Coronary heart disease in Chinese living in western countries: New insights from a systematic review and meta-analysis

Kai Jin*, Ding Ding, Janice Gullick, Fung Koo, Lis Neubeck

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingConference contribution


Background: Chinese form a large proportion of the immigrant population in Western countries and there is evidence that Chinese immigrants experience an increased risk of coronary heart disease (CHD) after migration, in part due to cultural habits and acculturation. This is the first systematic review and meta-analysis that examines the risk of CHD in people of Chinese ethnicity living in Western countries compared to Caucasians and South Asians.
Methods: A systematic review of six electronic databases was conducted from their dates of inception to December 2014, in any language that reported the prevalence, mortality and prognosis of CHD among Chinese living in Western countries.
Results: Of the 783 identified abstracts, 19 studies were included in the eventual review, equating to 20 941 Western Chinese cases. Chinese had lower incidence of CHD and overall cardiac mortality but higher short-term mortality after first hospitalisation for acute myocardial infarction compared with Caucasians (OR 1.40, 95% CI, 1.17-1.67) and South Asians (OR 1.75, 95% CI, 1.40-2.19) based on a meta-analysis of available studies. For long-term survival outcomes (mortality and recurrent rates) after acute myocardial infarction, there were no significant differences between Chinese and Caucasians.
Conclusion: The poor short-term survival after CHD in Chinese immigrants may suggest an impact of genetic differences, cultural habits and acculturation. Public health efforts should focus on secondary prevention in this population to reduce mortality from secondary events. Ethnic variations in AMI presentation and disease management should be considerations for health care providers caring for Chinese patients.
Original languageEnglish
Title of host publicationHeart, Lung and Circulation
Publication statusPublished - 1 Jan 2015


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