Key result
Migrant women did not have a significantly different incidence of stroke compared to Swedish-born women (4.5% vs 4.7%), although smoking, low physical activity, and low socio-economic status were identified as significant risk factors.
Why the study?
Does migrant status, socio-economic status, smoking, or physical activity modify the risk of stroke in middle-aged women?
Cohort (n=16,857)
No
Does migrant status, socio-economic status, smoking, or physical activity modify the risk of stroke in middle-aged women?
Smoking significantly increases and physical activity significantly decreases the risk of stroke in both Swedish-born and migrant women, with no overall difference in stroke incidence based on migration status alone.
Modifiable risks like smoking and inactivity warrant focus in all middle-aged women; leaves open any independent migrant status effect on stroke.
Introduction: The incidence of stroke has decreased in Sweden as well as in most developed countries, but a high number of migrants have arrived in Sweden, during the last decades, which may have influenced the incidence. Aim: The aim of this study was to examine the incidence of stroke in women, born outside as well as in Sweden. Furthermore, the aim was to examine how socio-economic factors, smoking, and physical activity could modify the risk for stroke. Method: Data from the “Malmö Diet and Cancer Study” was used for the analysis. In total, 16,857 women were included (14,849 of them born in and 2,008 born outside Sweden), aged 45 - 73 years with a mean age of 57.4 years. Result. A significantly increased relative risk (RR) was found for the incidence of stroke for current smokers in both Swedish-born and migrant women. In Swedish-born women the RR was 1.98 (CI: 1.66 - 2.36) and for migrant women the RR was 1.83(CI: 1.13 - 2.96). The adjusted relative risk for the incidence of stroke in Swedish-born women performing moderate/high physical activity was RR 0.71 (CI: 0.61 - 0.84) and for migrant women it was RR 0.77 (CI: 0.49 - 1.20). The relative risk in relation to low socio-economic circumstances (SES) was significant only for Swedish-born women (RR 0.85 [CI: 0.73 - 0.99]). Among currently smoking Swedish-born women with a low SES the RR was 1.27 (CI: 1.03 - 1.57) in comparison with smoking migrant women, whose RR was 1.68 (CI: 0.92 - 3.09). Conclusion: No differences were found indicating that migrant women in this population had a higher risk as compared to Swedish-born women. However, migrant smoking women were more vulnerable to stroke compared to Swedish-born women. Physical activity was effective in reducing the risk of stroke among the total population and especially in the Swedish-born women. To increase physical activity in middle-aged women, in both migrant and Swedish-born women, is a highly recommended public health strategy.
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Nayak et al. (2014) conducted a cohort in Stroke (n=16,857). Migrant status (born outside Sweden) vs. Swedish-born women was evaluated on Incidence of stroke (p=0.60). Migrant women did not have a significantly different incidence of stroke compared to Swedish-born women (4.5% vs 4.7%), although smoking, low physical activity, and low socio-economic status were identified as significant risk factors.
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