Cardiovascular mortality of Turkish nationals residing in West Germany

To test the hypothesis that cardiovascular mortality of Turkish nationals residing in West Germany (mainly former "guest workers" and their families) has been increasing over the past 15 years. Reasons would be their minority status and migration-related lifestyle changes.

Using registry data for the period 1981-1994, we calculated mortality rates from cardiovascular disease (CVD) (international classification of diseases (ICD) 390-459), ischemic heart disease (IHD) (ICD 410-414) and cerebrovascular disease (CVA) (ICD 430-438) of Turkish nationals aged 25-64 years and residing in West Germany, numbering 730,000 in 1981 and 941,000 in 1994.

Between 1981 and 1994, age-adjusted CVD mortality rates (per 100,000) decline from 103 to 85 (-18%) in Turkish men and from 227 to 149 (-34%) in West German men. IHD mortality declines from 64 to 53 (-16%) in Turkish men and from 138 to 82 (-41%) in German men. CVD mortality of Turkish women remains around 45 while that of West German women declines from 84 to 57 (-33%).

Our hypothesis was not confirmed. Turkish residents experience a stable or decreasing CVD and overall mortality which is lower than that of West Germans. Selective return to Turkey of individuals manifestly ill with CVD is improbable. Neither minority status nor a postulated unfavorable genetic disposition currently have a discernible effect on CVD mortality rates of Turkish residents. Future research should relate individual migration history, socio-economic status, and risk factor levels to mortality experience.