Abstract P229: Incidence of Acute Myocardial Infarction in First and Second Generation Migrants: Do Second Generation Migrants Converge Towards the Host Population?

Abstract

Background Differences in acute myocardial infarction (AMI) incidence between migrants and the host population have been reported. Incidence may converge towards the host population over generations. We assessed whether AMI incidence differences between migrants and ethnic Dutch exist, and whether they converge towards ethnic Dutch over generations. Methods A nationwide register-based cohort study was conducted (n=7,601,785) from 1997 to 2007. Using Cox Proportional Hazard Models, AMI incidence differences between migrant groups and ethnic Dutch were estimated. If possible, analyses were stratified by generation. Results AMI incidence differences between migrants and ethnic Dutch depended on the migrant’s country of origin, and often varied between migrant groups originating from the same geographical region. For example, among North African and Mediterranean migrants, incidence was higher in Turkish (Hazard Ratio (HR):1·34;1·28-1·41), but lower in Moroccan migrants (HR:0·46;0·40-0·52) compared with ethnic Dutch. Most migrant groups had a similar or lower incidence than ethnic Dutch, which converged towards or exceeded the incidence in ethnic Dutch over generations. This was most profound in Polish and Chinese migrants (first generation Chinese: HR:0·51;0·42-0·62, second generation Chinese: HR:1·36;0·90-2·04). Conclusions Health care professionals and policy makers should be aware of substantial AMI incidence differences between migrant groups and the host population, and the often unbeneficial change over generations, most striking in some of Europe’s most expanding migrant groups (Polish, Chinese). Future research should be cautious when clustering migrant groups based on geographical region of the country of origin.