A Chinese immigrant paradox? Low coronary heart disease incidence but higher short‐term mortality in western‐dwelling Chinese immigrants: a systematic review and meta‐analysis.

摘要

Background-—Chinese form a large proportion of the immigrant population in Western countries. There is evidence that Chineseimmigrants experience an increased risk of coronary heart disease (CHD) after immigration in part due to cultural habits andacculturation. This is the first systematic review and meta-analysis that aims to examine the risk of CHD in people of Chineseethnicity living in Western countries, in comparison with whites and another major immigrant group, South Asians.Methods and Results-—Literature on the incidence, mortality, and prognosis of CHD among Chinese living in Western countrieswas searched systematically in any language using 6 electronic databases up to December 2014. Based on the meta-analysis,Chinese had lower incidence of CHD compared with whites (odds ratio 0.29; 95% CI: 0.24–0.34) and South Asians (odds ratio 0.37;95% CI: 0.24–0.57) but higher short-term mortality after first hospitalization for acute myocardial infarction compared with whites(odds ratio 1.34; 95% CI, 1.04–1.73) and South Asians (odds ratio 1.82; 95% 1.33–2.50). There was no significant differencebetween Chinese immigrants and whites in long-term outcomes (mortality and recurrent events) after acute myocardial infarction.Conclusions-—These findings provide an important focus for resource planning to enhance early secondary prevention of CHD toimprove short-term survival outcomes among Western-dwelling Chinese immigrants.