THE RISING INCIDENCE OF MAJOR CARDIOVASCULAR EVENTS DUE TO ACCULTURATION IN CHINESE-CANADIANS

Abstract

Among the major ethnic groups in Canada, Chinese immigrants have the lowest rates of cardiovascular disease, but whether these rates change with longer duration of stay and acculturation to Westernized lifestyles is unknown. Therefore, we compared the incidence of cardiovascular disease among Chinese immigrants to Canada and Canadian-born Chinese. We conducted a national cohort study (except Québec, Manitoba and the territories) of 80,825 self-identified Chinese-Canadians aged 30 to 74 who participated in Statistic Canada’s 2006 Long-form Census by linking their records to hospitalization and death data in the Canadian Institute for Health Information (CIHI) Discharge Abstract Database and Statistics Canada’s Vital Statistics Death Database, respectively. Among those with no history of a cardiovascular disease hospitalization in the preceding 5 years, sex-stratified, age-adjusted 5-year (2006-2011) incidence rates of major cardiovascular events (myocardial infarction, stroke, coronary revascularization, and cardiovascular death) over the subsequent 5 years (2006-2011) were determined, stratified by years since immigration (< 10, 10-19 and ≥20 years) and the Canadian-born. Demographic characteristics and the incidence of major cardiovascular events in Chinese immigrants versus the Canadian-born are shown in Table 1. Compared to their immigrant counterparts, Canadian-born Chinese were more likely to have completed high school, speak English and/or French, be employed, and have a higher income (all P < 0.05). In spite of their favorable demographics, the incidence of major cardiovascular events was significantly higher in the Canadian-born Chinese than Chinese immigrants (3.0 vs. 1.6 events per 1000 population for males, 0.9 vs. 0.4 events per 1000 population for females, P < 0.05). Stratified by years since immigration and the Canadian-born, a striking rise in the incidence of cardiovascular events with longer duration in Canada was observed among immigrants (Figure 1). However, Canadian-born Chinese still had higher incidence rates than Chinese immigrants with the longest duration in Canada (≥20 years). Canadian-born Chinese have significantly higher rates of cardiovascular events than Chinese immigrants to Canada, suggesting sensitivity to the acculturation effects of living in a Western environment. These findings should be considered when developing health promotion strategies for the Chinese population living in Western countries.View Large Image Figure ViewerDownload Hi-res image Download (PPT)