A Systematic Review and Meta-Analysis of the Associations between Immigration Status and Stroke Incidence and Mortality.

Jun-Zhen Chen, Hai-Mei Wang, Wenhao Zhu
Author Information
  1. Jun-Zhen Chen: Department of Encephalopathy, Zibo Hospital of Traditional Chinese Medicine, Zibo, Shandong 255300, China. ORCID
  2. Hai-Mei Wang: Department of Oncology, Zibo Central Hospital, Zibo, Shandong 255300, China. ORCID
  3. Wenhao Zhu: Department of Encephalopathy, Zibo Hospital of Traditional Chinese Medicine, Zibo, Shandong 255300, China. ORCID

Abstract

Methods: We thoroughly searched PubMed, Embase, and MEDLINE databases for the literature on Stroke risk for immigrants and host populations by January 2022. Fourteen relevant cohort studies from eight countries met the inclusion criteria, and their data were included in this meta-analysis. Heterogeneity and publication bias were assessed.
Results: The results showed that the immigrant groups suffered from a lower incidence rate of Stroke compared with the host populations (HR = 0.81, 95% CI 0.71-0.91, = 0.001), but there was nonsignificant higher mortality of Stroke in immigrants (HR = 1.07; 95% CI 0.84-1.36). However, the pooled adjusted incidence HR reduced to 0.67 (95% CI 0.60-0.75) after adjustment for publication bias. Immigrants had a lower Stroke incidence compared to long-term residents, but the association varied with the country of origin, socioeconomic status, residence (urban rural), and comorbid conditions. . The present systematic review and meta-analysis implicated that Stroke risks are different for immigrants and the host populations; therefore, this knowledge may be useful for developing targeted Stroke prevention strategies.

References

  1. Health Rep. 2019 Apr 17;30(4):3-11 [PMID: 30994921]
  2. Ann Epidemiol. 2021 Feb;54:64-72.e7 [PMID: 32950654]
  3. PLoS Med. 2009 Jul 21;6(7):e1000097 [PMID: 19621072]
  4. Lancet. 2016 Aug 20;388(10046):761-75 [PMID: 27431356]
  5. Psychol Assess. 2018 Apr;30(4):459-473 [PMID: 28504537]
  6. Lancet Reg Health West Pac. 2022 Jul 30;28:100550 [PMID: 36507089]
  7. Biomed Res Int. 2020 Nov 01;2020:5868602 [PMID: 33204703]
  8. Am J Public Health. 1999 Oct;89(10):1543-8 [PMID: 10511837]
  9. J Racial Ethn Health Disparities. 2020 Oct;7(5):854-864 [PMID: 32026285]
  10. Stroke. 2011 Dec;42(12):3369-75 [PMID: 21960581]
  11. Am J Public Health. 2013 Mar;103(3):e52-60 [PMID: 23327278]
  12. Circulation. 2015 Aug 31;132(16):1549���1559 [PMID: 26324719]
  13. Circulation. 2001 Dec 4;104(23):2855-64 [PMID: 11733407]
  14. J Immigr Minor Health. 2011 Jun;13(3):546-54 [PMID: 20411331]
  15. J Psychiatr Res. 2015 Nov;70:67-82 [PMID: 26424425]
  16. Heart. 2009 May;95(9):747-53 [PMID: 19164329]
  17. Ethn Health. 2017 Jun;22(3):209-241 [PMID: 27809589]
  18. Eur J Epidemiol. 2010 Sep;25(9):603-5 [PMID: 20652370]
  19. J Immigr Minor Health. 2014 Feb;16(1):18-23 [PMID: 23324988]
  20. BMJ. 2015 Jan 02;350:g7647 [PMID: 25555855]
  21. Lancet. 2012 Dec 15;380(9859):2095-128 [PMID: 23245604]
  22. Stroke. 2012 May;43(5):1224-9 [PMID: 22357712]
  23. Eur J Epidemiol. 2016 Jul;31(7):667-77 [PMID: 25968173]
  24. J Am Coll Cardiol. 2013 Apr 30;61(17):1777-86 [PMID: 23500273]
  25. Circulation. 2017 Nov 21;136(21):e393-e423 [PMID: 29061565]
  26. Stroke. 2004 Sep;35(9):2054-8 [PMID: 15232121]
  27. Am J Epidemiol. 1998 Feb 1;147(3):259-68 [PMID: 9482500]
  28. Neurology. 2013 Jul 16;81(3):264-72 [PMID: 23858408]
  29. Circulation. 2015 Sep 1;132(9):873-98 [PMID: 26240271]
  30. Fam Pract. 2019 Jul 31;36(4):445-451 [PMID: 30219848]
  31. Dis Markers. 2018 Nov 26;2018:7925219 [PMID: 30598709]
  32. Health Rep. 2011 Dec;22(4):15-23 [PMID: 22352148]
  33. Popul Res Policy Rev. 2008;27(5):515-530 [PMID: 19122882]
  34. JAMA. 2012 Nov 7;308(17):1775-84 [PMID: 23117778]
  35. Asia Pac J Public Health. 2011 May;23(3):280-7 [PMID: 21490109]
  36. Lancet. 2012 Dec 15;380(9859):2197-223 [PMID: 23245608]
  37. Neurology. 2021 Sep 20;97(12):e1192-e1201 [PMID: 34408071]
  38. Circulation. 2010 Oct 19;122(16):1570-7 [PMID: 20921444]
  39. Can J Cardiol. 2015 Sep;31(9):1160-8 [PMID: 26195229]
  40. Stroke. 2014 Aug;45(8):2397-403 [PMID: 24938846]
  41. Syst Rev. 2015 Jan 01;4:1 [PMID: 25554246]
  42. Demography. 2017 Feb;54(1):175-200 [PMID: 28092071]
  43. Eur J Prev Cardiol. 2014 May;21(5):619-38 [PMID: 22692471]
  44. Eur J Cardiovasc Prev Rehabil. 2008 Dec;15(6):670-6 [PMID: 18779736]
  45. Eur J Epidemiol. 2010 Mar;25(3):155-61 [PMID: 20054612]
  46. Health Place. 2011 May;17(3):801-6 [PMID: 21458356]
  47. Neurology. 2010 Feb 9;74(6):451-7 [PMID: 20130230]
  48. CMAJ Open. 2017 Sep 11;5(3):E702-E709 [PMID: 28899946]
  49. Can J Public Health. 2005 Mar-Apr;96 Suppl 2:S30-44 [PMID: 16078554]
  50. JAMA. 1994 Apr 27;271(16):1237 [PMID: 8031363]
  51. BMJ. 1991 Mar 9;302(6776):560-4 [PMID: 2021718]
  52. J Obes. 2015;2015:186276 [PMID: 25893114]
  53. BMC Cancer. 2019 Jan 15;19(1):73 [PMID: 30646853]
  54. Neurology. 2021 Feb 22;96(8):e1145-e1155 [PMID: 33472924]

MeSH Term

Cohort Studies
Emigrants and Immigrants
Emigration and Immigration
Humans
Incidence
Stroke

Word Cloud

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