Coronary heart disease and stroke in the Sami and non-Sami populations in rural Northern and Mid Norway-the SAMINOR Study

Open Heart. 2020 May;7(1):e001213. doi: 10.1136/openhrt-2019-001213.

Abstract

Background: Previous studies have suggested that Sami have a similar risk of myocardial infarction and a higher risk of stroke compared with non-Sami living in the same geographical area.

Design: Participants in the SAMINOR 1 Survey (2003-2004) aged 30 and 36-79 years were followed to the 31 December 2016 for observation of fatal or non-fatal events of acute myocardial infarction (AMI), coronary heart disease (CHD), ischaemic stroke (IS), stroke and a composite endpoint (fatal or non-fatal AMI or stroke).

Aim: Compare the risk of AMI, CHD, IS, stroke and the composite endpoint in Sami and non-Sami populations, and identify intermediate factors if ethnic differences in risks are observed.

Methods: Cox regression models.

Results: The sex-adjusted and age-adjusted risks of AMI (HR for Sami versus non-Sami 0.99, 95% CI: 0.83 to 1.17), CHD (HR 1.03, 95% CI: 0.93 to 1.15) and of the composite endpoint (HR 1.09, 95% CI: 0.95 to 1.24) were similar in Sami and non-Sami populations. Sami ethnicity was, however, associated with increased risk of IS (HR 1.36, 95% CI: 1.10 to 1.68) and stroke (HR 1.31, 95% CI: 1.08 to 1.58). Height explained more of the excess risk observed in Sami than conventional risk factors.

Conclusions: The risk of IS and stroke were higher in Sami and height was identified as an important intermediate factor as it explained a considerable proportion of the ethnic differences in IS and stroke. The risk of AMI, CHD and the composite endpoint was similar in Sami and non-Sami populations.

Keywords: coronary artery disease; genetics; risk factors; stroke.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Body Height / ethnology
  • Coronary Disease / diagnosis
  • Coronary Disease / ethnology*
  • Coronary Disease / mortality
  • Female
  • Health Status Disparities*
  • Health Surveys
  • Heart Disease Risk Factors
  • Humans
  • Incidence
  • Indigenous Peoples*
  • Male
  • Middle Aged
  • Norway / epidemiology
  • Race Factors
  • Risk Assessment
  • Rural Health / ethnology*
  • Stroke / diagnosis
  • Stroke / ethnology*
  • Stroke / mortality
  • Time Factors