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Increased cardiovascular disease risk in international migrants is independent of residence duration or cultural orientation: the HELIUS study
  1. Wilco Perini1,2,
  2. Marieke B Snijder1,3,
  3. Ron J G Peters2,
  4. Karien Stronks1,
  5. Anton E Kunst1
  1. 1 Department of Public Health, Academic Medical Center of the University of Amsterdam, Amsterdam, The Netherlands
  2. 2 Department of Cardiology, Academic Medical Center of the University of Amsterdam, Amsterdam, The Netherlands
  3. 3 Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center Amsterdam, Amsterdam, The Netherlands
  1. Correspondence to Wilco Perini, Department of Public Health, Academic Medical Center of the University of Amsterdam, Amsterdam 1105 AZ, The Netherlands; w.perini{at}


Background International migrants differ from host populations in cardiovascular disease (CVD) risk. It has been postulated that these disparities narrow with longer residence duration. Our aim was to determine whether CVD risk still differs between migrants and host population after decades of residence and to determine whether this potential convergence of CVD risk would occur mainly among migrants with a strong cultural orientation towards the host culture.

Methods In the Healthy Life in an Urban Setting study, we obtained data regarding residence duration, cultural orientation as estimated by the Psychological Acculturation Scale and CVD risk as estimated by SCORE among the Dutch host population and first generation migrants from South-Asian Surinamese, African Surinamese, Moroccan and Turkish ethnic background residing in Amsterdam. Estimated CVD risk was compared with the Dutch, separately for medium-term residence (15–30 years) or long-term residence (>30 years) migrants, and by strong/weak cultural orientation towards the Dutch culture, using age-adjusted regression analyses.

Results Among 8672 participants without prior CVD, estimated CVD risk was higher among migrant groups relative to the Dutch. CVD risk relative to the Dutch did not differ by residence duration (betas ranging from 0.1 to 3.4 for medium-term and from 0.6 to 3.3 for long-term residence, respectively). Furthermore, these patterns did not differ by cultural orientation towards the Dutch culture.

Conclusion We find no indication that CVD risk among South-Asian Surinamese, African Surinamese, Turkish or Moroccan migrants converges to that of the Dutch host population with increasing residence duration, not even among those with strong cultural orientation towards the host culture.

  • cardiovascular disease
  • ethnic background
  • migration
  • duration of residence
  • acculturation
  • HELIUS study

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  • Contributors WP, RJGP and AEK contributed to the conception and design. MBS, RJGP and KS contributed to the data collection. WP analysed the data and drafted the article. MBS, RJGP, KS and AEK critically revised the article. All authors discussed the results and contributed to the final manuscript.

  • Funding The HELIUS study is conducted by the Academic Medical Center Amsterdam and the Public Health Service of Amsterdam. Both organisations provided core support for HELIUS. The HELIUS study is also funded by the Dutch Heart Foundation, the Netherlands Organization for Health Research and Development (ZonMw) and the European Union (FP-7) and the European Fund for the Integration of non-EU immigrants (EIF).

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval AMC Ethical Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.