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Incidence of Heart Failure Among Immigrants to Ontario, Canada: A CANHEART Immigrant Study
Giancarlo Di Giuseppe1, Anna Chu1, Jack V Tu2
1Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada.
Insights
Ethnicity impacts heart failure (HF) risk. Immigrants generally had lower HF hospitalization rates, but Black men and West Asian women showed higher risks, while East Asians had the lowest.
Area of Science:
- Cardiovascular epidemiology
- Health disparities research
- Population health science
Background:
- Traditional cardiovascular risk factors are known contributors to heart failure (HF).
- The role of ethnicity as an independent predictor of HF incidence is not well-established.
- Understanding ethnic variations in HF hospitalization is crucial for addressing health disparities.
Purpose of the Study:
- To determine the incidence of heart failure (HF) hospitalization across diverse ethnic groups in Ontario, Canada.
- To examine differences in risk factor prevalence among ethnic groups that may explain disparities in HF hospitalization.
- To investigate ethnicity as a potential independent risk factor for HF development.
Main Methods:
- Retrospective observational study using linked population-based health administrative, clinical, and survey datasets (2008-2012).
- Cohort included 895,823 recent immigrants from 8 ethnic groups and 5.3 million long-term residents (aged 40-105 years).
- Incident heart failure (HF) hospitalization was tracked, with sex-stratified age-standardized incidence rates calculated and adjusted for covariates.
Main Results:
- Overall, immigrant groups exhibited lower age-standardized HF hospitalization incidence compared to long-term residents.
- Among immigrants, Black men and West Asian women had the highest HF hospitalization incidence (1.19 and 1.60 per 1000 person-years, respectively).
- East Asian individuals of both sexes demonstrated the lowest HF hospitalization incidence; the association between ethnicity and HF risk remained significant after adjustment for multiple factors.
Conclusions:
- Heart failure (HF) hospitalization incidence significantly varies among ethnic immigrant populations.
- Ethnicity emerges as a potentially important independent risk factor for the development of heart failure (HF).
- Findings underscore the need to consider ethnic background in cardiovascular risk assessment and prevention strategies for heart failure.
Background:
Several known traditional cardiovascular risk factors contribute to the development of heart failure (HF); however, whether ethnicity is also an important predictor is not well established. We determined the incidence of hospitalization for HF among ethnic groups in Ontario, Canada, and examined differences in risk factor prevalence that may contribute to disparities in HF hospitalization incidence between groups.
Methods And Results:
We conducted a retrospective observational study from 2008 to 2012 with the use of a linked cohort derived from population-based health administrative, clinical, and survey datasets. We followed 895,823 recent immigrants from 8 ethnic groups and 5.3 million long-term residents aged 40-105 years for incident HF hospitalization. Sex-stratified age-standardized HF incidence was lower among all immigrant groups than long-term residents. Among immigrants, Black men and West Asian women had the highest incidence of hospitalizations for HF (1.19 and 1.60 per 1000 person-years, respectively), and East Asians of both sexes had the lowest incidence. After adjusting for sociodemographic characteristics, comorbidities, and other risk factors, the association between ethnicity and HF hospitalization risk remained significant.
Conclusions:
HF hospitalization incidence varies widely among ethnic immigrant groups, highlighting the importance of ethnicity as a potential independent risk factor for HF development.
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