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We undertook a study investigating whether immigrants from Turkey, Pakistan and Yugoslavia received adequate medical treatment with beta-blockers and statins after acute myocardial infarction (AMI) when compared with Danish-born residents and explored whether associations between patient origin and medical treatment were mediated by socioeconomic status (SES). This register-based follow-up study consisted of individuals >17 years of age, admitted to hospital with AMI between 2001 and 2005 ( n = 25 443). Danish-born residents were compared with immigrants from Turkey, Pakistan and Yugoslavia. Individuals were identified by civil registration number, and data were obtained through linkage to the national registers of hospitalisations and drug prescriptions. Odds of initiating treatment and hazard ratios (HR) of terminating treatment were estimated. Mediators such as income and employment were included in the models. Pakistanis were less likely than Danish-born residents to initiate treatment with beta-blockers after AMI [odds ratio 0.52; 95% confidence interval (CI) 0.34–0.80]. Immigrants from Turkey (HR 1.36; 95% CI 1.07–1.73) and Pakistan (HR 1.59; 95% CI 1.21–2.08) were more likely to terminate treatment with beta-blockers before being recommended to do so. Estimates did not change markedly when income and education were included in the models. The results of this study suggest that immigrants from Pakistan and Turkey do not receive adequate medical treatment with beta-blockers after a first AMI compared with Danish-born residents. Mediators such as income and employment may not be sufficient indicators of SES when the effect of patient origin on medical treatment is explored. A lower SES of immigrants, communication problems between doctor and patient and doctors’ attitudes towards immigrants may explain ethnic differences in medical treatment after AMI. [ABSTRACT FROM AUTHOR]

Background: This study compared the incidence of cardiovascular disease (CVD) and acute myocardial infarction (AMI) between native Danes and immigrants born in Turkey, Pakistan and the former Yugoslavia. Furthermore, we examined whether different indicators of socioeconomic status (SES), such as employment, income and housing conditions influenced potential differences., Methods: In this registry-based follow-up study individuals were identified in a large database that included individuals from two major regions in Denmark, corresponding to about 60% of the Danish population. Incident cases of CVD and AMI included fatal and non-fatal events and were taken from registries. Using Cox regression models, we estimated incidence rates at 5-year follow-up., Results: Immigrant men and women from Turkey and Pakistan had an increased incidence of CVD, compared with native Danish men. In the case of AMI, a similar pattern was observed; however, differences were more pronounced. Pakistanis and Turks with a shorter duration of residence had a lower incidence, compared with those of a longer residence. Generally, no notable differences were observed between former Yugoslavians and native Danes. In men, differences in CVD and AMI were reduced after adjustment for SES, in particular, among Turks regarding CVD. In women, effects were particularly reduced among Yugoslavians in the case of CVD and in Turks in the case of CVD and AMI after adjustment for SES., Conclusions: In conclusion, country of birth-related differences in the incidence of CVD and AMI were observed. At least some of the differences that we uncovered were results of a socioeconomic effect. Duration of residence also played a certain role. Future studies should collect and test different indicators of SES in studies of CVD among immigrants.

Purpose: We undertook a study investigating whether immigrants from Turkey, Pakistan and Yugoslavia received adequate medical treatment with beta-blockers and statins after acute myocardial infarction (AMI) when compared with Danish-born residents and explored whether associations between patient origin and medical treatment were mediated by socioeconomic status (SES)., Methods: This register-based follow-up study consisted of individuals >17 years of age, admitted to hospital with AMI between 2001 and 2005 (n=25,443). Danish-born residents were compared with immigrants from Turkey, Pakistan and Yugoslavia. Individuals were identified by civil registration number, and data were obtained through linkage to the national registers of hospitalisations and drug prescriptions. Odds of initiating treatment and hazard ratios (HR) of terminating treatment were estimated. Mediators such as income and employment were included in the models., Results: Pakistanis were less likely than Danish-born residents to initiate treatment with beta-blockers after AMI [odds ratio 0.52; 95% confidence interval (CI) 0.34-0.80]. Immigrants from Turkey (HR 1.36; 95% CI 1.07-1.73) and Pakistan (HR 1.59; 95% CI 1.21-2.08) were more likely to terminate treatment with beta-blockers before being recommended to do so. Estimates did not change markedly when income and education were included in the models., Conclusions: The results of this study suggest that immigrants from Pakistan and Turkey do not receive adequate medical treatment with beta-blockers after a first AMI compared with Danish-born residents. Mediators such as income and employment may not be sufficient indicators of SES when the effect of patient origin on medical treatment is explored. A lower SES of immigrants, communication problems between doctor and patient and doctors' attitudes towards immigrants may explain ethnic differences in medical treatment after AMI.