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Risk of premature stroke in recent immigrants (PRESARIO): population-based matched cohort study
G Saposnik1, D A Redelmeier, H Lu
1Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, 55 Queen St E, Toronto, Ontario, M5C 1R6, Canada. saposnikg@smh.toronto.on.ca
Neurology
|February 5, 2010
Summary
New immigrants have a lower risk of acute stroke compared to long-term residents. This finding on stroke risk in immigrants is not explained by healthcare access or income.
Area of Science:
- Public Health
- Epidemiology
- Cardiovascular Disease Research
Background:
- New immigrants often have fewer cardiovascular disease risk factors than native-born populations.
- The stress of resettlement may potentially increase stroke risk among immigrants.
- This study investigates the association between recent immigration and acute stroke risk.
Purpose of the Study:
- To determine the risk of acute stroke associated with recency of immigration.
- To compare stroke incidence between new immigrants and long-term residents.
- To explore factors influencing stroke risk in immigrant populations.
Main Methods:
- A population-based matched cohort study was conducted in Ontario, Canada.
- 965,829 new immigrants were matched with 3,272,393 long-term residents.
- Data were collected from April 1, 1995, to March 31, 2007.
Main Results:
- The incidence rate of acute stroke was lower in new immigrants (1.69/10,000 person-years) compared to long-term residents (2.56/10,000 person-years).
- The adjusted hazard ratio for stroke in new immigrants was 0.69 (95% CI 0.64-0.74).
- Similar risk estimates were observed for both ischemic and hemorrhagic stroke subtypes.
Conclusions:
- New immigrants appear to have a lower risk of premature acute stroke than long-term residents.
- Healthcare service availability and income level do not appear to explain this reduced stroke risk.
- Further research may be needed to understand the protective factors for stroke in immigrant populations.
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