain cancers (Luo et al 2004;Virk et al 2010;McDermott et al 2011). It is also possible that most people admitted into Canada are healthier because the medical examination required for immigration deems individuals inadmissible if they have an illness that poses a risk to public health or public safety or could place an excessive demand on health services (Gushulak and Williams 2004).…”

Cardiovascular risk among South Asians living in Canada: a systematic review and meta-analysis

“…13 The prevalence of CVD (defined as a history of MI, angina, silent MI, percutaneous transluminal coronary angioplasty, coronary artery bypass grafting or stroke) was also higher among South Asian people: 5.7% to 10.0% versus 5.4% to 5.7% among white people (p < 0.05) 3,4,14 (see Appendix 3 for details). Furthermore, from 1979 to 1993, sex-standardized rates of mortality from coronary disease were higher among South Asian people compared with white people: men, 42% versus 29% (p < 0.001); women, 29% versus 19% (p < 0.001).…”