Comparison of Framingham 10-year cardiovascular risks in Sweden- and foreign-born primary health care patients in Sweden.

BACKGROUND: The prevalence of cardiovascular disease around the world varies by ethnicity and region of birth. Immigrants living in Sweden may have a higher prevalence of cardiovascular diseases than native-born Swedes, but little is known about their actual cardiovascular risk. This study aimed to examine the relationship in Sweden between 10-year cardiovascular risk and birthplace. METHOD: This cross-sectional study was based on cardiovascular risk factor data obtained from the 4D Diabetes Project, a Programme 4D subproject in Sweden. Participants were recruited from two primary healthcare centres in Stockholm without a history of diabetes or pre-diabetes. The outcome variable was 10-year cardiovascular risk based on the calculation of a Framingham Risk Score with six risk factors: age, sex, LDL, HDL, BP, diabetes and smoking for each participant. Multiple linear regression was performed to generate ß-coefficients for the outcome. RESULTS: There was an average of 8.86% cardiovascular risk over 10 years in Sweden-born participants and a 5.45% 10-year risk in foreign-born, (P < 0.0001). Foreign-born participants were about 10 years younger (mean age 46 years vs. 56 years, P < 0.001), with a significantly higher proportion of smokers (23.9% vs. 13.7%; P = 0.001). To be born in Sweden (with parents born in Sweden) was significantly associated with a 10-year cardiovascular risk in the crude model (ß- coefficient = 3.40, 95% CI 2.59-4.22; P < 0.0001) and when adjusted for education and alcohol consumption (ß- coefficient = 2.70 95% CI 1.86-3.54; P < 0.0001). Regardless of the birthplace, 10-year cardiovascular risk was lower for those with higher education compared to those with less than 10 years of education. CONCLUSION: This study found a relationship between 10-year calculated cardiovascular risk and place of birth. Sweden-born participants had a higher association with 10-year cardiovascular risk than foreign-born participants. These results contradict previous reports of higher rates of CVD in residents of Middle-Eastern countries and Middle-Eastern immigrants living in Sweden.

Fasting plasma glucose and serum 25-hydroxy vitamin D levels in individuals with Middle Eastern and Swedish descent.

Purpose: To determine fasting plasma glucose and serum 25-hydroxyvitamin D (s-25(OH)D) levels and associations between abnormal fasting plasma glucose levels and inadequate s-25(OH)D levels in individuals of Middle Eastern and Swedish descent. Methods: Observational study with individuals without a diabetes diagnosis, 54.5% of Swedish descent and 45.5% of Middle Eastern descent. In total, 830 participants from two primary healthcare centres in Flemingsberg and Jakobsberg, which are southern and northern suburbs, respectively, of Stockholm, Sweden were included in the study. Results: Prevalence of inadequate s-25(OH)D levels (at or below 50 nmol/L) was 67.2% among those of Middle Eastern descent and 20.5% among those of Swedish descent (P < 0.001). S-25(OH)D levels correlated weakly positively with fasting plasma glucose levels (ρ = 0.20, P = 0.002) in individuals of Middle Eastern descent. Being of Middle Eastern descent (OR 6.7, 95% CI 4.3-10.4) and having abnormal fasting plasma glucose (OR 1.8, 95% CI 1.2-2.9) were independent predictors of having inadequate s-25(OH)D levels. Conclusions: Healthcare in Sweden should consider testing fasting plasma glucose and s-25(OH)D levels, particularly in individuals of Middle Eastern descent. The unclear relationship between vitamin D and glucose levels warrants investigation. Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-023-01226-0.