Artery hardening worse among immigrants: study

The longer immigrants stay in Canada, the worse their cardiovascular health and risk of premature death becomes, say researchers who suspect the stress of settling down could be part of the problem.

At the Canadian Cardiovascular Congress in Toronto on Monday, Prof. Scott Lear, a kinesiologist at Simon Fraser University in Vancouver presented his research on atherosclerosis — or narrowing of the arteries that is a major contributor to heart disease and stroke — in a group of 618 Chinese, South Asia and Europeans, 460 of whom were born outside of Canada.  

'Immigrants are very healthy when they first come to Canada, but as their time here increases, so does their cardiovascular risk.' —Scott Lear

When Lear and his colleagues used ultrasound in a well-established method to measure the thickness of each participant's carotid artery — the vessel in the neck often used for finding a pulse — they found that as time in Canada increased, the immigrants' risk of atherosclerosis surpassed that of people of the same ethnic background who were born in Canada.

"We don't want people to think 'Come to Canada and die,' " said Lear. "But there is something going on. Immigrants are very healthy when they first come to Canada, but as their time here increases, so does their cardiovascular risk."

Immigrants start out healthy since they must pass a medical screening as part of the immigration process.

But the deterioration held true after accounting for other risk factors for atherosclerosis, such as age, gender, family history and hypertension, the researchers said. The health of immigrants worsened with each decade of stay in Canada. 

Immigrants may neglect their own health

Lear speculated that stress of coming to a new country, finding a place to stay and earn a reliable income, as well as language and cultural barriers, may explain why the health of new immigrants deteriorates.

"While setting in Canada, don't forget about your health," said Dr. Chi-Ming Chow, a spokesperson for the Heart and Stroke Foundation, and a cardiologist at St. Michael's Hospital in Toronto. "Without your health, you can't take care of your family."

Chow, who immigrated to Canada with his family before studying medicine, said the results highlight what he sees in his practice, where patients may be learning English as a working language.

Newcomers are going through a vulnerable period in their lives, and may be so busy that they don't eat nutritious meals and turn to fast food, have less time to exercise, and skip out on having physicals or blood pressure checks, Chow said.

In China and Hong Kong for example, people often only go to the doctor when they're sick because they have to pay, and immigrants may not realize that a routine physical allows risk factors to be detected and treated before it causes damage, he added.

Resources available

To help bridge the gap, the Heart and Stroke Foundation offers culturally specific information in Chinese and South Asian languages on its website and through DVDs available at libraries, community centres and doctor's offices, such as karaoke video on the benefits of tai chi or a Bollywood-style video on making healthy food choices and food preparation techniques. 

Jim Brown, 74, who immigrated from Scotland 40 years ago, recalled the stress of arriving in Canada and trying to find work without an established reputation.

"You stress yourself out wondering if you're going to get hired, until you're in and you're hired and they see what your potential is and you're able to keep your job," said Brown, who suffered a suffered a heart attack in 2000 and learned one of his arteries was 90 per cent blocked.

Both Lear and Chow agreed that from a medical standpoint, Canada should offer more resources for immigrants, such as translating health information.

Lear's research was funded by the Canadian Institutes of Health Research and the Heart and Stroke Foundation, which offers grants to help researchers understand what specific factors are putting immigrants at greater risk.

The meeting ends Wednesday.