Heart failure in first‐ and second‐generation immigrants aged 18–54 years in Sweden: A national study

Abstract

Abstract Purpose We aimed at analysing the risk of congestive heart failure (CHF) among first‐ and second‐generation immigrants in younger age groups. Methods All individuals aged 18–54 years, n = 3 973 454 in the first‐generation study and n = 3 817 560 in the second‐generation study, were included. CHF was defined as at least one registered diagnosis in the National Patient Register between 1 January 1998 and 31 December 2018. Cox regression analysis was used to estimate the relative risk [hazard ratios (HRs) with 99% confidence intervals (CIs)] of incident CHF with adjustments for age, co‐morbidities and socio‐demographics. Results In the first‐generation study, a total of 85 719 cases of CHF were registered, 54 369 men and 31 350 women, where fully adjusted models showed HRs for all foreign‐born men of 1.12 (99% CI 1.06–1.17) and for women of 0.99 (0.92–1.05). Groups with higher risk included men from Eastern Europe, Central Europe, Africa and Asia and women from Africa and Asia, and a lower risk was found among Latin American women. In the second‐generation study, a total of 88 999 cases of CHF were registered, 58 403 men and 30 596 women, where fully adjusted models showed HRs for second‐generation men of 1.04 (0.99–1.09) and women of 0.97 (0.90–1.04). Conclusions The higher risk in some foreign‐born groups needs to be paid attention to in clinical practice. The fact that almost all increased risks were attenuated and absent in second‐generation immigrants suggests that lifestyle and environmental factors are more important than genetic differences in the risk of CHF.

Keywords

• congestive heart failure
• immigrants
• neighbourhood
• sex
• socio‐economic status