Abstract
Population-based data investigating generational differences in the risk of incident cardiovascular disease (CVD) and its risk determinants are rare. We examined the 6-year incidence of CVD and its risk factors in first- and second-generation ethnic Indians living in Singapore. 1749 participants (mean age [SD]: 55.5 [8.8] years; 47.5% male) from a population-based, longitudinal study of Indian adults were included for incident CVD outcome. Incident CVD was defined as self-reported myocardial infarction, angina pectoris or stroke which developed between baseline and follow-up. CVD-related risk factors included incident diabetes, hypertension, hyperlipidemia, obesity and chronic kidney disease (CKD). For incident CVD outcome, of the 1749 participants, 406 (23.2%) and 1343 (76.8%) were first and second-generation Indians, respectively. Of these, 73 (4.1%) reported incident CVD. In multivariable models, second-generation individuals had increased risk of developing CVD (RR = 2.04; 95% CI 1.04, 3.99; p = 0.038), hyperlipidemia (RR = 1.27; 95% CI 1.06, 1.53; p = 0.011), and CKD (RR = 1.92; 95% CI 1.22, 3.04; p = 0.005), compared to first-generation Indians. Second-generation Indians have increased risk of developing CVD and its associated risk factors such as hyperlipidemia and CKD compared to first-generation immigrants, independent of traditional CVD risk factors. More stratified and tailored CVD prevention strategies on second and subsequent generations of Indian immigrants in Singapore are warranted.
Highlights
Cope with illness and disease[24,25]
Population-based study of ethnic Indian adults living in Singapore, a significant generational difference in incidence of cardiovascular disease (CVD) and its risk factors was found
We demonstrated that second-generation Indian individuals had increased risk of incident CVD, hyperlipidemia and chronic kidney disease (CKD) compared to first-generation immigrants, independent of conventional cardiovascular risk factors
Summary
Cope with illness and disease[24,25] Addressing this knowledge gap can inform the temporal relationship between generational status and the development of CVD and its risk determinants, and health care agencies likely to target second-generation individuals in their prevention towards development of CVD and its risk determinants. Such information is important for Asian Indians who is one of the fastest growing immigrant groups across Asia and the world[26]. We evaluated the 6-year incidence of CVD and its risk factors between first- and second-generation Indians in Singapore. Findings from this study may potentially inform how nativity is related to change in cardiovascular health over time, and advise generation specific interventions to reduced future CVD risk
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